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Jeff Smith (Manchester, Withington) (Lab)
Nicola Richards (West Bromwich East) (Con)
The Minister for Women and Equalities (Kemi Badenoch)
Tackling violence against women and girls is one of the Government’s key priorities. We are making progress in delivering various cross-Government workstreams, including the tackling violence against women and girls strategy and the rape review action plan.
Jeff Smith
Three quarters of police-recorded domestic abuse cases are closed due to evidential difficulties or because the victim does not support further action. Does the Minister agree that Labour’s proposal to put rape and domestic abuse specialists in every police force in England and Wales will give women the confidence to come forward and secure more convictions?
Kemi Badenoch
We will have 2,000 rape specialists across all police forces by April. In the autumn statement, the Prime Minister announced that the Government would provide £2 million of additional funding for a flexible fund that trials one-off payments to victims of domestic abuse. That fund was made available to victims on 31 January.
Nicola Richards
Last week, I co-hosted an event here in Parliament with a delegation from Israel who have first-hand experience of the aftermath of 7 October. They described innocent women, dead or alive, who had been raped by terrorists. Hamas desecrated their bodies and even booby-trapped them. Those acts of sexual violence must be condemned by every institution and individual who cares about women’s rights.
Kemi Badenoch
I thank my hon. Friend and her co-chair for organising what was for attendees an extremely difficult meeting. We heard the harrowing accounts of witnesses and family members of young girls who were kidnapped on 7 October, and we heard from the first responders who found the bodies of women and girls of all ages with obvious signs of sexual violence. Female soldiers were found naked with nails and sharp objects shoved into their vaginas. One told of a mother he found with her hands tied behind her back, naked and bleeding from the waist down, shot in the back of the head, and with a live grenade left in her hand for whoever found her body.
We must support the courage of those witnesses in giving that harrowing testimony about Hamas’s mass-scale perpetration of sexual violence on 7 October. We cannot be silent about these atrocities. We must ensure that the world does not forget that sexual violence shatters lives and devastates communities. The UK stands in solidarity with survivors and continues to call for the release of the remaining hostages.
Christine Jardine (Edinburgh West) (LD)
I appreciate that the Government have been trying to tackle violence against women and girls, specifically with the Domestic Abuse Act 2021. Unfortunately, amendments that would have gone further to protect migrant women, who too often still feel unable to come forward and report abuse for fear of their data being shared and their being detained or deported, were not accepted. Will the Minister commit to reassessing the merits of preventing survivors’ personal data from being shared with the Home Office for immigration purposes?
Kemi Badenoch
That is a matter for the Home Office. I support all the work that Home Office Ministers are doing to tackle domestic abuse, and I know there would have been good reasons for not accepting those amendments to the Act. We will continue to do all we can. I have just heard from the Minister for safeguarding—the Under-Secretary of State for the Home Department, my hon. Friend the Member for Newbury (Laura Farris)—that concessions are being made. We will continue to work with her and others to tackle domestic violence in all its forms.
Caroline Nokes (Romsey and Southampton North) (Con)
In some instances, there are good reasons why immigration control should be able to work with forces of law enforcement when it comes to domestic abuse. My constituent Emma has been serially abused, harassed and stalked by a US national, who crosses the border with no visa—he does not need one—to continue his campaign of harassment. Will my right hon. Friend please work closely with the Home Office to ensure that British women are protected from foreign abusers who have found ways around our immigration system?
Kemi Badenoch
My right hon. Friend is right to raise that. I ask her to let her constituent know that the Government are doing all they can. The safeguarding Minister has said that she will write to my right hon. Friend so that this specific case can be further investigated.
Vicky Foxcroft (Lewisham, Deptford) (Lab)
Mohammad Yasin (Bedford) (Lab)
Janet Daby (Lewisham East) (Lab)
The Parliamentary Under-Secretary of State for the Home Department (Laura Farris)
As of December 2023, 91% of all claims either had received a final decision or were less than six months old. The Windrush scheme has reduced the time taken to allocate a substantive casework decision from 18 months to less than four months. That includes making all essential eligibility checks together with a preliminary assessment to make an initial interim payment of £10,000 wherever possible.
Vicky Foxcroft
In response to a parliamentary question, the former Immigration Minister, the right hon. Member for Newark (Robert Jenrick), confirmed that by April last year, 41 of the 6,122 Windrush compensation claimants had sadly died before their claims were settled—an increase of more than 100% since 2021. Will the Minister update us on how many applicants have now died while waiting for the Government to right the wrongs done to thousands of innocent survivors and their families?
Laura Farris
I can confirm that we have been made aware of 53 claimants who have unfortunately passed away. I want to provide the hon. Lady with two reassurances: first, if we are notified an individual is suffering from a critical or life-limiting illness, their claim is prioritised; secondly, if they do pass away, their family are still able to pursue their claim.
Mohammad Yasin
Only 14% of 150,000 eligible applicants to the compensation scheme have received redress. Will the Government learn lessons from the Horizon scandal and listen to victims and campaign groups who are calling on them to lower the burden of proof for claims, and ensure that legal aid is guaranteed to all eligible claimants?
Laura Farris
So far, £75 million has been paid out on more than 2,000 claims. I gently say to the hon. Gentleman that it is not appropriate to draw precise equivalence with things like the Horizon scheme, because that involved a judicial process, with different facts, different losses and different harms. However, we have been making consistent improvements to the compensation scheme, including making it easier for applicants to use, and we have rapidly accelerated the speed at which we make our payments.
Janet Daby
Victims of the Windrush scandal have experienced huge injustices of destitution, humiliation and varied health issues, as well as delays in receiving compensation. To make matters worse, they do not currently receive compensation for the loss of private pensions. Will the Minister look into reducing the delays and compensating Windrush victims for private pension losses?
Laura Farris
We consider each claim on its facts, and no two claims are the same. I would be happy to write to the hon. Lady about specific issues, but I reassure her that we do not take a blanket approach to each individual and we assess claims individually.
Anneliese Dodds (Oxford East) (Lab/Co-op)
The Conservatives have failed the Windrush generation twice now: first by denying their rights as British citizens, and secondly by delaying their compensation, as we have just heard again. Labour would sort out the compensation scheme, re-establish the major change programme and Windrush unit scrapped by the Conservatives and appoint a Windrush commissioner to ensure that this kind of scandal never happens again. What is the Government’s plan here?
Laura Farris
I find it difficult to accept that a scheme is failing when more than 80% of claims have now received a final decision, and more than 90% have either received a final decision or are less than six months old. So I disagree with that. I think it was suggested that we should take the scheme out of the Home Office—perhaps that is Labour’s proposal. I remind the hon. Lady that Martin Levermore, the independent adviser to the Windrush scheme, supported the scheme remaining in the Home Office in his most recent report, published in March 2022.
Anneliese Dodds
There is no accountability for the failures being felt so acutely by so many people who, frankly, do not have much time left to see justice. The Windrush generation and their families helped to build our NHS, but today we see big inequalities in health outcomes. Labour’s race equality Act would include a target to close the appalling maternal mortality gap for black and Asian women. It seems another nine months have passed since the maternity disparities taskforce last met—is that because the Minister for Women and Equalities thinks this is another of her alleged fake problems?
Laura Farris
I say to the hon. Lady that that is not accepted. In fact, the Health Secretary made an announcement on maternal services this week; I think it would be appropriate to refer to my colleagues at the Department of Health and Social Care, and then I will write to the hon. Lady on this point.
Kim Johnson (Liverpool, Riverside) (Lab)
The Parliamentary Under-Secretary of State for the Home Department (Laura Farris)
I meet the Domestic Abuse Commissioner regularly, and our last joint visit was to a refuge for minoritised women for whom honour-based abuse was a specific issue. It is important work of the Home Office to look at the specific harms connected with this issue. One of the things we are most proud of is our forced marriage unit, which has provided support services to more than 300 cases in the past year. We also fund a national honour-based abuse helpline, which has helped more than 2,500 people in the past 12 months.
Kim Johnson
Savera UK, which is based in my constituency, and the Domestic Abuse Commissioner are concerned by this Government’s failure to provide a statutory definition of so-called honour-based abuse. Does the Minister agree that that will lead to under-reporting and a lack of detail on the scale of the problem?
Laura Farris
I am afraid that the Government take the opposite view. We use the expression honour-based abuse, which has been controversial in itself, because often victims understand it the best. Victims of honour-based abuse are often the hardest to reach, and sometimes are the least able to articulate their claims and to escape their circumstance. We keep the definition wide to capture successfully all the various insidious forms that it takes. Let me reassure the hon. Lady that both the Crown Prosecution Service and the Home Office use a working definition to guide investigations and, so far, it is proving effective.
Michael Fabricant (Lichfield) (Con)
One of the most insidious forms of domestic abuse is conversion therapy. It is cruel and it does not work. Could my hon. Friend give me some indication of when legislation will come forward to ban it?
Laura Farris
I can reassure my hon. Friend that the Government will publish a draft Bill on that in due course.
Mrs Flick Drummond (Meon Valley) (Con)
The Minister for Women (Maria Caulfield)
We are helping to get young girls and women into STEM sectors in three key ways: first, by increasing the number of young girls taking up courses. We have seen a 50% increase in the number of undergraduate STEM courses taken up by young women. Secondly, this week is National Apprenticeship Week, and 70% of jobs are now accessed through an apprenticeship, which is helping young women get into STEM careers. Thirdly, we are helping women with experience of working in STEM who have left the profession to return to the workplace with our STEM returners project.
Mrs Drummond
University technical colleges are a good place for young women to start in STEM. I welcome the new UTC in Southampton, which will provide the extra places that Portsmouth UTC is unable to offer. Some 6,000 girls attend UTCs around the country, of whom 82% go on to apprenticeships, university or straight into employment—mostly into STEM careers. Does my hon. Friend agree that UTCs provide a great start to a career in STEM, and that the proposal for UTC sleeves in secondary schools will help more girls into STEM careers?
Maria Caulfield
I absolutely agree. University technical colleges provide an excellent experience for young people, not just academically but in providing technical skills. They have excellent links with industry, which provides great work experience for those pupils. I am pleased that the young people in my hon. Friend’s constituency have such great options for UTC provision.
Jim Shannon (Strangford) (DUP)
I am always encouraged by the number of young ladies and girls who wish to be involved in science, technology and mathematics in Northern Ireland. They can do the job every bit as well men. Is it not important to ensure that companies that wish to employ people do more to encourage young ladies to take up jobs?
Maria Caulfield
The hon. Member is absolutely right. The Government cannot do it all; we need industry, and there are some great examples. We have a £17 million scholarship programme for artificial intelligence and data science conversion courses. We also have the UK Space Agency investing £15 million into diverse workforce streams, particularly to help young women get into the sector. He is right that we need to work hand in glove with industry.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
The Minister for Women (Maria Caulfield)
We all know that women take on the bulk of caring responsibilities. The Carer’s Leave Regulations 2024 will come into force on 6 April across England, Wales and Scotland, allowing carers to take a week of unpaid leave from the workplace knowing that their jobs are protected.
Mr Sheerman
The ministerial team knows that it is an absolute scandal that in all these years of so-called popular Conservative Government we have seen such a bad deal for early years, carers and talented women. Legions of them want to use their talent at work but are stopped by the highest childcare costs in the world.
Maria Caulfield
I would respectfully say to the hon. Gentleman that God gave us two ears and a mouth for a reason, and I would encourage him to put his listening ears on to hear about the track record of this Government. We have, for instance, improved payments for carers, introduced groundbreaking legislation to allow flexible working from day one, and legislated for parental leave including shared parental leave and paternity leave. The kinship care strategy was launched in December to provide a funding model for kinship carers. We have gone further than any Government with our plan to improve the lives of carers and value the work that they do.
Kirsten Oswald (East Renfrewshire) (SNP)
That right to flexible working would particularly benefit workers with caring responsibilities, most of whom are women, but unfortunately the UK Government’s response to the results of their consultation on flexible working simply does not go far enough to provide some of the real practical support needed by many people with such responsibilities. Last week Nikki Pound of the TUC told the Women and Equalities Committee that one in three requests for flexible working were denied by employers. What steps are the UK Government taking to give real support to workers with caring responsibilities and ensure that flexible working is a day-one right by default?
Maria Caulfield
I am a carer myself, holding down a full-time job, so I am aware of the difficulties involved. As I have said, the Government have passed legislation allowing flexible working from day one, and we have also introduced 18 weeks of leave entitlement for parents. That is on top of the Carer’s Leave Regulations 2024, which will come into force on 6 April. We have gone further than any other Government in introducing those rights for carers.
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)
The Parliamentary Under-Secretary of State for Energy Security and Net Zero (Amanda Solloway)
The Government understand the importance of this issue. I have recently met key stakeholders representing disabled people, including members of Disability UK and cross-Whitehall colleagues.
Jamie Stone
My constituent Mr Peter Bodek has a severe lung condition which necessitates the use of oxygen. There is mould in his house, and it is getting on to his clothes. He can only afford two small electric heaters. I should be grateful if a Minister could meet me, very briefly, to discuss this rather difficult situation.
Amanda Solloway
I am grateful to the hon. Gentleman for raising that issue, and I speak both for myself and on behalf of the Minister for Disabled People, Health and Work in saying that of course we will have a meeting.
Stuart C. McDonald (Cumbernauld, Kilsyth and Kirkintilloch East) (SNP)
The Minister for Women and Equalities (Kemi Badenoch)
In the light of some of the commentary about the employment tribunal’s judgment in the case of Professor Miller and Bristol University, I want to clarify the fact that antisemitism must continue to be challenged wherever it arises. We have seen people in this country use their views on Israel as an excuse to display antisemitism. We have seen that in protests on our streets, and also in our universities. It is therefore important to stress that this ruling does not change the fact that while academics have the right to express views, they cannot behave in a way that amounts to harassment of Jewish students. Disguising that as discourse about Israel would be no more lawful than any other form of antisemitism. The Government will consider the ruling carefully, and we will continue to do all in our power to protect Jewish people throughout our country.
Stuart C. McDonald
On Monday, my hon. Friend the Member for Livingston (Hannah Bardell) hosted a very positive event marking the start of the Football v. Homophobia month of action. Will Ministers join me in thanking all those involved in the campaign—which includes LEAP sports and the TIE campaign in Scotland—and offer their wholehearted support for making football a safe and welcoming sport for LGBT people?
Kemi Badenoch
Of course we join the hon. Gentleman in that. I pay tribute to the work of the Minister for Equalities, who has been very supportive of the campaign—as are all of us in the ministerial team.
Marco Longhi (Dudley North) (Con)
Kemi Badenoch
As my hon. Friend will know, I too am an engineer by training, and we engineers have to stick together. We are very sceptical when people introduce to the lexicon terms that are not helpful to the real work of tackling serious criminal behaviour. I am not a fan of that term, and my hon. Friend will be pleased to know that microaggressions training was removed from the Government Campus prospectus in November 2022.
Ashley Dalton (West Lancashire) (Lab)
Under the Conservatives, police-recorded rapes have soared to record highs while convictions have fallen to record lows. It emerged last week that the Conservative police and crime commissioner in Cheshire victim-blamed girls wearing short skirts for this epidemic. Why are these attitudes still tolerated in the Conservative party?
Kemi Badenoch
Those attitudes are not tolerated in the Conservative party. I have not seen the remarks the hon. Lady refers to, but I am sure that we can investigate. However, I will push back on what she said about rape statistics. The fact is that, for the year ending March 2023, the crime survey for England and Wales shows a 5.1% reduction in the number of adults experienced domestic abuse—a statistically significant decrease—compared with the year ending March 2020.
Anna Firth (Southend West) (Con)
The Minister for Women (Maria Caulfield)
This Conservative Government and this Conservative Prime Minister have been clear that biological sex matters, and language is important too. We have issued guidance to trusts because there is evidence that clinical damage and harm can come with the removal of the use of the term “woman” from literature. I would be happy to write to my hon. Friend’s local trust to point that out.
Marion Fellows (Motherwell and Wishaw) (SNP)
The Minister for Disabled People, Health and Work (Mims Davies)
The hon. Lady joined me yesterday at the disability action plan event, where many stakeholders welcomed the changes and opportunities in disabled people’s lives. Many disabled people want to work, and we at the Department for Work and Pensions will always ensure that we listen to their wants and needs and that they will never be forced into anything that is not suitable for them.
Dame Caroline Dinenage (Gosport) (Con)
At 5 pm today, women’s groups and other community groups in Gosport will be staging a peaceful protest about the Lib Dem council’s decision to completely end all live CCTV monitoring. They are worried about the impact on people’s safety. Does the Minister agree with them?
Kemi Badenoch
It is important that people understand that CCTV and street lighting are important in helping women to feel safe on the streets. I fully understand the campaign and I am glad that my hon. Friend is supporting it. We are doing everything we can in Government to reduce violence against women and girls.
Mohammad Yasin (Bedford) (Lab)
Kemi Badenoch
I am working closely with the Foreign, Commonwealth and Development Office on this issue. We are very concerned about the events taking place in both Israel and Gaza and we want to see the violence end. The hon. Gentleman will know about all the work we have been doing on preventing sexual violence in conflict, for example, and we will continue to do everything we can to minimise any impact on women and girls.
Sir David Evennett (Bexleyheath and Crayford) (Con)
What steps is my right hon. Friend taking with Cabinet colleagues to help increase the number of female-led businesses?
Kemi Badenoch
Female-led businesses often face particular challenges, and in the Department for Business and Trade we work with the British Business Bank to ensure that those businesses continue to have access to finance. We have the Investing in Women code and a taskforce for women-led entrepreneurs. We hope that all these actions together will help improve the lives of women in business.
Cat Smith (Lancaster and Fleetwood) (Lab)
Maria Caulfield
The hon. Lady will know that the Government commissioned that report from the Patient Safety Commissioner to look at options for redress, specifically for those affected by sodium valproate, but also for those affected by mesh. The report has been published only today, so we will look at the details closely before reporting back to the House.
Fleur Anderson (Putney) (Lab)
The Prime Minister (Rishi Sunak)
I know the thoughts of the House and the country are with the King and his family. We wish His Majesty a speedy recovery and look forward to him resuming his public-facing duties in due course.
This morning I had meetings with ministerial colleagues and others. In addition to my duties in the House, and I shall have further such meetings later today.
Fleur Anderson
I, too, send my best wishes to the King.
Last week, the Foreign Secretary said that, with allies, we will look at the issue of recognising a Palestinian state, so that the Palestinian people
“can see that there is going to be irreversible progress to a two-state solution.”
Afterwards, it was briefed that these words had not been signed off by No. 10. Does the Prime Minister agree with his Foreign Secretary?
The Prime Minister
Our long-standing position has been that we will recognise a Palestinian state at a time that is most conducive to the peace process. The most important thing is that we are committed to that two-state solution and are working with our allies to bring it about.
Andrew Lewer (Northampton South) (Con)
The Prime Minister
We are publishing the dentistry recovery plan today, and my right hon. Friend the Health Secretary will be making a statement shortly. Over 1 million more people saw an NHS dentist last year than the year before, but we know that there is more to do. That is why the recovery plan will make sure that NHS dental care is faster, simpler and fairer for patients and staff.
Keir Starmer (Holborn and St Pancras) (Lab)
I join the Prime Minister in sending His Majesty the King our very best wishes for his treatment. Across the House, we all look forward to seeing him back to full health as quickly as possible.
This week, the unwavering bravery of Brianna Ghey’s mother, Esther, has touched us all. As a father, I cannot even imagine the pain that she is going through. I am glad that she is with us in the Gallery today.
A year ago, the Prime Minister promised to bring down NHS waiting lists. Isn’t he glad that he did not bet a grand on it?
The Prime Minister
At least I stand by my commitments. He is so indecisive that the only bet he would make is an each-way bet.
Keir Starmer
He says he stands by his commitments. He once insisted that if he missed his promises,
“I’m the Prime Minister…it’s on me personally”.
Today we learn from his own officials that he is the blocker to any deal to end the doctors’ strikes. Every time he is asked, he blames everyone else. What exactly did he mean when he said “it’s on me personally” if he does not meet his promise?
The Prime Minister
We are bringing down waiting lists for the longest waiters and making progress. It is a bit rich to hear about promises from someone who has broken every single promise he was elected on. I have counted almost 30 in the last year: pensions, planning, peerages, public sector pay, tuition fees, childcare, second referendums, defining a woman—although, in fairness, that was only 99% of a U-turn. The list goes on, but the theme is the same: empty words, broken promises and absolutely no plan.
Keir Starmer
Of all the weeks to say that, when Brianna’s mother is in this Chamber—shame! Parading as a man of integrity when he has got absolutely no responsibility, it is absolute—[Interruption.]
Mr Speaker
Order. I think Members are getting carried away. Our constituents want to hear the questions and they certainly want to hear the answers. They do not want to hear organised barracking, so please, I want no more of it.
Keir Starmer
I think the role of the Prime Minister is to ensure that every single citizen in this country feels safe and respected, and it is a shame that the Prime Minister does not share that view. I welcome the fact that he has finally admitted that he has failed on NHS waiting lists. I also welcome the fact that he has finally acknowledged the crisis in NHS dentistry. He is calling it a “recovery plan”, after 14 years of Tory Government. What exactly does he think NHS dentistry is recovering from?
Mr Speaker
Order. I am certainly not having that from the Opposition Front Bench either. Please, I want to hear this. I am hoping that election fever is not coming tomorrow, so let us not behave as though it is.
The Prime Minister
As ever, the right hon. and learned Gentleman conveniently forgets the impact of a pandemic on NHS dentistry; it was specifically because of the close proximity nature of dental provision that it was unable to operate as normal throughout the pandemic—that was a recommendation of the medical and clinical experts. That is why, inevitably, there is a backlog in dental care, with the impact that this has. But that is why, as my right hon. Friend the Health Secretary will outline later today for the House, we are putting in more funding to provide more NHS provision across the country, on top of plans that will see the number of dental training places increase by 40%. Our plans mean that there will be 2.5 million more NHS appointments, which is, in fact, three times more than the Labour party is proposing.
Keir Starmer
There are some areas in the country where people literally cannot have an NHS dentist, and the Prime Minister says that that is down to covid. People are literally pulling out their own teeth—[Interruption.]
Mr Speaker
Order. Let me just say that I do not need any more from those on the Government Front Bench either. Do we understand each other?
Keir Starmer
People are literally pulling out their teeth using pliers—an experience that can be compared with extracting an answer from the Prime Minister at the Dispatch Box. The truth is that after 14 years of neglect, this “recovery plan” is just a desperate attempt to recover back to square one. If he wanted to move forward, he should follow Labour: scrap the non-dom tax status and use the money to fund 2 million more hospital appointments every year. But the Prime Minister is oddly reluctant to follow us on this. What exactly is so special about this tax avoidance scheme that means he prioritises it above the NHS?
The Prime Minister
Let us look at that record. In the NHS, we have record funding; record numbers of doctors and nurses; a record number of appointments; and higher cancer survival rates. But what is happening on Labour’s watch in Wales? Let us have a look at that. A fifth of people in Wales are currently on a waiting list; the number of waits of 18 months or more is 10 times higher than in England; and people are waiting twice as long for an operation. Labour’s failure has sent the Welsh NHS back to square one, and we will never let them do that here.
Keir Starmer
When the Prime Minister admitted that he had failed on waiting lists, I actually thought that we might be entering a new era of “integrity, professionalism and accountability”—remember that one? But just like all the other relaunches, it has proved to be a false dawn. He is still blaming everyone else and is still removed from reality. It is very simple: you can either back more NHS appointments or more tax avoidance. We know what side we are on; why doesn’t he?
The Prime Minister
The best way to ensure that we continue to fund the NHS, as we have, is not to make £28 billion of unfunded spending commitments. Just this morning, independent Treasury officials have published a formal costing of just one part of Labour’s eco promise, its insulation scheme, and it turns out that it will cost double what Labour had previously claimed—it is not the £6 billion that Labour accounted for, but £13 billion every single year. It is now crystal clear that Labour has absolutely no plan, but we all know it is going to fund that gap: more taxes on hard-working people.
Keir Starmer
The Prime Minister is Mr 25 Tax Rises. He is literally the country’s expert on putting taxes up, and he thinks he can lecture everyone else on the economy. Last week, he and his MPs were laughing at someone whose mortgage had gone up £1,000 a month. This week, he casually made a £1,000 bet in the middle of an interview. Last week, he thought even raising questions about the cost of living was resorting to “the politics of envy”. This week, he has finally found the cause he wants to rally around: the non-dom status. When he finds himself backing tax avoidance over NHS appointments, does he start to understand why his own MPs are saying that he simply does not get what Britain needs?
The Prime Minister
I will take no lectures about getting Britain from a man who thought it was right to defend terrorists. What we are doing is building a brighter future for our country: just last week, we expanded healthcare in pharmacies; today, we are expanding dental care; and this week, we are helping millions with the cost of living and, most importantly, cutting national insurance. That is all while the Labour party argues over 28 billion different ways to raise people’s taxes. That is the difference between us: we are delivering a plan, but they cannot even agree on one.
Mr John Baron (Basildon and Billericay) (Con)
The Prime Minister
My hon. Friend is right to highlight our record of providing support to the country when it needed it, whether it is the NHS, vaccines, furlough during covid or, most recently, help with people’s energy bills. We are only able to afford that because of the strong management of our economy. That is why we must stick with the plan and not risk going back to square one with the Labour party, which, as we know, has absolutely no plan and will cost everyone in this country with its £28 billion of tax rises.
Stephen Flynn (Aberdeen South) (SNP)
I begin by expressing my heartfelt sympathies to Brianna’s mother, who is in the Public Gallery. I also send my best wishes to King Charles for what will hopefully be a quick and full recovery.
The public are used to the Tories gambling on the lives of others: Boris Johnson did it with public health during the pandemic, and his immediate successor did it with household finances. Not to be outdone, on Monday this week the Prime Minister accepted a crude bet regarding the lives of asylum seekers. In doing so, he demeaned them as individuals and he degraded the office that he currently holds. Will he apologise?
The Prime Minister
We may have a principled disagreement on this: I believe, and we believe, that if someone comes to this country illegally, they should not be able to stay and they should be removed. That is why we are committed to our Rwanda scheme.
Stephen Flynn
As ever, the Prime Minister does himself no favours, because the bet to which I refer was worth £1,000, and it came just hours before he ended cost of living support worth just £900. His justification for doing so was that the cost of living crisis is easing. What does he believe leaves him looking most out of touch with the public: gambling £1,000, or believing that the cost of living crisis is getting better?
The Prime Minister
The hon. Gentleman talks about the cost of living, but perhaps he can explain to the Scottish people why it is that, while the UK Conservative Government are cutting their taxes, the Scottish Government are raising them?
Tim Loughton (East Worthing and Shoreham) (Con)
The Prime Minister
When it comes to illegal migrants, we need to have a system whereby, if someone comes here illegally, they should not be able to stay. My right hon. Friend the Home Secretary has asked for more information about the extent to which migrants converting to Christianity is playing a role in our asylum system. More generally, under our Illegal Migration Act 2023, anybody entering the UK illegally will not be granted asylum here. That is why we need to have somewhere to send them and why our Rwanda scheme is so important. The Labour party has blocked these measures every single step of the way, because it does not have a plan and it will not keep Britain safe.
Sir Jeffrey M. Donaldson (Lagan Valley) (DUP)
May I, on behalf of my party, extend our best wishes to His Majesty the King for a full recovery?
I thank the Prime Minister for his dedication and leadership in helping us to restore our place in the United Kingdom and its internal market and to revive our political institutions at Stormont. The Union is more secure as a result of our combined endeavours and, together, we have greatly enhanced the potential to build a strong and prosperous economy that will help to cement our peace in Northern Ireland.
Securing peace in an unstable world is vital for all of us, so will the Prime Minister examine the findings of a recent report by Policy Exchange that calls for Northern Ireland to play an even greater role in the defence of our nation?
The Prime Minister
May I start by thanking and paying tribute to my right hon. Friend for his own leadership over the past few months? He and I agree that the Union is stronger for the return of devolution and the work that we have done. I would be delighted to examine the findings of the report, and I have seen, with my own visits, the vital role that Northern Ireland is playing through the location of firms such as Thales and Harland & Wolff. However, as he will know, I was delighted that, in last week’s Command Paper, we specifically committed to examining how we can further bolster Northern Ireland’s share of the UK defence sector, because it is another essential pillar of our precious economic Union.
Virginia Crosbie (Ynys Môn) (Con)
The Prime Minister
As ever, my hon. Friend is a fantastic champion for Wylfa and the nuclear industry. I can confirm to her that Wylfa is a candidate for the new nuclear site and one of a number of potential sites that could host civil nuclear projects. No decisions have been taken at present, but Great British Nuclear is working with the Government to support access. We are also developing a new national policy statement, providing the planning framework for new nuclear power, and we very much welcome her, and other, contributions to that consultation.
Stewart Malcolm McDonald (Glasgow South) (SNP)
The Prime Minister
We will continue to take a robust and proactive approach towards our relationship with China, rooted in the UK’s national interest and values. The National Security Act 2023 brings together vital new measures to protect our national security. That includes creating a foreign influence registration scheme through the Act specifically to tackle covert influence in the UK. We will continue to take all possible powers to keep the country safe.
Mr Philip Hollobone (Kettering) (Con)
The Prime Minister
I thank my hon. Friend for highlighting this exciting initiative, and commend Beccy and Lindsey for their campaigning. He will know that our £150 million community ownership fund is there specifically to help to safeguard small but much-loved local assets. Our cultural development fund, which he mentions, is there to support further cultural projects as well. I will ensure that he gets a meeting with the relevant Minister to discuss the plans further, and wish him and his constituents all the best with this redevelopment project.
Janet Daby (Lewisham East) (Lab)
The Prime Minister
In fact, what we are seeing is record investment in our towns across the UK, many of which were neglected by the Labour party for decades. If we really care about levelling up, we need to avoid saddling hard-working Britons with higher taxes, which is exactly what Labour’s £28 billion green spending spree would do.
Alun Cairns (Vale of Glamorgan) (Con)
The Prime Minister
My right hon. Friend is absolutely right. Here in England we have a plan when it comes to education, where we are marching up the league tables, and we have virtually eliminated the longest waiting times, but in Labour-run Wales, as he said, education rates are falling and waiting lists over 18 months are more than 10 times higher than in England. It is crystal clear that we should stick to our plan for a brighter future and not go back to square one with Labour.
Sam Tarry (Ilford South) (Lab)
The Prime Minister
It is in fact criminal gangs that are exploiting vulnerable people and leading many of them to lose their lives as they make these dangerous crossings. Conservative Members think that that is wrong, and we want to do something about it, which is why we need to get a deterrent up and running, and be able to send people to Rwanda. It is the hon. Gentleman’s party that opposes that, so the question for Labour Members is why they remain on the side of the criminal people smugglers.
Elliot Colburn (Carshalton and Wallington) (Con)
February marks Emotional Health, Boost Your Self Esteem and Children’s Mental Health Month. In recent years, about 6,500 people have died in the UK each year due to suicide. In 2021, I was nearly one of them. Luckily my attempt failed, I was found by family members quickly, I received amazing care at St Helier and Springfield Hospitals, I did not do any permanent damage and I was well looked after by the NHS in the months that followed. I want to say thank you to everyone who saved me and sorry to my family and loved ones, whom I put through such an awful ordeal. In that moment, I felt alone and scared, like there was no way out, and that the world would be better off without me in it. But I do not recognise that man any more. I know that nothing is ever really worth that, that help really is out there—and I am pretty awesome. [Hon. Members: “Hear, hear!”] Does the Prime Minister agree that one death by suicide is one too many, and will he send a message from the Dispatch Box today that, whatever you are going through, you are not alone, help is out there and better days lie ahead?
The Prime Minister
I know the whole House will join me in commending my hon. Friend for his bravery in sharing his story and I can absolutely assure him that we take this issue incredibly seriously. The new suicide prevention strategy ensures that we will have the actions in place to reduce suicide over the next years, because we absolutely recognise the impact that it has on people and their families, and we should do everything we can to prevent that from happening.
Liz Twist (Blaydon) (Lab)
The Prime Minister
I think the hon. Lady was talking about the report on Teesworks, as far as I can see. What that report noted was that the pace and scope of the regeneration had had a wide-reaching positive impact on the local economy—and of course it was an independent external report. It makes it clear that there is no evidence of corruption or illegality and the Government will of course respond to the recommendations in the report as soon as possible.
Alicia Kearns (Rutland and Melton) (Con)
I give my heartfelt thanks to the Prime Minster for his support for our Melton, Harborough and Stamford villages following the recent devastating flooding. Tens of homes, farms and businesses in Rutland were also devastated, but our county is in effect excluded from ever receiving support in the future due to the arbitrary floor currently in place. Flood support should be based on the most affected or a percentage of population, but Rutland must have 1,000 times more flooding than next-door Lincolnshire for us ever to access support. Will my right hon. Friend please give a meeting to me and my right hon. and learned Friend the Member for South Swindon (Sir Robert Buckland) to discuss this important issue?
The Prime Minister
I extend my sympathies to all those impacted by the recent storms and flooding. We are investing record sums in flood defence across England and a recovery support framework is in place for families and businesses in every area that has experienced exceptional flooding. I know that my hon. Friend is in touch with Ministers in the Department for Levelling Up, Housing and Communities about how those schemes affect her constituency, but I will ensure that she gets the correspondence and meetings that she needs to deliver for her local communities.
Daisy Cooper (St Albans) (LD)
The Prime Minister
Actually, we are investing record sums in improving hospital infrastructure across the country. In Eastbourne in particular, spades are already in the ground to deliver an elective surgical hub. I know that there is local Liberal Democrat scaremongering about the future of services, but the local Conservative MP is doing a fantastic job, engaging with her community and working with local health officials.
Jane Stevenson (Wolverhampton North East) (Con)
It was my huge pleasure to host the aerospace defence and security industry apprenticeships event in Parliament yesterday, welcoming two apprentices from Collins Aerospace in Wolverhampton. Will the Prime Minister join me, in National Apprenticeship Week, in celebrating the opportunities that apprenticeships can provide in the defence industry, as well as in our armed forces, which are all in the top 10 apprenticeship providers?
The Prime Minister
My hon. Friend is absolutely right to highlight the importance of our apprenticeship provision, which is providing young people with opportunities across the country, particularly in the defence and aerospace sectors, as she said. Those plans are in stark contrast to those of the Labour party, which has caved in to big business and is now proposing to halve the amount of apprenticeship funding and the number of apprenticeships.
Kenny MacAskill (East Lothian) (Alba)
The Prime Minister
The future of Grangemouth refinery is obviously a commercial decision for its owners, but I am told that the site will remain operating as a refinery until at least May 2025. In the meantime, the UK and Scottish Governments are working together to seek assurances from Grangemouth about how it is supporting employees. We remain confident in our fuel supply. On energy security, which the hon. Gentleman mentioned, this Government are unambiguously backing the North sea oil and gas sector because that is how we support energy security in this country, attract investment and create jobs, particularly in Scotland.
Caroline Nokes (Romsey and Southampton North) (Con)
I was very proud that it was a Conservative Government who appointed the Patient Safety Commissioner, and that we commissioned the Hughes report on medical devices and medicines, which was published this morning. Will my right hon. Friend also make me proud by addressing the points that the commissioner has raised and bringing forward a redress scheme in a timely manner?
The Prime Minister
I am grateful to the Patient Safety Commissioner and her team for their work on this important issue—one that I know my right hon. Friend has spoken about in the past. Of course, first and foremost, our sympathies remain with those affected by sodium valproate. We are focused on improving the system and how it listens to patients, and it is right that the Government carefully consider the report’s recommendations. The Department of Health and Social Care will respond to the report in due course, and the Health Secretary will keep the House updated on a regular basis.
Sarah Edwards (Tamworth) (Lab)
The Prime Minister
Of course, we want to see every child thrive at school, which is why we have tripled the amount going into special educational needs for capital places and put more money into support ECHPs. I am sorry to hear about the case that the hon. Lady mentions. I will ensure that we continue to look at this matter in particular, because, as she said, we want every child to thrive at school.
Sir Alec Shelbrooke (Elmet and Rothwell) (Con)
I put on the record my best wishes to His Majesty the King and to Her Royal Highness the Princess of Wales.
Building on the question asked by my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes), I know that my right hon. Friend the Prime Minister is exceptionally pleased about the Hughes report, which has been published today. A huge amount of work has been done by Members from across the Chamber, including the hon. Members for Livingston (Hannah Bardell) and for Washington and Sunderland West (Mrs Hodgson), and my right hon. Friend the Member for Romsey and Southampton North.
May I press my right hon. Friend the Prime Minister on the fact that tens of thousands of women and children have suffered immensely since the 1970s, with Government after Government doing nothing about it? I am proud that this Government have done something about it, but I urge him, in the strongest terms, to talk to the Chancellor to ensure that we can address the issues raised in the Hughes report at the Budget.
The Prime Minister
I thank my right hon. Friend and colleagues from all parts of the House for their campaigning over many years on this issue. As I said, it is right not only that we extend our sympathies to those affected, but that we carefully consider the recommendations from the Patient Safety Commissioner’s report. I can assure my right hon. Friend that we will do that with all due haste, and I know that the Health Secretary will keep the House updated.
Vicky Foxcroft (Lewisham, Deptford) (Lab)
Why did the Prime Minister downgrade the role of Minister for Disabled People? What message does he think that sends to disabled people, and will he commit to reconsider that move and ensure that the role is held by a Minister of State? If not, will he agree to meet with me and disabled people’s organisations to explain his reasoning?
The Prime Minister
Actually, the Minister for Disabled People, my hon. Friend the Member for Mid Sussex (Mims Davies), is going to do a fantastic job, because she cares passionately about this issue. This Government have a record to be proud of, whether that is supporting many more of those with disabilities into work and ensuring they can live independently, or making sure that children with complex disabilities have access to more changing places across the country. Those are the values of this Conservative Government.
I would also like to say to Brianna Ghey’s mum, who is here, that as I said earlier this week, what happened was an unspeakable and shocking tragedy. In the face of that, for her mother to demonstrate the compassion and empathy that she did last weekend demonstrated the very best of humanity in the face of seeing the very worst of humanity. She deserves all our admiration and praise for that.
NHS Dentistry: Recovery and Reform
(9 months, 2 weeks ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Victoria Atkins)
With your permission, Mr Speaker, I would like to make a statement on our plan to recover and reform NHS dentistry. First, though, on behalf of the entire House and my Department, I send our very best wishes to His Majesty the King. His decision to share his diagnosis will be welcomed by anyone whose life has been touched by cancer, and I know that we are all very much looking forward to seeing him make a speedy recovery and resume his public duties.
Thanks to a once-in-a-generation pandemic, 7 million patients across England did not come forward for appointments with NHS dentists between 2020 and 2022. Since then, we have taken decisive action to recover services: we have made reforms to the dental contract, so that practices are paid more fairly for caring for NHS patients with more complex needs; and we have made sure that dentists update the NHS website regularly so that the public know that they are taking on new patients. That has delivered results, with more than 1 million more people seeing an NHS dentist last year than in the year before. However, we know that too many, particularly those living in rural or coastal communities, are still struggling to find appointments. This recovery plan will put that right by making NHS dental care faster, simpler, and fairer for patients and staff. It is built on three key pillars, which I will address in turn.
First, we will help anyone who needs to see an NHS dentist to do so, wherever they live and whatever their background. To do this, we must incentivise dentists across the country to care for more NHS patients. That is why I am delighted to tell the House that for the coming year, we are offering dentists two new payments on top of their usual payments for care—£15 for every check-up they perform on NHS patients who have not been seen over the past two years, and £50 for every new NHS patient they treat who has not been seen over the same period—because we know that patients who do not have a relationship with a dentist find it harder to get care. That is not a long-term ambition: our new patient premium will be available from next month.
We are also increasing the minimum payment that dentists receive for delivering NHS treatments, which will support practices with the lowest unit of dental activity rates to provide more NHS care. However, we know that in many of our rural, remote and isolated communities, dentists themselves are in short supply. That is why starting this year, up to 240 dentists will receive golden hello payments worth up to £20,000 when they commit themselves to working in one of those areas for at least three years. These dentists will give patients the care they need faster, make dental provision fairer and tackle health inequalities.
We are also delivering dentistry to our most remote regions without delay. This year, we will deploy dental vans to more isolated, rural and coastal areas. Staffed by NHS dentists, they will offer check-ups and simple treatments such as fillings. This model has been a tried and tested success across many regions. For example, last year in Cornwall, a mobile van visited five harbours, treating more than 100 fishermen and their families. We will be rolling out up to 15 vans across Devon, Gloucestershire, Somerset, Norfolk, Suffolk, Lincolnshire, Cambridgeshire, Dorset, Cornwall, North Yorkshire and Northamptonshire. This move has been welcomed by Healthwatch, the Nuffield Trust and the College of General Dentistry. We will let patients know when vans will be in their area, so they can get the care they need faster.
These reforms will empower NHS dentists to treat more than 1 million people and deliver 2.5 million more appointments. As the chief executive of National Voices, a group of major health and care charities, said:
“This extra money…should help thousands of people who have been unable to see a dentist in the last two years to get the care they need.”
These reforms are just the beginning. This recovery plan will also drive forward reforms to make NHS dentistry sustainable for our children and our grandchildren.
That brings me to the second pillar: growing and upskilling our workforce for the long term. Our long-term workforce plan, the first in NHS history, gives us strong foundations on which to build. By 2031, training places for dentists will increase by 40%—forty per cent—and places for dental hygienists and therapists, who can perform simple tasks such as fillings, will also rise by 40%. More dentists and more dental therapists will mean more care for NHS patients.
I am delighted to tell the House today that we are going further in three key ways. First, we will consult on a tie-in to NHS work for dentistry graduates, because right now too many are choosing to deliver private work over valuable NHS care. More than 35,000 dentists in England are registered with the General Dental Council, but last year almost a third worked exclusively in the private sector. Training these dentists is a significant investment for taxpayers, and they rightly expect it to result in the strongest possible NHS care. That is why, this spring, we will launch a consultation on a tie-in for graduate dentists and how this could deliver more NHS care and better value for taxpayers.
Secondly, we will take full advantage of our dental professionals’ skills. Today, even though they have the right training, without written direction from a dentist dental therapists cannot do things such as administer antibiotics. This year, we will change this, making life simpler for dentists and making care faster for patients. As the president of the College of General Dentistry has said, the
“use of the full range of skills of all team members will enable the delivery of more care and make NHS dentistry more attractive to dental professionals.”
Thirdly, we will recruit more international dentists to the NHS. We have a plan to do this by working with the General Dental Council to get more international dentists taking exams and to get them on to the register sooner, and to explore the creation of a new provisional registration status so that, under the supervision of a dentist who is already on the register, highly skilled international dentists can start treating patients sooner, rather than working as hygienists while they are waiting to join the register.
I turn now to our plan’s third pillar, which is prioritising prevention and giving children a healthy smile for life. This begins by supporting parents to give their children the best possible start. That is why family hubs up and down the country will offer parents-to-be expert advice on looking after their baby’s teeth and gums. As those babies grow up, we will support parents and nurseries in making sure that before every child starts primary school, brushing their teeth is part of their routine.
The evidence is clear: the earlier good habits are built, the longer they will last. Seeing a dentist regularly is vital for children’s health, but since the pandemic, too many have been unable to do that. That is why this year we are taking care directly to children. We will deploy mobile dental teams to schools in areas with a shortage of NHS dentists. They will apply a preventive fluoride varnish to more than 165,000 reception-age children’s teeth, strengthening them early and preventing decay. Our Smile for Life programme has already been endorsed by the College of General Dentistry.
Six million people in England already benefit from water fluoridation. In order to go further in protecting children’s teeth, we will consult on strengthening more of our country’s water with fluoride. Again, the evidence is clear: in some of the most deprived parts of England, enhancing fluoride levels could reduce by up to 56% the number of teeth that are extracted because of decay. That is why, through the Health and Care Act 2022, we have made it simpler to add fluoride to more of our water supply. As a first step, this year we will launch a consultation on expanding water fluoridation across the north-east—an expansion that would give 1.6 million more people access to water that strengthens their teeth, preventing tooth decay and tackling inequality.
This is our Government’s plan to recover and reform dental care: dental training places up by 40%; 2.5 million more appointments; dental vans treating more patients; more dentists in remote areas; more dentists taking on NHS patients; better support for families and better care for children; patient access up and inequity coming down. It will make life simpler for staff, and treatment faster and fairer for patients and staff. We have taken the difficult decisions, and we have now delivered a long-term plan to make dental care faster, simpler, and fairer for people across the country. We are going to get on with the job and put our plan into action, and I commend this statement to the House.
Wes Streeting (Ilford North) (Lab)
I wholeheartedly associate myself and my party with the Secretary of State’s remarks on sending our best wishes to His Majesty the King. Having gone through a cancer diagnosis myself, I particularly send best wishes to his family, for whom a diagnosis is often more difficult than for the person receiving it.
Also in the generous spirit in which we have begun, may I thank the Health and Social Care Secretary for accidentally e-mailing me her entire plan yesterday? That goes above and beyond the courtesy that we normally expect. I look forward to receiving her party’s election manifesto any day now—but of course we will have to write ours first to give her party some inspiration.
After 14 years of Conservative Government, NHS dentistry is in decay. Eight in 10 dentists are not taking on new patients, and in the south-west of England the figure is 99%. One in 10 people has been forced to attempt DIY dentistry—Dickensian conditions!—because they cannot see an NHS dentist, and they cannot afford to go private. [Interruption.]
Mr Speaker
Order. Mr Baker, I am sorry, but I don’t want any more heckling from you; you did a little bit earlier. I wanted everybody to listen to the Secretary of State, and I expect them to do the same for the shadow Secretary of State.
Wes Streeting
Don’t worry, Mr Speaker: I will come back to the Parliamentary Private Secretary shortly. Tooth decay is the No.1 reason for children aged six to 10 being admitted to hospital. Unbelievably, there have been reports of Ukrainian refugees booking dentist appointments back home and returning for treatment, because it is easier to fly to a war-torn country than it is to see an NHS dentist in England. Well, at least one Government policy is getting flights off the ground—and it is certainly not the Government’s Rwanda scheme failure.
Let us look at the human consequences of this Conservative tragedy. Labour’s candidate in Great Yarmouth, Keir Cozens, told me about Jeanette, a young woman in her 30s who has struggled with gum and mouth problems all her life. She used to be able to get treatment; now she cannot find an NHS dentist in all of Norfolk to take her. She cannot afford to go private. It hurts to smile, it hurts to laugh, and the pain is so great that Jeanette does not go out anymore. Just this week, she resorted to trying to remove her tooth herself. That is not right for anyone of any age, but Jeanette should be in the prime of her life. Will the Secretary of State apologise to Jeanette and the millions like her for what the Conservatives have done to NHS dentistry?
After 14 years of neglect, cuts and incompetence, the Government have today announced a policy of more appointments, recruiting dentists to the areas most in need and toothbrushing for children. It sounds awfully familiar. They are adopting much of Labour’s rescue plan for dentistry. Does that not show that the Conservatives are out of ideas of their own, and are looking to Labour to fix the mess they have made? I say: next time Conservative Ministers say that Labour does not have a plan, or that Labour’s plan is not credible, don’t believe a word of it.
There are some differences between our two parties’ approaches. Labour is pledging an extra 700,000 urgent and emergency appointments, which are additional to the appointments announced today. Can the Health Secretary confirm that the Government’s plan does not provide any additional emergency support? Labour proposed supervised early-years toothbrushing, and Conservative MPs accused it of being “nanny state”. Does the Health Secretary stand by that label, or does she now support children under five being supported in brushing their teeth?
The key difference is that we recognise that our plan is a rescue plan, and that to put NHS dentistry back on its feet, immediate reform of the dental contract is needed. Without that, the Government’s plan is doomed to fail. Do not just take my word for it; the British Dental Association has said that the plan will not stop the exodus of dentists from the NHS, will not provide a dentist for every patient who needs one, and will not put an end to this crisis.
I come to the Parliamentary Private Secretary, the hon. Member for North Norfolk (Duncan Baker), and the miserable script that the Whips are spreading out on the Table. If Labour’s contract is to blame, why have the Government not reformed it in 14 years, and why are they not reforming it now? In 2010, the Conservatives promised in their election manifesto to reform the dental contract. They are bringing back not just Lord Cameron, but his broken promises. People have been desperately trying to get dental care for years, but there was nothing from the Conservative party. Now that we are in an election year, the Conservatives are trying to kick the can down the road, and are scrambling for a plan. They only discover their heart when they fear in their heart for their political futures, and the consequences have been seen: queues around the block in Bristol.
Finally, the Secretary of State is promising reform after 2025 and after the next general election. Who is she trying to kid? After 2025, the Conservatives will be gone, and if they are not, NHS dentistry will be. How many more chances do they expect? How many more broken promises will there be? We had 2010, 2015, 2017 and 2019. Their time is up, and it is time for Labour to deliver the change that this country needs.
Victoria Atkins
I tried to help the hon. Gentleman by giving him an advance copy of my speech yesterday, yet that was his speech. This Government are focused on delivering for patients. Perhaps I can help him understand the difference between the Opposition’s proposals and the Government’s fully funded dental recovery plan. The Opposition’s ambitions reach only as far as 700,000 more appointments. Our plan will provide more than three times that number of appointments across the country—that is 2.5 million, to help him with his maths. We are offering golden hellos to 240 dentists who will work in hard-to-reach and under-served areas; their proposals cover only 200. They have no plan for training more dentists; we set out in the long-term workforce plan last year, and again in the dental recovery plan, that we will increase training places for dentists by 40% by 2031.
Then we have the centrepiece of the Opposition’s proposals: making teachers swap their textbooks for toothbrushes—an idea that is hated by teachers and that patronises parents. We believe that most parents do a great job of looking after their children. I know that the Labour party does not agree with that; the hon. Gentleman called our children short and fat on a media round. We believe that most parents do a great job, and that is why we support pregnant mums-to-be, and support parents in family hubs and nurseries. We will not wait until reception class, by which time children have already got their teeth.
I want to dwell on the experience of anybody living under Labour in Labour-run Wales. Health services in Wales are devolved, and the Leader of the Opposition has called Wales “the blueprint” for how the Opposition will run our health system. Welsh Labour has the highest proportion of NHS dental practices not accepting new adult patients, and the joint highest proportion of those not accepting new child patients. In Wales, 93% of NHS dental practices are not accepting new adult patients. That is a higher figure than for any other nation in the UK. Some 86% of practices there are not accepting new child patients, which is the joint highest figure with Northern Ireland. Our plan is fully funded, but how will Labour pay for its plan? By using the magical money tree. The list of policies funded by the non-dom policy is as long as my arm. In 2022, it promised to fund a workforce plan. Last September, it became breakfast club meals. By October, it morphed into 2 million appointments and scanning equipment. By Christmas, it was funding a dentistry plan. It is the same old Labour: it has no plan.
Sir Peter Bottomley (Worthing West) (Con)
The House enjoyed the words of the Opposition spokesman, the hon. Member for Ilford North (Wes Streeting), although I am not sure how many he wrote himself; some may have seemed rather familiar to anyone who read Matthew Parris this morning on going to Ukraine to have a filling fixed.
In West Sussex, in Worthing and Arun, we want the same situation found in parts of London, where dentists have a sign saying, “New NHS patients welcome”. Has the Secretary of State been working with the British Dental Association and the General Dental Council to bring forward registrations, to get incentives right, and to make sure that dentists are no longer told, “You can’t serve any more patients because you will go above your limits”? Can she confirm that we are taking limits off, so that dentists, especially the young ones, can do as much work as they can, and can help as many patients as possible, so that we can get back to the situation that we were in before Labour changed the rules about 20 years ago?
Victoria Atkins
We have focused this plan on introducing the new patient premium—a bonus for new patients. Having discussed this carefully with professionals, we think that is one way that we can incentivise people into NHS practice. Dentists can already work up to 104% of the contract. Many do that, but some sadly do not, so we are trying to encourage those dentists who already have NHS contracts to go the extra mile and use the full slot available to them.
Rachael Maskell (York Central) (Lab/Co-op)
The Health and Social Care Committee took months gathering evidence and putting together a recovery plan, which the Government should have adopted. Dentists wanted that plan put in place. Central to it was reform of the NHS dental contract. However, the Secretary of State has completely failed to even mention reform of that contract. As a result, dentistry in my constituency in York, where constituents are waiting seven years to see a dentist, will not have the recovery that she talks about. Why did she not adopt our plan?
Victoria Atkins
I hope the hon. Lady will, as usual, be the help that I expect her to be to her constituents in publicising this plan. We are getting graphics and information out to all Members of Parliament, so that they can help their constituents understand what will be available in their area, because each and every one of us wants the very best for our constituents. She will be interested in the new patient premium, which is encouraging dentists back into NHS practice, or into NHS practice for the first time, and in the increased price for units of dental activity. Reform of the dental contract is part of our agenda, but we realised that we needed to give immediate help to communities such as hers.
Steve Brine (Winchester) (Con)
I welcome the plan. Recovery and reform is right, and the Select Committee will study the plan carefully. The dental Minister, my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), has already been invited to come before us, so that we can talk it through with her to see whether it reflects our aforementioned report on the subject. The golden hellos, the toothbrushing for pre-schoolers—as long as the workforce can handle it—and the mobile vans are good, but even a day longer of a contract focused on units of dental activity is a problem. Can the Secretary of State say how she plans to entice professionals into returning to NHS dentistry? So many have left, and that is key.
Victoria Atkins
Very much so, and that will be primarily through the patient premium, which will mean that from next month dentists will be able to turn their signs from “closed” to “open” for NHS patients. We wanted to use levers that could be deployed immediately in order to help our constituents.
Daisy Cooper (St Albans) (LD)
It is estimated that more than 12 million people are waiting for dental treatment, but the Government’s announcement says that it will help just 1 million. The Government’s underspend last year was £400 million, and it is expected to be the same this year, but only £200 million has been announced. This plan is a drop in the ocean. In St Albans, my dentists are desperate to provide NHS care, and my constituents are desperate to see a dentist. At the heart of the problem is the broken contract. Will the Government take up the Liberal Democrats’ plan to reform the contract and provide guaranteed access to an NHS dentist for everybody needing urgent and emergency care?
Victoria Atkins
I heartily recommend the recovery plan to the hon. Lady, because it offers 2.5 million more appointments and has a long-term ambition for the prevention of tooth decay in children. In addition, it has that long-turn vision about increasing training places for our dental professionals by 40% by 2031.
Sir Paul Beresford (Mole Valley) (Con)
As you are aware, Mr Speaker, I have a declared interest in this particular topic.
As my right hon. Friend the Secretary of State is aware, dentistry in England is a seller’s market. It is estimated that there are 5,000 dentist vacancies in England. When I came here in the early ’70s with my dental degree, like very many colleagues from Australia, New Zealand and so on, I presented at the General Dental Council, who said “welcome” and stamped my hand, and I went off and worked on the national health service the next day.
Now, and for decades, the General Dental Council has required graduates from world-class dental schools—every bit as good as the ones we have here—to wait, to pay and to sit what is called an overseas registration exam. Currently, the waiting list for the exam is 2,000 overseas dental graduates, many of whom are every bit as good as those we produce in this country. The GDC could change that overnight by accepting graduates automatically from known and trusted international schools. Will my right hon. Friend please have a small chat with the chairman of the General Dental Council?
Victoria Atkins
I thank my hon. Friend and recognise the enormous expertise he brings to the Chamber on this matter. He knows—he has genuinely talked to me about this on many occasions—the important role that the General Dental Council plays to ensure that we get international dentists registered as quickly as possible. I very much look forward to discussing that with the GDC so that we can get more international dentists on to our register and working in our practices.
Judith Cummins (Bradford South) (Lab)
I welcome much in the plan, which mirrors many of my ideas over the years, and indeed much in Labour’s plan. However, on access, the Government claim that the recovery plan will deliver care for up to 2.5 million people, but Government data shows that 12 million people in England have unmet dentistry needs, which leaves about 9.5 million people without an NHS dentist. That includes my constituent Beverley Kitson, who has osteoporosis and takes alendronic acid as treatment. The drug has damaged her teeth, and she now requires a check-up every three months after four of her teeth have decayed to such an extent that they need to be extracted. Beverley has been with the same dental practice for 50 years, but she has just been told that it is going fully private, leaving her without an NHS dentist. Will the Secretary of State guarantee Beverley that she will be able to access an NHS dentist under these plans?
Victoria Atkins
We have very much tried to ensure that dentists who already hold NHS contracts will keep them and keep working them. That is why we have fallen upon the new patient premium to make it more in their financial interests to take on new patients. I appreciate the hon. Lady’s point about retention, which, again, we are looking to address through the increase in the UDA. But we all acknowledge that dentists are independent contractors, so we must ask them—and particularly those who are new dental graduates—to do their bit and help our NHS out.
Maggie Throup (Erewash) (Con)
A number of NHS dentists across Erewash have recently retired, leaving a cohort of my constituents without access to NHS dentistry. Unfortunately, practices are finding it really difficult to recruit replacements for the retirees. How will the plan help speed up that recruitment so that my constituents are not without NHS dentistry for much longer?
Victoria Atkins
May I thank my hon. Friend for all the work she did in the Department and has done on this subject? We are taking a long-term view with training dentists. As I said, last year, through the long-term workforce plan, we set out an ambition to train up to 40% more dentists by 2031. As we also begin the consultation on a tie-in with those graduates, we are confident that we will see a greater supply of dentists to our NHS services.
Mrs Paulette Hamilton (Birmingham, Erdington) (Lab)
The £200 million pledged today is less than half last year’s record-breaking underspend. The plan says that any underspends will be ringfenced for dentistry. That was promised by a Minister last year, but it did not happen because integrated care boards were using that underspend. Why should the 73% of dentists in the west midlands who cannot and are not accepting any new patients believe it will be any different this year?
Victoria Atkins
The hon. Lady alights on an important fact that is sometimes lost in this debate: although an NHS dentist may have an NHS contract, they may not work the whole of that contract. Some NHS dentists very much do so; others work a fraction of it. We are trying to encourage dentists who do not use their full contract to do so, because that in itself will bring in more patients. We are confident that alongside the new patient premium, that will help constituents such as hers to get the treatment they need.
John Redwood (Wokingham) (Con)
Wokingham has a fast-growing population based on building a lot of new homes. So as the Secretary of State rolls out her new plans, will she also ensure that there are incentives to provide dental services on the NHS in areas where a population is moving in and needs them?
Victoria Atkins
My right hon. Friend raises an interesting point. Indeed, that is exactly the sort of discussion I am having with my right hon. Friend the Levelling Up Secretary, because I am really interested in having that connected and joined-up approach between planning and health. I think it could bring dividends for us all.
Barbara Keeley (Worsley and Eccles South) (Lab)
I do not believe that what the Secretary of State has described will deal with the complexity of dental problems out there. I have a constituent who was referred to the Manchester Dental Hospital for a possible abscess and was told that even an urgent referral would take a month. In fact, the dental hospital did not get back to her for five months after the referral; it offered her a telephone consultation. The amount of pain and infection meant that she had to seek private treatment at a cost of £4,000, but many cannot afford that, including the young man wheeled into Royal Bolton Hospital in great pain, leaking blood on the floor after trying to remove a painful tooth with pliers. What does the Health Secretary say to patients who have long-standing and complex dental problems and are paying the price by waiting in pain, paying for private treatment or trying to remove their own teeth?
Victoria Atkins
I take that constituency case very seriously. I am really keen to urge the hon. Lady that if a constituent contacts her in future with that level of discomfort and pain, she should advise that constituent to contact 111 and, if necessary, go to accident and emergency—[Interruption.] Labour Members are shaking their heads, but what she has just described is a serious situation. That constituent needs medical attention, and the NHS is there, ready and willing to help. That is the advice that she should be giving her constituents, and I hope that she takes it as seriously as I do. [Interruption.]
Madam Deputy Speaker (Dame Eleanor Laing)
Order. The Secretary of State was giving an answer to a question. We do not need all this shouting. People might not agree with the answer, but you have to listen to the answer.
Sir John Hayes (South Holland and The Deepings) (Con)
In congratulating my right hon. Friend—my personal friend—on this welcome, excellent statement, may I ask her to forgive the ferocity with which my right hon. Friend the Member for Gainsborough (Sir Edward Leigh) and I made the case for NHS dentistry when we met her recently? In that spirit, will she ensure that some of these new dentists come to rural Lincolnshire, where we desperately need good dental care? She has today irrigated the dental desert.
Victoria Atkins
I give my very sincere thanks to my right hon. Friend. The House can imagine the advocacy I have received from both him and my right hon. Friend the Member for Gainsborough (Sir Edward Leigh). On reaching rural and coastal areas, as a proud Lincolnshire MP myself I wanted to bring about a set of plans that will address those underserved areas. I am delighted that the plan meets with my right hon. Friend’s approval.
Sir George Howarth (Knowsley) (Lab)
The Secretary of State will be aware that the NHS dentistry crisis has been 14 years in the making. She will also be aware that it is impossible for anybody in Knowsley today to sign up with an NHS dentist. The measures the Secretary of State has described may, over time, help to meet the problem, but what advice would she give today to my constituents who cannot get an NHS dentist?
Victoria Atkins
The advice and guidance to dentists will be going out today, while the new patient premium that I have told the House about will come in from March—it is weeks away.
Dr Thérèse Coffey (Suffolk Coastal) (Con)
I thank my right hon. Friend the Secretary of State for an excellent statement and an excellent plan. It is exactly what patients in Suffolk have been waiting to hear—the rural payment, the bonus there and the mobile service. I am conscious that many dentists have chosen not to have more patients, and they might blame the contract—this, that or the other. That is why I welcome her plan about potentially tying in graduates to the NHS. My hon. Friend the Member for Mole Valley (Sir Paul Beresford) has already referred to the General Dental Council, which, in my view, has not taken full advantage of the regulations that came into force last March. Will the Secretary of State also look at the NHS’s own rules that further restrict the rapid supply of dentists into the NHS for our constituents?
Victoria Atkins
I thank my right hon. Friend for all the work she did on dentistry in the Department. I am conscious that many people have contributed to this plan; I am grateful to her and others. Again, I hear the observations on the General Dental Council, and will ensure that the GDC hears them as well. That is a fair challenge to the NHS. Colleagues will see that the plan is co-signed by NHS England, which shares our ambition to deliver those 2.5 million more appointments and set up the future of NHS dentistry for our country.
Christine Jardine (Edinburgh West) (LD)
Today’s statement by the Health Secretary will have been listened to with great interest by my constituents in Edinburgh West, who share a lot of the same concerns, face the same difficulty getting NHS dental treatment and will be looking for the same sort of solution as constituents in England. Could the Secretary of State clarify for me, and for all those who come to me, whether there will be Barnett consequentials? If there are, will she impress upon the Scottish Government the need to ringfence the money and actually invest it in dental services? If not, would she be willing to share with the Scottish Government how she is approaching the problem in the hope that they might actually respond and do something?
Victoria Atkins
I hear the frustration in the hon. Lady’s question. This is a devolved area—as it is in Wales—and is therefore a matter for the Scottish National party. I assume the hon. Lady will continue her usual advocacy on behalf of her constituents to ensure that the SNP looks at what is happening in England and tries to do better for Scotland.
Neil O’Brien (Harborough) (Con)
I really welcome this plan; I welcome the extra £200 million, the new patient bonus, the measures to get dentists into areas that do not have them and the minimum UDA. These are all good things that will help people in Harborough, Oadby and Wigston to get a dentist. Can I ask the Secretary of State to press on with two things? The first is the move to a proper national funding formula. Dentistry is the only part of the NHS without a funding formula, which disadvantages shire and coastal areas with older populations. The second is the next round of contract reform—the move to band 2b is working, and dentists are using it, but there are patients with complex cases for whom a capitation-like payment would be much better, as the British Dental Association pointed out. I encourage the Secretary of State to start working on that difficult group so that we can get extra help for them too.
Victoria Atkins
I must thank my hon. Friend for all his work. I know how much how much effort and commitment he has put into these plans, and it shows the genuine—[Interruption.] Sorry; the hon. Member for Ilford North (Wes Streeting) is being a little ungracious. My hon. Friend the Member for Harborough (Neil O’Brien) has been part of the united work across Government to deliver these plans. I very much take on board his recommendations and encouragement. As I say, we see this plan as delivering 2.5 million more appointments for our constituents, but of course we want to look to the long term as well.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
Is the Secretary of State aware that Rip Van Winkle fell asleep for 20 years? This Conservative Government have been asleep for even longer than that, as far as dentistry is concerned. Will the Secretary of State now wake up and talk to real working dentists, such as Phil Lucitt—one of my excellent NHS dentists in Huddersfield, who is in the Gallery with his wife today—and get something done about this crisis? It is a crisis in Huddersfield, as in every town in this country, such as Bristol, as we heard yesterday. People are in pain, people are suffering, and for 14 years her Government have done little about it.
Victoria Atkins
I must admit that I did not know quite where that question was going, but I think the hon. Gentleman is urging me to speak to dentists. I am delighted to reassure him that my ministerial officials and I do of course speak to dentists. In fact, only today I was at a practice in the heart of Westminster, speaking to a dental manager who welcomes this plan. I will veer away and resist the temptation to comment on Rip Van Winkle.
Peter Gibson (Darlington) (Con)
I welcome this dental recovery plan, which will help to deliver dentistry in Darlington. Can my right hon. Friend the Secretary of State provide me with advice on what more I can do to get my integrated care board to get on with the commissioning at Firthmoor community centre, which lost its dentistry practice 10 months ago? In looking to expand the number of dental training places, I urge the Secretary of State to look at Teesside University, which has ambitions to build on its existing dental technology provision and train the Tees Valley dentists of tomorrow.
Victoria Atkins
Thanks to the work of my hon. Friend and others, Tees Valley is a powerhouse of growth industries, as exemplified by the Chancellor in his Budget and autumn statements recently. I will take away my hon. Friend’s words of advice about his university. On the point about encouraging ICBs to take part in this work, as this plan is a joint document with NHS England, the expectation will be on ICBs to deliver the plan, because they exist to look after our constituents. This plan is one of the ways we will be able to secure that help.
Mohammad Yasin (Bedford) (Lab)
In Bedford and Kempston, like many areas in the country, we have a dental crisis. I have raised the matter of dentistry previously, including in a Westminster Hall debate. There can be no question but that under this Conservative Government there is a dentistry crisis and the people of this country have been failed. Why does the Health Secretary refuse to admit that 14 years of neglect and underspending have led us to this?
Victoria Atkins
Says the script. I assume the hon. Gentleman will welcome the 2.5 million more appointments that this dental recovery plan will deliver for all our country.
Mrs Heather Wheeler (South Derbyshire) (Con)
I thank my right hon. Friend the Secretary of State for this brilliant statement, and thank all the team for their huge amount of hard work. Today is dentist day—yesterday was dentist day for me, as I had an appointment with the Minister and an appointment with a real dentist from South Derbyshire. This news is absolutely superb. Will the Secretary of State get dentists to move to South Derbyshire, and ensure more free NHS dentistry there?
Victoria Atkins
I have no doubt that with my hon. Friend’s characteristic joy and as an irresistible force of nature, she herself will be an advert for dentists to come to work in her constituency.
Dame Diana Johnson (Kingston upon Hull North) (Lab)
A constituent recently told me that when she tried to register members of her family with an NHS dentist, she was told that there was an eight-year wait. We know that workforce is a really big issue. On that basis, will the Secretary of State meet me and a cross-party group of Members of Parliament to talk about how we could develop a dental school at the site of the excellent Hull York Medical School to grow our own dentists for the future?
Victoria Atkins
The right hon. Lady will know that part of the focus of the long-term workforce plan is to train people where they are most needed. I will happily arrange for her to meet the relevant Minister. On registration, the current system is not like a GP practice where, once a family is registered, they can only go to that GP. The whole reason that we have been encouraging dentists to update their details on the NHS website is so that people can move around to visit different dentists to get the treatment they need. Today’s plan will help turbocharge those efforts.
Peter Aldous (Waveney) (Con)
I welcome this recovery plan, which provides the foundation for putting NHS dentistry on a sustainable long-term footing. I urge my right hon. Friend to continue her negotiations to replace the existing NHS dentistry contract as soon as possible, and to provide funding to the Norfolk and Waveney integrated care board so that the University of Suffolk can open a new treatment and training facility in our area, to replicate the innovative service that is about to open in Ipswich.
Victoria Atkins
I understand my hon. Friend’s point, and I commend him for his work to ensure that his constituents receive the care and help that they deserve. On training, I hope he has drawn out from the plan the emphasis that we are putting on long-term ambitions. We understand that we need to train more dentists and get internationally trained dentists registered in our system. We recognise the critical role that dental hygienists and therapists can play as well.
Clive Efford (Eltham) (Lab)
If the Tories cared about the NHS, we would not have 7.6 million people on the NHS waiting list and dentistry in crisis. The answer that the Secretary of State gave to my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) demonstrates why we are in this situation. It is not about people turning up at A&E; the inability to access NHS dentistry services leads to people being in a crisis situation and needing emergency care. After 14 years of the Tory Government, why do we need a recovery plan for dentistry?
Victoria Atkins
The hon. Gentleman was obviously asleep at the beginning of my statement, because I set out what I hope is a fact agreed across the House about the pandemic—the real problem. People who had a relationship with a dentist before the pandemic do not face quite the same pressures as people who may have moved home or whose dentist may have moved practice. That is the cohort of people who we are trying to help. It really would help if Labour Members focused their arguments a little more on the facts, rather than on the scripts that their Whips have given out.
Andrew Lewer (Northampton South) (Con)
I very much welcome this statement and the meetings I have had with my neighbour, the Under-Secretary of State for Health and Social Care, my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom). The Secretary of State said that Northamptonshire will be included in a dental van roll-out, which is welcome, but the rest of the statement had a very rural focus. She will recall that my Prime Minister’s question focused on shortage in Duston. Is it at least a possibility that vans will go to suburban areas as well as rural ones?
Victoria Atkins
The criteria that will apply to the areas covered by vans are clearly set on dental need and other factors such as distance from an NHS dental practice. We have been able to identify areas of particular need, where we want to get that help as quickly as we can through the dental van initiative and the other ways detailed in the plan.
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
Last year, about half of my constituents were able to access dental services—well below pre-pandemic levels. Under the plans, what proportion of my constituents can now hope to access NHS dental services within the next six months?
Victoria Atkins
The dental recovery plan sets out immediate-term, medium-term and long-term plans. In the immediate term, we have the new patient premium that will be live from next month, the increase in UDA value to £28 and the golden hellos that I have described to under-served parts of the country. There is a batch of measures throughout the plan to address the concerns from colleagues across the House.
Paul Bristow (Peterborough) (Con)
I have a plan to open a brand-new NHS dentistry practice in Peterborough. New financial incentives, increased UDA rates and recruitment of overseas dentists to Peterborough are all part of that plan. Will my right hon. Friend meet me and those who want to open new NHS dental clinics in Peterborough, so that we can take advantage of every part of her excellent plan?
Victoria Atkins
I commend my hon. Friend for his excellent work as a constituency MP. It is exactly that sort of drive and ambition that will deliver results for his constituents. I would be delighted to meet him to discuss his plans, and I am pleased that our national dental recovery plan will fit well with his own local delivery plan.
Jonathan Edwards (Carmarthen East and Dinefwr) (Ind)
I regret to inform the House that the situation in west Wales is quite catastrophic, and recent reforms by the Welsh Government have probably made matters far worse. However, my constituents and I would like to know how much of what the Secretary of State has announced today is new money, resulting in Barnett consequentials for the Welsh Government.
Victoria Atkins
The hon. Gentleman articulates the case against Labour-run Wales with great power. There is £200 million on top of the £3 billion that we already spend on NHS dentistry in England
Siobhan Baillie (Stroud) (Con)
I have raised dentistry a lot, because Stroud constituents and dentists have been really worried, so I welcome the Government’s plans with NHS England. I give credit to Gloucestershire ICB, which recognised the complexity of this issue. Post pandemic, it set about raising provision and we have decent take-up so far. My plea to the Secretary of State and to the Under-Secretary of State for Health and Social Care, my right hon. Friend Member for South Northamptonshire (Dame Andrea Leadsom) is to continue their relentless focus on prioritising children’s appointments, and not to let parents off the hook, because we can all do better even if it is hard to get a toothbrush in a three-year-old’s gob every night. Will the Secretary of State say more about how ICBs will be supported to deliver the plans and integrate the work that they are already doing? The local areas that are prioritising this are making a difference.
Victoria Atkins
My hon. Friend was probably summing up this morning’s toothbrushing ahead of the school run for many mums and dads up and down the country. That is the point—we want to work with parents. We do not want to patronise them. The overwhelming majority of parents do a great job looking after their kids’ teeth. Our plans are to support those who are struggling. The expectation on ICBs is clear. The plan is a document between NHSE and us. We want to deliver this plan at local level. Expectations will be set on ICBs to make sure that they fulfil the potential of this great plan.
Justin Madders (Ellesmere Port and Neston) (Lab)
I welcome this long overdue focus on dental access. I am particularly interested in the 240 golden hellos that will be available. Clearly, they will be inadequate to deal with the scale of the challenge. I am also concerned that the focus of the statement seems to be on putting those golden hellos in rural areas. Visibility and transparency are needed about where they are allocated, because places such as Ellesmere Port have exactly the same issues as other areas in the country. We get phone calls every week from constituents asking where they can see an NHS dentist. We are not able to send them anywhere at the moment. Is the Secretary of State able to guarantee that in future we will be able to send them somewhere?
Victoria Atkins
I hope the hon. Gentleman will publicise the new patient premium, because that is one of the levers through which we will unlock places for new patients. I remember that he has taken an interest in this issue. I very much understand the point about location. We have set strict criteria for how dental vans will be deployed, but the new patient premium is across the country. We want as many people as possible to see NHS dentists and fill those 2.5 million more appointments.
Martin Vickers (Cleethorpes) (Con)
I particularly welcome the initiative to improve services in coastal and rural areas. The Health Secretary and I are constituency neighbours, and she will know the complexities of delivering local services in what we know as greater Lincolnshire, because her constituency is in the east midlands and mine is in Yorkshire and the Humber. Can she guarantee that the whole of greater Lincolnshire, from the south of the county up to Barton-upon-Humber, will receive the benefits of the new proposals?
Victoria Atkins
I am delighted to inform my hon. Friend and neighbour that the new patient premium applies across England, and of course people can move to the dental practice that can offer them the services they need, so I trust that his constituents will be as happy as mine.
Hywel Williams (Arfon) (PC)
Is the £200 million additional, in the sense of being diverted from other parts of the NHS in England, or is it new money from the Treasury that would attract the Barnett consequentials for Wales, Scotland and Northern Ireland? Which is it?
Victoria Atkins
We have finite resources. As I have said, this is additional money. I have prioritised dentistry across the board, but this is £200 million of additional money—in addition to the £3 billion that we spend in England.
Sir Jeremy Wright (Kenilworth and Southam) (Con)
I welcome what my right hon. Friend has said, and I understand why some of the new resources that she has announced are directed at particular types of intervention and particular groups of patients, but does she agree that one of the downsides of such an approach, at least potentially, is the extra administration that will obstruct dentists in the effective delivery of that resource? Will she therefore ensure that the funds are easily accessible, and that there is no such extra administration that would make that more difficult? Does she accept that longevity and consistency of funding matters, because it enables dentists to plan properly for their patients?
Victoria Atkins
My ethos is to make our NHS and social care system faster, simpler and fairer, and not just for patients but for practitioners. We do not want bureaucracy to get in the way of the delivery of these services, and I am impatiently keen to get them up and running in Members’ constituencies, so we will ensure that we make it is easy as possible for dental practices to use them.
Alistair Strathern (Mid Bedfordshire) (Lab)
I am sure that fellow former teachers who are here today will have memories of the disappointment they felt when, after repeated delays and excuses, a student finally handed in some work, only for it to turn out to be not just a copy of someone else’s work, but a pretty poor one at that. After so much delay and uncertainty, dentistry is at breaking point, so any progress, however late, has to be welcomed. But every local professional network I have met has stressed the need for fundamental reform of the dental contract so that things can get done. Given that this Tory Government have been in place for 14 years, why will the Minister not commit herself to finally reforming the contract and providing the boost to dentistry that my constituents so desperately want to see?
Victoria Atkins
I think it is very courageous of any Labour Member of Parliament to talk about education, because we know just how dire the education results are in Labour-run Wales. Yes, I have committed to reform of the dental contract, and we will deliver these services immediately because we want to deliver results for the hon. Gentleman’s constituents as well as ours.
Selaine Saxby (North Devon) (Con)
I thank my right hon. Friend for securing this vital plan, and I also thank her team for their ongoing engagement in what has been a difficult issue in my constituency since long before the pandemic. I cannot wait to see a dental van in South Molton and Ilfracombe, and to welcome new dentists to Barnstaple, Braunton and beyond. However, I recognise that this will take time. We have recruitment challenges despite our staggeringly beautiful surf beaches, which extend far beyond my right hon. Friend’s Department. Given her success in securing today’s announcement, might she be able to help me to promote these new dentistry opportunities to attract those who may not have previously considered spectacular, if remote, North Devon to be their future?
Victoria Atkins
My hon. Friend is exactly right. She is a wonderful constituency Member who speaks up for her constituents, and I can assure them that she has been talking to me since the moment I was appointed. As for advertising the new services, this is an opportunity for Members across the House—and I do hope that Opposition Members will be gracious—to ensure that their constituents are aware of them. We all want the best for our constituents, and the more we encourage local dentists to take up the new patient premiums and units of dental activity as well as the golden hellos, the sooner we will all see benefits in our constituencies.
Imran Hussain (Bradford East) (Lab)
For nearly a decade, I have stood in this Chamber and told numerous Ministers that there is more chance of finding gold bricks on the streets of Bradford than there is of getting an NHS dentist when you need one. For 14 years, Ministers have made a political choice to ignore our calls, but now, in a general election year, the Government suddenly want to take part of Labour’s plan and present it as their own—frankly, it is shameless. Will the Minister at least accept that unless there is proper reform, our NHS dentistry will remain rotten to the core?
Victoria Atkins
Again, we have heard a very loud performance from the hon. Gentleman—a typically loud performance. If only it had been as factual as it was loud. I have already set out, in response to the hon. Member for Ilford North (Wes Streeting), the difference between Labour’s plan and our fully funded plan to secure immediate and long-term changes. After 14 years of opposition, is this it?
James Sunderland (Bracknell) (Con)
As the Health Secretary will recall, we met recently to discuss dentistry in Bracknell, so I really welcome the plan that she has announced today. Will she please confirm, for the sake of absolute clarity, that a cornerstone of the recovery plan will be quicker and easier access to NHS dentists, and also that they will be properly incentivised to absorb all the patients who need support?
Victoria Atkins
Indeed, and it was a pleasure to meet my hon. Friend to discuss the issues facing his constituents. I hope he recognises that we will have those aims very much in mind in the delivery of the recovery plan. We will begin to see the roll-out of those 2.5 million more appointments in the coming weeks as the new patient premium takes hold.
Richard Burgon (Leeds East) (Lab)
Last month, Healthwatch Leeds submitted evidence to the Health and Social Care Committee—testimonies from people at the sharp end of the NHS crisis. One said:
“I am really struggling to find an NHS dentist that is accepting new patients at the moment. I am an apprentice and get paid minimum wage and cannot afford a private dentist.”
Others spoke of the way in which, according to Healthwatch Leeds,
“having no access to treatment is impacting on their general well-being and mental health.”
One of them said:
“ I just don’t know what to do, who to turn to, how to get help. I just want to be able to smile again”.
Is it not the case that this Government’s plan is too little too late, and that the queues snaking around dentists’ surgeries are testimony to the failure of 14 years of Conservative government and a deliberate undermining of our valuable public services?
Victoria Atkins
The hon. Gentleman has quoted Healthwatch. I presume that he will also be gracious enough to acknowledge that the move to introduce 15 dental vans has, in fact, been welcomed by Healthwatch.
Bob Seely (Isle of Wight) (Con)
We need more NHS dentistry on the Isle of Wight. I welcome this recovery plan, but can the Secretary of State tell me by when my constituents will see its benefits?
Victoria Atkins
By 1 March, because that is when the new patient premium comes into force. Other aspects will take a little longer, but we are clear about the immediate benefits, and we want to get those out to people as quickly as possible.
Richard Foord (Tiverton and Honiton) (LD)
In Devon and Cornwall last year, 57% of dental surgeries had at least one vacancy. Before 2016, more than 500 dentists registered in the UK had trained in European countries, and they made up a quarter of the workforce. Will the Secretary of State heed the call from the Association of Dental Groups for it to be made easier for qualified European dentists to practise here in the UK?
Victoria Atkins
That is exactly what we are doing, and not just in relation to other European nations but in relation to other countries around the world. We want the General Dental Council to ensure that qualified dentists from overseas are recognised and supported, and get on to our registers as quickly as possible.
Julian Sturdy (York Outer) (Con)
Like many others, I very much welcome the recovery plan, and I thank the Secretary of State for meeting me earlier to discuss the issues that we face in York. However, may I press her on the subject of integrated care boards? Will she ensure that they are held to account? Will they face increased monitoring to ensure that they spend the allocated money on dentistry and on the target areas in the recovery plan, and will that money remain ringfenced?
Victoria Atkins
I well understand why my hon. Friend has asked that question, about a matter that other Members have also raised. We are exploring ways in which we can make the expenditure of the dentistry budget more transparent, because it is right for ICBs to reflect the needs of local residents and deliver the services that should be available under this dental recovery plan.
Tom Hunt (Ipswich) (Con)
I very much welcome these interventions, particularly as I raised a question just a few weeks ago in Prime Minister’s questions about the time period. I am particularly pleased about that. On international dentists, I completely agree with what many colleagues have said. I have a close friend whose husband is Mexican and fully qualified as a dentist. The period between him getting the right to be in the UK and becoming a dentist in the UK is two or three years—it is far too long and there is far too much bureaucracy. I appreciate the announcement on therapists. We have 24 new ones on the new course in Suffolk, but 400 applied so I think there is room for even more therapists to play a key role. Can we also make sure that the consultation period is rapid? This is a common-sense policy and I think we should just get on with it. Finally, will the Secretary of State visit Ipswich to see the new dental centre and hear the case we are making for a dental school? We are the obvious place in the east of England, now that we have a dental centre.
Victoria Atkins
My hon. Friend will appreciate that I get a lot of invitations, but I will do everything I can to meet him. His passion and ambition for his local area shine through, and not just in the question he asks today but in the question he asked the Prime Minister a few weeks ago. He is absolutely right: we need the General Dental Council to work with us—I think it will—to ensure that we can get more international dentists registered as quickly as possible, for the benefit of our constituents.
Andy Carter (Warrington South) (Con)
I welcome what the Secretary of State has said today. I also pay tribute to the ICB in Cheshire for the work that it has done to make additional appointments available in Warrington, where it has been incredibly difficult to access NHS dentistry despite there being many dentists on the high street, because so many have decided to move away from the NHS. Can she explain how the changes announced today will incentivise dentists to return to providing NHS services, so that constituents in Warrington South can get the NHS appointments they want?
Victoria Atkins
As I have said, dentists are independent contractors but we want to encourage them back into the NHS if they have left it, and we believe that the new patient premium and the work on the UDA are just two of the levers that we can deploy to achieve that. We also have a longer-term vision for our NHS, and through the long-term workforce plan we will be training 40% more dentists by 2031. That is real ambition and a plan for the long-term future of our country.
Anna Firth (Southend West) (Con)
I completely welcome this plan, and particularly my right hon. Friend’s focus on underserved areas and coastal communities. This is something I have raised before in the Chamber. Southend is a coastal city with over 180,000 residents but only three dentists currently accepting NHS patients, so we qualify on both counts. Please could she confirm for Southend and Leigh residents that we will also get either a van or better dental care, preferably within months, not years?
Victoria Atkins
I am delighted to tell my hon. Friend that those dental surgeries already operating under NHS contracts will have the benefit of new patient premiums and the increased rate of UDA. On the dental van, she will appreciate that we are having to apply strict criteria to this, but I am delighted to see how enthusiastic she is about this recovery plan.
Holly Mumby-Croft (Scunthorpe) (Con)
I thank my right hon. Friend for this really welcome plan. Can she give any advice to patients who are registered with an NHS dentist but have not been seen in the last two years? Should they contact the dentist if they want an appointment or should they wait to be contacted? For those who are not registered, where will they find a list of dentists that they can contact to register their interest in becoming a patient?
Victoria Atkins
I thank my hon. Friend and fellow greater Lincolnshire MP for her question. In terms of the mechanics of this being delivered, the new patient premiums will come into force and patients can already look at the NHS website to see which practices have places available in their area. They can go there; they do not need to have had an existing relationship with that dental practice. We will also be setting out for constituents and Members of Parliament how, once the new premium comes in, people can get in contact and get the appointments we all want them to get.
Ben Everitt (Milton Keynes North) (Con)
More dentists, more appointments, more incentives for NHS work and a focus on underserved areas—this is exactly what Milton Keynes needs. I would like to thank the Secretary of State and, in particular, her dental Minister and my constituency neighbour, my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), for all the work they have done, and in particular for listening to me banging on about dentistry in Milton Keynes for so long. I seek just one more clarification, please. Will the mobile dentist vans be serving hard-to-reach rural areas, such as my beautiful market towns and villages in Milton Keynes North?
Victoria Atkins
I join my hon. Friend in his praise for our right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom). As I say, we are having to apply strict criteria to the dental vans. We want to get them out as quickly as possible to the most underserved areas, but we do not want dental vans to be the limit of our ambitions. The idea behind them is very much to revitalise those parts of the country that do not have NHS dental practices within a reasonable distance, and we are convinced that dental vans are just one of the levers by which we will achieve that.
Matt Vickers (Stockton South) (Con)
As my right hon. Friend knows, I am extremely concerned about access to dentistry for residents in Stockton South, so I hugely welcome this unprecedented investment and the places it will create locally. Can she confirm that the Government are committed to tackling the situation as quickly as possible and also for the long-term, and that they will continue to consult on broader workforce and contract reform?
Victoria Atkins
I am delighted to confirm that. We have wanted to deal with the issues as quickly as we can, but also with an eye to the future. This is the way in which the Government set out our plans for the NHS and for our social care system. I am confident, for example, about the introduction of golden hellos for new dentists. We know that that works with GPs and we now want to try it with dentists to see whether we can get dentists into those areas that do not have the service they need at the moment.
James Wild (North West Norfolk) (Con)
According to the National Audit Office, North West Norfolk has one of the lowest numbers of dentists per population. Can my right hon. Friend confirm that my constituents will benefit from the £20,000 incentives and from the mobile dental vans? On training, will she look closely at the proposal from the University of East Anglia for a dental training school? That is the obvious place to have it in the east of England.
Victoria Atkins
My hon. Friend will not be surprised to learn that I have received rather a lot of lobbying about the location of future dental schools. He will see in the plan that we are very open to the idea of training people with a view to their remaining in those areas. This is where golden hellos come in, and they will most definitely apply in the hardest-to-reach and underserved areas. As I say, we are taking very careful criteria-driven decisions about where the dental vans will be supplied, but we understand the problem that Norfolk has.
Andrew Jones (Harrogate and Knaresborough) (Con)
I welcome the statement and also thank my right hon. Friend for meeting me recently to discuss dental care in Harrogate and Knaresborough, where we have recently seen two practices hand back their NHS contracts, causing significant patient concern. I was pleased to hear her comments earlier about the retention of dentists within the NHS. Does she agree that good oral health is a critical part of good overall health, that establishing best practice early in life is essential and that that involves the very earliest years and supporting parents?
Victoria Atkins
Very much so. The truth is that teeth appear long before reception class, and this is why we want to focus not just on babies and toddlers in early years settings but, importantly, on pregnant mums because their oral health while pregnant can have ramifications for their baby. The dental recovery plan is seeking to address this through a long-term sweep from the very beginning of life to adulthood, with 2.5 million more appointments and a long-term plan for NHS dentistry in our country.
Madam Deputy Speaker (Dame Eleanor Laing)
I thank the Secretary of State for answering for more than an hour. We will now proceed, but first I will take points of order.
Points of Order
(9 months, 2 weeks ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate
Matt Rodda (Reading East) (Lab)
On a point of order, Madam Deputy Speaker. Earlier this week, the Government published a written statement as a response to the consultation on their White Paper on artificial intelligence. However, this statement was very limited in detail. This is in stark contrast to both the US and the EU, both of which have set out clear responses to the challenges and opportunities of AI. The Government’s written response failed to set out the full scale of opportunities to use AI in areas such as medicine, and failed to tackle concerns about safety such as those raised recently about deepfakes. Can you advise me on how I and other Members can ask Ministers to explain this very limited response, and on what opportunities there might be for us to raise this matter in the House?
Madam Deputy Speaker (Dame Eleanor Laing)
Yes, I can advise the hon. Gentleman, but he does not have to raise the matter with the occupant of the Chair to get that advice. We have excellent Clerks in the Table Office, the Journal Office, et cetera, who would happily give him that advice. He can submit a request for an urgent question, he can apply for an Adjournment debate or he can table a question to the relevant Minister, and I am quite sure he will get further answers to his questions.
Tim Loughton (East Worthing and Shoreham) (Con)
On a point of order, Madam Deputy Speaker. During Prime Minister’s Question Time there was a distinct sense of déjà vu when the hon. Member for St Albans (Daisy Cooper), whom I have notified of this point of order, asked a question about Eastbourne District General Hospital, which is nowhere near her constituency and is rather closer to mine. It repeated an attack on the hospital by her leader, the right hon. Member for Kingston and Surbiton (Ed Davey), last year, when I gather that he was forced to apologise to the House for misinformation—something that we do not often hear from him.
The hon. Member for St Albans claimed—the claim was also put out by the Liberal Democrat candidate who was recently on the same BBC programme as me and, again, it had to be put right—that the paediatric department at Eastbourne District General Hospital is being downgraded. This has led to many concerned constituents of my hon. Friend the Member for Eastbourne (Caroline Ansell), who cannot be here today because she is ill, fearing that paediatrics is being closed at Eastbourne District General Hospital and that patients would have to go a long way to Conquest Hospital.
None of that is remotely true. There will be no closure. What is happening is that two paediatric departments are being merged on the same site at Eastbourne District General Hospital, and children will receive urgent care under specialist paediatric nurses for seven days a week, which they do not get now. This is a scare story, and it seems to be the subject of serial scare stories from the Liberal Democrats. This is really frightening for people and families living in that constituency.
Madam Deputy Speaker, how can that correction be put on the record? Will the hon. Member for St Albans take this opportunity to withdraw her entirely inaccurate charges?
Madam Deputy Speaker
I thank the hon. Gentleman for his point of order. Of course, it is not for the occupant of the Chair to adjudicate on what is accurate and what is not accurate, but he has made a very serious point. I remind hon. Members that they ought to be very careful in what they say in this House because of the wide-reaching ramifications of any description they make of local events.
Daisy Cooper (St Albans) (LD)
Further to that point of order, Madam Deputy Speaker. I am grateful for the opportunity to respond to the hon. Member for East Worthing and Shoreham (Tim Loughton). He will be acutely aware that I am the health and social care spokesperson for the Liberal Democrats, and that I have raised questions about hospitals across the country 16, 17 or possibly even 18 times. My concern is about the NHS and hospital services more broadly.
I am sure the hon. Gentleman will also be aware that, at a hearing of the relevant county council’s health overview and scrutiny committee in December, the local trust was quoted as saying:
“We are substituting a consultant for an Advanced Nurse Practitioner. It might be that the ANP takes a more cautious approach and sends more children over to Hastings than a senior consultant.”
If there were no reason for concern, why did the cross-party health overview and scrutiny committee vote unanimously for a pause? If there were nothing to worry about, why has the hon. Member for Eastbourne (Caroline Ansell) followed the lead of campaigners by also calling for a call-in? It seems to me that local residents have concerns, and they want those concerns to be heard in this Chamber.
Madam Deputy Speaker
I thank the hon. Lady for responding to the point of order of the hon. Member for East Worthing and Shoreham (Tim Loughton). As I said earlier, it is not for the occupant of the Chair to adjudicate between different interpretations of fact. I am grateful to the hon. Lady for taking the opportunity to put her point to the House, and I quite understand the point made by the hon. Gentleman. I am sure there will be further opportunities, hopefully in the near future, for them to discuss this matter reasonably on the Floor of the House. I reiterate that it is very important that facts presented in the Chamber are accurate.
Hannah Bardell (Livingston) (SNP)
On a point of order, Madam Deputy Speaker. During Prime Minister’s questions, I was horrified to hear the Prime Minister, in LGBT History Month and on a day when Brianna Ghey’s mother was in Parliament, make a transphobic joke in the Chamber. As elected representatives, we come to this place to improve the condition of others, do we not? At a time when the trans community is facing unprecedented attacks from people in this place, from people in the other place and from the media, it is incumbent on us all to reflect on our language, on how we approach these issues and on how we talk about the trans and non-binary community.
Madam Deputy Speaker, can you guide us on how we can ensure that the Prime Minister apologises? He was given an opportunity towards the end of Prime Minister’s questions, and he refused. Can you use your good offices to encourage him to take the opportunity to come back to the Chamber to apologise for those remarks and to remove them from the record? I do not believe his remarks reflect the views of the majority of people in this Chamber who want to respect the trans and non-binary community, and who want to make it better and easier for them to live their lives in safety instead of what is increasingly becoming a hostile environment.
Madam Deputy Speaker
I appreciate the hon. Lady’s point, but it is often necessary for Mr Speaker or the Deputy Speakers to say that points of order are not designed to continue the arguments of Prime Minister’s questions. The Prime Minister, the Leader of the Opposition and, indeed, all Members are here for the time that the Prime Minister is here, and very often—indeed, almost always—Opposition Members will disagree with what the Prime Minister says. It is not for me to adjudicate, nor indeed to require him to say anything different.
I will say, however, that the hon. Lady touches on a very sensitive subject, and I understand that the mother of the tragically murdered teenager Brianna Ghey was present this afternoon. I reiterate, as I believe the Prime Minister did from what I heard at the end of Prime Minister’s questions, the enormous sympathy that everyone in this House has—[Interruption.] Could the hon. Member for Glasgow Central (Alison Thewliss) just let me finish, please.
It is not for me to comment on what the Prime Minister said or did not say. On behalf of the whole House, I reiterate our enormous sympathy and, indeed, admiration for Brianna Ghey’s mother on the way in which she has conducted her public profile during this tragic time for her and her family. The House ought to show sympathy and understanding when a tragedy occurs, rather than always making political points.
State Pension Age (Compensation)
Wednesday 7th February 2024
(9 months, 2 weeks ago)
Commons ChamberRead Full debate State Pension Age (Compensation) Bill 2023-24 View all State Pension Age (Compensation) Bill 2023-24 Debates Read Hansard Text
A Ten Minute Rule Bill is a First Reading of a Private Members Bill, but with the sponsor permitted to make a ten minute speech outlining the reasons for the proposed legislation.
There is little chance of the Bill proceeding further unless there is unanimous consent for the Bill or the Government elects to support the Bill directly.
For more information see: Ten Minute Bills
This information is provided by Parallel Parliament and does not comprise part of the offical record
Alan Brown (Kilmarnock and Loudoun) (SNP)
I beg to move,
That leave be given to bring in a Bill to require the Secretary of State to publish proposals for a compensation scheme for women born between 6th April 1950 and 5th April 1960 inclusive who have been affected by increases in the state pension age; and for connected purposes.
Like so many injustices created by Westminster, the lack of resolution for the 3.8 million WASPI—Women Against State Pension Inequality Campaign—women is a disgrace. Those 3.8 million women were given the bombshell that their state pension age was going to increase from 60 to 66 just as they were about to retire and it was too late to do any proper financial planning. Many were already in ill health or worse, and others had taken early retirement and were planning to get by until age 60, when they thought they would receive their state pension.
For nine years, this place has debated the matter, hearing harrowing individual stories, with many MPs, from across the Chamber, pledging they would do all they could to help those women. But for nine years the Government have ignored the plight of those women. They hoped the WASPI women would go away, but they have not, although, unfortunately, 40,000 are dying each year without getting any form of compensation, with some 240,000 having already, tragically, passed away without receiving compensation.
For those now trying to make the best of their retirement, while facing a cost of living crisis, polling has established that half of WASPI women have struggled to pay essential bills in the past six months and, worse, a quarter have struggled to buy food. We know that this is an injustice; indeed, the Parliamentary and Health Service Ombudsman judged as far back as July 2021 that the Department for Work and Pensions was guilty of maladministration due to lack of direct communication. Yet here we are, still fighting for compensation.
The majority of the Tory Back Benchers who previously were very vocal in supporting WASPI women, including the leader of the Tories in Scotland, have all gone quiet, as has the Labour party. Astonishingly, the best I can find from the current Labour leader is:
“We’ve met many of these women and campaigners. And our hearts go out to them…It’s a huge injustice.”
He also said he would need to hear the outcome of the court case he believed was ongoing—that was back in April 2023. Just saying
“our hearts go out to them”
is as bad as saying nothing. It is completely vacuous, and there has been silence in the 10 months since, when the court case had already concluded.
I urge the leader of the Labour party: instead of letting the Tories move his political dial and political compass, find a moral backbone and make a commitment that if this fag-end Tory Government will not deliver some form of compensation, a future Labour Government will. Having said that, given that the current Labour shadow Work and Pensions Secretary has never uttered the words “WASPI” or “1950s women” in Parliament, and neither has Labour’s Women and Equalities spokesperson, I do not see much pressure being put on the Labour leader from within his shadow Cabinet. This is a shocking dereliction of duty from what is supposed to be the main Opposition party at Westminster.
It is not just the main parties here at Westminster letting down the WASPI women; the ombudsman has taken way too long and is still dragging its feet, having given the women hope and dashed it time and again. It is hard to believe that in the almost three years since the maladministration assessment, a solution is still to be recommended by the ombudsman. It is a scandal in itself that the WASPI women had to go to court to confirm the flaws in the second ombudsman report. This process should have been closed out a long time ago, and I know from dealing with constituents affected by this that they find this dragging out of the process stressful and frustrating, and is rubbing salt in their wounds. As we head towards another general election, it helps the Government hide behind the myth that they cannot do anything until the PHSO concludes.
We also know that when the PHSO does conclude, the DWP still will not admit its failure to communicate adequately and its maladministration, so parliamentary intervention will probably be required to force the Government’s hand. The purpose of this Bill is to bring forward parliamentary intervention to stop those affected women having to wait any longer. Fair and fast compensation is the simple scheme that the WASPI women are looking for, using, as a minimum, level 5 of the ombudsman scale—realistically, however, level 6 of the PHSO bandings is the most appropriate—and this Bill could deliver a simple framework.
We are talking about a practical resolution, one that does not result in astronomical sums per person. It is not asking for a reversal of pension age to 60, and it is not a full restitution of pensions for those affected by the maladministration—no matter how nice an outcome that would be. The WASPI women understand there is no blank cheque from the Treasury; they are practical and they want to get on. That said, we cannot lose sight of the fact that the UK Government have saved £200 billion from the decision to equalise the state pension age at 66.
If we look at funding in the round, changing non-dom tax status could bring in £3.6 billion a year to the Treasury, and changing the capital gains rate to that of income tax could bring in a further £10 billion to £15 billion a year. Two simple tax changes would easily pay for compensation in a couple of years and create long-term additional income for the Treasury. If the Government properly tackled the personal protective equipment and covid support frauds, they could bring in even more money to pay out. There has never been a VIP lane for the WASPI women, and no Minister has ever agreed to meet them. Can the difference in attitudes be any starker?
Is that because Ministers do not want to hear the real stories of constituents? My constituent Ann contracted viral meningitis at age 59 and a half. Following consultant advice, she opted to stop working and gave her three months’ notice, in order to retire at 60. Literally days before her retirement date, she got the news that she would not get her state pension until age 66. She was too old-school to try to change her agreement and go for ill health retiral, which would have been the most appropriate outcome, so she endured six years without employment or pension, and the associated stress of that impacted on her health recovery.
My constituent Marie’s husband got cancer and had to stop working when she was aged 59. She was forced to work on for another seven years, doing work that required physical effort while doing caring duties, in order to survive financially.
My constituent Mary went part-time at age 55, due to health conditions, and then got the pension age increase bombshell at aged 59 and two months. That forced her to work on for several years, even while having cancer treatment in her 60s.
My constituent Pamela was given the news at age 60, just as she retired. She could not get back into the workforce and suffered ill health. She was forced to downsize her property twice, and she still has a financial hangover.
My constituent Violet was widowed at age 53. She had been working since the age of 15 and had been paying national insurance contributions for 45 years, but was forced to wait another six years due to that lack of notification.
My constituent Lynn was exhausted after working for 34 years in the NHS and agreed early retirement at 55. However, she found out on her very last day at work that it would be 11 years before she got her state pension, not the five she anticipated.
My constituent Nancy was widowed at 54, while she was working part-time. This was traumatic emotionally and then financially. She suffered umpteen chronic health conditions, while caring for parents and still being forced to continue taking NHS bank work to survive.
My constituent Lesley was sometimes working three jobs to make ends meet and put money away for the future. She was the carer for her partner when he had cancer and for her dad when he had cancer. She then had a period of travelling to Southampton every weekend to visit her aunt. Her superwoman efforts would exhaust anyone, and it is little wonder that she took early retirement at age 56, only later to discover she would have to get by for a further six years before getting her pension.
I have countless examples of constituents who would have put more into private pensions and who would have topped up NI contributions. I have examples of those who have had to use their savings, who have missed out on holidays and who have generally struggled to get by because of that lack of notification. Let us not forget that many of these women are well-qualified. They are intelligent, yet they are made to feel that it is somehow their fault that they did not know. The DWP’s denials make it worse for these women.
Westminster needs to make amends for its mistakes. Let me give a reminder, however, of how it operates: the miners’ strike miscarriages of justice, the Hillsborough cover-up, the infected blood scandal going back to the late 1970s, and the ongoing sub-postmaster scandal. Those are all issues that the three UK-wide parties have been complicit in at some point or another. It seems this place never learns.
However, on a positive note, I am grateful for the cross-party support for this Bill. I pay tribute to the tireless campaigning of the WASPI women, particularly locally, including Ann Hamell, who first brought this matter to my attention and has kept fighting for justice since. By sticking together, we will get some form of compensation. Even that will not undo the wrongs, and the emotional and financial distress for the women, but it will finally be an admission of guilt and a small financial redress that can bring some relief to women who were prejudiced against in terms of work pay and pension pots, and then prejudiced against in retirement since.
Question put and agreed to.
Ordered,
That Alan Brown, Steven Bonnar, Patricia Gibson, Jim Shannon, Marion Fellows, Grahame Morris, Amy Callaghan, Colum Eastwood, Peter Aldous, Wendy Chamberlain, Gavin Newlands and Chris Stephens present the Bill.
Alan Brown accordingly presented the Bill.
Bill read the First time; to be read a Second time on Friday 19 April, and to be printed (Bill 164).
Police Grant Report
(9 months, 2 weeks ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
The Minister for Crime, Policing and Fire (Chris Philp)
I beg to move,
That the Police Grant Report (England and Wales) 2024-25 (HC 482), which was laid before this House on 31 January, be approved.
Police officers, police community support officers, special constables and police staff up and down the country do great work every single day of the week, keeping us and our constituents safe, very often putting themselves in the line of danger to protect the public. I am sure Members across the House will want to pay tribute to those officers and staff, and thank them for the work they do. The vast majority of officers are decent, hard-working and brave, and we owe them a great deal.
The police look after and support us; it is important that we support and look after them in return. The funding settlement that we present to Parliament today does that. We are increasing the funding available for policing by £843 million compared with last year. Last year’s funding had already been increased by £330 million, accounting for the police pay settlement, effective from 1 September, so next year’s envelope in total will be £18.4 billion.
Within that, we are prioritising the frontline. We are getting more money than ever before into the hands of police and crime commissioners, who spend money on frontline policing. Presuming they use their precept flexibility, which I think they will, police and crime commissioners will receive an extra £922 million next year, which is a cash increase of 6% compared with the previous year.
Several hon. Members rose—
Andrew Selous (South West Bedfordshire) (Con)
I thank the Minister for Policing for those increases he mentions and for his help on section 59 of the Police Reform Act 2002 and dealing with illegal motorcycles in my area. The issue is that Bedfordshire police survives on a series of top-up grants because the national funding formula is not very fair to us. Does the Minister foresee a time when we can get rid of those grants and have our core funding baked into our core funding, so we do not rely on special grants?
Chris Philp
My hon. Friend campaigns tirelessly for Bedfordshire policing and to combat the scourge of antisocial motorcycle use. I believe we will shortly be organising a meeting to discuss that issue. He is right that Bedfordshire receives special grant support in order to fund its activity, particularly in relation to gang violence in certain urban parts of the county, but he is also right that we need to change the underlying funding formula because it is over 10 years out of date. It needs to better reflect population changes and changes in crime, and better reflect issues of sparsity and rurality. The Home Office is actively working on that.
Several hon. Members rose—
Sir John Hayes (South Holland and The Deepings) (Con)
I am grateful to my right hon. Friend for the very good meeting he had with Lincolnshire MPs yesterday. As he is an outstanding Minister, he will appreciate that Lincolnshire, even taking account of the extra money, is the worst funded authority in the country, with the lowest staffing level, and faces particular challenges because of its sparsity. Delivering any public service, including policing, over a sparsely populated area is a challenge. So, will he take a close look at what extra he can do in anticipation of the much-needed change to the funding formula, which he is advocating today?
Chris Philp
I met my right hon. Friend yesterday evening and he made a powerful case on Lincolnshire police, and for updating the funding formula, as we have discussed. He also made the case on Lincolnshire’s needs over the coming financial year, which I undertook to go away and look at. As he says, the issues of sparsity and rurality that affect Lincolnshire, as well as other counties, need to be properly accounted for. He spoke extremely powerfully and compellingly in our meeting yesterday.
Imran Hussain (Bradford East) (Lab)
The funding picture that the Minister paints is not entirely accurate. In West Yorkshire, direct funding from Ministers fell by £25 million between 2015-16 and 2019-20. What is more, the cumulative total of Government funding cut from West Yorkshire police since 2015-16 is more than £100 million. Once the figures that the Minister is announcing are compared to that cumulative amount, it will surely change things, and the picture will not look as rosy.
Chris Philp
On longer-term funding trends, the total cash funding for police in 2010-11 was about £13.1 billion. As I set out, it is now £18.4 billion, so it is £5.3 billion higher in cash terms. It has essentially kept pace with inflation, although crime is lower. He mentions West Yorkshire; the central Government grant for West Yorkshire in the financial year 2023-24, with the extra money for pay that I mentioned, is £415 million. Next year, the Government grant for West Yorkshire will go up by about £31 million, which is well above inflation, to £446 million. If we add in the police precept, which may go up a little bit as well, West Yorkshire’s funding next year will be 7.1% higher. If we look at policing as a whole, frontline policing will be up by 6% next year.
Sir Desmond Swayne (New Forest West) (Con)
Can I ask the Minister about the precept?
Chris Philp
In just a moment. Overall, next year, police funding will be up 6% on this year for frontline forces. Inflation is currently only 4% and is forecast to fall further.
Jonathan Edwards (Carmarthen East and Dinefwr) (Ind)
Further to the intervention by the hon. Member for Bradford East (Imran Hussain), is it not the reality that the contribution of the police precept to the overall cost of policing has increased substantially? In the case of Dyfed-Powys police, the precept was 37% of total funding in 2010-11, but this year it is 54.4%, so the burden is being pushed on to local taxpayers via the precept.
Chris Philp
Overall, across England and Wales, around two thirds of the total funding comes from central Government. As the hon. Gentleman says, that varies by police force, but on Dyfed-Powys police, the Government grant is going up next year by £6 million, which is nearly 10%, whereas the precept component is only going up by about £3 million. The Government grant for Dyfed-Powys will go up by double the amount of the precept increase. I say again that frontline police forces next year will have a funding increase of 6%, at a time when inflation is only 4% and falling.
Sir Desmond Swayne
Donna Jones, the police and crime commissioner for Hampshire and the Isle of Wight, has launched a consultation. My view is that if constituents attach great importance to policing—certainly, my correspondence tells me that they do—then they will be prepared to pay for it.
Chris Philp
My right hon. Friend is quite right. Of course, all policing, whether funded from central Government or via the precept, is ultimately paid for by taxpayers. In the most recent spending review a few years ago, the precept limit was set at £10—that is, English forces could put up the precept by only £10. We have given more flexibility—this year it is £15, and next year it will be £13—so that PCCs can decide to increase the precept by a bit more if they choose to, which is their democratic right.
Justin Madders (Ellesmere Port and Neston) (Lab)
On the issue of police and crime commissioners, I do not know whether the Minister is aware of the appalling comments made by the Cheshire police and crime commissioner about schoolgirls wearing very short skirts. This raises huge questions about whether victims can have confidence in the justice system in Cheshire. Will he take the opportunity to distance himself from those comments and join us in calling on the PCC to resign?
Chris Philp
I am afraid that I have not seen those comments, so it would not be right for me to remark on them, but I will say that the Government are completely committed to combating violence against women and girls, to increasing rape prosecutions and to increasing prosecutions for serious sexual assaults. The Under-Secretary of State for the Home Department, my hon. Friend the Member for Newbury (Laura Farris) and I had a meeting with policing leaders on that very topic just in the past few days, and those are actions to which we are committed.
In addition to the substantial funding increase of £922 million—nearly £1 billion—for frontline policing, an above inflation increase of 6% has been announced today. We have of course increased total police expenditure by about £2.7 billion since 2019, which has funded the police uplift programme. It is worth reiterating that in March last year, we exceeded our target, delivering 149,566 officers—about 3,500 more than we have seen at any time in the history of policing in England and Wales. That is an important commitment, and our intention is to maintain those officer numbers going forward. We have constructed the police uplift ringfence and the financial arrangements for this coming financial year to enable police forces around the country to maintain those higher officer numbers.
Jane Hunt (Loughborough) (Con)
As the Minister said, police forces across the country do some great work. That applies to Leicestershire police, particularly those in Loughborough who have to deal with county lines. Many of the new officers are based in Loughborough and are doing an excellent job. The increase in the precept is also excellent and very welcome in Leicestershire, but can we do more—that is, not just increase the value of the precept, but ensure that what police are asked to do is more efficient? Redaction is one example. Police should not have to redact evidence when 25% of cases that go to the Crime Prosecution Service are not taken further forward.
Chris Philp
My hon. Friend raises an important point. The issue is not just about providing more resources, but making sure that the police can operate efficiently. For example, we are rolling out the “Right Care, Right Person” initiative, which started in Humberside, to make sure that when a mental health case is purely medical, and there is no threat to public safety and no criminality, it is handled medically by the health service. Implementing that across the country will save about 1 million hours a year of police time.
There are other administrative changes that we can make, and the redaction issue is one of them. I discussed that with the new Director of Public Prosecutions, Stephen Parkinson, earlier this week, and I will discuss it with him again in March. Changing the rules around redaction will save very many hours of police time. There are also technology solutions that will help, not just in those 25% of cases in which the CPS decides not to charge, but in the 75% of cases in which it does charge. Automated redaction tools driven by artificial intelligence will save many tens of thousands—probably hundreds of thousands—of hours of police time. I am encouraging police forces up and down the country to adopt that technology to save a huge amount of time.
Before the intervention, I was saying that record police officer numbers and record funding are all well and good, but what the public want is results. As the Office for National Statistics has told us, the only reliable source of long-term trend data for high-volume crimes is the crime survey for England and Wales. That shows that overall crime, excluding fraud and computer misuse, which only came into the figures recently, went down from 9.5 million offences in the last year of the previous Labour Government to 4.3 million in the past year—a 55% reduction. Violent crimes went down from 1.8 million offences under the last Labour Government to just 900,000—a 51% reduction. Theft is down from about 5 million offences to 2.7 million—a 46% reduction. Robbery is down 74%, theft from the person down 40%, domestic burglary down 56%, vehicle-related theft down 39%, criminal damage down 72%, and even bicycle theft is down under this Government. The plan is working; let us not go back to square one.
As for homicide, the most serious crime of all, in the last year of the last Labour Government, there were 620 homicides. We have managed to get that down to 591. Every one of those crimes is a tragedy; every one of them is one too many. None the less, I am sure that all of us can welcome that reduction in homicide—
Chris Philp
—and I am sure that the hon. Member for Reading East (Matt Rodda) is about to join me in doing just that.
Matt Rodda
May I offer my support to our local police and say what a wonderful service they provide to our community? I was curious about what the Minister said about bureaucracy. It appears that what the Government have actually done in the past 14 years is cut police numbers very substantially and then replace some of those police officers with new officers who need to be trained. What proportion of those new officers are still undergoing some form of training or receiving support?
Chris Philp
To be clear, there was a reduction in police officer numbers in the coalition years—the years immediately after 2010—owing to the appalling financial conditions that we inherited. However, those police officers have been more than replaced. The total number of officers in England and Wales last year was about 3,500 higher than it was in 2010. It is therefore true to say that many officers have joined relatively recently, which means that there is a training and supervision job to do—and police forces are doing it. Retention rates are quite high. The staff survey shows quite high satisfaction rates, so with each month that passes since the influx of the past three or four years, those officers become more experienced. That will benefit our constituents and make sure that the trend of falling crime continues.
We are taking action on drugs, having closed down more than 2,000 county lines since April 2022. We are also tackling knife crime, which we discussed extensively yesterday. We are removing more than 130,000 knives through stop and search, which is important. We need to use stop and search and surrender programmes with confidence. We are investing in violence reduction units, and today we renew our commitment to funding those units and doing prevention work. We renew our commitment to hotspot patrolling against serious violence, knife crime and antisocial behaviour.
This funding settlement includes £66 million of extra money that will go to every single police force in the country for hotspot patrolling in areas where antisocial behaviour and serious violence are a problem. Where we have trialled that—for example, we trialled antisocial behaviour hotspot patrolling in parts of Essex, and serious violence patrolling in places such as Brighton—we have seen a reduction of approximately 30% in antisocial behaviour and crimes such as robbery. We know that it works. From April this year, every single police force will get that funding. I urge Members from all parts of the House to talk to their local PCCs and make sure that those hotspot patrols take place in town centres, on high streets, or wherever else, so that the public can see that the issue is being dealt with.
Holly Lynch (Halifax) (Lab)
I am grateful to the Minister for giving way.
During the years of austerity, which hit our police forces hard, we lost 21,000 police officers. He has talked about the uplift in numbers since then, but over the same period, police stations across the UK closed at the rate of one a week, which resulted in four in 10 police stations being closed during that period. What is his plan to reopen those police stations in the heart of our communities? That will be needed if communities are truly to take back some of the streets that have had massive problems with antisocial behaviour.
Chris Philp
It is up to police and crime commissioners how to spend the money in this record funding settlement. Some police forces are being creative by, for example, co-locating with fire stations. Good police and crime commissioners avoided closing police stations. For example, the former Conservative Mayor of London, Boris Johnson, managed to largely avoid police station closures—closures that his predecessor, Ken Livingstone, had planned, and that his successor, Sadiq Khan, has in some cases carried out, or at least threatened to carry out. In the west midlands, the current Labour police and crime commissioner, Simon Foster, is planning to close 20 police stations. There are ways of avoiding that by better managing the budgets. There is a record funding settlement here. These are choices made locally, and they are often avoidable.
We are also providing £1 billion for national policing priorities and capabilities, including various forms of technology, new national databases and so on. It is important that we continue to use technology to innovate. That includes investing heavily in such things as robotic process automation, which saves a lot of manual work. I mentioned automated redaction tools. Facial recognition can be used retrospectively, to identify suspects who have committed an offence and whose picture has been caught by CCTV, and used live, to spot people who are wanted by police, for example when they walk down a high street or through a train station.
In recent weeks, we have been deploying live facial recognition technology in my south London borough of Croydon. People who were wanted for rape, grievous bodily harm, drug offences, or failing to attend court have been caught wandering down the street. Our local superintendent thinks that, over about 10 deployments on Tuesday and Thursday afternoons in central Croydon between December and January, the police will end up arresting about 100 people who are wanted for really serious offences or did not turn up at court. Those people would otherwise never have been arrested. Again, Members should ask their local PCC and chief constable what they are doing with retrospective and live facial recognition. Those technologies can catch dangerous criminals who would otherwise go undetected. It is a really important area.
We continue to invest in various crime programmes. I mentioned violence reduction units and hotspot patrolling. Project ADDER—addiction, diversion, disruption, enforcement and recovery—continues, dealing with drugs, and the safer streets fund continues as well. We also continue to fund counter-terrorism policing at around £1 billion per year, in addition to our support for ROCUs—regional organised crime units—of around £25 million per year. This is record police funding. It is going up by more than inflation as far as police and crime commissioners are concerned. We hit record police numbers last year. Crime overall is 56% lower than in 2010, and is continuing to fall. There is, of course, more work to do, but we are here to fund and back the police, and to keep our constituents safe. That is what this financial settlement does.
Alex Norris (Nottingham North) (Lab/Co-op)
Our thanks go to police officers, police community support officers and police staff across the country for their work. It can be dangerous, but it is always important. Our communities value it greatly, and it is essential to British life. We are grateful and lucky to have them. I also thank police and crime commissioners. They are 85 days away from the next set of PCC elections. Some will not stand again, some might not be returned, and some will be re-elected. Again, our thanks go to them all for doing a very difficult job, often across huge geographies, representing and stepping up for their communities. As I said, we are lucky to have them.
Police forces across England and Wales are still living with the impact of 14 years of failure by the Government. Rates of serious violence are up, and charge rates are plummeting. I am amazed by what the Minister said about morale among rank and file officers, which we know is at low levels. The loss of staff has been significant in the last year, and it is very strange to hear that that is not a problem. We know that chief constables and police and crime commissioners are grappling with limited resources and trying to deal with the crisis in public confidence, which is frankly disconnected from what the Minister just said. All the while, the real, everyday problems that our constituents see in their communities are getting worse, not better.
We have witnessed a collapse in neighbourhood policing in recent years, with 10,000 fewer officers on the beat. Police forces are still reeling from the years of experience and expertise that were lost when the Government cut police officers by 20,000. Of the new recruits brought in when the Government realised that grave error, an estimated 6,000 officers are not on frontline duty but are instead covering roles that are traditionally done by vital civilian staff. Is it any wonder that 50% of people say that they no longer ever see police on the streets? I ask colleagues whose case better marries up with what their constituents say: the Minister’s or mine. I know the answer.
Imran Hussain
My hon. Friend is making an excellent case. He is right that during the last decade, due to austerity, there have been substantial cuts to neighbourhood policing. In West Yorkshire, we have lost 1,000 neighbourhood police officers. Does he agree that neighbourhood policing is the essential link between the police and our communities? Not only does it increase confidence in policing but it makes the role much easier by preventing antisocial behaviour and in many other ways, because of the bond between the community and the police.
Alex Norris
My hon. Friend makes an important point, and I absolutely share his view. Neighbourhood policing is the bedrock of policing. A lot of the problems that we are trying to deal with—I will speak about them in a second—have grown and festered because we have given up on neighbourhood policing for well over a decade and have lost control of our streets. Whether it is antisocial behaviour, shoplifting on high streets, the epidemic level of violence and abuse against our retail workers, communities where there is drug dealing in broad daylight, or the horrific levels of knife crime—up 77% since 2015—the experience of our constituents under this Government is that criminals get let off and victims get let down. After 14 years in government—the Minister did not use this in his statistical run-down—over 90% of crimes go unsolved, meaning that criminals are less than half as likely to be caught than they were when the Government took office in 2010. That is the Government’s record on law and order.
The Government and the Minister want us to believe that we have never had it so good, but everywhere we look there are serious problems, which are compounded to a degree by the settlement. This is an unamendable motion about more money for our policing, and of course we will support it, but the detail that sits beneath it deserves serious scrutiny. Colleagues will have seen the dismay across policing at the 6% cash increase, set below the level of the pay award. That is before on-costs, and before inflation. The settlement exacerbates rather than resolves some of the funding challenges. Particularly challenging—the Minister said this himself—is that a third of the settlement is based on the assumption that police and crime commissioners will increase council tax for local ratepayers to the maximum. Yet again we see a shift from central Government funding to local communities for vital everyday services.
As the Minister said, the Government have lifted the cap on the precept so that PCCs can raise it by £13 next year for band D properties. That in itself is a challenge for people’s finances, but it also creates differential challenges across the country, as the money is not then spread equitably. The most deprived areas of our country, which have the fewest higher-banded properties paying higher rates of council tax, get the least return from a local precept. Better-off areas will get more funding because their tax base is higher. That is not levelling up, which I suspect has long since been put in a drawer somewhere, but drives a wedge between different parts of our country when the safety and security of our constituents is at stake. That failure of leadership has consequences for less well-off areas—the parts of the country more likely to suffer from antisocial behaviour, violence, sexual offences or robbery.
Chris Philp
The shadow Minister said that the balance of funding is being shifted on to local areas. To be clear about the facts, the increase in the central Government grant going to police and crime commissioners is just over £600 million. The anticipated increase through the precept is about £300 million. The Government grant increase is about double the precept increase. The central Government finance line is bearing by far the lion’s share of the increase—about two thirds of it, in fact.
Alex Norris
I am grateful for that intervention. I do not think that it is revelatory—indeed, we will decades if not a century and a half’s worth of precedent—that central Government fund policing in this country. What I am saying is that, year on year, the share provided by the local ratepayer is increasing, and this is a continuation of that. It is legitimate to ask whether that is the best funding model. I will get to the funding formula shortly, but, as I say, that differential impact is not a serious way to bring down crime rates across the country.
To add insult to injury, the Minister says in his written statement:
“When setting their budgets, PCCs should be mindful of the cost of living pressures that householders are facing.”
Are the Government for real? Given the Minister’s role in the previous Government, and given the Government’s indifference to the challenges that people across the UK face, that is front beyond imagination. Telling our PCCs that they should be mindful? I say, “Physician, heal thyself.” The public will not be taken for fools by the Government, though. Just as, when they open their mortgage statements, they know what has happened, when they open their council tax bill, it will tell them all they need to know.
I turn now to the funding formula, which other colleagues have raised. Countless Ministers, including this Minister, have stood at the Dispatch Box or answered written questions over the years, pledging to do something about a system that is badly overdue for renewal. Members across the House have been raising this for many years with the Government. In December, the Treasury informed the Public Accounts Committee that a new formula would be introduced as soon as possible. In January, the Minister said, in response to a question from my hon. Friend the Member for Mid Bedfordshire (Alistair Strathern), that he would update the House on work to update the formula
“as soon as I can.”—[Official Report, 15 January 2024; Vol. 743, c. 569.]
Yet, two weeks ago, we saw in the press that the can is to be kicked down the road again, because No. 10 is worried about police funding cuts in a general election year.
Alistair Strathern (Mid Bedfordshire) (Lab)
I start by expressing my thanks for the fantastic work undertaken by local police officers right across Bedfordshire. However, with the Conservatives’ own police and crime commissioner agreeing that the current unfair funding formula leaves no meat on the bone at all for local police, does my hon. Friend agree that it is police officers and local residents who are being let down by inaction on this issue, and that Ministers owe it to them to live up to their previous commitment to ensure that a fair formula is delivered within this Parliament?
Alex Norris
I am grateful for that contribution from my hon. Friend. Yes, I think the public would expect not only that the formulas reflect the need across the country, but that when promises are made repeatedly over multiple years, those promises are kept; even if the upshot was difficult political questions, the Government ought to rise above that. Instead, it just looks as though they are trying to dodge responsibility. I hope the Minister will be clear in his summing-up about the status of that formula. Has No. 10 Downing Street told him to put it on hold? If not, when will it be announced? The public deserve to know.
Jonathan Edwards
May I ask the hon. Gentleman kindly to take a look at the recommendations of the Welsh Government’s own independent commission on the constitutional future of Wales, which reported earlier this month? The commission strongly argued in favour of devolving policing and criminal justice powers to Wales, a position that is supported by the Welsh Government and the current First Minister. That would make a huge difference to funding for policing in Wales, because it would be based on population share and Barnett consequentials of spending in England, unlike the funding formula at present.
Alex Norris
I have had conversations with my colleagues in Wales on that matter. There is something to be said about the funding formula and Barnett—I am not conflating them, but I think that shows how badly broken the formula is. That point is well made and, as I say, I have had conversations with colleagues in Wales about it.
I will move on to the Minister’s priorities, as outlined in the settlement, and the police uplift programme. As I said earlier, 6,000 of the new recruits are not where the public would expect them to be. I have had a front-row seat, over my few months in post, as the Government have gone through all the contortions on this issue. Last autumn, they told us we had record numbers of police on the neighbourhood beat, but that has long since been disproven. Earlier this year, the Minister tried a new tack and said the Government would rebadge response police as neighbourhood police, so they could add those numbers together to would match up with the rhetoric. The public have seen right through that as well.
Last week, the Home Secretary tried another approach, demanding that police chiefs put more officers on the beat as part of his “back to basics” campaign—as if those chiefs were not working in overdrive to do that all the time, all year round. We respect and recognise the huge amount of work they are doing to get police out where communities want them. That is another approach by the Government, and another one that will fail; I was in short trousers the last time they did a “back to basics” campaign, but I do not think it has a very good history and I am not sure it is the right approach for them.
What we see, as always, is denial and deflection; it is always someone else’s fault. Labour has a better plan. Our community policing guarantee would rebuild neighbourhood policing. It would put 13,000 police and police community support officers back on the beat, embedded in our communities; not counting crimes, but solving problems and working with local communities to tackle and deter crime. That would be funded through a police efficiency and collaboration programme, saving £360 million through centralised standard-setting for procurement and increased collaboration on shared services and specialist functions. The Minister said in his statement that he wants to reduce inefficiencies, so that is a two-for-one for him: more efficiency and more officers on the frontline. Why are we not seeing those plans from the Government today?
To conclude, if the Minister expects garlands from colleagues, he will not get them from Labour. He tells the British people repeatedly that they have never had it so good on crime and policing. That rhetoric does not match reality or the public experience. As a result, this settlement is in line with those that preceded it for more than a decade. It will not deliver. The Government are wrong and the public know it. I know that sometimes the public and people in the policing family lose hope; all I would say is that, if we all pull together, we can make sure this is the last police grant settlement that this Government make.
Steve Double (St Austell and Newquay) (Con)
I am delighted to be able to contribute to this debate. In the interests of transparency, let me first make the House aware that an immediate member of my family is a serving police officer with Devon and Cornwall Police—and very proud of them we are. I also put on the record my huge thanks and appreciation to all police officers across Devon and Cornwall, particularly those who work out of St Austell and Newquay police stations. I have seen at first hand their dedication and they have helped me a number of times when I have needed it. They do an incredible job and I am very grateful to them.
I very much welcome the uplift in funding that has been made available to police across England and Wales today, and I am particularly grateful that the funding made available for Devon and Cornwall Police is being increased by 7.1%, which is higher than the national average and goes some way to closing the historical funding gap for our police. We are using that money incredibly well in Devon and Cornwall, particularly in recruiting more police officers.
The number of police officers in Devon and Cornwall is now at an all-time record of 3,610, an uplift of 470 above the 2019 figure. I have also been made aware that, as opposed to some other parts of the country, we have done so well in recruitment that more funding has been made available to enable us to recruit an additional 71 officers, so the number is only going to get higher. That is hugely welcome, and I pay tribute to the hard work of our police and crime commissioner, Alison Hernandez, for the leadership and work that she has put in to get us to such healthy police numbers.
However, one thing that continually concerns me whenever I go out on patrol and observe the police on the frontline is the amount of time they spend dealing with issues that are not policing matters. Far too often they have to pick up the slack for other parts of the public sector that are not stepping up and fulfilling their roles, be that mental health support, other parts of the NHS or social services.
One thing the Minister could do to support our frontline police officers across the country is to work with other parts of the public sector and other Government Departments to ensure that they are doing everything they can to fulfil their duties, and not just taking the default position of falling back on the police to pick up the slack every time. That is one thing that I know is putting huge pressure on frontline policing, taking officers away from the job that the public actually want and expect them to be doing: keeping us safe.
Devon and Cornwall Police actually polices the largest force area, in terms of land mass, of any force in England. We also have the longest coast and the longest road network, at 13,000 miles, of any police force in England. For all those reasons, Devon and Cornwall Police faces a hugely challenging job policing two of the most rural counties in the country. In Cornwall, over 40% of people live in communities of fewer than 3,000 people, and we have no towns with populations above 25,000 people, which demonstrates just how rural and sparsely population our force area is. That has an impact on the police’s ability to deliver the service that we expect of them.
Tourism has an additional impact on Cornwall and Devon. Our average population in the tourist season increases by 7%, although that rise is concentrated in a relatively small number of areas. Towns such as Newquay see their populations go up by six or seven times the resident population in peak tourism season, so the number of incidents to which the police are expected to respond inevitably goes up significantly.
Sally-Ann Hart (Hastings and Rye) (Con)
The situation in Devon and Cornwall is similar to that in Sussex, where an influx of people to Camber Sands can mean that there are 25,000 people on the beach. That obviously makes police resourcing difficult. Does my hon. Friend agree that, when it comes to police funding, we need to consider the geography of the area and the specific and absolute need, not the relative need?
Steve Double
My hon. Friend makes precisely the point that I was about to make. In Devon and Cornwall, our geography and the number of tourists we welcome every year mean that our police force faces a unique challenge in delivering the service that we require of them.
Another point that I continually make is that in Cornwall, a narrow peninsula with only one neighbouring mainland county, we have to build in our own resilience as we cannot rely on other areas to turn up quickly to help us out. That needs to be reflected in the funding formula. I am greatly encouraged that the Government have recognised that and have committed to reviewing the funding formula by taking into consideration geography, sparseness, rurality and the impact of tourism. I urge the Minister to do all he can to get the review carried out and in place in order to adjust the funding.
We will certainly take no lessons from Labour about funding police in rural areas. It was under the last Labour Government that rural areas were virtually abandoned by the funding formula. The formula was tweaked so that all that money would go towards densely populated urban areas, even though delivering services in rural areas costs far more, so we will take no lessons from Labour on that.
I urge the Minister to do all he can to ensure that the police funding review is carried out and implemented as quickly as possible so that the funding gap with which we have had to deal for so long is narrowed, and rural areas such as Devon and Cornwall get the police funding that they rightly deserve.
Several hon. Members rose—
Madam Deputy Speaker (Dame Eleanor Laing)
Order. Before I call the next Member to speak, I should clarify something. As the House will have noted, the Order Paper notes that the police grant report and the local government finance instruments have not yet been considered by the Select Committee on Statutory Instruments. I have now been informed that the Committee met a short time ago. It has considered the instruments and has not drawn them to the attention of the House. To interpret what I have just said for the sake of anyone listening, that means that we can proceed as normal and do not have to take any further steps that we were not already planning to take.
Peter Aldous (Waveney) (Con)
Thank you very much, Madam Deputy Speaker. I am most grateful for that clarification.
I am grateful to my right hon. Friend the Minister for Crime, Policing and Fire for setting out the Government’s proposals for the police funding settlement for 2024-25. Suffolk is due to receive an increase in core funding of 6.7%, and hotspot response finance of £1 million. Those settlements are welcome, but I will briefly raise three issues, two of which have already been addressed in some detail.
The first of those issues is the funding review. At present, Suffolk constabulary is the fourth lowest funded force in the UK, and as such, we are looking for the long-promised funding review to be carried out as soon as possible. Many of the challenges that we face are similar to what we have heard is happening in Cornwall. At Home Office questions on 27 November, I asked my right hon. Friend for an update on the progress of the review. He responded by stating:
“I completely accept the need for a new police funding formula”
and said that his team had been
“working on it extremely hard, with colleagues across government”
and that he hoped
“to have something…to say on the topic shortly”.—[Official Report, 27 November 2023; Vol. 741, c. 545.]
It is in that context that I would be most grateful for a further update on the progress of the review and on when we can expect the draft proposals for the new formula. There is a worry, as we have heard, that the review is being kicked into the long grass. I hope that the Minister can allay that concern in summing up.
Let me come to my second point. For police and crime commissioners such as Tim Passmore in Suffolk, budgeting presents considerable challenges. He and other PCCs are entitled to expect consistency in Government commitments. In that respect, the changes in funding for the safer streets initiative are disappointing. Initially, the Home Office offered Suffolk £1.4 million. It then reduced that by £400,000, and it is now taking away a further £180,000. That approach is, I suggest, unfair, and it penalises smaller forces such as Suffolk constabulary, which, through no fault of its own, now faces a funding gap without any explanation or justification being given. I therefore ask my right hon. Friend to review that decision, which affects not just Suffolk, but forces all across the country.
Finally, as we have heard, this is not just about money. A policeman’s lot can be made considerably easier and, I hope, happier, if red tape is reduced. In that regard, I applaud the work of Ben Hudson, the secretary and treasurer of the Suffolk Police Federation, who is ably supported by my hon. Friend the Member for Loughborough (Jane Hunt) in their campaign to amend the Data Protection Act 2018 so as to mitigate the impact of the bureaucratic burden of evidence redaction that is imposed on police officers when they seek charging decisions from the Crown Prosecution Service. A further amendment to the Data Protection and Digital Information Bill is being tabled in the other place by the noble Baroness Morgan. I urge the Government to consider this matter closely and do all they can to accept those measures. Doing so would free up thousands of policing hours every year, as pre-charge redactions would not be required, and would enable chief constables to better utilise allocated budgets, which, as we have heard today, are restricted and not quite as bountiful as we would all hope.
I hope that, in winding up, the Under-Secretary of State for the Home Department, my hon. Friend the Member for Newbury (Laura Farris), can allay the concerns that I have expressed: we need that long-overdue funding review; we need funding commitments to be adhered to and kept; and finally, as I have said, please, let there be less red tape.
The Parliamentary Under-Secretary of State for the Home Department (Laura Farris)
It is a pleasure to wind up this short but perfectly formed debate on police funding, and I am grateful to the Members who have spoken in it. Before I respond to the points that have been raised, I want to offer my own personal word of thanks and appreciation for the police officers, all the staff and the volunteers who work tirelessly to keep us safe and run towards danger when everybody else is leaving the scene. We are fortunate to have them on our side.
I do not propose to repeat the headline parts of the settlement that we are debating today. I will simply say that our investment of £11.4 billion is a significant commitment to policing, which goes to the heart of our three priorities for the police. The first is personnel: we have delivered ahead of time on our commitment to recruit 20,000 police officers in this Parliament, and today’s funding will continue to support and properly resource the 149,000 police officers who are employed in England and Wales. It will also allow us to give them a 7% pay rise on average, which is consistent with the recommendation of the Police Remuneration Review Body.
The second priority is, of course, public protection. Whether shadow Ministers like it or not, we are proud of the progress that, according to the crime survey for England and Wales, we have made since 2010. I know that they do not like that survey, but the Office for National Statistics—which the public are entitled to rely on—has described it as
“the best estimate of long-term trends in crimes against the household population.”
Shadow Ministers cannot get away from the fact that that survey says that overall crime levels have more than halved since 2010. All offensive weapon crimes have come down by more than 52%, and thefts, including domestic burglaries, have halved—in fact, domestic burglary is now at the lowest level on record.
I listened carefully to the shadow Minister, the hon. Member for Nottingham North (Alex Norris). I say this with respect: he gave three examples of where he asserted the Government had failed, but two of those concerned the retail environment. I accept that there has been an issue with retail theft, but he had to give two examples that were focused on retail crime because he did not want to get into domestic burglary.
Laura Farris
Of course it is serious, but it has fallen so much. My right hon. Friend the Member for Croydon South (Chris Philp) quite properly talked about homicide, the maximum high-harm offence. Homicide rates have fallen since 2010, but we are making progress every year: they have fallen by 10% in the past 12 months alone.
Our third priority is performance. The Government make no apology for seeking to drive improvement and efficiencies; one such efficiency was the partnership between the police and the BlueLight Commercial exercise that has already saved over £170 million, but we are continuing to drive efficiencies through technological advancements in areas such as detection. My right hon. Friend the Member for Croydon South gave the example of facial recognition technology, which has been so successful in his own constituency. There is also imagery and better intelligence, and we are improving the performance of police officers themselves through the deployment of specialist trained officers for the most sensitive crimes, such as rape. More than 2,000 specialist trained officers will be deployed across all 43 forces in England and Wales by April of this year.
I will now address some of the points that were made by hon. Members, starting with my hon. Friend the Member for St Austell and Newquay (Steve Double). First, he is correct, and it is good to see, that police numbers in his constituency have risen: they are north of 3,650 in Devon and Cornwall. He is also right to mention the fact that so much police time has historically been consumed by dealing with mental health problems, and I hope I can provide him with some reassurance. There is now a national roll-out of a scheme called Right Care, Right Person, which is effectively a toolkit that was very successfully piloted in 2021 by Humberside police. It means that police will not ordinarily attend a mental health incident: there is an exception when there is a possibility of a referral under section 3 of the Mental Health Act 1983, but other than that, they will not be involved. It is estimated that on a nationwide basis, that could save 1 million hours of police officer time in any year. My hon. Friend also made some very valid points about geography and the special requirements of policing in rural areas, which Labour has never fully or adequately dealt with. The reason—I say this very respectfully—is that very few Labour MPs represent rural areas, and there is a consistent ignorance of the kinds of crimes that are specific to rural environments.
In his very good speech, my hon. Friend the Member for Waveney (Peter Aldous) acknowledged that Suffolk constabulary had received a percentage increase. I listened carefully to what he said about the safer streets programme and the £500,000 reduction, but I would gently point out to him that overall, Suffolk constabulary is getting an increase of £11 million in its budget. What he has referred to involves only a small number of officers, but I promise to take his point away and get back to him on it.
To conclude, we could not be clearer: public protection is our priority. We have delivered on it, and we will always stand on the side of the law-abiding majority and support the police. We will take the fight to the criminals again and again, even as their nefarious practices evolve. This Government will always ensure that police have the resources, powers and capability to do their crucial work, and this settlement underlines our enduring commitment to strong and effective policing in England and Wales. I commend it to the House.
Question put and agreed to.
Resolved,
That the Police Grant Report (England and Wales) 2024–25 (HC 482), which was laid before this House on 31 January, be approved.
Local Government Finance
(9 months, 2 weeks ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
The Minister for Housing, Planning and Building Safety (Lee Rowley)
I beg to move,
That the Local Government Finance Report (England) 2024–25 (HC 318), which was laid before this House on 5 February, be approved.
Madam Deputy Speaker (Dame Eleanor Laing)
With this we shall consider the following motions:
That the Referendums Relating to Council Tax Increases (Principles) (England) Report 2024–25 (HC 319), which was laid before this House on 5 February, be approved.
That the Referendums Relating to Council Tax Increases (Alternative Notional Amounts) (England) Report 2024–25 (HC 320), which was laid before this House on 5 February, be approved.
Lee Rowley
Today, we are confirming the major parts of the settlement announced in December, as well as reiterating the £600 million additional funding boost announced in January. Local government has welcomed the extra money as important in offering the ability to provide further support to children, particularly those with special educational needs and disabilities, while also being mindful of the increased demand for social care. Governments always need to take tough decisions, and despite the suggestions of some in this place, there is always a balance to be struck: infinite worthy demands, but finite resources. None the less, we recognise that it is important to support local government in the face of increasing demands for services and the rising inflation and costs that are the legacy of the war in Ukraine and instability in the middle east. That is exactly what we are seeking to do.
In recognition of those challenges, I am pleased to announce a settlement totalling nearly £65 billion for local authorities in England for the next financial year. The settlement includes an increase in core spending power of up to £4.5 billion compared with 2023-24; a £1.2 billion uplift to the social care grant, which can be used for children’s or adult services subject to individual local priorities; an increase in the funding guarantee, which will ensure that all authorities see a minimum increase in core spending power of 4% before any local decisions are made on council tax rates; additional support for rural councils through a £15 million increase to the rural service delivery grant; funding worth £3 million to support authorities experiencing significant difficulties because of internal drainage board levy costs; and additional funding for the Isle of Wight and the Isles of Scilly, in recognition of their circumstances and their physical separation from the mainland. As a result, available funding for local government in England will rise by 7.5% in cash terms for 2024-25.
Bob Seely (Isle of Wight) (Con)
I am most grateful for the Minister’s statement, and I am also grateful for the uplift in funding for the Island. As I understand it, that is higher than average—we are most grateful—and that took place after meetings between me and Ministers. I am also grateful that they have specifically mentioned and accepted the additional costs that the Isle of Wight faces by dint of being an island, and that we are in effect now catching up with other parts of or other islands in the UK. I am very keen for this uplift to be seen as permanent, and then to be built on. Will Ministers meet me to discuss ways in which we can ensure that the uplift for the Island and the recognition of island status are now fixed?
Lee Rowley
I am grateful to my hon. Friend for, while I have been in post looking at this portfolio specifically, his invite to the Isle of Wight, his support in facilitating that and his continued work on behalf of the Island. The change, which has been brought forward today by the Under-Secretary of State for Levelling Up, Housing and Communities, my hon. Friend the Member for North Dorset (Simon Hoare), and the Secretary of State, is in direct recognition of the work he has done, and I am grateful for it. I know that the Under-Secretary will meet my hon. Friend to continue that discussion.
Sir Desmond Swayne (New Forest West) (Con)
Very briefly, is the Minister comfortable with our persisting in protecting our constituents from the local councils they elect with the referendum threshold? When are we going to allow local authorities to govern, and to suffer the consequences if the electorate disagrees with what they have done?
Lee Rowley
I am grateful to my right hon. Friend for raising a very philosophical important point, which is about the balance between local and national Government, and he is absolutely right to raise it. It is a long-standing principle of our local government settlement that we allow local councils the flexibility to be able to make decisions about the finances in their local areas, while also taking a general view that there are caps in place on how far they can go. I will come on to say more about that in my speech, but he raises an important point, and I know it will have been noted by my hon. Friend the Under-Secretary.
With available funding for local government in England rising by 7.5% in cash terms for the coming financial year, that significant increase will allow councils to continue to deliver local services. Thanks to the funding guarantee, all authorities will see an increase of at least 4%, before any council tax increases are taken into account.
We continue to monitor the financial health of all councils on a regular basis, using a range of data as well as extensive direct engagement. Examples of significant financial failure in local government remain low, but we will take action where necessary. We will always be ready to speak to councils should that be necessary, and should any have concerns about their ability to manage their finances or pressures that they have not planned for.
We do not just provide funding through the settlement. Separately, we are proud that there is £15 billion of taxpayer funding in a suite of complementary levelling-up projects that will help grow local economies, create local jobs, improve local transport, provide local skills training and support local businesses, making real differences to real people’s lives in communities all across the country.
Since 2021, the levelling-up fund has been changing communities across the United Kingdom, with £4.8 billion of taxpayer funds allocated to 271 projects, kick-starting regeneration and funding vital projects across the UK. Our levelling-up partnerships are delivering regeneration, and 12 investment zones are driving innovation all across the country. In addition, there is £1.1 billion for 55 left-behind towns through the long-term plan for towns, which is reviving high streets and tackling antisocial behaviour, and more than 250 venues are to be saved through the community ownership fund.
I know I speak for the whole ministerial team when I say that we cherish our close working relationship with local government partners. Every year, we have the opportunity, through consultation on the provisional settlement, to listen to them even more keenly, along with the public and right hon. and hon. Members, on the funding proposals for the coming financial year. The number of responses was particularly high this year at 267. The Under-Secretary, who is the Minister for local government—he is sitting beside me—engaged personally with over 90 Members and local government leaders. We are grateful to all who responded, and I pay tribute to the work my hon. Friend did in listening.
It was after listening to these views that the Secretary of State announced in January an additional £500 million to bolster social care budgets, which are a key concern for councils. We have heard about and listened to councils in relation to pressures on social care services, particularly for children, which we know have increased. The £500 million uplift to the social care grant, announced on 24 January, can be used for children’s or adult services, subject to local priorities. That is on top of the £1 billion in additional grant funding for social care in 2024-25 confirmed at the provisional settlement in December.
Overall, this means that, in the next financial year, local authorities with social care responsibilities will receive £5 billion through the social care grant, £1.1 billion through the market sustainability and improvement fund, £500 million through the discharge fund and £2.1 billion through the improved better care fund, and that is on top of their local decisions about funding for social care in their area. We recognise that some councils can generate more income from council tax to fund social care, so we have equalised against the adult social care precept since it was introduced, and we will continue to do that in the coming financial year.
As my hon. Friend the Member for Isle of Wight (Bob Seely) indicated, we have heard through the consultation—we know this from our constant contact with local government partners—that the sector is keen for progress across the board, not just in authorities with social care responsibilities. We will support all tiers of government, so we have announced an uplift of the funding guarantee proposed at the provisional settlement. This means that every council will see a 4% increase in its core spending power before any local decisions are made about council tax.
We have also heard about the particular impacts in rural areas, which is why we have announced a £15 million increase to the rural services delivery grant. That is making available a total of £110 million of taxpayers’ money, in the second successive year of above inflation increases. In recognition of the unique circumstances facing our island authorities and their physical separation from the mainland, we are increasing funding to the Isle of Wight and the Isles of Scilly.
However, we are clear—I do not hesitate to repeat it today—that this money is for the frontline services on which our communities rely. It is not to be put aside for later use, nor wasted on myriad council hobby-horses and schemes. Taxpayers deserve value for money. So many of those involved in the settlement—so many parts of the community and so many parts of the local government sector—do that brilliantly already. The small number that do not are on clear notice this afternoon that they must do so. To ensure that, we are asking all local authorities to produce productivity plans, which will encourage them to set out how they will improve service performance and reduce wasteful expenditure.
Turning to council tax, we continue to strike the balance between giving councils flexibility to make local decisions, to meet local pressures and support the most vulnerable, and continuing to seek to protect council tax payers from excessive increases. In any constitutional settlement that divides responsibilities between central and local government, it must follow that local government has the ability and the responsibility to raise some of its own funds, and that it is held to account for the decisions it makes to do that. So this year, as in previous years, we have set core referendum principles of up to 3%, plus 2% for the adult social care precept.
At the same time, it remains the case that some council reserves are significantly higher than prior to the pandemic. For some, that will be for good reasons, but a number of councils have reserves well in excess of 100% of their core spending power, and the latest data shows that about half of all local authorities have seen their unallocated reserves grow since the 2019-20 financial year. It is for those councils to decide the appropriate balance between council tax increases and the use of reserves to fund services, depending on their local context. However, I very much hope that they will consider their unallocated reserves, and I hope that appropriate questions are asked in each locality where that applies by those who are interested.
At the provisional local government finance settlement, in consideration of the significant failures of a number of councils—Thurrock Council, Slough Borough Council and Woking Borough Council historically—and their need for ongoing exceptional financing support, the Government proposed that bespoke council tax referendum principles should apply. We are today confirming those principles, with a core council tax referendum of 8% for Thurrock and Slough and of 10% for Woking. As councils with adult social care responsibilities, Thurrock and Slough will also be able to use the 2% adult social care precept, and the councils can make use of the additional flexibilities provided to support their financial recovery.
At the provisional local government finance settlement, the Department set out that councils could seek additional support from the Government via the exceptional support framework. As part of that process, the Government were prepared to consider representations from councils on council tax provision. In recognition of the scale and nature of the council’s failings, and its precarious financial situation, the Government have decided not to oppose a request from Birmingham City Council for the flexibility to increase council tax by an additional 5% above referendum principles, to start paying for the historic failures of the Labour council.
We have heard requests from devolved authorities about the benefits of tax being retained in the area where it is raised. The trailblazer deals with Greater Manchester and the west midlands are unprecedented in their reach, and include a significant transfer of fiscal power. Sixty per cent of England is now covered by a devolution deal, which is up 20% since the levelling-up White Paper was published. We will continue to expand and deepen local devolution in England through the devolution framework and the work of the Under-Secretary of State for Levelling Up, Housing and Communities, my hon. Friend the Member for Redcar (Jacob Young).
Finally, I wish to make a general point about how local government is financed. Many right hon. and hon. Members, as well as colleagues in the sector, have emphasised the need for reform in the system—I heard that when I was covering this brief—particularly of the funding formula. We have heard those concerns loud and clear. Today we continue to restate our commitment to reform and modernise the local government finance settlement and system in the next Parliament, to deliver the most effective financial settlements for councils—[Laughter.] I hear noises from the Opposition Benches. If Opposition Members had wanted to say that at the beginning of this Parliament, when covid started and when we asked our local authorities to do the most extraordinary things, that would have been an interesting position for the Labour party had it been in government at the time. We took decisions that were necessary at the time. We are restating our commitment to reform. That is what a sensible, proportionate and reasonable Government do, and it demonstrates yet again the difference between a Labour party that is seeking to play at being a Government and will be unsuccessful, and the actual difficult decisions that are being taken every day on the Government Benches.
In a year that has seen unprecedented increases in demand for social care, housing and other vital local government services, the Government have listened and are providing more support. The above-inflation funding increase will allow councils to carry on delivering the local services on which we all depend. Because local authorities must be accountable to local people, we are putting in place ways to ensure that they are working effectively and efficiently. We have a long-term economic plan that is working. We are supporting local councils with what is needed, and ensuring that they spend wisely. That is exactly what the Conservatives have done throughout this time and what we will continue to do, and I commend the settlement to the House.
Jim McMahon (Oldham West and Royton) (Lab/Co-op)
Today should and could have been the day when the Government, after 14 years in power, finally fixed the crisis in local government. After a lost decade, they could and should have used today to turn the tide on the unsustainable and growing crisis in adult social care, children’s services and homelessness services, and finally to end the postcode lottery for those vital services that create the clean, green and safe communities in which working people deserve to live in return for the now record taxes that they pay under this Conservative Government.
After six years of single-year settlements, which started well before covid, today could and should have been the day when the Government brought forward a sustained multi-year settlement, but the Government have failed on every test. Councils of all political stripes up and down the country, covering cities, towns and counties, are being forced to the edge of survival. We know that councils are the first responder, and often the last line of defence for our communities. That they have managed to keep things going for so long is testament to their duty and public service.
I thank each and every one, every councillor of every party and every council worker, for the work they do for millions of people up and down the country. We owe them a debt of gratitude. From waste management to maintaining roads and parks, from providing housing assistance to supporting local businesses, councils are at the forefront of ensuring that communities can thrive and realise their full potential. Contrast that civic responsibility with a Government who seem happier treating local government as a political scapegoat than as an equal partner.
What support are councils receiving in this settlement? Six hundred million pounds recycled from elsewhere, and a continuation of the begging-bowl culture that continues on a never-ending loop, like groundhog day. In one of the worst cost of living crises for generations, it is a shameful indictment that the council tax bill is set to top £57 billion under the Conservatives, which is more than twice than under the last Labour Government. It stands as a matter of fact that people are paying more and more for less and less. Alongside the biggest tax burden in peacetime, that adds to the struggles households already feel when managing mortgages, food and energy bills. On top of that, working people will be slapped with yet another Tory bombshell. In fact, council tax bills under the Tories are set to rise by £13 billion over the next five years. It is clear as day that councils have been hollowed out, and they are now being told once again that the only solution is to raise council tax more and more.
The Institute for Government shows that core spending power will still be 10% lower, even after today’s uplift, than before the Tories came to power. That does not even take into account the rocketing demand in social care, children’s services and homelessness services. Ad hoc injections of cash, while perhaps offering modest relief, are a painful repeat of the sticking plaster politics that have left the country, our politics, and our public services much weaker. The Government’s reckless approach is undermining the fundamentals of local public services. Stability is needed to ensure that older people get the high-quality care they deserve and that councils are in the best place to give children the protection they need, to help put an end to the crisis in homelessness that the Government are perpetuating, and to keep our public services running where this Government have hollowed them out elsewhere in the system.
This Government’s approach is short-term and reckless, and it saves nothing. In the end the cost is huge, and we can see the consequences today. It cannot be right that there were more section 114 notices last year than in the previous 30 years combined. That is not a coincidence; it is the result of a toxic mixture of the Government’s financial mismanagement, and a deep and worrying lack of accountability. To make matters worse, the early warning system that could have raised the red flag earlier has been dismantled. In 2010, the coalition Government announced the closure of the Audit Commission. It was not without its faults and certainly was not universally well received, but removing the early warning system in its entirety was clearly going to set up problems for the future. Councils were left to inspect financial risk themselves, rather than seek value for money or even address issues of what is now clearly a broken audit market. The facts speak for themselves: in 2022-23, just five of the 467 councils delivered their audited accounts on time. That is just 1% of councils submitting audited accounts before the deadline.
Chris Loder (West Dorset) (Con)
The hon. Gentleman mentions audited accounts. Does he have an opinion on the audit of Plymouth City Council’s accounts? I was delighted to go to Plymouth on Friday, and debated the matter with the Labour leader of the council. It is clear that the Labour council’s accounts have not been able to be audited, because there is a question mark over £70 million being moved from capital spend to a pension pot. Does he have a view to share on his party’s situation in Plymouth?
Jim McMahon
I thank the hon. Member for inviting me to celebrate the success of Labour in Plymouth, and the work that our councillors are doing, after taking back control, to show leadership to the city. Plymouth is a proud place, and the Labour party there is making a huge difference. He may want to consult those on his party’s Front Bench when it comes to the submission of audited accounts, because there is an issue to reconcile here. Only 1% of councils have submitted accounts; how do we break through that bottleneck, given that the market is not responding? The Government will have to respond to that sooner rather than later. I politely advise him, if I may, to withhold his criticism, and to wait to see what his Government’s approach will be. I suspect he may be slightly embarrassed.
Mr Clive Betts (Sheffield South East) (Lab)
The Select Committee has written a report recently on local authority audit, which is a complete mess, with only 1% of accounts done on time. This is not a party political matter, as councils right across the country are struggling with this issue. One factor is low audit fees. Another is the complication of pension fund valuations, which is holding many accounts up. The likelihood is that the only way to get through that will be to agree accounts that are qualified because it has not been possible to confirm pension fund valuations. I hope that party political points are not made about councils and the qualification of accounts.
Jim McMahon
First, I thank the Select Committee for the work that it has done in this area. Last week, we received the report “Financial distress in local authorities”, and a great deal of work has been done to understand the detail and the contributing factors. There is no doubt that the accountancy regime for pension funds is a contributory factor to the delay in some cases. We need to know that councils are financially resilient, and that the financial settlement is robust. Where there are issues, an early warning system should allow them to be picked up earlier, so that if an intervention is required, it is made at the right time and in the right way, whereas now, section 114 notices are being issued at a rate not seen for the past three decades. That cannot stand, and it is not sustainable. We look forward to the Government’s response on that.
On the wider point about cross-party agreement, I think all of us and the Local Government Association, which is cross-party, would welcome with open arms the day when party politics was taken out of local government finance, and when there was consensus on how to fund local public services. I sincerely hope that after the next election, when those on the Government Front Bench are in opposition, they join us in that call, but let us wait and see.
The Government will know, as we do, that because of the financial fragility of local councils and the lack of an early warning system, it now takes only a small shock to send town halls into financial meltdown; the resilience just is not there. The Local Government Association has done a fantastic job in leading from the front and ensuring that adequate support is supplied when needed, but it cannot be expected to lead the charge on its own, nor should it be expected to. Councils need certainty and stability. They need to have the fear and anxiety of financial bankruptcy removed, so that they can continue to deliver for local communities. Councils need to be given adequate time to plan ahead for the fiscal year. Labour would support local councils where the Government have failed.
Single-year settlements do not provide the certainty or stability needed for planning ahead. We recognise that councils need something more than that to end this disjointed approach. Labour will embed transparency in the relationship between local and national Government, and move towards multi-year funding settlements for councils that allow them to plan well ahead. We will give towns and cities the tools that they need to foster local growth and deliver better public services. Should we be privileged enough to form the Government after the next election, Labour will empower councils to get on with the job that they have been elected to do.
Finally, we will see a radical transfer of power away from Westminster and into the hands of the British people through the landmark take back control Act, but we will not wait; where we can accelerate improvement, we will. We want a new relationship between central and local government as genuine partners in power. We want to see the right powers in the right places. Our communities are resilient, and so are our councils, but we need to do far more to work, hand in hand, as true partners going forward.
Chris Loder (West Dorset) (Con)
It is a pleasure to contribute to this debate, which for me is the highlight of the parliamentary calendar. Relentlessly, year after year, I have contributed to the debate with great fondness. Last year, I remember vividly the Under-Secretary of State for Levelling Up, Housing and Communities, my hon. Friend and next-door neighbour the Member for North Dorset (Simon Hoare), advocating, from the Back Benches, for a great rural tsar. Of course, nowadays we have the great rural tsar sat on the Front Bench; I am pleased about that. I am also pleased that the debate has three hours of protected time, which is valuable. None the less, I will try not to take up too much time, Mr Deputy Speaker.
Each year, I stand up in this place to make the case not just for rural West Dorset, and Dorset as a whole, but rural Britain, in what I believe are some of our most important discussions and decisions about enabling the capability of local government. Most years, I have stood here and protested that we in Dorset have been in need of our fair share of government finances; indeed, in many previous years, we have not received that. But today is not D-day. Today is S-day, because my hon. Friend and neighbour—knight in shining armour that he is—is charging over Bulbarrow hill and through the Chalke valleys to Dorset Council in Dorchester, to deliver a £4 million boost to its finances. That is to be greatly welcomed. My other neighbour, my hon. Friend the Member for South Dorset (Richard Drax), who cannot be with us as he is away on parliamentary business with the Defence Committee, has asked me to reflect his views, so that my hon. Friend the Minister understands full well that we very much appreciate this in Dorset, after many years of campaigning for a greater and fairer share.
However, it is important to note that we still need to address the fundamental structural issues that we face in local government funding. I recognise that that is a vast task, which will take considerable work. I hope that, in winding up, my hon. Friend the Minister can give not just me but a number of colleagues who are in their places real confidence that the Government intend to achieve that in relatively short order, and that we will ensure that a fairer share of taxpayers’ money is allocated to where it is required.
The £110 million through the rural services delivery grant is much welcomed. That funding of up to £3.2 million for some areas—including Dorset—is much better, but is that enough to deal with the issues we have to face? From discussions that I have had in the House before the debate, I have a real sense that it is not. The additional £1.5 billion for social care is enormously welcome. A third of the community that I represent in West Dorset is over 65, so it has additional social care requirements. Are we in Dorset really getting our fair share of £1.5 billion, given that we are talking about a few million pounds? That is a question for us to ask.
In the wider context of making the case for rural Britain, I remind my hon. Friend and neighbour the Minister, and the Minister for Housing, Planning and Building Safety, that we have had high-energy debates, it is fair to say, about local government finances with both of them. I would like to reiterate some of the unfairness that remains in the “urban versus rural financing” debate. Rural areas still receive some 59% less per head in settlement funding than their urban counterparts; in real terms, that is about £111. Rural residents will also pay on average 20% per head more in council tax than their urban counterparts—although we should probably take Somerset to one side in that assumption. Rural residents receive on average 13% less per head in social care support overall than residents of urban areas, which is very important when it comes to providing that care in constituencies such as mine and those of my hon. Friends.
West Dorset constituency, which I am proud to represent, has an enormous county boundary with the county of Somerset. Many of my constituents use services and facilities in Somerset, and vice versa. It is fair to say that over the past month, many of my constituents and people in Somerset have looked with absolute horror at how the proposed council tax increases will affect them. For the benefit of the House, I would like to clarify the extent of those increases in real terms. Those living Yeovil can expect a 90% increase in the town council precept, while those living in Taunton, the county town of Somerset, can expect a 200% increase. In real terms, that is an increase of between £109 and £277 per annum in the town council precept alone.
I am well aware of this matter because a Somerset councillor, a Liberal Democrat, works in my constituency and contributes frequently to the Liberal Democrat leaflets that are shared in West Dorset. I should say that he is the head of the Somerset Council audit committee, of all committees; I can confirm that his mantra is “raise taxes and cut services”, which is definitely what is happening in Somerset. In November 2022, the Somerset Liberal Democrats said that they needed an additional £35 million because of a financial difficulty that they had experienced. There was no reporting of any finances to the council for five months, and then, all of a sudden, out of nowhere, came a black hole of £100 million.
Sarah Dyke (Somerton and Frome) (LD)
I am a proud serving Somerset councillor and am fully aware of the issues Somerset is facing. However, those issues have occurred not just over the last nine months, under the new Somerset Council; they have been very long drawn out. Indeed, between 2010 and 2016, Somerset faced one of the longest council tax freezes—I think it was the longest for any council across the country—under the last Conservative administration, which led to huge pressures on funding in Somerset. Indeed, under Conservative administration, the council was nearly drawn into bankruptcy in 2019 due to pressures on adult social care. Would the hon. Member agree that the issue is not a party political stance, as he is trying to make it, but the legacy left by a previous Tory administration? The issues that we face in local government go across all colours.
Chris Loder
I thank the hon. Lady very much for her intervention. She and I are frequently in Westminster Hall debating these matters with great passion and vigour. I know that she feels as strongly as I do about these matters, but it will probably come as no surprise to her to hear that I do not agree with her conclusion. Previous Conservative administrations who ran Somerset Council left a considerable legacy in terms of reserves. Since the Liberal Democrat Council was elected and started serving last year, a number of decisions have been made across the board that have ended up in the lap of council tax payers in Somerset.I am alarmed about that, because ahead of the Dorset local elections, a number of constituents in West Dorset look with great horror at what is happening in Somerset, and wonder what is truly the case.
Chris Loder
I have not quite finished replying to the hon. Lady’s previous intervention. I would like further to put into context the contrast between the finances of Somerset and Dorset. Last year, we in Dorset received just £700,000 in revenue support grants; Somerset received £8 million. Our social care grant last year was £22 million; in Somerset, it was £39 million. The high needs block funding was just £48 million for Dorset; it was £74 million for Somerset. The schools block funding was £76 million for Dorset, but £122 million for Somerset. I could go on, but I will not. There is an enormous contrast, which has happened in relatively short order. That is what happens when the Liberal Democrats run the council in Somerset, compared with a long-standing and financially well-run Conservative council in Dorset.
Sarah Dyke
I thank the hon. Member for allowing me to intervene again. He is making some unfair points that need some context. As a Dorset Member, he will know that the council tax in Dorset is vastly higher. In the local government reform back in the 1970s, Somerset was left with most of the rural county, and following the 1991 council tax change most of the higher banding was taken into Bath and Avon. We have fewer properties in the higher banded rates, so the council does not generate as much in council tax. He says that that is an issue for the Liberal Democrats, but he should remember that we are delivering on a plan to change to a unitary council that was implemented by the Conservative Government against the will of people in Somerset. We have delivered more than half the £18.4 million of savings within nine months, when the full savings were expected to be delivered within three years. The Liberal Democrats in Somerset are delivering.
Chris Loder
The reality is that the Liberal Democrats are not delivering on the Conservative legacy. That is clear for all to see, especially those who live in Yeovil and Taunton. It will hurt people financially, as they will see hundreds of pounds extra on their council tax because of having a Liberal Democrat administration rather than a Conservative one.
My constituency neighbour, my hon. Friend the Member for North Dorset, is saving the people of Somerset from a further 10% council tax hike that the Liberal Democrats want to pile on them. I am very grateful to him, as are a number of colleagues who are not able to be here, for saying that the Liberal Democrats have to be held accountable. They have to find solutions and carry through on what was a very good proposal several years ago. I hope that the people of Somerset will benefit from his good work and, in the mid to longer term, the people of Dorset will benefit, too.
Mr Deputy Speaker (Sir Roger Gale)
I call the Chairman of the Levelling Up, Housing and Communities Committee.
Mr Clive Betts (Sheffield South East) (Lab)
Let me begin by thanking a few people. The shadow Minister, my hon. Friend the Member for Oldham West and Royton (Jim McMahon), referred to the report “Financial distress in local authorities”, which the Select Committee published last week and on which I made a statement in the House last Thursday. I want to thank the staff of the Committee and our special advisers for all the work that they did in helping to put the report together: it was much appreciated. I also want to thank the Local Government Association—I declare my interest as a vice-president—for all that it does for local government throughout the year, and for helping us and advising us on the challenges that local government is facing, not least with regard to finances.
The Under-Secretary of State for Levelling Up, Housing and Communities, the hon. Member for North Dorset (Simon Hoare), is sitting on the Front Bench. I want to thank him as well, not for providing enough money on this occasion—I would not go as far as that—but for being genuinely helpful and open in his willingness to be approached by Members on both sides of the House and to engage with local councils across the country. He has also been open to discussion and an exchange of views with me, in my capacity as Chair of the Select Committee, so I thank him for the way in which he has approached this matter on a personal basis.
The difficulty for councils is that they are not just dealing with what is happening this year; they are also dealing with the problem of the year upon year of austerity that we have seen since 2010. There is now a funding gap of £4 billion, which £600 million goes nowhere near filling. In fact, the Institute for Fiscal Studies said the other day that the gap was £7 billion, but either way it is a much larger sum than the £600 million that the Minister has made available. I was a little disappointed when the Minister for Housing, Planning and Building Safety, the hon. Member for North East Derbyshire (Lee Rowley) —who opened the debate—began referring to reserves again. When local government finance gets into difficulties, Ministers always resort to saying, “Councils have all this money, so why don’t they spend it?” I remember that when Lord Pickles was Secretary of State for Communities and Local Government, he was berating councils back then for not spending all their reserves. I think that most of them are quite grateful for not having done so, in view of what has happened subsequently.
Some councils have simply run out of money and have issued section 114 notices, while others are wary of what is coming. They can see things getting worse rather than better because that is what has happened year on year, and, rightly, they are not rushing to spend all their reserves at once. They are being prudent to a degree, but they can see those reserves running out in two or three years’ time, even if they are not facing section 114 notices immediately. We have heard from the LGA that about 20% of councils could be facing them in the next 12 months. It may not be as many as that, and everyone hopes it is not, but it could be a significant number. In the last six years eight councils have issued section 114 notices, effectively declaring bankruptcy, whereas in the previous 18 years, none did so.
It is not only individual councils that are experiencing difficulties. The whole system is now broken. That is the evidence that we were given: the Committee did not pluck the information out of thin air. We heard from councils of every kind—county councils, district councils, metropolitan councils, unitary authorities and London councils—and the problem is now widespread across all of them. Yes, individual councils have made mistakes, some of which have caused them to get into difficulties, but as we look forward, we see that it is not only the councils that make mistakes that will get into difficulties. Many will simply run out of money, and they will have no leeway to deal with any adverse consequences because their reserves will have been run down.
In fact, for the most part, councils have done brilliantly to survive this long. Credit is due to councils and councillors throughout the country who have managed to keep themselves going, and managed to make efficiency savings on a scale of which any central Government Department would be proud. Local government has seen bigger cuts in its budgets than any other part of the public sector. The temptation for Ministers is always to pick on councils, because they can blame them from the Front Bench for the difficult choices that have been made, and do not have to claim responsibility for the cuts.
My own city of Sheffield has experienced a 30% cut in its spending power, and of course it has cut services. Libraries have closed in my constituency, there has been less funding for tendered bus services, the grass is cut less often, and the planning department has fewer resources and wants more because of the number of planning applications being submitted for the redevelopment and regeneration of the city. Those are all consequences of the spending cuts. This is about the two things coming together: the cuts to resources and the pressure from all the things that everyone talks about, including social care.
Adult social care was seen as a developing problem, and it is. Another way of looking at it is as a great benefit, because people are living longer and they are here to need the care, which is absolutely wonderful, but now children in care as a demand is rising faster even than adult social care. The Select Committee looked at children with special needs, their education and the cost of transporting them, and there are things that can be done there that are not just about more money. It is about looking at the provision of care for children and looking at councils collectively providing that. We could get costs down in that way.
This is also about looking again at education, health and care plans. There is a feeling that sometimes the more well-educated, knowledgeable and affluent parents see the benefit of demanding an almost unconstrained amount of money for certain educational provision for their children. The cost of that is going up exponentially, and those plans have to be reviewed. Of course we have to give kids with special needs the education they deserve, but perhaps we ought to look at the system that is causing such a massive increase in the costs that are now occurring.
At the other end of this is the fact that the overall budgets have been constrained as demand has gone up. What about ordinary council tax payers? They are paying 5% extra every year. For the most part, those council tax payers do not receive adult social care, do not have a kid with special needs and do not require homelessness services—another area of increasing demand—yet they are being asked to pay 5% extra. They are also seeing their libraries and bus services disappearing and their streets not being swept as often. They are saying, “But I’m paying more every year and I’m getting less.” The system cannot continue in the way it is. It is a challenge to the basis of democracy, which is that people feel they are paying for something and getting it. Here, they feel they are paying more and getting less. That is not sustainable in the long term, as I think we can all see.
Another problem with the settlement is that it is for only one year. Local government has asked repeatedly for multi-year settlements, and we got there in 2016. Covid interfered with that, but there is no reason they could not have come back since then. We were also promised fair funding in 2016. What has happened to it? This settlement is based on data that goes back to the last century. That cannot be right either, can it? It really cannot be right that we are allocating money based on how many people lived in areas so many years ago that it now makes no sense because of the demographic changes that have taken place since. These are all issues that could have been addressed. They are big challenges but they could have been met.
We have not mentioned the public health grant today. When public health went over to local government, it was pretty well funded because it was linked to NHS settlement increases. Public health is really important because it looks at prevention in our most deprived communities, but there has been a 27% real-terms cut since it went over to local government. We do not use it enough. During covid, we should have used the expertise of the directors of public health for tracking and tracing, instead of the phone banks that were set up at national level at a cost of billions of pounds. The director of public health in Sheffield, Greg Fell, has sent me information about the cuts that he is dealing with. This is a fundamental issue of equality. Public health is about helping the poorest communities disproportionately, and that is now not happening because of those cuts. Yes, there is some welcome extra money for smoking cessation and for dealing with people with alcohol problems, but it does not fill the gap that has been created by the cuts.
Perhaps the Minister could have a word with the Chancellor. He probably cannot offer us any more than the £600 million today, but perhaps he could have a look at the household support fund, which our Select Committee has just written about. In Sheffield, the fund provides 32,000 children who have free school meals during term time with vouchers to compensate in the summer holidays. Have a look at that, as local authorities cannot compensate for it in the current crisis. It would not take a lot simply to keep the fund going from March, when it comes to an end. This is the last school holiday in which kids will get the funding. It is a small issue but, if the Minister adds his voice to those of the Select Committee and many others in this House, we might be able to get a bit of movement in the Chancellor’s upcoming statement.
Things are bad, but they could get worse and probably will. The Minister said it will be for the next Parliament and, yes, it will. The Secretary of State for Levelling Up, Housing and Communities announced more than a year ago that he would ask a Minister to review council tax, and I understand that nothing has happened yet. Council tax has not been touched for 30 years, and we cannot explain to people moving into a new build home how their council tax is calculated. It is based on the value in 1991, before their home had not been built. We can all see that it is nonsense, so we need reform. The Minister suggested the other day, and I agree, that whoever wins the election has to make local government funding, and certainly social care funding, stick for the long term. We had cross-party agreement on pension reform, and it has stuck for the long term, so let us look at both those issues. I hope we can then move on.
Finally, what on earth are the productivity plans? Does local government not have enough work to do without having to produce another set of plans for a purpose that only the Secretary of State seems to understand? I have read that councils apparently have to stop spending on “discredited” equality, diversity and inclusion programmes. Can anyone tell me what a discredited equality, diversity and inclusion programme is? Who is going to decide? Does the Minister have a little list of criteria and tick boxes? Is he going to review all these programmes, or is it just another attempt to say that councils obviously have plenty of money if they are engaged in these sorts of programmes? They have not. In my view, councils are engaged in providing proper, decent and needed services for their communities, and there are not enough of those services because of the spending cuts. I hope that in due course we can move forward to a better time for local government. Our councils deserve it and, even more importantly, our communities deserve it too.
Sally-Ann Hart (Hastings and Rye) (Con)
I am grateful to the Under-Secretary of State for Levelling Up, Housing and Communities, my hon. Friend the Member for North Dorset (Simon Hoare), and to the Chancellor for listening to our concerns about significant pressures on local authorities, especially those with responsibilities for child and adult social care. I welcome the recently announced £600 million of extra funding, including £500 million for local authorities with child and adult social care responsibilities. East Sussex County Council has welcomed the extra £5.386 million it will receive.
However, despite this extra funding, East Sussex County Council, a well-run Conservative council, has reported that, due to the significant pressures arising from the current economic situation and changing demography and need, the financial position for the coming year is the most challenging it has seen in recent years. This is in direct contrast to Labour-run Hastings Borough Council, whose independent auditor, Grant Thornton, said:
“We have identified significant weaknesses arising from funding gaps and unidentified savings and the council’s approach to due diligence when undertaking commercial investments which has resulted in a failure to achieve expected financial returns.”
The borough council is teetering on the brink of bankruptcy, so the Labour leader and six Labour councillors resigned from the Labour party and set themselves up as the Hastings Independent party. Their change of name will not absolve them of their failures and their refusal to take responsibility for the mess they got the council into.
Although welcome, the additional funding does not bridge East Sussex County Council’s financial gap for 2024-25, and it is for one year only. That means that, despite previous careful budget management, the budget for the coming year will still be supported by a significant withdrawal from limited reserves and there remains considerable uncertainty about funding for future years. That is not a sustainable position, at both a national and local level, because available reserves would be depleted by the end of 2025-26.
In its budget and 2024-25 council plan, East Sussex County Council agreed proposals to spend its £538.1 million net revenue budget on services and activities that will deliver its priority outcomes, including funding to cover a range of significant demand and cost pressures being experienced by services. Those plans are supported by a 2.99% increase in council tax and 2% adult social care levy. That decision was not made lightly, given the current pressures on household budgets, but in the light of the very significant deficit the council faces in the coming year and beyond, it needs to apply those increases in order to safeguard services as far as possible.
East Sussex County Council also agreed an £837.9 million, 10-year capital programme, which includes badly needed investment in local roads and highways structures, in reducing the council’s carbon emissions and in school places, including for children with special educational needs and disabilities. Dealing with our potholes in East Sussex, especially those in Hastings and Rye, desperately needs more funding from national Government, and I must emphasise that with a view to the March Budget. So we must look at how we fund the particular needs and characteristics of East Sussex. There is an urgent requirement for sustainable, long-term funding to meet these needs, and that must be understood by the Government, so that our residents benefit from high-quality services in the future. That means reviewing, developing and implementing a fairer funding formula for local authorities, and for the police, that reflects the actual need, as well as deprivation, geography, demographics and so on. That is especially important for local authorities with coastal communities, which, due to a lack of granular data, are often left behind.
Fairer funding does not necessarily mean more Government funding—as we have heard, it has been focused on more urban areas—but a redistribution or reallocation of existing resources more equitably. It is very encouraging to hear the Minister outline the plan for a fairer funding formula to come soon, in the next Parliament. Coastal communities face unique challenges related to their geography, demographics—often they have older populations—population density and economic activities. A fair funding formula would consider those specific needs, rather than applying a one-size-fits-all approach.
Coastal areas often have diverse populations, including seasonal residents and tourists. These fluctuations have an impact on service demands, infrastructure maintenance and social services. A fair formula would account for population dynamics and deprivation levels in these regions. Coastal communities are often more isolated due to their geographical location, which affects transportation, healthcare, education and access to essential services. A fairer formula would address the challenges of sparsity and ensure adequate support. Coastal areas require investment in flood defences, coastal erosion management and environmental protection. A fair formula would allocate funds to address those critical issues. Coastal economies often rely on tourism, fishing and maritime industries. A fair funding formula would recognise the need for economic resilience and support diversification efforts.
A fairer funding formula is essential to ensure that local authorities, especially those in coastal communities, receive adequate resources to address their unique challenges, focus on actual need and serve their residents effectively.
Helen Morgan (North Shropshire) (LD)
In common with many Members of the House, including 40 Members of the Government Benches who signed a County Councils Network letter a couple of weeks ago, I can report that my local council—Shropshire Council—is cutting services because it is chronically underfunded. I declare my interest as a vice-president of the Local Government Association.
It is disappointing to try to score political points about an issue that is so important and directly affects the lives of so many people. Shropshire Council is run by the Conservatives and, while undoubtedly the Liberal Democrats would make different political choices about how money is spent, there is no getting away from the fact that the issue affects councils of all types, under all parties, because there is a chronic structural funding issue that we need to address. Most people in Shropshire are paying more for less because of our social care costs, which amount to 85% of the budget. No political party will be able to solve that issue without additional help from central Government. There must be recognition of the social care crisis that is overwhelming councils such as mine.
It is worth reflecting on the amount of central Government funding that has been awarded to councils since 2016-17. According to the House of Commons Library, there has been a £5.75 billion decrease in real-terms funding—in Shropshire, that is about £37.3 million—and compared to 2015-16 there is 51.3% less funding per person in Shropshire from central Government. How are we going to stop people paying more for less? I do not have the answer, and I know the leader of Shropshire Council does not have the answer either.
What does that mean for people across the country? Providing fewer services drives inequality of all types. Let us think about the example of swimming pools. The Government have said 276 local authority pools have been closed since 2015, including the Whitchurch swimming pool in my constituency, although we are lucky because that pool is being rebuilt. Many places are not so lucky; people in my constituency may be without a swimming pool for years, but in some places it will be forever. If they cannot get to a neighbouring town, have access to a car or pay to go to a nice private swimming pool, their children will not learn to swim. That fundamental and deep inequality, which we should avoid, is a direct consequence of poor council funding.
Another example in my constituency is that the civic centre in Whitchurch has had to close recently because of issues with reinforced autoclaved aerated concrete and asbestos. The council cannot afford to either rectify or rebuild that civic centre because of the interest on the money they would have to borrow. The amount to be borrowed would be about £7 million, so the interest would be about £750,000 a year. The council should not be in a situation where it cannot provide cultural enrichment or generate economic benefit by bringing people into the town centre because it cannot afford that relatively small amount of additional borrowing for something so basic.
As I mentioned, Shropshire Council is Conservative-run. I have had some constructive meetings with its leader, who has been very open and said that the social care requirements will overwhelm the whole budget in future years unless something urgent is done. No amount of paperclip savings will get the council to the point where it will be able to afford our social care budget in the future. Not only do we have an ageing population and an elderly demographic, but we are also a very rural area. The cost of delivering social care is much higher in such areas—a point to which other Members have alluded—as carers have to travel long distances between each person they are caring for and so pay high fuel costs. It is much more expensive to deliver that social care.
We need to look urgently at the issue of fair funding, taking into account the cost of service delivery. While the £15 million increase in the rural services delivery grant is welcome, the total budget of £120 million will not touch the sides of the social care issues that councils in rural areas face. We urgently need the Minister to work with his colleagues in the Department for Health and Social Care to fundamentally reform how we fund and deliver social care. Until we grasp that nettle, we will not solve the issue of local authority funding with the odd extra bit of money here and there. Someone could end up in crisis just so that fewer councils have to issue section 114 notices.
I wish to touch on children’s social care and special educational needs and disabilities. I had an interesting conversation with a school recently about its budget. I realise that this is not a topic for this Department, but, while the money the school gets to support a child on an education, health and care plan is woefully inadequate—it makes a loss on each child that it is trying to support—the £6,000 cost is crippling the council budget. We need to look at that, but, again I urge the Minister to consider what that means for the lives of individual people. I have a case of a young man who has just turned 16. He has a life-limiting illness and severe disability. The council had to save money and made a policy decision not to fund transport for young people over 16 with special educational needs and disabilities, so his transport funding was cut. Thankfully, we have resolved the situation for that one individual, but there will be thousands of other individuals in the same position across the country, and the impact on the family is devastating. Those young people need to go to a special place during the day for additional care or schooling, and their parents need to go to work. If the transport is not there, it has a fundamental and detrimental impact on the life of that family. We need to acknowledge that and find a way to solve the issue.
The Levelling Up, Housing and Communities Committee report, which has already been referred to by the hon. Member for Sheffield South East (Mr Betts), has said that SEND support is an issue that will lead councils to a cliff-edge of section 144 notices, so we need to address that matter properly.
I also wish to touch on the issue of housing, which affects those district and unitary councils that have to deal with the problem of temporary housing. A couple of weeks ago, Eastbourne District Council organised an event in Westminster; they invited council leaders of all parties and from all parts of the country to discuss the issue of temporary housing and its impact on their budgets. It was a well-attended event, with a good deal of cross-party agreement. However, I was a little disappointed not to see a Minister there to talk to those council leaders.
Eastbourne is spending 48% of its budget on temporary housing. That is not sustainable. Even in Shropshire, which cannot be counted as one of the councils with the most critical issue of temporary housing, we have seen the numbers of those in temporary housing double since 2018. It is important that the Government grasp this issue of social housing—housing for social rent—because people are living in temporary accommodation that is often unsuitable, inadequate, and not anywhere that any of us would be satisfied to live in. The problem could be solved by investing in social housing. We have a plan to deliver 150,000 social houses a year by the end of the next Parliament. To put that into context, it would save, according to the House of Commons Library, £11 billion a year in housing benefit, which currently ends up in the hands of private landlords. Therefore, it makes economic sense to solve this problem, and I urge the Minister to consider that.
I am aware that I have repeated some of the points that other Members have made. Rural councils are struggling to meet the needs of an ageing population and the increased costs of delivering those services. They are struggling to plan not only with this single-year settlement, but with the fact that there is no certainty about what happens after next year. Shropshire Council is trying to save £50 million this year. That means £1 million of cuts every week to services that people have paid more for, and the council does not know what it will cut next year. That is the reality. Dipping into reserves, using some of its capital budget for revenue, or selling off some of its assets are one-stop solutions and do not solve the ongoing structural deficit into the years ahead. Therefore, once a council has sold the library and spent that money on adult social care, what does it do the following year? There is no library left to sell. It is so important that we do not plug these gaps with short-term fixes. We must address the structural problem affecting our councils.
In my meeting with the council leader, I was told that even after a 30% increase in council tax in Shropshire to plug the gap, people would still see a cut in services. Clearly, that is unsustainable and unacceptable.
Let me return to this point about the difference between rural and urban councils. The Rural Services Network has said that urban councils get 38% more than rural ones. However, we should not be having an argument about robbing Peter to pay Paul, because those urban councils are in crisis as well. We need to look at the overall cost of delivering services, and find a solution to deal with the fundamental drivers of increased costs.
I know that the Minister has been a councillor, as have many Members. Regardless of their political party, no councillor has got themselves elected and put themselves on the frontline in order to charge their own residents more and deliver less. We should be considerate of individuals in that situation, and address the fundamental drivers of the crisis affecting councils led by all parties and in all parts of the country. To reiterate, the issues are social care, children with special educational needs and disabilities, and housing. I urge the Minister to work with his colleagues in the relevant Departments to come up with long-term fundamental reform in those areas to solve this crisis.
David Simmonds (Ruislip, Northwood and Pinner) (Con)
I draw the House’s attention to my entry in the Register of Members’ Financial Interests. There is an old saying that we can tell the state of a civilisation by the condition of its public toilets. It is often one of the services that the wider public and voters associate with local government, alongside potholes. However, as has been well reflected in the debate, local government finance is a huge part of overall Government and public sector expenditure. The vast majority of it—around 75% of the average local authority’s budget—goes not on public toilets, libraries or potholes, but on the care of the most vulnerable people in our society. All of it is hugely influential on the quality of life of our constituents, because it affects everything from education to the built environment, and things such as parks and sports facilities, which are incredibly important in people’s day-to-day lives.
In that context, it is important to start by recognising the positive news in the statement: the recognition by Government that on the core statutory services around adult and children’s care, cost pressures are becoming unsustainable. That has been acknowledged with a significant injection of extra cash. There will be a huge debate about whether that money is sufficient to address the concerns, but it demonstrates that the Government recognise the impact that unsustainable cost pressures are having, and are addressing them. Of course, it continues to create pressure that legislation on the setting of council tax requires local authorities to consult with residents in the autumn, around October, before council tax is set by law the following February. It is quite late in the day for us to be factoring in the additional funding announcements, welcome as they are.
I reiterate the calls from both sides of the Chamber that the earlier we can get any of these announcements into the system, and the more they can be structured into a multi-annual financial settlement, the more efficient the use of those resources and the greater the benefit to our constituents will be. It is always immensely challenging to run around trying to get road contractors to mend some extra potholes at the tail end of the financial year, but if we know that extra money is coming down the tracks we can invest in such things as jet patchers, which have been used in both Hillingdon and Harrow for many years, as a means of proactively getting out there and dealing with pothole repairs before the condition of the roads deteriorates any further.
I will pick up on a couple of issues in a little more detail, some of which have been touched on and some of which I hope will be fresh to the Chamber. The first is the impact that deficits on the dedicated schools grant high-needs block has on the funding announcement that we are debating. For many years, not just before 1991 and the setting of the council tax bands but since the earliest inception of business rates, the funding of education has been based on the business rate take from a given education authority’s area. That carries through today in the form of the dedicated schools grant, and it is why we see such differential funding rates for education from local authority area to area. However, around half of local authorities now have significant deficits on the dedicated schools grant.
While the dedicated schools grant, and the education budget generally, sits with the Department for Education, for the purposes of local government law it has to be covered by the annual balance requirement that is covered when council tax is set by the given local authority each February. If there is a substantial deficit on that budget, which is pretty much entirely under the control of the Department for Education, then significant savings have to be made in the general fund, which today’s statement covers, to make up for it. That has been dealt with in recent years by an annual renewal of a disregard, which essentially says to the accountants and monitoring officers in local authorities, “You simply have to allow the DfE to carry this forward, and don’t allow it directly to impact on your council tax every year.” However, there is no absolute certainty about the long-term position with the impact of the dedicated schools grant.
While the efforts being made by local authorities, borrowing against their own revenue budgets to fund an expansion of capital investment to create more SEND school places—the subject of a Westminster Hall debate by my constituency neighbour, hon. Friend the Member for Uxbridge and South Ruislip (Steve Tuckwell) this afternoon—will begin to have an impact in bringing those costs down, it remains a significant financial risk to local authorities. It would be helpful to hear, from the Minister today if possible, but certainly from the Government before too long, that that will be addressed and there can be some certainty for local authorities on that long-term position, not least because of the impact it has on the balances held by local authorities around the country.
It was great to hear the hon. Member for Sheffield South East (Mr Betts) refer to public health, which remains a key responsibility of local authorities. The covid pandemic rather brought that into the light once again, and the capacity of local authority public health team test, track and trace services, which have been there for many years, was critical to the national response to covid. It also highlighted the fact that, as a country, we went into that pandemic with a population that was, on the whole, a bit less healthy than in many comparable countries. Continued investment in that public health function, to ensure that our children in particular are able to enjoy a better degree of general health in the future, will make us much more resilient as a country in the face of future such challenges.
Turning to the local government funding formula, it is important to recognise that, as all hon. Members reflect, one major challenge in its impact on our constituents is the enormous historical inequity in the way the formula operates. That has a number of different manifestations. Many Members have talked about rural versus urban and suburban impact. Having served, alongside several other hon. Members in this Chamber over the years, at the Local Government Association, that was a pretty much annual subject of lobbying to Ministers, and a number of studies were done on the rural/urban/suburban differential.
The reason that many of those studies did not see the light of day is that the conclusion was that there was not, in the end, much difference—that the challenges that arose from high degrees of density, particularly the consequences for the delivery of all kinds of public services, were pretty much in balance with the equivalent challenges that arose from a greater degree of geographical sparsity in rural areas. Those studies tended to look at the costs of a whole variety of public services.
What is also clear, however, is that the move to significant rises in council tax will raise significantly different additional amounts in different parts of the country. I represent a constituency in a relatively prosperous London suburb, covering two local authorities. However, even in London, with 33 local authorities, we see a differential. When the last calculation was done, a 2% rise in council tax would create, for the local authority that generated most of its money from council tax, which at the time was Richmond, an additional 1.8% increase in its revenue budget, or disposable money to spend. In comparison, the City of London, which was largely dependent on Government grants, would see an additional 0.02% increase in its disposable income as a consequence.
Across the country we see that effect magnified. The ability to raise money of a local authority with a large number of band A properties will be much less than that of a local authority with band G and H properties, such as the constituency I represent. While it will help, therefore, it will not be a long-term solution, and we need to find a way to address the differentials for the long term.
I want to express my strong support for Ministers in the Department and for our Prime Minister, who came in for a bit of criticism for saying he wanted to get to grips with the way the funding formula has historically divided up funds. I spent my time as a councillor during all but one year of the last Labour Government and then for most years of the coalition. Every year was challenging, but there was enormous frustration during those years of Labour government. Most additional funding was not placed, as we are debating today, within the core funding settlement; it came in the form of additional grants that were routed to local authorities based on needs that were not reflected in the statutory obligations of the local authority.
A local authority for a seaside town with lots of elderly people to whom it had a statutory obligation to deliver adult social care, or a local authority in an outer London suburb with many children with significant care needs to whom it had a statutory obligation, got no extra funding at all. However, cities in certain parts of the country—although there was perhaps genuine poverty and housing need that had to be address—often had more money than they could possibly spend.
Many local authorities would have spent every single one of those years having to make cuts to statutory services while being given additional grants for things that were less of a priority. It is enormously welcome that the Government are beginning to get to grips with that by saying that the way in which the money flows must first reflect the legal obligations that Parliament has placed on local authorities. If we in this House say that adult and children’s social care must be delivered to a certain standard and driven by certain costs, we must ensure that the money is flowing in that direction.
Let me gently push back on the couple of Members who mentioned equalities. I had the joy of being a peer reviewer for the equalities standard for local government during my time as a councillor. There has been criticism, or perhaps an implication, that councils are wasting money in that area. One reason that councils do things such as equalities impact assessments is to avoid expensive legal challenges of the kind that used to be extremely common, that cost taxpayers huge amounts, and that obstructed reform, particularly of social care services. If officials at the town hall are ensuring that contracts are tendered in a way that reflects the diverse needs of a community and means that they will not be tangled up in years of legal challenges based on the Human Rights Act 1998 or any other element of equality legislation, that increases the efficiency of service delivery by that local authority. We should be cautious about assuming that if it comes with an equalities badge, it must, in some sense, be a waste of money.
Funding reform will be enormously welcome across the country. Let me set out the key things on which I ask the Minister to reflect as he embarks on that process. First, the work that has already started, to ensure that local government funding reflects the cost drivers arising from legislation passed by this House, is critical. If we say, “This must happen and must be done by local government,” we must ensure that the resources are there for the delivery of that thing, otherwise we create an unsustainable and unbridgeable gap between our constituents’ expectations and the available funding.
As the bigger picture of reform is taken forward, I suggest that we look at the role that planning gain will play in how local authorities are funded. Despite economic development being an enormous priority for our Government and our country, most forms of development remain a net cost to local authorities. In Hillingdon, we certainly had that spelled out to us starkly in respect of Heathrow airport, the campaign for expansion and the national debate about whether that was an additional benefit to UK plc. However, it was extremely clear, especially because the business rates all went to central Government, that the expansion of Heathrow airport simply created significant additional cost to the local authority. A recent study estimated that each new citizen moving to a city represented an additional cost of £15,000 per annum to its public services, after all the benefits, including the tax that they pay, were accounted for.
As development proceeds, we must ensure that our constituents see a real benefit, so that local authorities, and Members of Parliament—instead of standing up in this House and saying, “We want more housing and more economic development,” before appearing on leaflets in the constituency opposing it all—can look their voters in the eye and say genuinely, “If we get this new factory, it will be disruptive, but the money from it will mean that we get a new bus service or an improved GP service.”
The Minister will be looking at a lot of detail, but I ask him to reflect in particular on the impact of funding temporary accommodation costs from local authorities’ general fund. The housing revenue account is ringfenced, and we know that that comprises both the rents that are paid by local authority tenants and several other funding streams. However, the fact that it is ringfenced and often significantly in profit has encouraged Governments in the past to look at it as, for example, a source of funding borrowing to invest in housing. The temporary accommodation challenge that we face—especially because of the large numbers of people arriving in the UK over fairly short periods of time, exacerbating some pre-existing challenges—is significant and acute. I urge the Minister to look at whether some additional flexibility around the housing revenue account could begin to relieve some of the pressures on the general fund referred to in the motion.
I finish my remarks by thanking the people who serve in all local authorities, in particular those who serve as councillors in my constituency and lead my two local authorities. The feedback that I receive from constituents, despite all the potential gloom and doom about local government, continues to be extremely positive and is often improving: people see that their streets are becoming cleaner and their environment is being cared for. That is incredibly important to them—often far more important than the issues we are debating in this House—and we owe those councillors a huge debt of thanks as fellow elected politicians.
Rachael Maskell (York Central) (Lab/Co-op)
It is always a pleasure to listen to the hon. Member for Ruislip, Northwood and Pinner (David Simmonds), and to all hon. Members who have made the case for the real reform we are seeking from the Minister today. I appreciate his listening to the debate.
City of York Council is a small authority, but like so many, it is on its knees. The last Lib Dem-Green administration drained the reserves, and therefore real pressure has been put on the new Labour administration. I am grateful to Councillor Claire Douglas, who has taken up the leadership in York, for her work to try to address the big issues of inequality facing our city by driving through innovation—not least the already-delivered lifting of the blue badge ban, delivering free school meals into schools where there is the greatest deprivation, and reforming services.
However, it is apparent to us all that not only is local authority funding insufficient, but the funding formula itself needs addressing. It is just sad that we have had to wait 14 years to get to this point. We really need that reform to be brought forward, and I agree that if there can be cross-party talks—even at this late hour—we would welcome them, because meeting statutory requirements will clearly be incredibly challenging for all local authorities. While York, unlike other authorities, will scrape through this year and avoid a section 114 notice, we know that the starvation of funds from central Government has meant that the city is under significant stress.
If we do not address the funding formula, we are all going to struggle, and this is not just about local government. The design of the formula and how it operates crosses all areas, and therefore I ask the Minister to consider it with other colleagues. It is not working for health, education, the police, fire, or the broad rental market area, which I will turn to shortly. That puts more and more pressure on local government, as it has to integrate its services more with those of others while addressing all the challenges.
York is by no means the poorest place, but it is by no means the most affluent. We are a post-industrial city in the north and experience many challenges, yet we are the worst-funded upper-tier authority if all the services are added together. That does not ring right—and it is not right, because we have some of the deepest areas of deprivation in the country. We are the eighth lowest upper-tier local authority on a stand-alone basis. In real terms, my local authority is £33 million worse off than in 2010, but accounting for the rise in service demand in adult and children’s social care, we have lost £40 million in much-needed funding since 2010.
If we look at education—I am grateful for what was said about the dedicated schools grant—we have the 17th lowest funding in the country, which again does not meet the area’s needs, and we sit in the bottom third for pupils with special educational needs and disabilities, which causes real stress. We need the Education Secretary to step up and really invest in those children, because we are seeing a significant rise in the number of children with SEND, and in York it is higher than across the country. We need to understand why that is, but also how we can fund it. School transport falls to local authorities, and it is another area under significant stress. Children need EHCPs to get additional services from different agencies, and 98% of appeals are successful, yet the costs to local authorities, parents, children, schools and all the agencies do not add up. We therefore need reform to ensure that those children get the necessary timely support.
We also have an ageing population. Like rural areas, it happens in urban areas too, but the age is rising faster in places such as York, and the pressures falling on social care budgets are significant now. In the spirit of cross-departmental working, we know that the Health Secretary has invested heavily in emergency departments at the front door of hospitals, but it is the back door of hospitals that need the funding, and that is for social care. A quarter of the patients in York Hospital are waiting for discharge. If that can be sorted out, our NHS would be able to function. Again, that spirit of cross-party working is needed in the light of where we are today, and such a plan would take the pressure off elsewhere on the wider piece of Government funding.
The same goes for police and fire funding, and I must highlight—I had a useful conversation with a former Home Secretary about this—that if we do not fund local authorities correctly for youth services, we will be paying for that out of the police budget. All these things are interconnected, which is why I urge the Minister not just to look at local authority funding, but to look at this in the round. Of course, public health is another example, and it moved into local government for a reason, as Professor Sir Michael Marmot would highlight, to address the social determinants of poor health, ensure people can have greater equality and address issues around having longer healthy lives. However, if we are not making the crucial right investments, we will again see the fallout in other services.
I want to understand why we have this real disparity in the funding formulas. We have heard today about the council tax regime, which was introduced in 1991, but business rates are another massive challenge. I am pleased that those on our Front Bench have said they will reform that area, because we need that reform urgently.
The Minister will know that York is a place that floods. I am really grateful for the support we have had to build flood defences, but we now fall below the threshold for triggering the Bellwin scheme. Those businesses that still flood are not getting the support they would otherwise have had, so it seems as though there is almost a perverse incentive. It would be really helpful not only if he looked at that, but also if he would ensure that there is business rate relief for flooded businesses while they are not able to trade. I would be grateful if he will comment on that.
Turning to the broad rental market area, York is an incredibly expensive place to live. Bearing in mind what said about it being a post-industrial city, the costs are driving people out of our area. We do not have the supply of social housing that we need right now. As a result, the local housing allowance is just £650 for a two-bedroom property, yet the cost in the private rented sector is £1,026. The disparity is such because the broad rental market area is just too broad. As a result, people are being pushed out, which is impacting on our economy. It is a comparatively low-wage economy, with the gig economy, the hospitality sector, retail and tourism, and the disparity is putting more pressure on local authorities to find support for housing and, increasingly, to address homelessness issues as well. Again, these things are out of kilter, and we need to bring them together to ensure that the system works for local government.
I look at the inequality between York Outer and my constituency; the centre of York is where the greatest strains are felt. Those strains are clearly being felt by families right now, and I urge the Government to carry forward the household support fund. Perhaps the Minister could have a word with the Chancellor about that ahead of the forthcoming fiscal event; it would really help our city. There was a debate on the subject in Westminster Hall last week. That disparity needs addressing for people in my constituency.
It was disappointing to hear that the fair funding formula will not happen in this Parliament, and that we will have to wait for the next Parliament—my hon. Friend the Member for Oldham West and Royton (Jim McMahon) also heard that message clearly—because that needs to be brought in across the piece. Look at health, and what happens under the primary health trusts, or the primary care groups, as they were back in the day. My predecessor, Sir Hugh Bayley, made the case that York, which was lowest funded in that arena, lost out, and that put pressures on local government. It is ironic that the Carr-Hill health funding formula was devised in the Centre for Health Economics at the University of York, yet somehow it perversely means a disadvantage for York.
In recent times, real pressure has been put on services, and I wish to highlight what that means to York. There has been a 15.8% increase in the cost of children’s social care. I congratulate our team on the council, which has cut agency spend. I met the director of children’s social care the other day, and he said that the team has two agency staff left, and that the department has cleared out agency staff to cut costs. Where will the additional headroom come from to pay for that? The cost of adult social care has risen by 12.5%. The cost of social protection housing services has risen by 26.1%, yet the minimum wage increase was 9.7% last April and 9.8% this April. It all adds up. The average rise that local authorities get is around 4%. That is squeezing resources more and more, and the disparity is taking its toll. We must protect those most in need, and certainly the voluntary and community sector to ensure that we keep its vitality. Clearly it delivers so much. We need a cushion, not a knife, and the fact that we face the challenge of cuts, rather than getting protection, is extremely worrying.
In his opening remarks, the Minister talked about other sources of revenue that local authorities have had, including levelling-up funding, the towns fund and the high street fund. York has not had any of that money. It seems that whether it is received depends more on political affiliation than need, so we have missed out on that, and additional resources have not been put in place. After 14 years, we need not only more funding in numerical terms, but a funding formula that works. If that is for the next Government to do, we will deliver it; it is so urgent and overdue. My constituents are smart; they know what is happening, and they are concerned. They are feeling the pinch. They are being stretched as far as they can, and we must ensure that they get opportunities. My constituents deserve so much better; my constituents deserve a Labour Government.
Steve Double (St Austell and Newquay) (Con)
It is a pleasure to contribute to this debate, and to follow the hon. Member for York Central (Rachael Maskell). I was delighted when the Under-Secretary of State for Levelling Up, Housing and Communities, my great hon. Friend the Member for North Dorset (Simon Hoare), was appointed to his ministerial role, not just because he is a very good friend of mine—indeed, he was a friend before either of us was elected to the House in 2015—but because ever since he was first elected, he has been a warrior on the Back Benches for rural councils. It is therefore no surprise whatsoever to me that he has engaged with colleagues in recent weeks on the funding settlement for councils, and particularly the allocation for rural councils. He has worked tirelessly to secure additional funding. I place on record my thanks to him for how he has listened to colleagues, and for his work to secure additional funding from the Treasury. That has been hugely welcomed in Cornwall, including by Cornwall Council. The additional almost £6 million that we will receive does not completely fill the gap that we were facing, but it has certainly been a huge help and has gone a long way to address the funding concerns we had, going into the next financial year.
That funding, however, does not remove the long-term challenges we face in Cornwall in delivering public services. As you will know, Mr Deputy Speaker, I had an Adjournment debate two weeks ago, in which I clearly laid out the many challenges we face in Cornwall. I will not bore the House by repeating everything that I said on that occasion, but we face a perfect storm of a unique combination of factors in Cornwall. First, we have an ageing population. I believe that 24% of the population is now elderly, which is more than 6% higher than the national average in England, and that is putting pressure on social care. Cornwall Council is due to spend £256 million in the coming year on delivering social care. That is one third of its revenue budget, and that is clearly an unsustainable position for a unitary council.
Secondly, we have the challenges that come with being a rural and coastal county on a long, narrow peninsula, and that poses challenges for delivering services. Although I very much welcome the additional funding being made available through the rural services delivery grant this coming year, the position is not sustainable in the long term. We need a fair funding review to address the needs and challenges that rural councils face in delivering services in the future. We were expecting that in 2021, but for understandable reasons, in the light of the pandemic, we could not do that. However, I would not be being honest with myself if I did not say that I am disappointed that we have not yet delivered it. I urge the Government to come forward with that review as soon as possible.
In Cornwall, we face the ongoing challenge of trying to meet ever-growing demand with the resources we have. That is placing more and more demand on the council tax payer. Council tax in Cornwall is now 39% higher than the English average. It is simply unfair that council tax payers in Cornwall have to pay a far bigger proportion of their income to the council to deliver local services than those in other parts of the country, particularly those in urban areas. I gently say to the shadow Minister that his proposals seemed to suggest that he thinks that funding from Government grant, rather than council tax, is not taxpayers’ money. The news is that they are both taxpayers’ money. The issue is where the balance sits.
Money for local government in the funding settlement is not free money. If we want to increase that funding, clearly we have to pay for it somehow, and I assume that the only way that the Labour party proposes paying for that is by raising taxes, so the taxpayer would pay. I am calling for a fairer distribution of the funding that is available. I am not necessarily talking about hiking the Government’s contribution to local government funding, but there should be a fairer distribution of the funding that the Government make available, to accurately reflect need, demand, and the cost of delivering services in rural areas. I massively welcome the rural services delivery grant and the uplift announced for this coming year, but it is not a long-term solution, and we need to address the fundamental issue of funding for local councils in rural areas.
I will add a final point on temporary accommodation. We face a massive issue in Cornwall. Many people see Cornwall as a wonderful place to come, but every year many people come to Cornwall who require emergency housing, which puts a huge demand on the council. The last time I saw the figures, I think we had about 1,000 people in Cornwall in temporary accommodation; that is unsustainable for the council. The cost of delivering that accommodation in a largely tourist area is astronomical because of how people who need temporary accommodation have to be housed.
We have a particular problem in St Austell; over many years, the council has sought to house a disproportionate number of people in temporary housing and supported accommodation in the town. The sheer numbers placed there by the council has had a huge impact on the community. Local residents regularly tell me that although they are happy to play their part and provide their fair share of accommodation, which is clearly needed, they are unhappy when they are expected to provide a disproportionate amount. The council really needs to look at that. It is disturbing that when I asked the council for accurate figures on how many people are placed in St Austell by various providers, it did not seem able to give an answer; we just know that it is an awful lot. That has an impact on local services, particularly GP services and the police, and the associated antisocial behaviour is getting to a point where local people are saying that they have had enough. We need the matter addressed, so that the number of people that the council places in St Austell is reduced as soon as possible.
I very much welcome the uplift announced in the funding settlement for the coming year; that is hugely important to Cornwall Council. However, I still await the fundamental review of the funding formula, and a fair funding settlement for Cornwall Council, so that, going forward, we do not rely on extra pots of money being announced.
Sarah Dyke (Somerton and Frome) (LD)
I was pleased to debate local government finances in Somerset with the hon. Member for West Dorset (Chris Loder) at the beginning of the debate, but it would have been better if some of his Somerset colleagues had been here to do that with me.
It is easy to criticise local government and burden it with blame, but let us face it: it is the perfect scapegoat to distract us from the real-terms cuts inflicted by this Tory Government. I am proud to be an active Somerset councillor, and have had the pleasure and honour of serving my local community both on Somerset Council and in this House. I know councillors of all colours are working hard in Somerset to deliver for their residents, but the funding system for local government is simply broken. I am desperately concerned for the future of local government; it needs major reform.
I have spoken on multiple occasions about the issues facing Somerset Council, because of the national problems facing all local government. The council had to declare a financial emergency just last year owing to a £100 million funding gap for 2024-25. The Government have offered a £5 million payment to try to plug the gap, but that is woefully inadequate. While the additional support through the financial settlement is welcome, it is simply not enough. I thank the Under-Secretary of State for Levelling Up, Housing and Communities, the hon. Member for North Dorset (Simon Hoare), for engaging with me and the council; that engagement has been very much appreciated across the county. However, unless the Government can provide substantially greater funds, this will not work.
Mr Deputy Speaker (Sir Roger Gale)
Order. The hon. Member for Tiverton and Honiton (Richard Foord) has been in the Chamber for about five minutes. I do not expect hon. Members to walk into the Chamber and seek to support colleagues through an intervention.
Sarah Dyke
We need fundamental change to the way we fund local government. Across the country, we have an ageing population; in Somerset specifically, it is forecast that the 75-plus age group will double over the next 25 years. The demands of adult social care are becoming more complex and the costs are rising. We can no longer fund such an important and expensive service through council tax based on house prices from more than 30 years ago.
The issue is particularly difficult in Somerset. Historically low council tax rates and a damaging six-year freeze under the previous Conservative administration have left the band D rates in Somerset almost £260 lower than in its contiguous neighbour, Dorset. The rurality of Somerset also poses specific challenges because it costs more to provide services in rural areas. The council just cannot make enough money locally to fund adult social care. When I spoke recently to the leaders of Somerset Council, they described the situation as grim. They have to explain to residents why they will be paying more in council tax but receiving less, as cuts to discretionary services are being considered.
This is a nationwide issue that requires a nationwide solution. Nine councils have essentially gone bust since 2018, and the recent report by the Levelling Up, Housing and Communities Committee portrayed the critical situation facing local government. I am thankful to the Committee for its report, which recommended urgent reform to the funding of local authorities. I know that many of my colleagues in local government share those concerns. Some think it is now impossible to solve the crisis in local government through local funding.
I want to take this opportunity to highlight what our future could look like if we fail to reform local government, provide both statutory and discretionary services and look after the communities that we hold dear. Our communities will be left with high streets full of boarded-up businesses as the outdated business rates system puts pressure on entrepreneurs without adequately funding councils. Our fields will be littered with household waste from fly-tipping as councils shut down recycling centres, our streets overflowing with rubbish from uncollected bins. Our town centres will be bereft of quality libraries, and our roads full of even more potholes. As councils struggle more year on year to fund adult and children’s social care, SEND and housing, those services will undoubtedly deteriorate. Much of what I have mentioned is already a reality for millions around the country—it is simply terrifying to think how much worse it could get.
Council leaders have told me that we need a long-term solution, but politics is a short-term game. The Government have been reluctant to approach this issue seriously with a long-term plan, as evidenced by their unwillingness to follow the recommendations of the Levelling Up, Housing and Communities Committee and to publish a 10-year plan to tackle the long-term funding of adult social care.
I conclude by calling for cross-party unity to work together to solve this issue, which we must do for our communities. I know that councillors of all colours want to continue to provide the best level of services for their residents, and that councils of all colours are aware of the specific challenges they face. We must ensure that councils are adequately funded in the long term so that essential reforms are realised.
Chris Loder
I thank the hon. Lady for giving way. I appreciate the point she makes and agree with much of what she says. I just wanted to briefly say—
Helen Morgan
On a point of order, Mr Deputy Speaker. I believe my hon. Friend had finished her speech. She was not accepting an intervention.
Mr Deputy Speaker (Sir Roger Gale)
Are we saying that the hon. Lady had sat down?
Mr Deputy Speaker
In that case, you cannot possibly have an intervention. I call Peter Aldous.
Peter Aldous (Waveney) (Con)
This settlement is welcome because for many councils it staves off financial armageddon. However, as we have heard, we need a far more strategic approach to the funding of local councils and to how they deliver the crucial services that they provide. Year after year we go through an annual routine of the Government issuing a provisional local government funding settlement in December, which presents many councils with significant challenges. That is followed by an intense period of lobbying by councils, their representative bodies and MPs. The Government then find some more money to solve the short-term challenge. We then agree the settlement, as we will do tonight. Life goes on, and we repeat the whole exercise again the next year. I think there is consensus across the Chamber that we must break out of that cycle.
A county such as Suffolk faces significant challenges, including an ageing population, which means that there is an ever-increasing group of vulnerable people who require care and support. It is right that my right hon. Friend the Chancellor increased the national living wage in his autumn statement but it was wrong that, in the first instance, councils such as Suffolk were asked to fund most of the increase themselves from their existing resources. We need to pay properly and support the thousands of workers going out in all weather conditions to care for and assist vulnerable people in their own homes.
Like Cornwall, Somerset and Dorset, Suffolk covers a large geographical area. In such circumstances it is expensive to deliver services, including, as we have heard, home to school transport and SEND provision. Faced with those challenges and an inadequate provisional settlement, Suffolk County Council cut its funding for arts and heritage. The latter in particular leaves the Waveney and Lowestoft area inadequately served and resourced with regard to archives and records. I am sure that I will return to that issue in due course.
My right hon. Friend the Levelling Up Secretary is right to set up an expert panel to advise on financial stability, and to ask local authorities to produce productivity plans, but more is required. As I have said, we need to move away from the current short-term approach to local government funding. To do that, I suggest the following changes should be considered. First, as many Members have said, there should be multi-year financial settlements rather than the annual settlements that we have had for the past six years. Secondly, we must recognise the added cost of delivering services over large rural and coastal areas such as Suffolk. Thirdly, working in conjunction with the Department of Health and Social Care, the Department for Levelling Up, Housing and Communities must provide a sustainable long-term plan for social care, with care workers being fairly paid and provided with proper career paths.
There should also be a review of statutory responsibilities in such areas as home to school transport, to ensure that they are properly funded. Finally, as we have heard, the Government should carry out the relative needs and resources review—the so-called fair funding review. The review should look at not only the opaque and complicated formulas used, but the data used for the assessment of relative needs, which, as we have heard, dates way back—much of it to the last century.
In his summing up, I hope that the Minister, my hon. Friend the Member for North Dorset (Simon Hoare), who has taken extremely well to his new role, will be able to herald in the long-term strategic approach that local government so desperately needs.
Jane Hunt (Loughborough) (Con)
Let me first declare an interest. Although I am no longer a borough councillor, I was until last May, and I understand that I still have to register that until 12 months have passed.
I want to thank the Department for Levelling Up, Housing and Communities and Ministers past and present, because the £600 million is a significant increase and is very welcome. I also thank Leicestershire County Council, Charnwood Borough Council, my parish and town councils, and others throughout the county. My colleagues there do wonderful work, as do the officials, and I greatly appreciate what they do.
I will not go into too much detail about the issue of fairer funding, because it has been well rehearsed. Since 2019 and, I understand, before I entered the House, all the Leicestershire MPs have lobbied Ministers continuously, including many a Secretary of State and many a Chancellor. I will say, however, that if we are talking about a fairer funding formula, the operative word is “fairer”, and that standard is not being met at present. If something could be done about this in the very near future, I would be most grateful.
The arguments about rural areas have also been well rehearsed. I thoroughly support what was said by my hon. Friend the Member for West Dorset (Chris Loder), and it is always worth listening to my hon. Friend the Member for Ruislip, Northwood and Pinner (David Simmonds). Many of his points were exactly the points that I was intending to make. I do not like to moan—I prefer to come up with a solution if I possibly can—so I want to suggest something along the lines of what my hon. Friend the Member for St Austell and Newquay (Steve Double) said in the police debate earlier this afternoon. He talked about the use of police resources by other Departments, such as the Department of Health and Social Care, and I think that the same applies to the use of council resources by the Department for Levelling Up, Housing and Communities.
The hon. Member for York Central (Rachael Maskell) alluded to this, in the context of education, health and care plans. Last Friday evening two of the eight slots in my constituency surgery were about EHCPs, and on the previous Friday three of them were. The county council has a statutory responsibility to deliver EHCPs, but the Department of Health and Social Care can say what it wants about the “H” element without having to deliver the resources. The county council feels that it has to deliver them itself, and that puts additional cost and time pressures on the 20-week window within which it must finalise an EHCP. I should like something to be done about that, so that the Department that asks for something actually pays for it.
Exactly the same happens in my borough council in respect of supported housing benefit. Because some charities in my constituency are not registered social landlords, the council cannot claim the whole of the benefit back from the Department for Work and Pensions, and is therefore out of pocket by about £1.5 million, which is simply unsustainable on a budget of about £16 million a year. Instead of the customers of Departments such as the Department for Levelling Up, Housing and Communities—the councils—paying for those things, the Department that wants them to be done should pay.
In his opening speech, my hon. Friend the Minister for Housing, Planning and Building Safety talked about spending on frontline services. I agree entirely with what he said, but I also believe that if councils spend money on things that they want to do, they should not necessarily be unable to get money back from Departments.
Liz Twist (Blaydon) (Lab)
For 14 years Ministers in this Government have come to the House to lay out their plans for local government finance, and for 14 years there has been a constant theme: sticking plaster policies. Instead of providing the certainty and stability that local government is crying out for, the Government have again set out proposals that have been chopped and changed in admission of their own failure. Councils of all political stripes are left shelling out millions and communities and service users are paying the price, but I do not believe for a moment that Ministers have taken the steps necessary to end this crisis—a crisis compounded by spiralling inflation and a failure to grow our economy, where councils are spending eye-watering amounts on temporary accommodation, and where at any moment the next domino could fall and another council could be on the brink of collapse. This is not sustainable. Local authorities need a Government who will support them with a long-term plan, because we are under no illusions about the scale of the problem.
John Redwood (Wokingham) (Con)
Given the need for a long-term plan, were Labour to win the election, how much extra would local government get in the first year of a Labour Government?
Liz Twist
As I will come on to say shortly, we will have a review to look at the long-term plans. We understand the problems that local government is facing.
We have heard from hon. Members on this side of the House, including the Chair of the Select Committee, my hon. Friend the Member for Sheffield South East (Mr Betts), who set out a comprehensive summary of the issues facing local authorities and councils generally and thanked councils and councillors for carrying on and doing the work they need to do to run the councils. He also reminded us of the impact of the public health cuts that local authorities have seen. My hon. Friend the Member for York Central (Rachael Maskell) referred to issues in her local authority and to the gap between rising need and available funding. As many other Members also mentioned, SEND funding is an issue, as is the impact of public health cuts.
We all understand that there is no magic wand and no quick fix, but if the Government are prepared to work with councils to build from the ground up and to deliver the services that taxpayers need and deserve, I truly believe that we can bring an end to this crisis. However, over this last decade the Government have abandoned any interest in this kind of co-operation and instead torn down the protections that were meant to prevent a crisis like this. As we have heard, they have ripped away any financial oversight of local council spending, scrapped the Audit Commission and pushed councils to borrow more and more. They have also left councils without a functioning early warning system, meaning that they cannot even sound the alarm when they are struggling.
We cannot go on like this, and that is why a Labour Government would instead prioritise stability and greater certainty, unlocking multi-year funding settlements to give local taxpayers better value for money, fixing our broken audit system to restore genuine oversight and partnership with local government, and prioritising certainty and stability over this Government’s narrow and short-term fixes to problems of their own making.
The Parliamentary Under-Secretary of State for Levelling Up, Housing and Communities (Simon Hoare)
It is a pleasure to wind up for the Government in this debate. I will just say gently to one of my shadows, the hon. Member for Blaydon (Liz Twist), that if the situation is as bad as she and the hon. Member for Oldham West and Royton (Jim McMahon) have painted it, I am surprised that with the exception of those on the Front Bench and the hon. Member for Sheffield South East (Mr Betts)—I know, as a former Select Committee Chairman, that one is obliged to take part in these debates when they relate to one’s Department—we have, against all this horror, had only one Labour Back-Bench contribution. I thank and congratulate the hon. Member for York Central (Rachael Maskell)—at least there is one Labour Member who is concerned about local government and who is not obliged to come and talk about it.
What an exciting prospect we have—the nation sits agog! After 14 years of opposition, a review to look at long-term plans is what the hon. Member for Blaydon tantalisingly holds before the House and the electorate. After 14 years of opposition, one has to ask what on earth they have been doing with the time. A review to look at long-term plans! As always, the Labour party is quick to critique and slow to deliver. What a contrast to the speeches we have heard from Conservative Members.
Mr Betts
I take the Minister back to the beginning of the debate, when the Minister for Housing, Planning and Building Safety talked about doing a long-term review of local government finance in the next Parliament. The difference, of course, is that the Government have been in power for the last 14 years and could have done something about it.
Simon Hoare
The hon. Gentleman and I have discussed this on many occasions, and I know he broadly agrees with me on this point. Local council chief executives and leaders would have come at the Department with pitchforks and flaming torches if we had dumped a 200-page consultation document on their desks at a time when they were rallying to support their communities during the covid crisis.
This year, as last year, the Government have rightly set our focus on stability, certainty and security. I believe this local government finance settlement delivers on all three.
Simon Hoare
No. If the hon. Gentleman is not here for the opening, he cannot take part in the summing up. He has tried that trick before, and it did not work then.
As we heard from the hon. Members for North Shropshire (Helen Morgan), for Sheffield South East and for Blaydon, some of these issues came through in the consultation and in the engagement: support for special educational needs; a long-term view of adult social care; and reform to the funding formula, which so many hon. and right hon. Members have referenced. A reformed funding formula would provide stability and security to our local authorities, and the best way to deliver it is through cross-party working. That is what this House owes them.
When I was asked to take on this job, I had no idea of the complexity and time required to arrive at a local government finance settlement. I thank all colleagues who came along to take part in my parliamentary engagement, which was hugely helpful. I pay tribute to my private office and to officials in the Department—long hours, huge work. I pay particular tribute, not least because her note tells me I have to, to Victoria Peace for all her hard work, as well as to Kate, Nico and others. It has truly been a team effort.
I also thank the Chancellor of the Exchequer and the Prime Minister for listening to the case that the Secretary of State and I took to them on revising the formula. We said that we would listen, we did and we have acted. Those are the hallmarks of prudent, listening, caring, one-nation conservativism, and it is writ large in this local government finance settlement.
I also pay tribute, as so many others have, to the work that councillors and council officers do, day in and day out, to deliver to make the lives of some of the most vulnerable people in our society more bearable and a little better, and to create a sense of place in which people wish to live. We salute all of them. Are all of them brilliant? Of course not, but not all of us are brilliant either. But I know that, day in and day out, they focus on doing their best.
I have been called many things, but the hon. Member for Sheffield South East called me “genuinely helpful”. My hon. Friend the Member for West Dorset (Chris Loder) called me “the great rural tsar” and a “knight in shining armour”. And my hon. Friend the Member for St Austell and Newquay (Steve Double) called me a “warrior” for rural councils. I am grateful for those comments, and I look forward to their being carved into my headstone in due course.
Simon Hoare
Not too soon, I hope.
I could bore the House with the figures for the local authorities of each Member who has contributed, but those figures are on the public record. They are all going in a positive direction. I think we have started to make significant inroads into addressing those concerns, by turning our thinking to the common themes that have ranged through this debate. The trajectories on SEND and adult social care show no sign of abating, and we need a long-term solution. The formula does need reforming and the Government are committed to doing just that in the next Parliament.
I say to everyone that the transformation and productivity plans, which we see as a key part of the settlement, are all part of underscoring that “Agenda for Change” is a process, not an event; it has to be iterative and organic, because, as my hon. Friend the Member for St Austell and Newquay mentioned, we have no money and councils have no money save that which we raise through the taxpayer. We have a duty to ensure that we deliver the biggest bang for each and every buck.
My hon. Friends the Members for Hastings and Rye (Sally-Ann Hart) and for West Dorset, the hon. Member for Somerton and Frome (Sarah Dyke), and my hon. Friends the Members for Loughborough (Jane Hunt) and for Waveney (Peter Aldous) all made important points about how the formula review must ensure that we take into account the differentials in the demand of need in delivering services in a rural or coastal area. I do not believe that we would be right in any definition of the term to say that “need” in an urban area outranks that in a rural or coastal area, or vice versa. Need is need and our local authorities want to play their part in making a difference on that. My hon. Friend the Member for Loughborough was not the only one, but she was right to mention the need for other Departments, when they create a new burden or duty on local authorities, to take into account the budgetary impacts that those services have, and I certainly take that on board. My hon. Friend the Member for Hastings and Rye made that point as well and I agree with all who have made it.
The hon. Member for York Central asked a specific question about the flood recovery framework and business rates. I am delighted to confirm to her that 100% business rate relief is available to business for a minimum of three months where they have been flooded and that that relief can continue to an agreed date until the business is able to be reoccupied for trading. I hope that that gives some comfort to her and to her constituents who have suffered from flooding issues in the recent time.
A lot has been done, services can continue, but the need for reform, cross-party working, blue skies thinking and significant change remains. This settlement is a generous one, with more than half a billion pounds or, I should say, “just” half a billion pounds, available for children’s services and adult social care. My hon. Friend the Member for West Dorset has long advocated for the rural services delivery grant and that is up now to its highest level, at £115 million. I know that rural councils, including that of the hon. Member for North Shropshire, will have welcomed that as a useful means of supporting their services.
We understand, applaud and appreciate the important contribution that councils make across our country, and the difference they deliver for their communities. We understand and are going to work with the sector, sector leaders, council leaders and others to ensure a bright, secure and stable future for local councils. We are providing a £600 million uplift, and, on average, a 6% to 7% increase in core spending power for most councils. This is a fantastic opportunity for councils to continue to deliver and for us to support them. I close with the point that many have made: we will deliver better for our constituents when central and local government work in partnership, matched horses pulling in the same direction, serving our communities and making a vital difference for those who need it. I commend the settlement to the House.
Question put and agreed to.
Resolved,
That the Local Government Finance Report (England) 2024–25 (HC 318), which was laid before this House on 5 February, be approved.
Resolved,
That the Referendums Relating to Council Tax Increases (Principles) (England) Report 2024–25 (HC 319), which was laid before this House on 5 February, be approved.—(Simon Hoare.)
Resolved,
That the Referendums Relating to Council Tax Increases (Alternative Notional Amounts) (England) Report 2024–25 (HC 320), which was laid before this House on 5 February, be approved.—(Simon Hoare.)
Business of the House (Today)
Ordered,
That, notwithstanding the provisions of paragraph (14) of Standing Order No. 80A (Carry-over of bills), the Speaker shall put the Questions necessary to dispose of proceedings on the Motions in the names of:
(1) Secretary Michelle Donelan relating to the Data Protection and Digital Information Bill: Carry-over extension; and
(2) Secretary Alex Chalk relating to the Victims and Prisoners Bill: Carry-over extension not later than one and a half hours after the commencement of proceedings on the Motion for this Order; such Questions shall include the Questions on any Amendments selected by the Speaker which may then be moved; proceedings may continue, though opposed, after the moment of interruption; and Standing Order No. 41A (Deferred divisions) shall not apply.—(Penny Mordaunt.)
Business Without Debate
(9 months, 2 weeks ago)
Commons ChamberRead Full debate Read Hansard Text
Delegated Legislation
(9 months, 2 weeks ago)
Commons ChamberRead Full debate Read Hansard Text
Physician Associates
(9 months, 2 weeks ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)
I draw the attention of the House to my entry in the Register of Members’ Financial Interests as a practising NHS consultant psychiatrist.
The UK has a severe shortage of healthcare professionals, amounting to more than 110,000 in England alone, coupled with a growing ageing population with an ever-increasing need for a strong and responsive health service. To address the shortage, the Government in England have introduced the NHS long-term workforce plan, with additional proposals also set out in the devolved nations.
NHS England’s plan sets out a wide range of mostly unfunded workforce measures, including doubling the current number of medical student places to potentially add 60,000 doctors to the workforce by 2036-37. Controversially, it also includes plans to increase the number of physician associates from approximately 3,250 to 10,000, an increase of over 300%, and anaesthesia associates from approximately 180 to 2,000. That is not to say that physician and anaesthesia associates should not have an important role in the future NHS workplace. However, at this time, serious regulatory and safety concerns relating to associates need to be addressed before the NHS seeks to expand their numbers and roles. Furthermore, standardised high-quality training pathways and a properly defined scope of practice are essential.
Physician associates, anaesthesia associates and surgical care practitioners are collectively known as the medical associate professions, and I may use the terms interchangeably. Physician associates and anaesthesia associates currently complete a two year postgraduate course and are employed in a variety of settings in the NHS, including GP surgeries, emergency departments, and medical and surgical settings, and they have also been introduced to mental health settings.
Jim Shannon (Strangford) (DUP)
I commend the hon. Gentleman for securing the debate. The issue is massive—it is massive for me back home, as well—so I thank him for his reasoned and knowledgeable speech, as well as his contribution to the NHS over the years. Without an increase in the number of GPs and doctors, does he agree that the healthcare crisis we face will become an abyss? In small countries such as Northern Ireland, students cannot get places in our small medical schools and are training, working and living in other countries, which is a real loss to future stability. Does he agree we need to do more to keep our young medical staff rather than let them head to greener grass in far off fields?
Dr Poulter
I completely agree with the hon. Member. He advocates strongly for his constituents, as always, and for the need to better retain our medical workforce in general, our junior doctors in particular. The Government will have heard his comments. I am sure that things can be done to improve the current offer to junior doctors in England. Indeed, things can be looked at in Northern Ireland, too, with the restoration of political arrangements.
An agreement could be put in place that will properly renumerate junior doctors, and also look at the other terms and conditions of employment that are important in respect of retaining the medical and healthcare workforce. These situations are not always about pay; it is also about wider terms and conditions. The Government could certainly look in more detail at student debt, for example, as the Times Health Commission outlined this week, which may incentivise people to stay in medicine for longer.
We have diverged slightly into the broader healthcare challenges, so I will return to physician associates, which was the point of this evening’s debate. There are concerns about the regulation and training of this particular group in the medical workforce. Physician associates and anaesthesia associates are not currently regulated. There have been a number of recent high-profile cases of patient harm as a result of being seen by medical associate professionals, including, sadly, some deaths. We know, for example, of the tragic case of Emily Chesterton from Salford who died of a pulmonary embolism having been seen twice and had her deep vein thrombosis misdiagnosed as a musculoskeletal problem by a physician associate at her local GP practice.
Anybody who watches the TV programme “24 Hours in A&E” may have seen some fairly enlightening scenes in respect of the clinical skills of some medical associate professionals, including physician associates. There are many examples of poor clinical diagnosis and judgment, including, for example, making initial decisions to send patients with compound fractures home without an X-ray when the patient actually required surgery.
In my own clinical practice, I have worked alongside some very competent physician associates, but there is a high degree of variability in their training and skills. Only last year, I was forced to directly intervene to prevent patient harm following a paracetamol overdose by a patient who attended A&E. The physician associate incorrectly informed me that they did not require N-acetylcysteine treatment because their liver function test was normal, in spite of the fact that they were over the treatment line as a result of their paracetamol overdose. Of course, at that time, the patient’s liver function tests were normal, but they would not have been for very long. The consequences of that diagnostic decision by the physician associate could have been fatal. The key issue for me is that many physician associates do not know or have the self-awareness to understand the limits of their knowledge and practice, but this is perhaps understandable in a health system that fails to adequately regulate and indeed define its scope of practice.
There are many other areas of concern that have been highlighted in a recent British Medical Association survey of 18,000 doctors, an overwhelming majority of whom work with physician associates. In November 2023, due to severe concerns around patient safety, the BMA called a halt to the recruitment of medical associate professionals to allow proper time for the extent of patient safety claims to be investigated and the scope of the role to be considered.
When the physician associate role was introduced, it was clearly seen as part of the solution to a shortage of doctors, which currently stands at in excess of 8,500. By freeing up doctors from administrative tasks and minor clinical roles, it allowed them to see more complex patients and get the training required to become excellent consultants or GPs.
Unfortunately, physician associates and anaesthesia assistants have been employed in the NHS in roles that stretch far beyond that original remit, and in many cases that were reported in the recent BMA survey that I mentioned, they appear to be working well beyond their competence. That has raised serious patient safety concerns—I gave some examples earlier—and led to calls to review the role, limit the scope of practice, and protect training for the doctors that the NHS desperately needs. When consultant time is taken by supervising physician associates, that is to the detriment of training and supervising junior doctors. That has not yet been addressed or even considered in the NHS England workforce plan.
Rachael Maskell (York Central) (Lab/Co-op)
I am grateful to the hon. Member for introducing this evening’s debate. I sat on the Committee that considered the Anaesthesia Associates and Physician Associates Order 2024. He is drawing out several issues. One is competency; another is patient literacy. A lot of new roles are emerging—technicians, assistants, associates, and advanced practitioners—and to the public this is now becoming a blurred space. People do not understand the competences that individuals possess, their scope of practice, and where they fit into the medical family, or indeed professions allied to health. Does he agree that we need to define those roles clearly, and that associate roles should be around professions allied to health, rather than associated directly with the medical profession?
Dr Poulter
I fully agree with the hon. Lady, and I will expand on that a little later. There is certainly confusion among the public about what a physician associate is. Many members of the public assume them to be doctors or other healthcare professionals. They therefore lack a much greater degree of competence. Given that it is envisaged that the role will be significantly expanded, the public understanding and awareness of it, and people’s expectations when being treated by somebody in that role, are really important. That needs to be better addressed through the current proposals for regulation, which I will come to in a moment.
I will talk briefly about general practice and the additional roles reimbursement scheme. Through the ARRS, the Government have provided funding to GP practices that can be used to pay for physician associates and other clinical staff, but not for hiring additional doctors and nurses. That is quite extraordinary, and results in GP practices having physician associates rather than fully qualified GPs. Currently, most physician associates in general practice are funded through the additional roles reimbursement scheme: an NHS scheme that funds primary care networks to support recruitment across a very limited set of eligible roles. The current rules for ARRS funding are causing inefficiencies as they are not flexible enough to respond to locality needs for healthcare staff. In particular, the rules do not allow practices to hire primary care nurses, practice nurses, or indeed GPs, as I mentioned.
Over the past year, there have been many developments in how the Government and the profession view the roles of physician and anaesthesia associates, but it seems extraordinary that when we are talking about supporting general practice in developing the right skills and competences, and delivering the right service for patients, one of the key funding schemes does not allow for the hiring of the GPs and practice nurses that are needed, and is skewed towards physician associates. I wonder whether the Minister might take that away, look at the scheme, and help to provide additional flexibility, which general practice would like and which seems eminently sensible, to allow recruitment at a local level, in line with patient need.
There are significant concerns connected with the roll-out of the anaesthesia associates project. While the GMC addressed some of those issues in its recent letter to NHS England, a number of concerns remain. In particular, the NHS long-term workforce plan suddenly projected a huge expansion in the number of anaesthesia associates, but no expansion in the number of doctors in anaesthesia—or, as we are talking about position assessments, in the number of doctors in other specialities. To many, that looks like a replacement of doctors with anaesthesia associates, rather than anaesthesia associates being employed to complement the anaesthesia team, which was the idea previously portrayed.
There are many examples of medical associate professionals in the wider sense working in ways that have caused concern, as we have discussed in this debate, particularly with regard to their scope of practice. Anaesthesia provision in the UK must continue to be led and delivered by doctors, who are properly trained and properly regulated. Anaesthesia associates are valuable members of the anaesthesia team in addition to doctors, but they are not a solution to the challenges of low workforce numbers in anaesthesia and growing waiting lists.
The answer is to expand consultant numbers, an expansion in training scheme places for doctors in anaesthesia, and the development of the large number of speciality doctors and locally employed doctors already in post. Creation of speciality and specialist doctors and consultants via the General Medical Council’s new portfolio pathway could result in our having many more independent doctors in anaesthesia and other medical disciplines. It seems extraordinary that we are not looking at that first, given that we have a properly regulated and properly trained profession, rather than at expanding a workforce that is not subject to proper regulation to date, does not have a certified training pathway, and has been associated with a significant number of adverse patient outcomes and incidents.
Regulation ensures consistent standards for training, and for the practice of physician associates and anaesthesia associates. It maintains standards and, critically, contributes to patient safety. As per the recent Anaesthesia Associates and Physician Associates Order 2024 laid before the UK and Scottish Parliaments, those associates will be registered with the General Medical Council. However, there are increasing concerns that that could further blur the distinction between doctors and anaesthesia associates.
In response to those concerns, the GMC has said that physician associates and anaesthesia associates will be issued with a registration number format that distinguishes them from doctors. That is to be welcomed. However, it must go further and present doctors on a separate register from physician associates and anaesthesia associates, whether we are talking about a register online or in print—that aligns with the point that the hon. Member for York Central (Rachael Maskell) made—so that it is very clear that the different professions are regulated under separate registers. That is important for both accountability and transparency, and it is important that patients understand that.
There should be a clear distinction between the register of doctors and other registers. That is necessary to provide absolute clarity for patients and others who wish to access the registers, and it is essential to protect everyone from accidental or deliberate misrepresentation. With modern information technology systems, there is no legitimate reason why that cannot be done. It would be simple, and it is about transparency, openness and patients better understanding the difference between the responsibilities of doctors, and those of physician associates and anaesthesia associates. I hope the GMC is listening to this debate and will ensure properly separate registers. That does not cost much, but is very important.
Perhaps the crucial point in this debate is the scope of practice. There should be a national scope of practice for physician associates and anaesthesia associates, both on qualification and after any post-qualification extension of practice. Any future changes to scope of practice should be developed in conjunction with the regulator and should be agreed at national level. I understand that currently the GMC will not regulate extended scopes of practice, which is very regrettable. For example, we are aware of whether a doctor is on the GP register or a specialist register, or just has a licence to practise. Those levels of expertise are part of the regulatory framework. It seems extraordinary that although the GMC has been asked to look at regulating physician associates, there is no understanding of the scope of a physician associate’s practice. That needs to be properly mapped out and explored.
Rachael Maskell
I am grateful to the hon. Gentleman for making those points. It is particularly concerning that a prescribing nurse, say, could become a physician associate, but perhaps without the ability to prescribe. That would create even greater confusion. Does he agree that we need clarity and distinctions to be drawn on those kinds of issues?
Dr Poulter
I fully agree; the hon. Lady is absolutely right. I was going to address that very point about prescribers a little later. There is clear agreement on the challenges. Those issues should be thought through before a workforce plan is brought forward, and before there is a significant expansion of the workforce, for reasons of patient safety, particularly as concerns have consistently been raised about the scope of practice and adverse incidents. It is rather putting the cart before the horse to say, “We want to expand the workforce without dealing with the important issues of how that workforce is trained, how it can properly be regulated, and what its scope of practice is.” That is unfortunately a regrettable failing of NHS England’s plan, which I hope it will consider.
If the GMC cannot regulate extended scopes of practice, they should be devised according to a national framework. There needs to be an understanding of what that should be. It is unacceptable for employing organisations in the NHS to devise their own extended scopes of practice without reference to at least some national framework—one that has the confidence of regulators and standard setters—so that we know and understand what good practice looks like.
Doctors should be directly involved in devising any changes to the scope of physician associate and anaesthesia associate practice, whether on qualification or at extended level. There should be no extension of roles beyond the scope of practice on qualification until national guidance is issued. Where organisations are planning such an extension, it should be paused for reasons of patient safety. Where physician associates or anaesthesia associates are already working in an extended role, it should be recorded on the healthcare organisation’s risk register, and the organisation should ensure that it has full confidence in its standards of supervision, access to support, indemnity of the anaesthesia or physician associate and the supervising doctor, and patient information and consent. Anaesthesia associates have a role to play as part of the wider anaesthesia team, but it is important to ensure that it is a complementary role as an addition to the workforce, not as a replacement for doctors and nurses, as the hon. Lady rightly underlined. Expansion in the number of anaesthesia and physician associates should not be at the expense of expansion in the number of doctors in specialist posts.
Let me come briefly to assessment, which is another area that has not been well thought through. It is important that assessment for anaesthesia associate roles is standardised at national level. The Royal College of Physicians does a national exam for physician associates, but a national body needs to be established to undertake the assessment process for anaesthesia associates if we are to ensure confidence in their competencies. It may be possible for that to be delivered locally, if there are stringent controls in place to ensure consistency. However, before the anaesthesia associate workforce is expanded, there needs to be some process for assessing competency.
On indemnity, which was also addressed by the hon. Lady, further information is needed around indemnity cover for both physician associates and anaesthesia associates, as well as for any doctors supervising them. “Good medical practice” expects all doctors to ensure that they are fully indemnified. The same standard should apply to physician associates and anaesthesia associates. Many doctors in anaesthesia, in general practice and in emergency departments are already worried about medicolegal liability when working with physician associates, and clear guidance is urgently needed. Although reference is made to accountability, more information is required in this area, given the challenges that we know have arisen.
The hon. Lady mentioned prescribing rights. Some physician and anaesthesia associates—for example, those with a nursing background—may already have those rights from their parent profession. The Commission on Human Medicines is responsible for deciding which professions are able to prescribe, and it is important that it is clear in its guidance and reasoning in respect of physician and anaesthesia associates before there is a wider roll-out of those roles.
I draw the Minister’s attention to key findings from the British Medical Association’s recent survey, which sought the views of over 18,000 doctors about the role of the medical associate professions. Almost 80% of respondents—that is well in excess of 15,000 doctors—had worked with or trained medical associate professionals, which means that contact with those professionals is widespread throughout the NHS. Medical associate professionals are currently unregulated and have a poorly defined scope of practice. The BMA survey respondents were very concerned about that, as well as about the fact that MAPs have been employed in the NHS in a variety of roles, which go well beyond what was originally envisioned as an assistant role. A staggering 87% of doctors surveyed believed that the way that physician and anaesthesia associates work in the NHS is a risk to patient safety. For the Minister’s benefit, that is the best part of 18,000 doctors who work with this workforce raising concerns about working practice and patient safety.
Rachael Maskell
Once again, I am grateful to the hon. Member for giving way. Doctors in training need a very clear career pathway, but because of the rise in anaesthesia associates in particular, but also in physician associates, the pathway to many more senior roles will be blocked. As a result, people will stagnate as doctors in training, as opposed to getting a consultancy. Does he agree that that is highly problematic, and that the career pathway needs working through before there is any increase in the number of physician and anaesthesia associates?
Dr Poulter
That is absolutely essential. At the moment, the prerequisite appears to be a biomedical science degree, which is incredibly variable—depending on whether a person went to Hull, Newcastle or a London university, a biomedical science degree could be very different—and then two years of study. A physician associate would then have to pass an exam set by the Royal College of Physicians, but when a person passes that exam, it does not necessarily mean that they had standardised or good training; potentially, it just means that they prepared well to pass their exam. The difference with doctors in medical school—and indeed the difference with nurses going through nursing school—is that they are consistently assessed, all the way through their undergraduate training. When they graduate at the end of that training, they are consistently assessed as they progress.
None of that exists in the training pathway for physician or anaesthesia associates; in fact, as we have discussed, there is not even an exam for anaesthesia associates at the end of the process. It is absolutely essential that those issues are addressed as a priority, and it is little wonder that patient deaths and adverse incidents are occurring on such a scale. Perhaps when the Minister is suffering from insomnia late at night, he may wish to watch old episodes of “24 Hours in A&E”. He will see the huge variability in the expertise of physician associates. Some are very good, but some are not, and we should not be dealing with variability in the British health system. That is what we are trying to address, so the hon. Member for York Central is absolutely right in everything she has said.
That highlights the last point I am going to draw to the House’s attention from the BMA survey of 18,000 doctors. Some 75% of respondents said that the quality of training among medical associate professions—physician and anaesthesia associates—was woefully inadequate; 84% said that the quality of their supervision when they are at work was inadequate; 91% outlined the fact that they work outside their competence; and 86% of respondents confirmed that the public would confuse them with doctors, as the hon. Lady outlined. This is not just a few hundred doctors; this is 18,000 doctors saying in a survey that they have serious patient safety concerns due to the variability in training of anaesthesia associates. There have been far too many adverse incidents where things have gone wrong, and it is time for the Government to give NHS England some clear direction that this area needs to be looked at, and some proper planning and consideration of the expansion of this workforce put in place.
These are the asks I have of my right hon. Friend the Minister. First, we should ensure there is a standardised and quality assured training programme for physician associates, anaesthesia associates, surgical care practitioners and all other medical associate professionals, and indeed that there is ongoing training and supervision to a nationally standardised level when that group is in the workplace post qualification. Secondly, we should ensure that the General Medical Council sets up a register for the regulation of medical associate professionals, separate from the register for doctors. Thirdly, as is the case with all other healthcare professionals, we should ensure that the scope of practice of physician associates is clearly set out to make sure that we can develop appropriate training pathways and supervisory pathways, but, more importantly, to ensure patient safety. Finally, the Government should support the introduction of a system with greater flexibility to hire GPs and general practice nurses using the ARRS funding. I thank the House, and I look forward to the Minister’s response.
The Minister for Health and Secondary Care (Andrew Stephenson)
I congratulate my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) on securing this debate. He spoke knowledgeably, both as a serving NHS medic and as a former Health Minister.
Let me begin by making a very important point. I addressed it in the Delegated Legislation Committee on 17 January, but it is worth repeating. The role of a physician associate is to work with doctors, not to replace them. Improved patient safety and care is at the heart of the NHS long-term workforce plan, which, backed by significant Government investment, shows our determination to support and grow the workforce. As set out in the plan, roles such as physician associates, who remain supervised by doctors, play an important part in NHS provision, and it is therefore right that we include a range of roles and skills in our multi-disciplinary teams that can offer personalised, responsive care to patients.
It is important to note that the NHS long-term workforce plan commits to doubling medical school degree places to 15,000 a year by 2031-32. That compares with 1,500 physician associate places. In turn, this will mean a major expansion of specialty training, on which we are committed to working with the royal colleges. We have accelerated this expansion by allocating 205 additional medical school places for the 2024-25 academic year, with the process for allocating 350 additional places for the 2025-26 academic year already under way. This demonstrates our commitment to the medical profession, and reaffirms that we absolutely do not see physician associates as replacements for doctors. There are currently 139,200 full-time equivalent doctors working in the NHS in England, which is over 42,100, or 43.4%, more than in 2010. Patient safety remains of the utmost importance, and regulation will help bring further clarity to patients and healthcare professionals on the nature of these roles and their remits.
Physician associates are qualified and trained health professionals. They undergo a three-year undergraduate degree in a health, biomedical science or life sciences subject, followed by two years of postgraduate training, gaining significant clinical experience. Alternatively, some universities now offer an undergraduate degree PA course that includes an integrated master’s degree in physician associate studies. Those courses take four years to complete. Training involves supervised practice with real patients, with at least 1,600 hours of clinical training. It also includes 350 hours in general hospital medicine, and a minimum 90 hours in other settings, including mental health, surgery, and paediatrics. The dedicated medical supervisor is responsible for the supervision and management of a student’s educational process throughout the clinical placement of the course.
Dr Poulter
Earlier, in response to the hon. Member for York Central (Rachael Maskell), I made the point about the variability of biomedical science degrees from different institutions. The GMC would not recognise a biomedical science degree as being adequate for a doctor in training as part of their preclinical studies, because of that variability. Will my right hon. Friend raise that issue directly with NHS England, with regard to putting in place a standardised training pathway for physician assistants?
Andrew Stephenson
My hon. Friend makes a valid point, and that is one reason why regulation is so important. The GMC has assured me that although draft regulations are out there, it will be consulting further on them later this year, so my hon. Friend, the BMA and various others can make strong representations about how the training framework should be provided. With that introductory regulation, the GMC will be responsible for setting, owning and maintaining a shared outcomes framework for physician associates, which will set a combination of professional and clinical outcomes. The outcomes framework will help to establish and maintain consistency, embed flexibility, and establish principles and expectations to support career development and lifelong learning. While at the moment there is significant variability in the system, I hope that the regulations we passed in this House on 17 January will help to provide that clarity and give the GMC the powers it needs to ensure that the training provided to physician associates is of the appropriate quality for the roles we are expecting them to undertake in our NHS.
Physician associates can work autonomously with appropriate support, but always under the supervision of a fully trained and experienced doctor. As with any regulated profession, an individual’s scope of practice is determined by their experience and training, and will normally expand as they spend longer in the role. That must be coupled with appropriate local governance arrangements to ensure that healthcare professionals only carry out tasks that they have received the necessary training to perform. Statutory regulation is an important part of ensuring patient safety, but that is also achieved through robust clinical governance processes within healthcare organisations, which are required to have systems of oversight and supervision for their staff.
NHS England is working with the relevant professional colleges and regulators, to ensure that the use of associate roles is expanded safely and effectively. That includes working with the GMC, royal colleges and other stakeholders to develop appropriate curriculums, core capabilities and career frameworks, standards for continual professional development, assessment and appraisal, and supervision guidance for anaesthetist and physician associates. NHS England will also work with colleges, doctors’ representative organisations, AAs and PAs to identify areas of concern. Specifically, the NHS has committed to working with the Academy of Medical Royal Colleges and individual professional bodies to develop and implement recommendations as a result.
Regulation will give the GMC responsibility and oversight of AAs and PAs, in addition to doctors, allowing it to take a holistic approach to education, training and standards. That will enable a more coherent and co-ordinated approach to regulation and, by making it easier for employers, patients and the public to understand the relationship between the roles of associates and doctors, help to embed such roles in the workforce. Indeed, regulation addresses many of the concerns that we have heard in the debate last month and today. The GMC will set standards of practice, education and training and operate the fitness to practice procedures, ensuring that PAs meet the right standards and can be held to account if serious concerns are raised. GMC guidance sets out the principles and standards expected of all its registrants, and that will apply to PAs once regulation commences. Those standards will give assurance that PA students have demonstrated the core knowledge, skills and professional and ethical behaviours necessary to work safely and competently in their areas of practice and in a care context as newly qualified practitioners.
Rachael Maskell
On that point, can the Minister clarify where the liability will sit if error does occur? Will it sit with the clinician or the consultant who is supervising them? I am not clear on that particular issue.
Andrew Stephenson
In many ways, it will be the same as with many medical professionals. Once we have the situation clarified in regulation, it will not be any different from the personal liability of a doctor or others working in an organisation. Those are the kind of things that the GMC will be consulting on and discussing with stakeholders in the coming months, and is important that all these points are clarified. The hon. Lady was in the debate we had in January, where the tragic case of Emily Chesterton was raised. In that case, unfortunately we saw a PA move from one practice to work in another, and we need to ensure that there is a proper, robust fitness-to-practice regime so that any medical professional can be held to account in such cases for what has happened and, if necessary, struck off the register and no longer able to practice.
Dr Poulter
The Minister is being generous in giving, and we are taking advantage of the slightly extended time we have for this Adjournment debate, but it is an important issue, because it is about patient safety. On that point, he is putting a lot of faith in the GMC doing things quickly, when we know there are existing patient safety issues. Would it not be more sensible to wait for the GMC to put in place the proper regulatory framework, the proper scope of practice and the other pieces of work that are being done before we commit to an expansion of a workforce when we know there is variability and patient safety concerns?
Andrew Stephenson
I feel that I am being criticised from both angles on this point. Some people are saying we are going too fast, and other people are saying we are going far too slow. A number of years ago, we consulted on regulating these professions. We are now moving forward. Those regulations have passed through the UK Parliament and the Scottish Parliament. The GMC has had a long time to prepare. In my meetings with the GMC, it has reassured me that it is ready to go. It will want to consult to ensure that any further concerns that people wish to raise are reflected in the regulations. It wants to ensure that it gets the regulations right, but it has known that they have been coming for some time. We consulted on who was best placed to regulate physician associates and anaesthetist associates back in 2019, so the GMC has had some time to lay the groundwork.
Under the long-term workforce plan, there is a much more significant expansion of doctors, as opposed to physician associates or anaesthetist associates. The number of extra doctors we are bringing in to the health service, as compared with physician associates, is of a magnitude of five to one. I hope I can reassure hon. Members that this is not in any way about replacing doctors. Doctors are still absolutely pivotal to patient care and will be heavily involved in overseeing physician associates, who are not doctors and need to be overseen in clinical practice.
The role of physician associates is in no way a replacement for that of any other member of the general practice team. They work in conjunction with and are complementary to an existing team. Physician associates can help to broaden the capacity and skills mix within a practice team by helping to address the needs of patients in response to the growing and ageing population, but let me be clear that the employment of PAs does not mitigate the need for more GPs, nor does it remove the need for other practice staff.
There will be a wide range of clinicians, such as PAs, who are well suited to providing care in general practice as part of a multidisciplinary team, but GPs remain at the heart of general practice and primary care, and that is not going to change. As we develop and progress with changes to the NHS workforce, it is vital that the expansion of physician associates and their role is delivered safely. GMC regulation is a positive step forward in the safe expansion and further integration of AAs’ and PAs’ roles within the NHS.
I thank my hon. Friend the Member for Central Suffolk and North Ipswich for once again bringing the House’s attention to this important issue. I look forward to continuing to work with him and other right hon. and hon. Members to ensure that we get this right.
Question put and agreed to.