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Emma Foody (Cramlington and Killingworth) (Lab/Co-op)
The Secretary of State for Science, Innovation and Technology (Peter Kyle)
More than 85% of UK premises can now access a gigabit-capable broadband connection. Through Project Gigabit, more than a dozen suppliers are delivering contracts to bring fast, reliable broadband to more than 1 million more homes and businesses across the country. My team are making good progress and pushing forward with further plans to improve digital connectivity in hard-to-reach communities that would otherwise be missing out.
Emma Foody
Access to reliable broadband is essential to residents across my constituency, but for those who fall just outside commercial full-fibre broadband deployment areas, it remains a real issue that impacts their ability to work and study. What further action can the Government take to ensure that residents falling just outside current roll-out areas are not left behind?
Peter Kyle
My hon. Friend is a good advocate for her new constituency. I want everyone to understand that this new Department is not far removed from people’s lives, because we represent areas of technology all the way from space to digital infrastructure. We realise that every aspect of the Department’s work is connected to human beings trying to move forward and get on in life, and nowhere is that more important than in their ability to express their lives online. I can reassure her that we are ensuring that the market for digital provision is a functioning market that delivers for her constituents. In areas where the market is not as full as we would like, market providers need to work together, to ensure that all residents across her constituency have the connectivity they deserve.
Helen Whately (Faversham and Mid Kent) (Con)
My constituents in Throwley and Wichling have been battling for high-speed broadband. We thought we had it over the line, but in a recent telephone conversation Building Digital UK said that it was still to be confirmed. Would the Secretary of State be willing to meet me to discuss how we can ensure that those communities do not miss out again?
Peter Kyle
I can hear encouraging sounds from the hon. Lady’s colleagues asking for that meeting. Let me say at the outset that this Department wants to engage with everyone—[Hon. Members: “Hear, hear.”] I haven’t finished yet. We want to ensure that everyone in every constituency has full access to the connectivity that they need. With that in mind, the Minister responsible for the roll-out of these services will meet officials to ensure that the hon. Lady is given the attention that her constituents deserve.
Victoria Collins (Harpenden and Berkhamsted) (LD)
People and businesses in my constituency, like many elsewhere, are plagued with patchy access. Andy from Wheathampstead has found that the only way he can move on to working from home and running a business is to have expensive satellite broadband. Will the Secretary of State commit to ensuring that every home and business has access to gigabit broadband in rural and remote communities, and will he also ensure that there are bespoke solutions so that no home or business is left out?
Peter Kyle
Our manifesto commitment is to get to 99% coverage by 2030, and that is something we are determined to do. The programme run by BDUK for shared rural networks is technology-neutral. Along with the Minister responsible, I am encouraging BDUK as fulsomely as I can to ensure that every single technology emerging, as well as existing, is put to good use in that endeavour.
Kevin Bonavia (Stevenage) (Lab)
The Parliamentary Under-Secretary of State for Science, Innovation and Technology (Feryal Clark)
My hon. Friend takes every opportunity to raise this subject. He will be happy to learn that the Government have a clear plan for supporting the life sciences sector, as set out in our life sciences plan. Stevenage has a thriving life sciences community: it is home to GSK, Autolus and a growing number of biotech companies. We are continuing to encourage companies to expand their footprint in the area, supported by the cell and gene therapy catapult, which operates the manufacturing innovation centre, and the skills and training laboratories.
Kevin Bonavia
I am proud that my constituency is a top location for life sciences companies to develop cutting-edge technologies. One of them, BioOrbit, which is hosted by Airbus Defence and Space in Stevenage through its small and medium-sized enterprises accelerator programme, is building a pharmaceuticals factory in space to leverage the benefits of microgravity for large-scale administration of cancer treatments. Another UK prime company, GSK, hosts more than 40 SMEs. Does my hon. Friend agree that we need to do all we can to support innovative SMEs in the life sciences and space sectors?
Feryal Clark
My hon. Friend rightly acknowledges that Stevenage is a leading hub for life sciences companies to develop and commercialise cutting-edge therapeutics. GSK and Airbus are shining examples of UK innovation at work. Earlier this week we published the industrial strategy Green Paper to drive long-term, sustainable, inclusive and secure growth, and to secure investment in crucial sectors of the economy, including life sciences. There is an opportunity to renew the UK’s leadership in life sciences through bold innovation and collective partnerships with the sector, to build an NHS that is fit for the future and to drive economic growth across the regions of the UK.
Alison Griffiths (Bognor Regis and Littlehampton) (Con)
Following the successful investment in Rolls-Royce’s technology and logistics centre, what is the Minister doing to get more investment into my Bognor Regis and Littlehampton constituency?
Mr Speaker
I am not sure that Rolls-Royce fits into a question on life sciences. Does the Minister have an answer?
Feryal Clark
I thank the hon. Member for her question. She will have seen from the investment summit earlier this week that there is huge interest from a number of companies in investing in the UK, and there is huge support from this Government for those companies that wish to invest.
Sir Ashley Fox (Bridgwater) (Con)
The Minister for Data Protection and Telecoms (Chris Bryant)
The most recent statistics, which are available for the old shape of the hon. Gentleman’s constituency, suggest that 97% of properties there have 4G connection. However, I am not sure that the statistics reflect the lived experience of most people in his constituency—or, I suspect, any other constituency in the land. That is not good enough, which is why our ambition is for all populated areas to have stand-alone 5G by 2030.
Sir Ashley Fox
I am grateful to the Minister for his answer. Bridgwater has a mixture of urban and rural areas, and many of my constituents in the rural parts complain of almost non-existent signals. The O2 signal in Burnham-on-Sea is non-existent. In Pawlett, the Vodafone and EE signals are non-existent. In Chedzoy, the EE signal is non-existent. [Interruption.] Can he confirm that the Government intend to continue funding the shared rural network, so that we can improve coverage for all our constituents?
Chris Bryant
Well, I note that the mobile signal seems to be working in here, which is unusual for the rest of the country. We have to get this right, because people cannot live without a proper mobile signal. It is essential for people’s lives, their health and their ability to run a business, and we are determined to put things right. In direct answer to the hon. Gentleman’s question, yes, we will continue to fund the shared rural network.
Ms Julie Minns (Carlisle) (Lab)
In constituencies such as Bridgwater and Carlisle, poor mobile coverage forces people to rely on their fixed-line services. Does the Minister share my concern that the switch-off of the public switched telephone network will leave constituents unable to access 999 services in the event of an emergency?
Chris Bryant
I welcome my hon. Friend to her place. She makes a really good point: as we take away the copper lines and move over to the new technology, which we need to do, it is absolutely essential that we ensure there is a safe transition, even if it is only for people who have telecare devices on which they rely for their own safety—I am sure we all have relatives who have one of those. I have already met all the operators, and I am determined to crack the whip on this issue.
Mark Ferguson (Gateshead Central and Whickham) (Lab)
The Secretary of State for Science, Innovation and Technology (Peter Kyle)
The UK’s R&D system is a central strength and vital for the future prosperity and wellbeing of our citizens. We are recognised for the strengths of our universities system and research base, and we are investing through UK Research and Innovation to continuously improve our R&D capabilities. In July we launched five new quantum technology hubs, which are delivered by UKRI and backed by over £100 million-worth of Government funding. This will ensure that the British people benefit from the potential of quantum technologies in a range of areas, from healthcare and computing to national security and critical infra- structure alike.
Mark Ferguson
Turbo Power Systems in my constituency is a great example of a global company built on research and development but with proud local roots. Would the Secretary of State be happy to visit it, as I have, to see its fantastic work?
Peter Kyle
Of course, I look forward to visiting Turbo Power Systems the next time I am in the region and seeing the amazing work it does. It is contributing to one of the key missions of this Government, which is to get to clean superpower status by 2030, and I look forward to seeing what it is doing to make that a reality.
Tom Gordon (Harrogate and Knaresborough) (LD)
I recently visited Yorkshire Cancer Research in my constituency. It is coming up to 100 years since it was founded, and it has created amazing drugs, such as tamoxifen, to extend people’s lives and help them fight cancer. We know that less than 5% of medical research investment is spent on R&D in Yorkshire. Given that we have 8% of the population, what more can the Secretary of State do to ensure that R&D opportunity investment is spread across our country?
Peter Kyle
It is incredibly important for this Government that we invest across the whole country, which is why we have invested £118 million in healthcare research and partnership hubs that are outside London and across the United Kingdom. I hope that this benefits the hon. Gentleman’s area too.
Mr Speaker
I call the Chair of the Science, Innovation and Technology Committee.
Chi Onwurah (Newcastle upon Tyne Central and West) (Lab)
The whole House recognises—certainly, the Government’s industrial strategy does—that in order to drive growth we need innovation clusters across the country. The last Government committed to increasing R&D spend outside of the greater south-east by 40% by 2030 as part of the failed levelling-up strategy. Will the Secretary of State say whether he intends to maintain that target, and/or what steps he will take to ensure that funding is available to drive regional growth and innovation?
Peter Kyle
I am extremely grateful to my hon. Friend for her question, and I congratulate her, on behalf the whole House, on her election as Chair of the Select Committee—I look forward to appearing before it soon and regularly thereafter. She raises an incredibly important point. I can say that this Government are committed to working with local and regional mayors to ensure that local growth plans and the partnerships with UKRI will benefit all regions. These include a £100 million innovation accelerator pilot and £80 million in launchpad programmes, all of which will meet the needs that she outlines.
Jim Shannon (Strangford) (DUP)
The Secretary of State has an interest in Northern Ireland, so can I ask him whether he holds statistics on how much research and development tax relief support has been issued to Northern Ireland in the last 12 months to help support science and technology? If he does not have the figures today, I would be happy for him to send them to me.
Peter Kyle
As always, I am grateful to hear from the hon. Gentleman. I will be in touch with any specifics that I can follow up with, but we are a Government committed to Northern Ireland, which I believe he will have seen from day one of this Labour Government back in July. I can also show that there have been great advancements in investment in Northern Ireland, which is why Northern Ireland has the highest coverage rates for fast fibre-optic broadband of any part of the United Kingdom. I want to be a champion for Northern Ireland, and I visited recently to ensure that everybody in the science and technology community there realises that this is a Government who are on their side.
Saqib Bhatti (Meriden and Solihull East) (Con)
The Secretary of State, in one of his first acts in his new role, cut £1.3 billion-worth of funding that would have been transformative for enabling cutting-edge research and development in Britain. I note that he has also ditched our ambition to turn Britain into a science and technology superpower. We set a target of £20 billion for R&D, which we met, but he has set no such target. Will he be setting a target, and can he today promise that there will be no cuts to R&D expenditure?
Peter Kyle
I congratulate the hon. Gentleman on his appointment to his Front-Bench role. Let us just be honest about what this Government inherited. That £20 billion black hole affects every single Department across Government. My Department inherited a situation where the previous Government—including the former Chancellor, the right hon. Member for Godalming and Ash (Jeremy Hunt), who is sitting on the Opposition Front Bench—committed at this Dispatch Box to an exascale project to which not one single penny had been committed. That was a fraud committed on the scientific community of our country by that Government, and I had to make the difficult decision to move forward—
Mr Speaker
Order. I think we have gone on long enough on that question.
Aphra Brandreth (Chester South and Eddisbury) (Con)
The Minister for Data Protection and Telecoms (Chris Bryant)
As part of Project Gigabit, Freedom Fibre is delivering a contract to provide 15,000 homes and businesses across Cheshire, including in the hon. Lady’s constituency, with access to fast, reliable broadband. In addition, over 800 vouchers have been issued to connect premises in her constituency through the gigabit broadband voucher scheme.
Aphra Brandreth
Close to half the wards in my constituency are judged by Ofcom to be in the worst 30% of all areas in the UK when it comes to having a decent broadband connection. My constituents will be deeply concerned by reports that the current review of the next stage of Project Gigabit could see funds diverted from hard-to-reach rural areas to major cities such as central London. Will the Minister offer a concrete guarantee that no rural community will be left behind by the Government’s review?
Chris Bryant
I do not see it as a divide between rural and urban, because there are urban issues as well as rural issues. The hon. Lady is absolutely right that the previous Government failed to deliver in her constituency, and we intend to put that right. She should not believe everything she reads in the newspapers. I know that she was trying to have a meeting with Building Digital UK, and I am happy to make sure that we can both sit down with officials to try to sort out these problems in her constituency—and I am happy to do the same for any other Members.
Nick Smith (Blaenau Gwent and Rhymney) (Lab)
The Minister knows that improved connectivity is important to the economy of our south Wales valleys. However, it has been hard for me to get definitive information on the roll-out of Project Gigabit to Trefil, just north of Tredegar, in my constituency. Will he please look into this so that my constituents in Trefil, and across the rest of Blaenau Gwent and Rhymney, know when their broadband service will improve?
Chris Bryant
I am happy to arrange the same kind of meeting with my hon. Friend as I offered to the hon. Member for Chester South and Eddisbury (Aphra Brandreth). He is right that there are very significant problems in south Wales valleys communities, and we need to put those right. It is a shame that we have not had a digital inclusion strategy for 10 whole years, which is a disgrace. That is one of the things we need to put right.
Mr Alistair Carmichael (Orkney and Shetland) (LD)
The Minister for Data Protection and Telecoms (Chris Bryant)
We have already debated some of these issues, as the right hon. Gentleman knows, and he is right to stress that the UK space sector is one of our most important areas of possible economic growth. We want to maximise our unique potential in this area, and I look forward to working with him and the companies based in his constituency that are seeking to do this.
Mr Carmichael
I thank the Minister, as this sector offers massive economic and strategic opportunities for the United Kingdom. The development of the Shetland spaceport at SaxaVord is now significantly ahead of the field, so getting that project across the line will bring benefits to other projects across the United Kingdom. Will the Minister meet me and the developers of SaxaVord in Shetland to discuss what the Government can do, directly or indirectly, to help?
Chris Bryant
It feels like I will be meeting everyone, but I am very happy to meet the right hon. Gentleman. Indeed, I am meeting Orbex later today, because an important point is that we have a specific geographical and skills advantage in the launch sector, which we need to exploit to our best advantage for the whole UK economy. It is not just about what happens on Shetland; it is about lots of businesses in the supply chain, from mission control to technological support. Yes, I am very happy to meet him.
Mike Reader (Northampton South) (Lab)
The Secretary of State for Science, Innovation and Technology (Peter Kyle)
Keeping children safe online is the priority for this Government. The Online Safety Act 2023 places strict safety duties on online platforms, such as Roblox, to protect children from being groomed by online predators. Ofcom is the regime’s regulator and, by the end of this year, it will set out steps for the platforms to take to fulfil their duties.
Mike Reader
One of my constituents is a volunteer moderator on the Roblox platform. His group has identified and banned over 14,000 accounts involved in child grooming, exploitation and sharing indecent images. Does the Secretary of State agree that while we drive for tech innovation and investment, we must keep online safety at the heart of our strategy?
Peter Kyle
I extend my deepest sympathies to those who have been affected by the crimes that my hon. Friend outlines. The Online Safety Act—and its measures that will soon come into force—is there to address that concern directly. I want these powers to be used as assertively as possible. Just today, I have heard about another story concerning Roblox. I expect that company to do better in protecting service users, particularly children, on its platform.
Melanie Ward (Cowdenbeath and Kirkcaldy) (Lab)
The Secretary of State for Science, Innovation and Technology (Peter Kyle)
At the international investment summit on Monday, some of the world’s biggest science and tech firms committed to investing billions of pounds in Britain, growing our economy and creating new jobs across our country.
In Rome last week, I launched the UK’s first online safety agreement with the United States. By working with our closest partner, home to the world’s biggest tech companies, we will create a safer online world for our children.
Finally, on behalf of the whole House, I congratulate Sir Demis Hassabis and Geoffrey Hinton on the Nobel prizes they won last week. Their extraordinary achievements are testament to the phenomenal level of AI talent fostered in Britain today.
Melanie Ward
There are numerous examples of the damage that out of control social media and mobile phone usage is doing to our young people, including in my area of Fife. The Courier newspaper has played an important role in highlighting this. Does the Secretary of State recognise the concerns that the safer phones Bill—the Protection of Children (Digital Safety and Data Protection) Bill—presented today by my hon. Friend the Member for Whitehaven and Workington (Josh MacAlister) and backed by many hon. Members across the House, seeks to address?
Peter Kyle
I pay tribute to The Courier for exposing some of these issues. We must keep children and vulnerable people safe when they are online. I intend to ensure that safety is baked in from the outset. When it comes to keeping children safe in this country, everything is on the table and I am open minded about how we move forward to achieve a much safer environment. Companies releasing products into our society should see that as a privilege, not a right. I have high expectations, on behalf of this country, to ensure that safety is baked in from the start.
Andrew Griffith (Arundel and South Downs) (Con)
Did the Secretary of State fully disclose to the Civil Service Commission the Labour links of one of the most senior civil service appointments, or the £66,000 donation he received?
Peter Kyle
Every donation that was made to this party in opposition has been declared in the appropriate ways. I am proud to be part of a party that raises standards in public life rather than votes to lower them. [Interruption.] I am also proud to be part of a party that comes into government and attracts talent to working for it, whereas when the Conservatives see talent, they libel it.
Andrew Griffith
Thanks to Whitehall Watch, we have a copy of the form. It is clear the Secretary of State failed to mention the conflicts of interest, as required by the ministerial code. In the words of the Prime Minister’s favourite pop star, some would say he is “Guilty as Sin”. Will he refer himself to the adviser on standards, or do we have to wait for the Prime Minister to finish organising VIP motorcades and do it for him?
Peter Kyle
There we have it—a party that attacks civil servants and the world’s greatest talent gravitating towards this party and this Government, to work for them. When he sees talent in Government, he libels it and saddles the taxpayer with the bill. This Government attract talent and I am proud of that.
Alex Baker (Aldershot) (Lab)
Peter Kyle
Farnborough has done an astonishing job at getting British aviation, which I have supported, into the global news. My dad served in the Fleet Air Arm back in the 1960s, and I went with him many times to Farnborough to see the planes he worked on up in the sky. As a country and a House, we should celebrate the fact that Farnborough is now moving into space. I am very grateful for what Farnborough is doing, and of course I will be there to participate in the event in any way that is meaningful.
Rebecca Smith (South West Devon) (Con)
The Minister for Data Protection and Telecoms (Chris Bryant)
it seems—[Interruption.] It seems I have never been so popular!
I am very happy to meet the hon. Lady, as she makes a serious point. We want every single part of this country to share in the digital future. We can do that only if we have the infrastructure that we need everywhere in the UK.
Samantha Niblett (South Derbyshire) (Lab)
The Parliamentary Under-Secretary of State for Science, Innovation and Technology (Feryal Clark)
I thank my hon. Friend for her question and for all the work that she does to encourage more women into tech. It is great to know that the tech world is full not just of “tech bros”, but quite a lot of tech sisters as well. We are committed to building on the UK’s success as a global AI leader, and the upcoming AI action plan demonstrates that commitment to ensure the safe development of AI models by introducing binding regulation on a handful of companies developing the most powerful AI systems, fostering trust in those technologies. We will also continue—
Dr Danny Chambers (Winchester) (LD)
The Prime Minister (Keir Starmer)
Alex Salmond was a monumental figure in Scottish and UK politics. He leaves a lasting legacy. I know that the deepest condolences of the whole House are with Moira, his family and his loved ones.
This week, we also remember our colleague and friend, Sir David Amess, whose kindness and commitment to public service continues to inspire us all. I know how deeply this is felt by those on the Opposition Benches, and I am so glad that his plaque is here in the House with us.
I also wish to acknowledge the extraordinary life of Holocaust survivor Lily Ebert whose message of hope showed such courage. May her memory be a blessing. We also extend our sympathies to the family of General Sir Mike Jackson. He was an inspirational leader of the British Army and served with distinction.
I know the whole House will join me in wishing the best of luck to the new England manager, Thomas Tuchel. I will not hold his old job against him, but I wish him well in the new one.
This morning, I had meetings with ministerial colleagues and others. In addition to my duties in this House, I shall have further such meetings later today.
Dr Chambers
In last week’s maternity services debate, we heard of the devastating impact of the removal of consultant-led maternity services from hospitals. Under the previous Government’s unfunded new hospitals programme, there were proposals to remove consultant-led maternity services from our hospital in Winchester. Can the Prime Minister reassure me and my constituents that, under the new Government, consultant-led maternity and A&E services will remain in Winchester, and will he commit to funding properly the backlog of maintenance issues that has developed in our hospital?
The Prime Minister
I thank the hon. Member for raising that very important issue and for championing the voices of women in his constituency. We are committed to ensuring that all women and babies receive safe, compassionate and personalised care through pregnancy, birth and the critical following months. Reconfiguration of the services, as he knows, is a matter for the integrated care boards, which is important, as it allows decisions to be made locally and to be tailored to local interests. All changes should be based on evidence, be clinically led and involve engagement with patients to ensure that they will deliver better outcomes. This is a very important matter.
Alison Hume (Scarborough and Whitby) (Lab)
The Prime Minister
Yes, I do, and I know this is a concerning time for families who rely on the brilliant work of Whitby InterActive. Children with special educational needs and disabilities have been failed for too long. It comes up repeatedly in the House, with parents struggling to get their children the support they need and deserve. We must raise the standards for every child so that they can succeed in education. We will fix the foundations and ensure that every child can achieve their potential.
Rishi Sunak (Richmond and Northallerton) (Con)
I join the Prime Minister’s words of tribute to Alex Salmond and the Holocaust survivor Lily Ebert, and thank him for his kind words about Sir David Amess, whom we remember fondly. We are thinking of all their families at this moment.
This week, China has carried out unwarranted, aggressive and intimidatory military exercises in the Taiwan strait. Our allies are rightly concerned. After worrying reports that the Government may have intervened to stop a visit to the UK by the former Taiwanese President, will the Prime Minister confirm that the Foreign Secretary will use his meetings in Beijing this week to condemn China’s dangerous escalatory acts in the strait?
The Prime Minister
The continued military activity in the strait is not conducive to peace and stability. Stability in the Taiwan strait is in all of our interests. On the wider point that he raises, we will co-operate where we can as permanent members of the UN Security Council on issues such as net zero and health and trade, compete where we have different interests, and challenge—the point he makes is absolutely right—where it is needed to protect national security, human rights and our values. We will put that challenge in.
Rishi Sunak
Given what the Prime Minister said—I agree of course that we must engage and should use that engagement for our national interest—I hope that the Foreign Secretary will unequivocally condemn this military escalation and stand up for democracy in Taiwan.
The whole House will be concerned about the fate of the democracy campaigner Jimmy Lai. He is a British citizen who has been wrongly imprisoned in Hong Kong for four years. The previous Government pressured China for his release. Does the Prime Minister agree that this is a politically motivated prosecution and that it is a breach of China’s legal obligations to Hong Kong under the Sino-British declaration?
The Prime Minister
Yes, and that case, as the right hon. Gentleman will understand, is a priority for the Government. We call on the Hong Kong authorities to release immediately our British national. The Foreign Secretary raised this case in his first meeting with China’s Foreign Minister and we will continue to do so.
Rishi Sunak
I thank the Prime Minister for that answer. As he knows, China has become a decisive enabler of Russia’s war against Ukraine, now supplying the vast majority of Russia’s imported military micro-electronics and components and worsening the suffering of the Ukrainian people. Will the Prime Minister confirm that he is prepared to sanction any Chinese business or individual involved in aiding Russia’s invasion of Ukraine, including imposing secondary sanctions on financial institutions?
The Prime Minister
Yes. We have called for that in the past and we continue to do so. I hope that this is an issue where we can have unity across the House.
Rishi Sunak
Yes, I assure the Prime Minister of our support. It is something that the last Government began. The United States recently expanded their sanctions and I hope the new Government will continue to look at doing the same.
The last Government also established a new system of registration and monitoring to protect the UK from interference from foreign states, including China, Russia and Iran. The foreign influence registration scheme was described as essential by MI5 in the fight to help to keep Britain safe, but since the Prime Minister took office, he has halted its implementation. Why?
Rishi Sunak
That is very clearly what the Government have said. Only last week, the Prime Minister said at the Dispatch Box that he would give the security forces
“the powers that they need”.—[Official Report, 9 October 2024; Vol. 754, c. 297.]
If he is to fulfil that promise, I urge him to get up to speed on this issue and implement the scheme.
Furthermore, Parliament’s Intelligence and Security Committee has warned that British universities are increasingly a rich feeding ground for China to exert political influence over us. That is why we passed the Higher Education (Freedom of Speech) Act 2023, with new powers to help to defend universities from that threat, but the new Education Secretary has since blocked it. Can the Prime Minister tell us how, without that tool, the Government will prevent Chinese influence over our universities?
The Prime Minister
I really do not think that party political points on security and intelligence—[Interruption.] Throughout the last Parliament, we stood with the Government on all questions of security and intelligence, because it was important to the outside world that we did so. I worked with the security and intelligence services for five years prosecuting cases. I know at first hand, as a lawyer, the work that they do. I have known at first hand, as the Prime Minister, the work that they do. We support them in everything that we do, and the right hon. Gentleman knows that.
Rishi Sunak
The FIR scheme and the Higher Education (Freedom of Speech) Act were new tools—new sets of powers—that the previous Government passed in order to give our universities and security services the powers that they need to tackle a growing threat. The Opposition will of course continue to support the Government in protecting our national security, but we believe that those tools are needed, and we are concerned by reports that the new Government have paused their implementation or indeed scrapped them.
Finally, the Chinese Government have sanctioned multiple Members of our Parliament for championing human rights. As a result, they have faced intimidation, abuse and surveillance. I commend you, Mr Speaker, for your defence of the right of every Member of this House to speak out on crucial issues without fear of retaliation from foreign states. I know that the Prime Minister will agree with that too, so this week will the Foreign Secretary in his meetings not just raise the issue but tell the Chinese Government to lift those sanctions on our colleagues?
The Prime Minister
Yes—we speak with one voice. The right hon. Gentleman speaks about the record of the last Government. That record was 14 years of failure. Six years of austerity, three years of Brexit logjam, then Johnson, Truss and the present Leader of the Opposition—utter failure. This Government were elected to do things differently, make fairer choices, and most importantly, give Britain its future back. We will fix the foundations, with a long-term plan to grow our economy, protect working people and rebuild our country.
Jen Craft (Thurrock) (Lab)
The Prime Minister
I thank my hon. Friend for her question, because years of underfunding have left councils facing huge budget pressures—[Interruption.] Opposition Members yawn; they do not know the impact that it has on working people up and down the country, who rely on public services. What has happened in Thurrock is shocking. We are committed to resetting the relationship, and helping those under intervention to recover and reform. Fourteen years is a long time of destroying local services, and it is clear that it will take time to fix them. We will get councils back on their feet by providing multi-year funding settlements, but ultimately we have to grow our economy. I am surprised that the Leader of the Opposition did not welcome the £63 billion of investment that we were able to announce on Monday.
Ed Davey (Kingston and Surbiton) (LD)
I echo the Prime Minister’s tributes to Alex Salmond, Sir David Amess and Lily Ebert.
I welcome the news that Ministers are going to review the carer’s allowance repayment scandal, after campaigns by carers organisations, The Guardian and the Liberal Democrats, culminating in our motion on the Order Paper today, but does the Prime Minister agree that the evidence needed for the review is already long established, and many of the decisions self-evident? Will he and his colleagues vote for our motion today, so that we can write off the overpayments, end the crazy cliff edge to the earnings limit now, and have a fuller review of the support that carers deserve?
The Prime Minister
I thank the right hon. Gentleman for raising that really important issue, which is affecting a number of people. We have launched an independent review into the carer’s allowance overpayments, to look at the circumstances of the overpayments and see what went wrong and what can be done to put it right, because carers must get the support that they deserve. I am grateful to him for raising it and I am glad that we have been able to take this action today to go forward on that really important issue.
Ed Davey
I thank the Prime Minister for that answer, and ask him that Ministers listen to the voices of carers throughout the review.
Let me turn to the middle east. Israeli Finance Minister Smotrich has said that starving 2 million people in Gaza might be “justified and moral”. National Security Minister Ben-Gvir called settlers who killed a 19-year-old on the west bank “heroes”. After my visit to Israel and Palestine last February, having witnessed the damaged that those extremist Ministers in the Netanyahu Government are doing, I called on the last UK Government to sanction them. They refused, but we now learn that the former Foreign Secretary was considering it. Will the Prime Minister now sanction Ministers Ben-Gvir and Smotrich?
The Prime Minister
We are looking at that, because those are obviously abhorrent comments, as the right hon. Gentleman rightly says, along with other really concerning activity in the west bank and across the region. The humanitarian situation in Gaza is dire: the death toll has surpassed 42,000 and access to basic services is becoming much harder. Israel must take all possible steps to avoid civilian casualties, to allow aid into Gaza in much greater volume, and to provide the UN and humanitarian partners the ability to operate effectively. Along with France, the UK will convene an urgent meeting of the UN Security Council to address that.
Mary Glindon (Newcastle upon Tyne East and Wallsend) (Lab)
The Prime Minister
I welcome Tom to the House. It is encouraging to see young people engaging in democracy. County lines is a real problem, and all of us will have experienced its effect and impact in our constituencies. Our county lines programme focuses on preventing young people from being exploited and lured into criminal gangs, which is far too common, and we are committed to introducing a new offence of child criminal exploitation—that is long overdue. We will also create a network of Young Futures hubs, staffed with professional youth workers, mental health support workers and career advisers, to provide focused support for young people, helping them to fulfil their ambitions and preventing them from being drawn into crime.
Liz Saville Roberts (Dwyfor Meirionnydd) (PC)
Plaid Cymru, too, pays tribute to Alex Salmond and Sir David Amess.
One in five people in Wales are on an NHS waiting list. The Secretary of State for Wales says that a new cross-border NHS plan would bring down Welsh surgery waiting lists, but the Labour First Minister of Wales contradicts her and denies that it has anything to do with bringing down waiting lists. Are they making it up as they go along?
The Prime Minister
The difference is that we now have a Westminster Government who want to work with the Welsh Government to deliver for the people of Wales. For 14 long years the Welsh Government were in a position where the then UK Government were in conflict with them. Now, we will work together, collaborate and ensure that we deliver across Wales.
Chris McDonald (Stockton North) (Lab)
The Prime Minister
I welcome my hon. Friend’s work with the new Labour police and crime commissioner. It is sad to say that in Cleveland, the number of full-time equivalent police officers fell by over 12% under the last Government; when you fail on the economy and growth, those are the types of things that happen across the country. As part of our neighbourhood policing guarantee, we will put 13,000 more neighbourhood police and police community support officers back on our streets and ensure that every community has a named local officer. Through our safer streets mission, we will tackle illegal drugs, halve knife crime and crack down on antisocial behaviour, and go after the gangs that lure young people into violence.
Simon Hoare (North Dorset) (Con)
The Prime Minister
I am grateful to the hon. Gentleman for raising the question of SEND, because it is a really important issue—I think this is the fourth time in two Prime Minister’s Question Times that it has been raised, by Members on both sides of the House. I quibble with his suggestion that it is both parties, since his party was in power for 14 years, but the spirit in which he proposes that this work should be cross-party is something that we should take up, because SEND is such an important issue. It affects so many children and parents, so notwithstanding that quibble, I am very happy to work across the House on an issue as important as SEND.
Katrina Murray (Cumbernauld and Kirkintilloch) (Lab)
The Prime Minister
Yes: the Employment Rights Bill is pro-worker and pro-growth, and proudly so. I do not believe we can build a strong economy by having people in insecure work. The Conservative party goes against every protection for workers—it was against the minimum wage, and it is against these new protections—but the vast majority of businesses, large and small, already know that investing in their human capital and treating people properly at work is what produces growth. Here is the big political divide: the Conservatives always oppose workers’ rights, and we will always champion them.
Adrian Ramsay (Waveney Valley) (Green)
The Prime Minister
The hon. Gentleman raises a really important issue. Dentistry was left in a shocking state by the last Government: I was shocked to hear that the commonest cause of A&E admission for six to 10-year-olds in this country’s children’s hospitals is to have teeth taken out, because of the failure of the last Government. That is shocking on any analysis, and we will put it right; we will take the necessary steps, and we will work across the House to do so as quickly as possible.
Cat Smith (Lancaster and Wyre) (Lab)
The Prime Minister
My hon. Friend makes a good point. The Conservative party wants to get rid of maternity pay, but keep hereditary peers. It is the same old Tories. This is an important issue that she has raised. The letters are honest, powerful and important, and I think they hold up a mirror to our country. We will deliver a Budget that drives economic growth, improves the lives of working people, fixes our public services and rebuilds our country with a decade of national renewal.
Ann Davies (Caerfyrddin) (PC)
The Prime Minister
On this issue of winter fuel payments, we have inherited a £22 billion black hole. [Interruption.] Conservative Members should be apologising, not groaning, for leaving the country in such a state. We are committed to the triple lock. The point about pensions is really important, and the triple lock means that the pension will increase again by £460 next year. That means pensioners under Labour will be better off, because we are going to stabilise the economy after that lot lost control of it.
Shaun Davies (Telford) (Lab)
The Prime Minister
I thank my hon. Friend for raising this vital issue. The statistics on male suicide are truly shocking. I went to an event a few years ago here in this place, where everyone in attendance was asked if they had lost someone to suicide, and I then reflected on my own experience, which was profound—as it was, I could see, for everybody across the room, and will be across this House—so reducing deaths from suicide is a vital part of our health mission. We are recruiting an additional 8,500 mental health workers specially trained to support people at risk of suicide to provide faster treatment and ease pressure on our services.
Alicia Kearns (Rutland and Stamford) (Con)
The Prime Minister
I thank the hon. Member for raising what is obviously a very important case, and she is right to do so. I am not across the individual details of it, but it obviously does need to be looked into. So we will commit to look into it, and I will make sure that she gets a meeting with the relevant Minister to lay out such details as she has and to get some answers as to our inquiries.
Jake Richards (Rother Valley) (Lab)
The Prime Minister
I thank my hon. Friend for raising this issue and being a champion on it. He is absolutely right about the appalling inheritance: one in four children in absolute poverty—that is a terrible inheritance—and too many vulnerable children in unregulated accommodation. Through our children’s wellbeing Bill, we will put children and their wellbeing at the heart of the education and social care systems. We will also provide a home for all young care leavers to ensure that they are not homeless, and remove the barriers to opportunity so every child can thrive in safe and loving homes.
Kit Malthouse (North West Hampshire) (Con)
The Prime Minister
I am grateful to the right hon. Gentleman for raising that; it is obviously of huge importance to his constituents and he is right to do so. As he knows, we are reviewing the programme. The programme that the last Government put in place for 40 new hospitals had a number of flaws: they were not all hospitals, they were not new, and they were not funded, so we are reviewing it. He is right to raise this matter, and I will ensure that he has a meeting with the relevant Minister to discuss the development in his constituency. It will matter to his constituents who are listening to this, and it is important that they know where the failure lay.
Luke Myer (Middlesbrough South and East Cleveland) (Lab)
I welcome the Government’s historic investment in carbon capture and storage technology for Teesside and Merseyside. This week I have been at the sector’s conference, and the feeling there is that this is a Government who are delivering after years of delay. Will the Prime Minister recognise the unique potential that Teesside has for jobs, prosperity and economic growth into the future?
The Prime Minister
Yes, and you will have observed, Mr Speaker, that on Monday we had a very successful investment summit, with £63 billion coming into this country, jobs in every part of the UK, and a clear message from businesses that they are prepared to invest now under this new Labour Government. Part of that was a £22 billion commitment to carbon capture, usage and storage, creating the first clusters in the world including, as my hon. Friend points out, in various parts of the country. We will support those jobs and investment. We will grow our economy and rebuild our country.
Ben Maguire (North Cornwall) (LD)
The Prime Minister
I am grateful to the hon. Member for raising that. I do believe in transferring power out of Westminster and into the hands of leaders who know their communities best. Those with skin in the game know what is best for their communities. We are already making steps in the south-west by signing the devolution agreement for Devon and Torbay, and I encourage local authorities to work with their neighbours to pursue deeper and wider devolution for their area. I will ensure that the hon. Member has the meeting that he is asking for.
Blair McDougall (East Renfrewshire) (Lab)
As the Prime Minister works for a ceasefire and the return of the hostages, he will have the support of Members across the House. He will have noted the comments from the White House calling for urgent action to deal with the humanitarian crisis in Gaza, and for the Netanyahu Government to increase access to aid and the amount of aid getting through. Does the Prime Minister agree with those comments from the White House, and what representations is he making on that matter?
The Prime Minister
Yes, I do agree with those remarks, and we are constantly making representations on this with our partners. There is an urgent need, as there has been for a long time, for more aid to get into Gaza. It is a desperate situation, and Israel must comply with its international humanitarian law obligations. That is why we are convening a session of the UN Security Council, with others, to address that issue.
Speaker’s Statement
(2 days, 6 hours ago)
Commons ChamberRead Full debate Read Hansard Text
Mr Speaker
I should inform the House that there has been an issue with the publication of the data from last night’s Division on the reasoned amendment to the Second Reading of the House of Lords (Hereditary Peers) Bill. The result of the Division is not in doubt. As always, it is determined by the Tellers’ count, as announced in the Chamber last night. The names of the Members recorded on the pass reader terminals were not available on the usual timetable as a result of human error. Those names have now been published on the CommonsVotes app and will be available in Hansard online shortly. The House authorities are taking steps to prevent this from happening again.
Points of Order
(2 days, 6 hours ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate
Sir Christopher Chope (Christchurch) (Con)
On a point of order, Mr Speaker. I was going to raise the issue you have just spoken about as a point of order. My concern is that, for the first time ever in my experience within this House, the list of Members participating in a Division has not been published in the hard copy of Hansard. I ask you to insist that Hansard publishes the list in hard copy, rather than relying upon its being put online. Can I also ask how it came about? This is to do with new technology, and when I inquired about this matter earlier today, the list was still not available at 11.30 this morning. Why was it not?
Mr Speaker
Let me deal with the hon. Gentleman’s main point. I can assure him that we will get it printed, even if it is on a separate sheet, to make sure that who voted what way is available in hard copy. That is the key thing. On his other point, this was human error. It is not about technology; it is nothing to do with technology. Sometimes mistakes are made. I do not want to go on a witch hunt over a mistake made by human error. What I will say is that we will put something in place to ensure that this does not happen again. I am sure he would agree that that is the best way to deal with this matter.
Alicia Kearns (Rutland and Stamford) (Con)
On a point of order, Mr Speaker. The Prime Minister said during Prime Minister’s questions, in answer to the Leader of the Opposition, that it was not correct that the current Government have postponed the implementation of the foreign influence registration scheme, yet on 14 August the Government website was updated and a statement was proactively issued by the Home Office stating that the FIR scheme was “no longer expected” to come into force in 2024. That is a postponement, so please will you insist that the Prime Minister returns to the House to correct the record and ensure that we are not misled?
Mr Speaker
The hon. Lady has been here long enough—[Interruption.] Let me at least finish before you start chipping back at me. I am grateful to her for giving me notice of her point of order. As she well knows, I am not responsible for the accuracy of the Prime Minister’s answers in this House. However, she has put the point on the record, and I am sure that those on the Treasury Bench will have heard her remarks. Let us see where we go from there.
Mr Toby Perkins (Chesterfield) (Lab)
On a point of order, Mr Speaker. Some of us were hoping to get an opportunity to ask the Secretary of State for Science, Innovation and Technology about the steps his Department is taking to improve diversity and inclusion in the science, technology, engineering and mathematics workforce, but we were not able to do so, because the hon. Member for Birmingham Perry Barr (Ayoub Khan) did not turn up to ask the question on the Order Paper. I know that you, Mr Speaker, and your staff have been at tremendous pains—
Mr Speaker
Order. We both know that that is not a point of order. You have put on the record the point you were—[Interruption.] No, it is a continuation of questions that finished quite a long time ago. You have made the point that you were not able to get the question in, and we will leave it at that. I am not opening up that debate at this stage.
Mr Mark Francois (Rayleigh and Wickford) (Con)
On a point of order, Mr Speaker. The Prime Minister paid tribute to Sir David Amess at questions—we all still miss him—and to General Sir Mike Jackson, who served a number of tours in Northern Ireland, as did hundreds of thousands of British servicemen upholding the rule of law. Hundreds were killed and thousands were maimed by bombs. We brought in the Northern Ireland Troubles (Legacy and Reconciliation) Act 2023 to stop them being endlessly investigated and reinvestigated at the hands of Sinn Féin. Labour said that it would repeal it, so the whole cycle will begin again. Mr Speaker, have you been given any indication of when the Government will come to the House, make a statement and explain their reasoning for putting all those vulnerable servicemen at risk yet again?
Mr Speaker
The right hon. Member has put his point on the record. I have had no indication of a statement.
Bills Presented
(2 days, 6 hours ago)
Commons ChamberRead Full debate Read Hansard Text
Mr Speaker
I had a good go at that one as well.
Gambling Act 2005 (Monetary Limits for Lotteries) Bill
Presentation and First Reading (Standing Order No. 57)
Wendy Chamberlain, supported by Ben Lake, Pete Wishart, Rebecca Harris and Tonia Antoniazzi, presented a Bill to remove monetary limits on proceeds from the mandatory conditions of lottery operating licences; and for connected purposes.
Bill read the First time; to be read a Second time on Friday 24 January 2025, and to be printed (Bill 30).
Sale of Tickets (Sporting and Cultural Events) Bill
Presentation and First Reading (Standing Order No. 57)
Dr Rupa Huq, supported by Jim Shannon, Rosie Duffield, Lillian Jones, Nadia Whittome, Christine Jardine, Wera Hobhouse, Sarah Champion, Dawn Butler, Bambos Charalambous, Martin Vickers and Kim Johnson, presented a Bill to make provision about transparency of ticket prices for sporting and cultural events; and for connected purposes.
Bill read the First time; to be read a Second time on Friday 6 December, and to be printed (Bill 31).
Opposition Day
(2 days, 6 hours ago)
Commons ChamberRead Full debate Read Hansard Text
Carer’s Allowance
(2 days, 6 hours ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
15:26 - The House divided: - Ayes: 87 / Noes: 335 - Question accordingly negatived.
Mr Speaker
I inform the House that I have selected amendment (a) tabled in the name of the Prime Minister. I call Ed Davey.
Ed Davey (Kingston and Surbiton) (LD)
I beg to move,
That this House recognises the remarkable contributions that the UK’s 5.7 million unpaid carers make to society and the huge financial challenges many face; notes with deep concern that tens of thousands of carers are unfairly punished for overpayments of Carer’s Allowance due to the £151-a-week earnings limit; believes that carers should not be forced to face the stress, humiliation and fear caused by demands for repayments of Carer’s Allowance; condemns the previous Government for failing to address this scandal; calls on the Government to write-off existing overpayments immediately, raise the Carer’s Allowance earnings limit and introduce a taper to end the unfair cliff edge; and further calls on the Government to conduct a comprehensive review of support for carers to help people juggle care and work.
It is a great honour to open the first full Liberal Democrat Opposition day in 15 years. I assure the House that we will not waste our precious debates on the sort of political game playing to which Opposition days often fall victim. Instead, we will use them to focus on the things that really matter to ordinary people, and to tell Ministers directly about the real problems that our constituents face.
That brings me to our first motion on unpaid carers, or family carers as I prefer to say. They are people looking after relatives, friends or neighbours, and they do a remarkable and important job. Looking after someone they love can be rewarding and full of love—whether they are a parent of a disabled child, a teenager looking after a terminally ill parent or a close relative of an elderly family member—but it is far from glamorous. Caring for a family member can be relentless and exhausting.
As the House knows, I have been a carer for much of my life but, more importantly, I have also had the great privilege of meeting and hearing from thousands of carers in my constituency and across the United Kingdom. I have some understanding of the challenges that carers face every single day: the worries, the exhaustion, the lack of breaks and the financial difficulties, too. Britain’s carers deserve our support.
Chris Vince (Harlow) (Lab/Co-op)
I hope that the right hon. Gentleman will take this as a friendly intervention, as he knows what I am going to say. He talks about family carers and mentioned teenagers who support loved ones, which is important, but does he agree that we should recognise the role of young carers? Having worked with them, I know that they can be as young as five years old and supporting a loved one or family member.
Ed Davey
The hon. Member is absolutely right. I include young carers; indeed, I am a member of the all-party parliamentary group on young carers and young adult carers, and I invite him to join us. It is chaired by a well-established Labour Member. Young carers are very much part of our thinking, but for some, who will not be young—
Mr Speaker
Order. May I say to the hon. Member for Reading West and Mid Berkshire (Olivia Bailey), please do not walk in front of Members when they are intervening? Please, can we think of others?
Jim Shannon (Strangford) (DUP)
I commend the right hon. Gentleman for his endeavours in the debate, which we support, and on his compassion for carers given his own experience. Someone who cares for their parents all day and then works a couple of hours in the evening is precluded from receiving carer’s allowance. Does the right hon. Gentleman agree that those people, who do not get carer’s allowance because they happen to work a few hours, should qualify?
Ed Davey
I am grateful to the hon. Gentleman for that point. That should certainly be part of the review, but one or two other issues, which I will talk about, are critical to reform probably even before that.
At just £81.90 a week, carer’s allowance is the lowest benefit of its kind. For someone doing 35 hours of caring a week—the minimum period for eligibility—that is just £2.34 an hour. It is not just the low rate of the carer’s allowance that worries me but the fact that the eligibility rules are inflexible and very badly designed, chief among them being the earnings limit of £151 a week. Even for someone on minimum wage, that is just 13 hours and 20 minutes a week. The earning limit operates like a cliff edge. As soon as someone makes £151.01 a week, they lose the whole carer’s allowance—every penny of the £81.90. It acts as a significant barrier and a major disincentive to work. It means carers on low incomes cannot work a bit more to help make ends meet, so it is bad for them, bad for the person they are caring for, bad for their employers and bad for the economy.
But here is where things get worse. There are tens of thousands of carers who go slightly over the earnings limit, mostly without realising it. Maybe they pick up an extra shift, happen to get an end-of-year bonus, or understandably do not realise the way carer’s allowance operates in such a daft way. Even though the Department for Work and Pensions gets regular alerts from His Majesty’s Revenue and Customs when people go over the earnings limit, it has not been telling carers and it keeps paying carer’s allowance until one day, out of the blue, the carer gets hit with demands to repay those overpayments, which may have built up over months and years due to the DWP’s own inaction.
Back in July, I told the Prime Minister about one of my constituents, Andrea, who lives in Chessington. She is a full-time carer for her mum. Back in 2019, Andrea decided to go back to work part-time in a charity shop—mainly for her mental health, she told me. She informed the DWP at the time and it continued her payments. Five years later, it wrote to her and said that no, she now had to repay £4,600. Andrea says she feels “harassed, bullied and overwhelmed.” She now does just six hours’ unpaid work a month to avoid going over the earnings limit and getting into more debt. She says the whole thing makes her “want to give up work and give up caring.”
Mr Adnan Hussain (Blackburn) (Ind)
The right hon. Gentleman refers to mental health. Romi Taylor is a 16-year-old who cares for her mother, who has chronic obstructive pulmonary disease. Romi recently won an award at the BBC Radio Lancashire’s Make a Difference awards—you were there, Mr Speaker. Many carers find caring for a loved one to be a lonely place. This is a 16-year-old taking care of her mother and not having time with her friends. Does the right hon. Gentleman agree that carers need to be recognised, and that the support they require beyond benefits, including mental health support, should be—
Mr Speaker
Order. May I just say to my constituency neighbour that interventions are meant to be short? I have a list, so if you want to make a speech I am more than happy because these contributions do matter, but try not to make a speech through interventions. Don’t follow Mr Shannon—he will mislead you. [Laughter.]
Ed Davey
Thank you, Mr Speaker. The hon. Gentleman is of course right and I pay tribute to his constituent, who was lucky enough to be presented the award by Mr Speaker. He is right about the mental health of carers. NHS data shows that the mental health of carers is twice as poor as it is for the population at large because of the isolation, so that issue is absolutely a part of this debate.
Sir Julian Lewis
Before the right hon. Gentleman resumes his narrative—he speaks with huge authority on this subject—can he underline what he told the House before the previous intervention? This was a case where someone reported what they were doing, was wrongly told it was okay to proceed and was then hit with a bill for thousands of pounds retrospectively. Surely that is incompetence and maladministration. Is there not any way for that person to have recourse to justice?
Ed Davey
The right hon. Gentleman makes exactly the right point and as her MP I am pursuing that line of argument, but we need a change of culture and attitude at the DWP to be able to proceed with these cases on behalf of our constituents. She told me that the whole thing makes her want to give up caring and give up working. That is how affected she has been. Who is it helping, when carers feel like that?
I am sure that someone, somewhere in the DWP or the Treasury, thinks this sort of penny pinching saves the Government money, but they could not be more wrong. It is millions of carers like Andrea who save the Government money: £162 billion a year, according to Carers UK, through the vital work they do for free. When badly designed Government policies fail to support carers and instead push them over the edge, the real cost—an enormous cost—is to taxpayers and the economy.
There are so many stories like Andrea’s. Government figures suggest that more than 130,000 people have outstanding carer’s allowance debt, some going back years. According to the DWP’s own figures, last year alone there were 34,500 overpayments due to the earnings limit. We have heard how carers have even been threatened with prosecution. This is a terrible scandal: tens of thousands of carers becoming victims of a system that is supposed to be there to support them.
Although the stories we have heard in recent months have been truly shocking, they are not new. The Work and Pensions Committee launched an inquiry into this issue almost six years ago, back in 2018. The National Audit Office published its own report in 2019. The last Government should have acted then, but they did nothing. I raised it with the last Prime Minister. He did nothing. Conservative Ministers failed to tackle it for the entirety of the last Parliament. They just passed it on to the new Government, as yet another part of their legacy.
I raised the matter, therefore, at the new Prime Minister’s first oral questions in July. Although he was non-committal, I am genuinely pleased and grateful that Ministers have now announced a review, at least into the scandal of carer’s allowance overpayments. Whether that was in response to our motion, I will let others decide. I hope the Minister will say a lot more about the review when she speaks and how the Government are thinking about that. I hope the debate can be seen as the first input to, or kick-off of, that review. I certainly hope the Minister will make it clear that the review will not be a repeat of the type of review we had in the last Parliament, when Conservative reviews were set up primarily for delay and kicking issues into the long grass.
As I hinted at during today’s Question Time, my concern about the review is that the evidence to make a decision is already well-founded, with two recent Select Committee reports and mountains of evidence immediately available from organisations such as Carers UK or Carers Trust, and the National Audit Office carrying out its second review in just five years over the last four months. I ask the Secretary of State, therefore, to reshape the review that she has announced, because it is self-evident that the vast majority of overpayments of carer’s allowance should be written off immediately. I accept that there may be a few cases of genuine fraud in which that would not be appropriate, but the DWP should not be persecuting tens of thousands of carers whose overpayments were caused by the crazy cliff edge in the current carer’s allowance system, and by the DWP’s own incompetence in failing to notify them of overpayments immediately.
Some changes could be made to the rules that are just common sense, making it easier for carers to juggle work and care and thus boost our economy, such as raising the earnings limit and replacing the cliff edge with a taper. There are changes that do not need a long review; there are decisions that can be taken now, or at least very quickly. However, as our motion says, we need to go further for carers than these obvious and relatively simple decisions. The Government should conduct a full-scale review of all support for carers, so that we can make it easier for them to carry on caring and to juggle caring with work. That will be better for them, better for their loved ones, and better for our economy.
I urge the House to pass the motion. Let us not allow carers to be forgotten and ignored any longer.
The Minister for Employment (Alison McGovern)
I beg to move an amendment, to leave out from “society” to the end and add:
“; believes it is essential that carers are provided with the support they need at the time they need it; condemns the previous Government for failing to address the scandal of demands for repayments of Carer’s Allowance; and welcomes the Government’s review into how these overpayments have occurred, what best can be done to support those who have accrued them and how to reduce the risk of these problems occurring in future.”
Let me begin by paying tribute to the right hon. Member for Kingston and Surbiton (Ed Davey). It is excellent that he has brought this subject to the House. I heard what he said about family carers as opposed to unpaid carers, and while I do not want to get involved in a big linguistic debate, I think he made an important point that will be recognised by many carers up and down the country. When we are making policy, we should always listen to those with direct experience. I think that the right hon. Gentleman made his point on behalf of millions of people, and it is good that the House has heard it.
Many people will be personally acquainted with this issue. There are 5 million carers in the UK and about 1 million people are receiving carer’s allowance, so this debate is extremely important. According to the latest census, just under one in 10 people in England and Wales provide unpaid care, but the subject of carers is not at the top of the political agenda nearly as often as it should be.
Dr Luke Evans (Hinckley and Bosworth) (Con)
When I was a clinician, people did not even realise that they could be labelled as carers and could apply to be carers, and were unaware of the gateway that that would provide. Might the Government consider doing some work to make more people aware that they are undertaking caring responsibilities, so that they can then obtain the support that is actually out there, if they only knew?
Alison McGovern
That is a very good point, and the hon. Gentleman’s experience as a clinician is welcome. The Secretary of State has considerable experience of working with carers, and I will alert her to his comments, because I think she would appreciate what he has said.
We must never think this is not an issue that does not affect us all. Many of us will become carers—if not now, at some point in our lives. This affects all of us, and everyone’s life is different. Support for family carers needs to be tailored so that it works for the individual and takes into account the different circumstances that people face. When you are caring for someone, that is a huge part of your life, and it never stops. Even if you are working, you are still thinking about that person for whom you are caring day in, day out. It is not just a physical job; it is a mental, intellectual job, and that is why the issue of stress and how carers are treated is so important.
Helena Dollimore (Hastings and Rye) (Lab/Co-op)
I join the Minister in paying tribute to the millions of carers in the country, including those in my constituency. Does she agree that when someone is juggling the daily stresses of life, it can be difficult to remember to notify the DWP of a change in circumstances, which is required under the current arrangement?
Alison McGovern
I will come to the review that we will be conducting, but let me make the general point that we in the Government ought to be able to understand the realities of life and take that into account.
The position that I have described makes the dire situation we have inherited all the more shameful. Family carers are being pushed to breaking point. They have too often been forced to quit jobs that they want to keep and could keep with the right support, which isolates them and shrinks our workforce. With the right support, we could help carers and help our economy as well. To rub salt into the wound, we have inherited a system whereby busy carers, already struggling under a huge weight of responsibility, have been left having to repay large sums of overpaid carer’s allowance, sometimes amounting to thousands of pounds. It seems as though what is supposed to be a safety net designed to catch those in need was instead designed to catch them out.
Jim Shannon
For some time constituents of mine have found that they are due to repay an overpayment. I always ask them whether they remember when they made their complaint. All telephone conversations with the Department are recorded, so there is a way of making it clear that the fault lies not with the applicant but with the Department. Is there also a way of ensuring that those who have been penalised unfairly for following the Department’s advice should not have to pay that money?
Alison McGovern
As the hon. Member knows, the Department is not responsible for the delivery of social security benefits in Northern Ireland, but I am sure that Northern Ireland’s Department for Communities will be keeping a close eye on the debate and will want to take his points into account.
This problem is one of the numerous ways in which our social security system is failing the people of this country, with 2.8 million left out of work because they are unwell and more than 4 million children growing up poor, and we have therefore moved fast to fix the foundations of the DWP. That includes our setting up a taskforce to tackle child poverty, extending the household support fund for six months, and holding the first meeting of our new Labour Market Advisory Board. The board’s expertise and fresh thinking will help us break down barriers to work, such as an inability to balance paid work with family care.
Daisy Cooper (St Albans) (LD)
This Government have talked about a duty of candour. Can the Minister give an assurance that if people working at the DWP have information about maladministration and poor management of the service that they have witnessed and wish to come forward with that information, they will be protected as whistleblowers?
Alison McGovern
Obviously whistleblowing is very important. The Hillsborough law that is being introduced is not my responsibility, so the hon. Lady will understand that I cannot go over it extensively, but I will say, as someone who worked on the Hillsborough issue for many years, that it is very important to me personally.
These problems are significant, and given the scale of the challenges, we will not be able to solve all of them overnight, but we have taken important first steps, including tackling the issue of overpayments of carer’s allowance related to earnings. We have all heard the stories of some of the thousands of carers who have been affected, we have all heard and know about the stress and anxiety that it has caused them, and we all want—I hope—to establish the facts.
To address this problem, we must first truly understand what has gone wrong. That is why the DWP has announced today an independent review of overpayments of carer’s allowance that have exceeded the entitlement threshold. The review will investigate how the overpayments have occurred, what can best be done to support those who have accrued them, and how to reduce the risk of such problems occurring in future. We are delighted that Liz Sayce OBE has agreed to lead the review. My colleagues the Minister for Social Security and Disability, my right hon. Friend the Member for East Ham (Sir Stephen Timms), and the Under-Secretary of State for Work and Pensions, my hon. Friend the Member for Stretford and Urmston (Andrew Western), have already met representatives of Carers UK, along with carers themselves, to discuss their report on overpayments, and we will consider the findings of that report alongside the independent review.
Shockat Adam (Leicester South) (Ind)
On that point, does the Minister agree that there should be a failsafe system? If an overpayment is made and the receiver is not notified, they should be allowed not to pay back any of the money.
Alison McGovern
I thank the hon. Member for his intervention. I am sure that many Members will want to provide their views to the review, which is welcome. I will come to some of the steps we have already taken to try to address the problems in a moment.
It is vital to move quickly to understand exactly what has gone wrong, so that we can set out a plan to put things right. Right now, we want to make it as easy as possible for carers to tell us when something has changed that could affect their carer’s allowance. We will continue to look at improving communications, and we are now reviewing the results of a test of text alerts to claimants who may be at risk of building up overpayments.
In response to the point that the right hon. Member for Kingston and Surbiton (Ed Davey) made about the need for a review, I assure him that we are not waiting for an extensive review in order to act; we have acted already. Our pilot involved texting 3,500 claimants to alert them when we were told by HMRC that they have breached the current earnings limit. Going forward, we want to make the best use of earnings data already held by HMRC in order to reduce the burdens on busy carers, which also responds to the point made earlier.
Alison McGovern
In a moment.
If the results of the pilot are positive, that will be the first step towards addressing the overpayments problem. I know that we need to do much more, and there are many other issues, but it will be a good start.
Ed Davey
I am grateful to the Minister for what she has just said, but will she confirm that the remit of the review will go further into the structure of carer’s allowance? Many of us think that the earnings limit is way too low, and the whole cliff-edge structure has to change. Can she confirm that the review will look at that?
Alison McGovern
I thank the right hon. Member for his question. I went through the details of what the review will look at just a moment ago, but there are wider problems with support for carers. The right hon. Member will know that the Department is currently looking at a whole host of areas, and we need family carers to be much better supported, both in work and when they are not working, so we will look at the wider issues. The review is about doing that, as I have said, but that does not mean that we are not fully aware of all the issues that carers face. As I was saying, addressing overpayments is only part of the action we need to take to ensure that unpaid carers get the support they need and deserve.
Alison McGovern
I will make a bit of progress.
We are looking closely at how the benefits system currently works, and it is right that the Government focus on addressing overpayments of carer’s allowance. As I was just saying, we have set up an independent review, but we have heard the concerns about the broader system, including the earnings limit and the lack of taper. As Members will know, earlier this year the Work and Pensions Committee, which was then chaired by my right hon. Friend the Member for East Ham, raised a number of issues with carer’s allowance—not only overpayments, but the need for modernisation more generally. As the right hon. Member for Kingston and Surbiton will know, we have given the Committee’s recommendations the detailed consideration that they deserve, and we will respond later in the autumn.
Mr Speaker
Order. May I gently say to the Minister that she should look towards the Chair when speaking? I struggle to hear when she is constantly looking the other way. We operate in the third person, which is why Members should always speak through the Chair. Otherwise, I struggle to catch the words.
Alison McGovern
I apologise, Mr Speaker. You would think that after 14 years I would be able to get it right.
Alison McGovern
Yes, 14 years. It just goes to show that every day in this House is a school day. Thank you, Mr Speaker; I always welcome your suggestions.
I cannot pre-empt the Secretary of State’s decision, but she will shortly start her uprating review of carer’s allowance, following the release of yesterday’s earnings data and today’s inflation figures, and the outcome of that review will include the new weekly rate of carer’s allowance from April 2025.
Alison McGovern
Apologies, but I feel that I should keep going.
Means-tested benefits can help where appropriate. Universal credit, for example, pays an extra £2,400 a year to unpaid family carers. I do not underestimate the challenges within the universal credit system, and we want to ensure that carers who need it get that support. As I was saying to the right hon. Member for Kingston and Surbiton a moment ago, we are looking at different aspects of the system, including by reviewing universal credit to ensure that it does the job we all want it to do. We will set out the details in due course.
Pension credit can also be paid to carers at a higher rate than what those without caring responsibilities receive, and over 100,000 carers receive an extra amount of pension credit because of their entitlement to carer’s allowance. However, we think that as many as 760,000 pensioners who are eligible for pension credit are not receiving it, which is why the Government have already taken action to drive up pension credit take-up. Last month, we started a national campaign to encourage eligible pensioners to check their eligibility and apply. We are asking local authorities to support that and, as the House will know, the Secretary of State and the Deputy Prime Minister wrote to them in August.
Following that, we have seen a 152% increase in applications for pension credit since 29 July, with almost 75,000 applications in just eight weeks. In November we will write to around 120,000 pensioners in receipt of housing benefit who may be eligible but are not currently claiming pension credit, and I encourage all family carers to check that they are receiving all the support to which they are entitled. The gov.uk website has lots of information on carer’s allowance, and 90% of people claim online, although traditional paper forms are available for those who want to claim it that way. I know that organisations such as Carers UK and Citizens Advice are also on hand and do a fantastic job of giving advice.
Financial help for carers is really important, but it is only one pillar of a proper support system. All of us need a balance in life, and that is important for carers too. Most carers of working age want to consider working in some form, and not just for financial wellbeing but to enhance their life and the life of the person for whom they care. We want to help family carers combine their caring responsibilities with paid work where they can. We will review the implementation of the Carer’s Leave Act 2023, which gave unemployed carers a right to time off work for the first time, and we will explore the benefits of paid leave while being mindful of the impact of any changes on small employers. Through the Employment Rights Bill, we will ensure that flexible working, which can play such an important role in helping carers to balance their work and caring responsibilities, is available to all workers, except where it is genuinely not feasible.
The Government will carefully consider the findings of Lord Darzi’s independent review of the NHS, which is very clear about the need for a fresh approach to supporting family carers. Caring is a demanding role in which no one can function at their best without ever having a break, and the better care fund includes money that can be used for unpaid carer support, including short breaks and respite services for carers. As I mentioned at the beginning of my contribution, we will ensure that family carers’ voices are heard as we develop plans to create a national care service as part of our reforms to adult social care.
Every day, unpaid family carers step up when loved ones need their support. Without the contribution of family carers, our country would not function. The pressure on social care in this country is already unbearable; without unpaid family carers, it would become completely untenable.
Jess Brown-Fuller (Chichester) (LD)
For all the talk of a £22 billion black hole, the value that carers give to the economy is £162 billion. Does the Minister agree that it is an absolute scandal that many carers are struggling financially?
Alison McGovern
Our country is in a very serious financial situation indeed. As I said at the beginning of my speech, anyone who thinks that the issue of care ought not to be right at the top of the political agenda is labouring under a serious misapprehension.
This is an important subject, which is why I am proud of the first steps that this Government have already taken to improve support for carers and to address the overpayment of carer’s allowance, which has caused so much distress for thousands of people. This shows our commitment to recognising and valuing the vital role that carers play in our communities. Of course there is much more to do, so it is my hope that, as we deliver the fundamental change that we need, we can work together with carer organisations and with carers themselves with a renewed sense of purpose to ensure that carers get all the support they need to carry out the incredible work of caring and to live full and fulfilled lives.
Mel Stride (Central Devon) (Con)
I welcome this debate on this important matter. There is unanimity across the House that carers up and down this country do an extraordinary job, often in very difficult circumstances. We owe them a huge amount, and not only for the compassion and social value that their work brings, but for the financial and fiscal benefits, as Carers UK has identified, because of the costs that the taxpayer is not required to pick up.
I recognise the experience that the leader of the Liberal Democrats has in this area, through his campaigning and his personal experience. I think he said that it was good that the Liberal Democrats had brought forward a motion today that was devoid of any politics, but I am not sure that I entirely agree with him. The motion of course contains much that we can all agree on, but the relevant poisonous pills within it will ensure that when we divide later—I confidently predict that the motion will fall—only the Liberal Democrats, and perhaps a few other minority parties, will go through the Aye Lobby. They will then be able to crank up the Risographs so that their leaflets can say that only they care about this particular matter. That is far from the truth. My party, the official Opposition, cares very deeply.
When we were in Government, we brought forward a number of measures to ensure that we supported those carers. The level of carer’s allowance has increased by £1,500 since 2010. In 2023 it was my party that brought in the statutory entitlement to one week per year of carer’s leave. It was only last year that we, through the better care fund, provided £327 million to those in desperate need of respite from their caring duties. The care Act of this year increased the rights of carers and also the duties placed upon local authorities. I am also pleased to tell the House that, even more recently, my hon. Friend the Member for East Grinstead and Uckfield (Mims Davies), the shadow Minister for Women and Equalities, attended an event here hosted by Carers UK so that we could continue that really important dialogue.
Mel Stride
I think the right hon. Gentleman will find that that measure was supported by our Government—[Laughter.] No, no—most private Members’ Bills are not supported by the Government of the day and therefore make no progress. We were happy, whatever legislative vehicle was available, to ensure that that important measure came into effect on our watch.
Let me speak for a moment about the complexities of carer’s allowance, because this is really important. It goes to the heart of many of the assertions that have been made in the Chamber today. This is how it works. It is £81.90 per week. We expect somebody who is in receipt of that benefit to be providing care for 35 hours or more to one or more individuals. There is an element of trust in the way the benefit works, because the Department for Work and Pensions cannot establish exactly what individuals are doing up and down the country, and therefore there is an earnings limit, which is a proxy for the amount of paid work that somebody is doing, rather than the amount of time they are spending looking after a loved one. That is the purpose of the limit.
A complication, which has not yet been raised in this debate, is that someone’s income has to be adjusted in order to determine whether they are above or below that limit. There are adjustments. For example, they can reduce their declared income in this respect by 50% of any pension contributions they may make. They can adjust the amount of income that they compare to the limit for any equipment that they purchase in respect of their caring obligations. There are also travel costs. If someone is self-employed, various business costs can also see a reduction in the level of income. This lies at the heart of why there is a challenge in notifying people of whether they are above or below the earnings limit, because it is impossible, at the centre, to determine the answer to that question, for the reasons that I have given.
Mr Amos
The right hon. Gentleman espouses the benefits of cross-party working in an interesting way. Whatever adjustments are made to the earnings limit, will he join those on the Liberal Democrat Benches in asking the Minister to allow a higher level of earnings? That is the crucial factor that prevents so many people who badly need carer’s allowance from getting it.
Mel Stride
The hon. Gentleman makes an important point, and of course the motion states that there should be an increase—an unspecified amount, but it is there none the less. I think the answer to his question is that it is a balance, because the higher we put up the earnings limit and the more generous we are to carers, which of course is something we all want to do, the more people can earn and the longer they can work. Potentially, therefore, if this is acting as a proxy for the amount that people are working, they might not have the real time to spend 35 hours a week caring for a loved one. So it is inevitably a balance. I certainly accept that this is worth reviewing, and I note that the Minister for Social Security and Disability, the right hon. Member for East Ham (Sir Stephen Timms), when he chaired the Work and Pensions Committee, called forcefully for a significant increase in the level of carer’s allowance.
Wendy Chamberlain (North East Fife) (LD)
The right hon. Gentleman has obviously set out a number of the adjustments that need to be made, but in doing so he has outlined just how complex the system is and therefore exactly why we have had the scandal in the first instance. Does he agree that we should be asking the Minister to ensure that in the carer’s allowance review we simplify this process? I can assure him that many unpaid carers are not doing 35 hours a week.
Mel Stride
Indeed. What we want, ideally, is a system that is as simple as possible. The motion suggests that we bring in a taper, but that would be a complication of the system. I will come to why there are problems with that. It is easy to suggest these things, but the detail often makes them really quite complicated.
The last Government made it clear, when someone applied for this particular benefit, exactly what the arrangements were. When uprating occurred every year, we wrote to everybody to explain the uprating and to inquire as to whether any changes in their circumstances or earnings might impact their entitlement to benefits. And it was we, not this Government, who in our May update to our fraud plan brought in the pilots for texting to alert those on carer’s allowance that they may—I say “may” because the Department will not know—be close to exceeding the earnings limit. I am pleased that the Minister has indicated that the Government will continue with our fine work, but let us be very clear who it was that started those particular measures.
Nesil Caliskan (Barking) (Lab)
On that point, would the right hon. Member therefore accept that the Department for Work and Pensions is in a complete mess and that unpaid carers in our constituencies are having to pay the price and bear the brunt of that because the system is clearly not working for them?
Mel Stride
No, I would not. I am not ruling out the possibility that it may yet become a mess, but certainly on our watch it was never a mess. In fact, it dispenses about £280 billion-worth of transfer payments both to pensioners and through the benefits system, and by and large it does a remarkable job in doing that efficiently. I want to pay tribute to all the officials and civil servants that work in that Department. They work incredibly hard and, for the vast majority of their time, produce outstanding results. None the less, of course, we can always point to elements of the system where things break down, and we must always strive to get better. That is why I welcome the Government’s review.
The suggestion that the Government should not seek the repayment of overpayments is absurd. We cannot go that far. If someone goes over a threshold, we cannot say, “Do not worry about it.” We might as well not have the threshold in the first place. By all means, change the threshold—that may be a perfectly legitimate thing to do. Otherwise, the threshold should be removed altogether.
Some Members will perfectly legitimately raise failings in the system, but when I was Secretary of State there were examples of fraud. For instance, one individual was working 100 hours a week as a taxi driver while apparently still having the time to spend 35 hours a week looking after a loved one. To my mind, that is clearly fraud, so we cannot write off absolutely everything. The Department does the right thing by looking at this issue on a case-by-case basis.
Jess Brown-Fuller
If a carer receives a bonus from their employer for doing a good job and it takes them over the threshold, should they lose their carer’s allowance?
Mel Stride
Quite possibly not, which is why the Department operates on a case-by-case basis. That is the correct approach, rather than a blanket approach that says it does not matter if someone goes over the threshold. As I said, if there is never going to be a requirement for repayment, we might as well not have a threshold at all. In some cases, going over the threshold is egregious. The Government know this, and they will have to take it into account.
Mel Stride
It is difficult to give a precise answer; what does the right hon. Gentleman mean by “a small amount over the earnings limit”? We know that, for the vast majority of the thousands of people in this situation, it will almost certainly be small amounts, including some very small amounts. None the less, fraud and error are a significant challenge across the benefits system, and need to be addressed. Any responsible Government will take that approach. Simply to say, “We have a problem, so we should take off the brakes and have no limit. We should let people claim what they like, whatever it might be, even if it is fraud”, as suggested by the leader of the Liberal Democrats, is not viable.
Mel Stride
I will give way, but I invite the right hon. Gentleman to explain how he would deal with fraud when he is pushing for none of the overpayments to be returned.
Ed Davey
I made it very clear in my speech that there could be examples of fraud, so I ask the right hon. Gentleman to check the record. I could not have been clearer, and we have talked about this at length in other fora—indeed, we made it clear at the general election.
I am afraid that the right hon. Gentleman has shown to the House that he failed to get a grip of this issue when he was Secretary of State. He recognises that the vast majority of overpayments were small amounts, often because the DWP, in which he was Secretary of State, did not pass on information to HMRC. I am afraid that he is digging a hole for himself.
Mel Stride
Regardless of what the right hon. Gentleman may or may not have said in his opening remarks, the text of the motion cannot be disputed. On the point of whether anyone should be expected to repay, the motion says that this House
“believes that carers should not be forced to face the stress, humiliation and fear caused by demands for repayments of Carer’s Allowance”.
To me, that suggests everyone. The motion goes on to say that the Government should “write-off existing overpayments immediately”. It is clear and obvious that that would include any fraudulent payments.
It may be that the earnings limit could be increased, but there would be a fiscal cost. Indeed, the Liberal Democrat manifesto reforms would cost about £1.5 billion, which is significant. We would have to take account of the balance between being more generous to carers and respecting the 35-hour rule, if that remains.
Finally, whenever there is a cliff edge, it is suggested that tapering will solve the problem, but that neglects the fact that it introduces complexity, which is the very thing that universal credit, for example, was designed to iron out. The system was like spaghetti, and nobody could quite understand how it worked. In the tax system, for example, the personal allowance tapers away after £100,000. Many people just stop working further when they reach that level of earnings, because it is not worth their while, given the marginal tax rate.
There is an interplay between universal credit and carer’s allowance, because people who earn more will end up having their carer’s allowance withdrawn. There is already a taper within carer’s allowance to make sure that work pays, so that as people earn more, their benefit is reduced but not sufficiently to make them worse off. Under the system advocated by the Liberal Democrats, there will be two tapers in two interacting benefits, which I do not think would best serve anybody, least of all carers.
Madam Deputy Speaker is seeking my conclusion. I welcome this motion, and like other parties in this House, we stand four-square behind our carers, who do an extraordinary job. I wish the Government well with their review, which we will consider seriously and objectively, as we are all on the side of carers. I stand by our record in office, of which I am proud.
Rebecca Long Bailey (Salford) (Ind)
I very much welcome the Minister’s opening comments. It is clear that she is fully cognisant of many of the issues that I am about to raise. I also welcome the announcement of the independent Government review of carer’s allowance overpayments, which I hope will be carried out urgently. I hope it will consider writing off substantial overpayments, where it is clear that carers should have been notified sooner.
On the wider issues faced by unpaid carers, I start by reading out an email from a constituent:
“I cared for my mother, who had Alzheimer’s and vascular dementia plus severe osteoarthritis, for several years. At the time of this, if the person requiring care was deemed capable of performing any self-care tasks, only part of the Carer’s Allowance was paid. My mother would, occasionally, wipe a flannel over her face and was therefore deemed to be capable of self-care, despite all other evidence.
Caring for someone is not a 9 to 5 job, it is often a 24 hour job, as in my case, with no break for the carer (as few are ever told about respite care). Those who manage employment outside the home are also overburdened, as they have no time to decompress from their paid employment before having to spend their time at home caring for someone.
Due to the nature of being a carer, the carer’s physical and mental health often declines and goes untreated as they often have no help with their situation from the Authorities or, should they have them, siblings. That alone can impact the carer’s own physical and mental health, but carers go unnoticed until there is a crisis.
To only receive the paltry current Carer’s Allowance, which will barely cover utilities and Council Tax, ignoring food and clothing, is an insult to people who are working far harder than most but remain unseen as it is not deemed to be a ‘real job’ and is considered ‘easy.’ Only those who have cared for another adult know this is blatantly untrue.”
Sadly, my constituent’s feelings are not rare. Many people care for their loved ones out of love and, all too often, it impacts on their ability to work, resulting in many living in poverty. A new report from Carers UK and WPI Economics found that 1.2 million unpaid carers are living in poverty, while one in 10 of all carers are in deep poverty. It is not hard to understand why, as carer’s allowance is the lowest benefit of its kind—currently, just £81.90 a week—and it is available only to carers who can prove that they provide more than 35 hours of unpaid care a week.
Nesil Caliskan
Does my hon. Friend agree that the evidence shows that it is disproportionately women who are carers, and therefore women who experience those levels of poverty because of the low figure she mentioned?
Rebecca Long Bailey
I welcome my hon. Friend’s comments and I agree with them.
To solve the crisis, Care UK’s modelling suggests that an immediate uplift, an increase in the earnings limit and an earnings taper would lift huge numbers out of poverty. However, a number of brutal loopholes, already highlighted by the right hon. Member for Kingston and Surbiton (Ed Davey), need to be addressed urgently, including the rules on young carers and students. Many people do not know that carer’s allowance is not paid to those studying for more than 21 hours a week. A number of young carers in Salford have told me that that means they are often excluded from any support. The pressures on them to study and care for their loved ones are immense, all while often living in extreme poverty. Sadly, many feel they have no option but to leave education aged 16.
Further, if a carer is looking after more than one person for a cumulative amount of 35 hours a week, the carer is not eligible to receive carer’s allowance. If two people share the care, each providing 35 hours a week, only one person can claim carer’s allowance.
Joe Robertson (Isle of Wight East) (Con)
I support the sentiment that we need more funding and support for carers—more finance, more money—but the email the hon. Lady read out powerfully showed that it is not just money that carers need. They need much broader support to give respite and relief, and to allow them to address their own mental health concerns that arise from their job, as well as support to stay in education longer, as she mentioned. Although money is important, does she agree that carers need the much wider community support that charities and other local groups can give?
Rebecca Long Bailey
The hon. Gentleman makes an important point. Unfortunately, the ability of local authorities to reach out to carers who are struggling and directly offer them the respite care they should be entitled to has been hampered, certainly in the past 10 to 14 years. The burden of stepping in has been left to many charities. For those who live in an area with a large charitable presence, that is fantastic, but unfortunately not a lot of unpaid carers live in such areas. That is an issue that the Government must grapple with.
Another brutal issue, which is relatively unknown, is that of pensions. As far as I am aware, carer’s allowance does not get paid to those in receipt of the state pension, unless the state pension amount is lower than the weekly value of carer’s allowance. As with the pension credit threshold, at the moment a huge number of people are just over the cusp of eligibility; they live in poverty but cannot access the help they need.
There is another brutal loophole for pensioners receiving care. The Government website currently states:
“When you get Carer’s Allowance, the person you care for will usually stop getting: a severe disability premium paid with their benefits”
or
“an extra amount for severe disability paid with Pension Credit”.
That left one of my constituents, whose daughter provides care but does not live with her, in a situation where she is not entitled to the top-up in pension credit that she should be entitled to, which she needs to survive and to deal with her daily living costs as a severely disabled person.
I wanted to highlight those points, but I will bring my comments to a close as many colleagues want to speak. I welcome the encouraging comments made by my hon. Friends on the Government Front Bench. I encourage them to address the loopholes that have been mentioned urgently and, as I am sure they are doing already, to encourage action from the Chancellor at the upcoming Budget, so that we can provide the financial and social support our unpaid carers desperately need.
Several hon. Members rose—
Madam Deputy Speaker (Ms Nusrat Ghani)
Order. This is a heavily subscribed debate and I am determined to get everybody in, so this is fair warning. After the next speaker, Back Benchers will be limited to three minutes and maiden speeches will be limited to five minutes. These will be hard limits to ensure everybody gets in after our next speaker, Wendy Chamberlain, who has unlimited time.
Wendy Chamberlain (North East Fife) (LD)
I declare an interest as I am in the process of joining the board of Fife Carers in an unpaid capacity; it is a privilege to join the organisation. I have worked with unpaid carers throughout the past few years, as constituency MP for North East Fife and through the passage of my private Member’s Bill that became the Carer’s Leave Act 2023. If hon. Members want to learn more widely about carers, they may wish to read my Adjournment debate on the subject, which took place in the first few weeks of this Parliament, where I talked about the need for a strategy on carers to ensure that carers get the cross-cutting governmental and departmental support they need.
I will not touch on the overpayments scandal specifically, but I welcome the announcement of the review after months of campaigning by my dear friend the Leader of the Liberal Democrat party, my right hon. Friend the Member for Kingston and Surbiton (Ed Davey), as well as by the Liberal Democrats, carer charities and journalists. However, I want to raise some points about the carer’s allowance more generally.
I recently asked the Minister responsible for carer’s allowance, the right hon. Member for East Ham (Sir Stephen Timms), a written question about a review of how carer’s allowance is working. The response said:
“This government will keep eligibility criteria and processes of Carer’s Allowance under review, to see if it is meeting its objectives.”
That response poses more questions than it provides answers. What are the Government’s objectives for carer’s allowance? Are they ever reviewed? How do they know if they are meeting them? What metrics are being used? What would happen if it was found that the objectives were not being met?
I assume that the objective of carer’s allowance is to keep unpaid carers out of poverty, given the additional barriers they face to working and the additional costs they face through their caring. I also assume that we want to help unpaid carers to stay linked to the workplace, if possible, through part-time work or training. On any assessment, carer’s allowance is failing these objectives. It is a failure when a third of households in receipt of carer’s allowance are classed as food insecure, compared with 10% of households as a whole; when Carers UK research from 2019 found that 600 people per day who were caring were giving up work; and when the rate of poverty among unpaid carers is 50% higher than among non-carers.
One immediate remedy that could be considered, as is set out in our motion, is an increase in carer’s allowance. It may not seem much in the big scheme of things, but during the pandemic we saw the impact of the £20 uplift to universal credit, which delivered an immediate and marked fall in food bank use.
We must do all we can to support people into work and to stay in work, so that they are not relying on carer’s allowance to get by. That point refers to the earnings allowance, which stops carers from working more than 13 hours a week on the minimum wage before losing carer’s allowance. As has already been discussed, there is no taper rate, so as soon as carers earn a penny more, the allowance goes.
Bizarrely, yearly increases to the allowance are not pegged to changes to the national minimum wage. Historically, people could work for 16 hours before they lost carer’s allowance; some of the scandal we have seen could be because people have continued to make those assumptions. We need to take the complexity out of the system. It is completely reasonable for people to assume that if they are earning national minimum wage and receiving carer’s allowance in one financial year, they can continue to do so in the following financial year, as long as they do not increase their hours, but that is not how the system works. The national minimum wage went up by 9.8% this year, but the earnings allowance did not go up at all. That sounds to me like a system set up to make people fail.
Should we not be enabling people to take on more hours and to progress in their jobs if they can? We know that often people—especially those who are below or near the poverty line, as too many unpaid carers are—are scared to risk losing their benefits in case that does not work out. One of the unseen outcomes of the scandal is that people are simply not looking for work or to get into employment because they are scared about the consequences.
Many young carers have high levels of absence from school and there are barriers to them accessing education. Potentially, if we do not help them to claim carer’s allowance when they are entitled to do so, they will never go into work and be able to make a contribution. Fife Young Carers, in my constituency, supports people up to the age of 25. We want to encourage young carers to complete their education so they have the best possible options later.
To return to my cross-cutting strategy, the Department for Work and Pensions may think that it is for the Department for Education to support young people. However, as the hon. Member for Salford (Rebecca Long Bailey) said, under the under-21 rule, doing a vocational qualification could preclude somebody from receiving carer’s allowance, as T-levels are one of the qualifications that falls into that trap. She is right that we need to think about how we are potentially inhibiting those young people in employment and training from moving forward. We need to ensure that we improve young people’s outcomes.
The Minister will know that employment among unpaid carers is about more than just benefits. We welcome her reference to the Carer’s Leave Act 2023 in her opening remarks and the fact that the Government are looking for that leave to be paid, which has long been a party policy of the Liberal Democrats. However, I do have to express my disappointment that there was no sign of paid leave in the Employment Rights Bill, because there was a real opportunity there to move the matter forward. I would appreciate it if, in her closing remarks, the Minister provided an update on the likely timescales in relation to the Carer’s Leave Act. I am concerned that, since the implementation of the Act, we do not actually know what the take-up of carer’s leave is. I am hearing worrying anecdotes that, six months after the legislation was fully implemented, some companies are still not aware of, or properly recording, carer’s leave. Part of that is because the communication from the then Government was not good enough. Unless somebody was starting a small business, or actively looking for these details, they would not find anything on carer’s leave.
I would like to raise one final point with the Minister. Again, the hon. Member for Salford highlighted this. I am often contacted by constituents who are upset to find that, having retired, they have lost their carer’s allowance—or, in Scotland, the carer support payment—because they are claiming their state pension. We know that female pensioners are more likely to be in poverty because of the working life that they have had—or not had—as a result of raising their families, and that unpaid carers are more likely to be female and older. I would like the Minister to pick up on that point, because too many pensioners are in poverty this winter as well as carrying caring responsibilities.
Madam Deputy Speaker (Ms Nusrat Ghani)
I call Gill German to make her maiden speech.
Gill German (Clwyd North) (Lab)
I am delighted to make my maiden speech in this debate today. Dw i’n mor falch o fod yn sefyll yma—I am so proud to be standing here.
Our carers, including our young carers, many of whom I have had the privilege to know as their teacher, are a vital part of our communities. It is incumbent on us to represent their voices and right that we take time to do that in this debate. I thank hon. Members who have contributed today, and other hon. Members who have already made their maiden speeches in this House. I hope that I can follow them with aplomb.
I wish to start by paying tribute to my predecessors. First, I would like to thank David Jones, the former MP for Clwyd West, for his 19 years of service to Clwyd West and, indeed, to his country as a former Secretary of State for Wales. Next, I wish to thank the former MP for the Vale of Clwyd, James Davies, for his service and for his keen eye for an impressive floral display through his work with Britain in Bloom. Finally, I pay warm tribute to the previous MP for Vale of Clwyd, Chris Ruane. An early local advocate of breaking down barriers to opportunity, Chris worked hard over many years to bring investment to the area, and never more so than in support of the development of the beautiful Rhyl harbour and the magnificent Pont y Ddraig, or Dragon’s Bridge. He leaves a legacy that I am proud to have the opportunity to build on as MP for Clwyd North.
I am also proud to be breaking new ground. As one of three newly elected Welsh Labour women MPs in north Wales, I join my neighbours, my hon. Friends the Members for Bangor Aberconwy (Claire Hughes) and for Clwyd East (Becky Gittins), to form a formidable force along the coast. Clwyd North boasts miles of golden coastline—from Rhyl to Rhos on Sea, taking in Kinmel Bay, Towyn, Abergele and Pensarn, Llanddulas and Colwyn Bay. Our sandy beaches are a huge source of pride.
Since Victorian times, the Clwyd North coast has been a magnet for visitors. Generations of families have holidayed there from the north-west of England and beyond, with many families making north Wales their home, including my own. As well as the usual seaside fare of ice cream, buckets and spades, and fish and chips, the Clwyd North coast boasts a water sports centre, a Michelin-recognised restaurant at Porth Eirias, live music and picture-window dining at the Pavilion theatre, and the fabulous Theatr Colwyn, one of the oldest working theatres in Wales.
Move inland in Clwyd North and the wonder continues. From the gothic Marble Church in Bodelwyddan to the magnificent St Asaph Cathedral, impressive architecture and mountain views abound. Clwyd North boasts not just one but two medieval castles—in historic Rhuddlan and the market town of Denbigh.
Of course, areas such as ours have challenges too. As a local teacher for over 20 years, I saw at first hand the issues dealt with by local families, as they struggled to make ends meet with rising costs and flatlining wages. I knew that I needed to step up. I stood for election and became deputy leader of the local council and cabinet member for education, children and families. Make no mistake, my route into politics came straight through my classroom. A teacher of the very youngest, I saw children fizzing with potential coming through my door, only to see that potential dimmed in later years by struggle and circumstance. I saw a lack of economic growth hinder the lives of their families. Most stark of all, as the years went on, I saw the children I had once taught now grown, with children of their own and those same struggles continuing.
Our missions of growing the economy and breaking down barriers to opportunity are personal to me. I am motivated every day by the vision of every child being able to fulfil their potential. I am motivated by a vision of Clwyd North with a year-round, sustainable economy, playing our part in generating green energy, as well as in design, manufacturing and installation—economic growth powered by innovation, investment and a wealth of local skills.
I have been so lucky to have been surrounded by the best and most supportive people that anyone could wish for: my hard-working and loyal dad, Graham; my kind, clever, deeply caring brother, Lee; my bright and brilliant children, Sam and Josie. Then there is my trinity of invincible, inspiring women: my best friend, Kelly; my much-missed Grandma Celia; and the linchpin of it all, my amazing mum, Kath. These people and more have made me who I am. Living, growing and working in our beautiful part of north Wales has made me who I am. As Member of Parliament for Clwyd North, I will work hard, day in, day out, to make it the very best it can be for our families, for our communities, for all of us.
Bobby Dean (Carshalton and Wallington) (LD)
Colleagues have outlined the scale of the crisis, so I shall focus on a story of one of my constituents in Carshalton and Wallington. She was told that she had to repay more than £2,300 in carer’s allowance over- payments. This constituent already makes huge sacrifices to keep her family afloat, while caring for her disabled son. She gave up her full-time job to take on caring responsibilities and has limited her part-time hours to ensure that she remains qualified for carer’s allowance. It made me so angry to hear how meticulously she tried to manage her pay cheques each month, only to have it thrown in her face. She turned down pay rises, turned down overtime and turned down Christmas bonuses to ensure that she stayed under the limit. Her employers agreed to keep her on an advance rota to help her plan her earnings. Despite her diligence, she received no notice, no warnings and no forgiveness when one day the payments stopped and the bill came in for over two grand.
Here is the bit that really gets me. The repayment demand that she received is for the entire entitlement for each occasion when she earned too much. That means that the smallest indiscretions come with the heaviest of consequences. In one month, it was because she earned £28 too much. In another, it was £20. It gets worse: one November, she was £8 over the limit—not even an hour’s work in London. Finally, and most depressingly, she once dared to earn £2 too much. She owes the whole of the allowance back for each of those periods, and then a £50 fine to boot from the Department for Work and Pensions. This is nothing short of a national scandal, and the DWP should be ashamed of itself.
Today, the Liberal Democrats are calling on the Government to right this wrong, to stop pursuing hard-working carers for these innocent overpayments, and then to fix the system that let this scandal emerge in the first place. We need to taper the allowance, raise the earning limits and treat carers with the compassion they deserve.
I am conscious of time, so finally, I welcome and am encouraged by the Minister’s comments about the review. However, for it to be successful, carers need to play a big part and have full input. We also need to make sure that carers now in debt distress get some immediate reassurances and support and do not have to wait until the end of the review.
Madam Deputy Speaker (Ms Nusrat Ghani)
I call Dan Aldridge to make his maiden speech.
Dan Aldridge (Weston-super-Mare) (Lab)
I am honoured to make my maiden address during this debate on carer’s allowance. We all know people who are working tirelessly to care for loved ones. Indeed, making life better for those who sacrifice so much was one of the main reasons I made the decision to run for election to this place. In Weston-super-Mare, it has been a privilege to get to know some of our residents who care tirelessly for loved ones in the most challenging circumstances. I pay tribute to carers in my constituency and specifically to Pat O’Connell, Jan Quan and everybody at the Parkinson’s UK Weston-super-Mare branch for being so fearless in fighting for appropriate care services for their loved ones. I am in awe of their love, compassion and conviction to secure better care and respite services not just for themselves, but for everyone. It is a real tragedy that the care system was not able to provide them with suitable respite from the 24/7 care they provide. I continue to fight their corner and that of all carers across the constituency.
Weston-super-Mare is an extraordinary place, full of a vibrant mix of people. Since my family moved to the village of Kewstoke in 2001, Weston and the surrounding areas have become deeply intertwined with our lives. I may still have my Stokie accent and a love of pottery and Staffordshire oat cakes, but Weston is now where my heart is. It is a town where we find people with roots from across our nation and from across the world. My younger sisters Emily and Lauren have become expert code-switchers between Stokie and west country based on the situation, but my younger brother Scott has embraced the local lingo and I can almost hear him now saying, “Alright, my lover?”
Weston has provided us all with a friendly community, a beautiful coastline and the best British seaside experience in the country—that is a fact. It is hard not to feel immense pride being there, and even though I will not play favourites with our local chip shops and ice cream stops, I can assure hon. Members that there are many excellent choices in the town.
This year we celebrate the 160th birthday of Birnbeck pier—Weston’s oldest—which has been closed for nearly 30 years. Its restoration has been a labour of love for many people who have worked tirelessly to preserve this piece of our history, and I am overjoyed to be the MP who will hopefully see it brought back to life for our community and for commercial use.
Weston is made up of diverse communities, from the town itself, which hosted its first mela this summer to celebrate our diversity, to areas such as Worle and villages such as Bleadon, Uphill and Hutton. Those neighbourhoods have grown significantly over the years, with post-war estates such as Bournville, Coronation, Potteries and Oldmixon fostering some of the most creative, friendly and resilient people and hosting events from community Pride to some of the most fantastic creative art events I have ever attended.
I come from a community just like those. Under the last Labour Government, I was the first in my family to pursue A-levels and go to university. It is because of those life-changing opportunities that I am here today. A constituent said to me recently, “Politics doesn’t make any difference,” but I could not disagree more. Yes, we have seen challenges, but for many of us, especially in my generation, the decisions of a Labour Government gave us the chance to succeed in ways we never thought possible. I am determined to build on that legacy and ensure we continue to empower future generations.
Recently, Weston has evolved into a haven for food and beverage enterprise, offering everything from traditional British seaside fare to incredible vegan options thanks to local champions such as Anna Southwell, who have transformed perceptions of vegan cuisine—including my own—and shown how to build and sustain inclusive communities through food, drink and entertainment. Businesses such as Kinda Co., known for its dairy-free cheese, have chosen Weston as their home, thriving there because of the opportunities we create for growth and sustainability, and while it is now just outside my constituency, the iconic Thatchers Cider will always be associated with our town.
Even though our high street, like many across the country, has struggled over the years, traditional stores such as the phenomenal family-run Walker and Ling, opened in 1904 and trading in the same place since, have kept the faith and are part of the fabric of this great town. I sincerely hope it will be there for many more years to come as we work together to revitalise the high street. Weston is also home to some amazing tech start-ups, and as the world becomes more interconnected, with high-skill, high-wage jobs tied less to cities, places such as Weston are starting to see investment. More people have cottoned on to what a great place it is, and I can totally understand why.
I thank my predecessor John Penrose for his service in this place over 19 years. I particularly pay tribute to him for his work on the Digital Markets, Competition and Consumers Act 2024 and as the anti-corruption champion in the May and Johnson Ministries. Before him came the late Lord Cotter, who was a visionary for our town, advocating for digital transformation and regional economic development. He was also a patron of a homeless and rough sleeping charity in Weston, Somewhere to Go, which he cared for deeply. I am honoured to continue in his footsteps as a trustee. I look forward to playing an active role in the Government’s ambitious plans to end homelessness, and to ensuring that technology is a force for good and that digital inclusion becomes a reality for all.
Our youth and, indeed, all those seeking to learn and develop deserve the best opportunities. I am inspired constantly by the hope, resilience and community spirit of the children and young people I am fortunate enough to be surrounded by in Weston. I am committed to ensuring that Weston continues to be a place where everyone can thrive, and where community and innovation come together to build a brighter future for all. If the children and young people I see in my constituency week in, week out are anything to judge our future by, we are in excellent hands. Thank you, Weston-super-Mare, for being my home and for giving me the opportunity to serve you.
Victoria Collins (Harpenden and Berkhamsted) (LD)
I congratulate the hon. Members for Clwyd North (Gill German) and for Weston-super-Mare (Dan Aldridge) on their maiden speeches.
Earlier this year I spoke to a family member whose mother was suffering with severe depression. Her mental health had started to plummet once she became a carer for her husband. He had fallen and been rushed to hospital, but he could not leave without a full-time carer in place. The only option for the family was to have his wife give up work and be there when he came home. The toll of that care as she became older and had to give up her job grew heavier.
I hear such heartbreaking stories of families caring for their loved ones again and again across Harpenden, Berkhamsted and Tring. Recent censuses have shown that there are thousands of unpaid carers, or family carers, across the constituency—and as has been mentioned today, those are the ones who have realised they are indeed carers.
Catherine Fookes (Monmouthshire) (Lab)
There are 311,000 unpaid carers in Wales, many in my constituency of Monmouthshire. Carers Wales estimates they provide free care worth £10.6 billion to the Welsh economy each year. Will the hon. Lady join me in condemning the previous Government for not dealing with the issue of overpayment?
Victoria Collins
Absolutely; it is a real travesty. It has come up again and again in the House that we are letting down the people who are caring for our communities and the families in them, or indeed our own families. Facing the cost and complication of getting the support they need is often left to the families and unpaid carers who lovingly pick up the pieces.
On the hon. Lady’s point, our carers are the equivalent of a second NHS. Not only are they supporting their loved ones, but they are propping up our healthcare service. It is estimated they contribute a staggering £162 billion a year, compared with an estimated £164 billion in funding for the NHS. That is a shocking £445 million per day, in comparison with the previously mentioned £81.90 per week of carer’s allowance.
I have mentioned this before in the House, but I will mention it again. In the West Hertfordshire teaching hospitals NHS trust, in one month alone, we lost 843 bed days because of a backlog in social care. That has an impact on A&E waiting times, ambulance waiting times, waiting lists and, crucially, the people waiting in hospital and their families. People want to be back home. They do not want to be stuck in hospital because of a failing system, so taking care of care and our carers is not only the right thing to do, but it helps us all.
I support the motion, which calls for overpayments to be written off, for the carer’s allowance earnings limit to be raised, and for the introduction of a taper to end the unfair cliff edge. I welcome the review, and call on the Government to support carers to juggle work and care, and as my hon. Friend the Member for Carshalton and Wallington (Bobby Dean) highlighted, to bring carers into the review. We must ensure that all carers, of all ages, are given the care that they need. We must support those who support our loved ones, and who are supporting our NHS and every one of us in ways that we may never know.
Josh Dean (Hertford and Stortford) (Lab)
I thank hon. Members for their constructive contributions to this debate, on a topic that I know is important to all our constituents. The enormous contributions made to our communities by unpaid or family carers have rightly been recognised across the House. We know that our country would grind to a halt without them, but many today are pushed to breaking point caring for those they love, and that cannot be right. The treatment of unpaid carers, unknowingly overpaid their carer’s allowance under the previous Administration, was unacceptable. Having spoken to unpaid carers in Hertford and Stortford, I know that those failures have caused many of them stress, and shockingly even left some in fear of claiming the carer’s allowance to which they are rightly entitled.
I know that local benefits advice has been invaluable to those residents, and I pay tribute to the work of Citizens Advice East Herts and other groups that offer a lifeline to those in need of support. I welcome today’s announcement from the Minister that the Government will launch a review into carer’s allowance overpayments. I am pleased that the review will look at not only what went wrong previously but, importantly, how we can prevent such problems in the future. I know that it will be welcomed by carers and unpaid family carers in my community. I am proud that the Government recognise the challenges faced by unpaid carers, and it is essential that we consider how we can provide them with the support that they deserve. I am heartened by our commitment to introduce flexible working as a right, to provide time away from work for caring responsibilities, and to join up services so that my constituents do not have to battle to get the care for their loved ones that they need.
It is also important that we turn to the task of delivering much-needed reform in adult social care. The Government’s commitment to reform of the sector, with an ambition to build a world-class national care service, is something that I am sure we all support. It is right that the project will be undertaken in collaboration with care users and their families, sector partners and care organisations, to ensure that their lived experiences are at the heart of the social care system that we build. I look forward to working with those groups in my constituency to ensure that their voices are heard.
We will all have received correspondence from constituents sharing their personal experiences of the social care system. Many of us will have relatives or friends who have struggled to access care themselves, and others will have caring responsibilities too. Now is our opportunity to fix unpaid care, and the social care system more widely, and deliver lasting change for the future. I warmly welcome today’s announcement and the Government’s programme for reform.
Liz Jarvis (Eastleigh) (LD)
I rise to speak as someone with direct personal experience of battling the care system. Since I became the MP for Eastleigh, I have been contacted by numerous constituents who have been asked to pay back thousands in overpayments by the DWP. One is a single parent of a child with special educational needs, who worked narrowly over the threshold and has had her allowance cut completely. She has been left without her allowance and is now repaying the overpayment, struggling on a limited income while caring for her son.
The carer’s allowance overpayment scandal highlights deep flaws in our social security system. Unpaid carers—those dedicating their lives to caring for loved ones—are being unfairly penalised. Many of the debts could have been avoided had the previous Government fixed system failures and responded to warnings. The system needs urgent reform. The Government must take responsibility and compensate carers for overpayments that could have been prevented. I welcome the news that the Government will review overpayments in the carer’s allowance scandal, but for the sake of all vulnerable carers facing penalties I hope that we see urgent action to rectify the situation too.
The financial reality for carers in Eastleigh is incredibly challenging; 29% of unpaid carers in the UK live in poverty, and many are forced to leave work because of their caring responsibilities. One million carers across the country are relying on a carer’s allowance of just £81.90 a week. We must raise the earnings cap, allowing carers to continue working without fear of financial penalty, but financial instability is just one aspect of the difficulties that carers are facing as we head into winter. Changes to the winter fuel payment will impact the 1.2 million unpaid carers over 65. Estimates show that 1.2 million carers are already in fuel poverty, with 42% of caring households struggling to heat their homes. That highlights the urgent need for more targeted support to ensure that carers are not forced to choose between caring and basic necessities.
We need urgent reform of carer’s allowance, better pay for care workers and more support for unpaid carers. The social care crisis is leaving too many in Eastleigh stranded in hospital beds because there are not enough care workers to support them at home. We must address these issues, with a higher carer’s minimum wage, paid carer’s leave and guaranteed respite breaks. We must ensure that carers in Eastleigh and across the UK have enough to live on, and are given the respect and support that they deserve.
Johanna Baxter (Paisley and Renfrewshire South) (Lab)
I welcome the debate, brought by the right hon. Member for Kingston and Surbiton (Ed Davey), and pay tribute to my hon. Friends the Members for Clwyd North (Gill German) and for Weston-super-Mare (Dan Aldridge) on their maiden speeches. I welcome the Minister’s announcement of the independent review into how overpayments of carer’s allowance have occurred, what can be done to support those who have accrued them, and how to reduce the risk of overpayments occurring in the future.
Around 175,000 carers in receipt of carer’s allowance are combining paid work with care, and in 2023-24, there were 34,500 overpayments as a result of earnings and carer’s allowance. That means that around one in five carers who are doing paid work and claiming carer’s allowance have had an overpayment in the last year. That the previous Government allowed this situation to occur is, frankly, utterly shameful. It has pushed many unpaid carers, including many in my constituency of Paisley and Renfrewshire South, to breaking point for the sole crime of caring for somebody they love and saving the taxpayer thousands of pounds in doing so. Without their contribution, our country would grind to a halt. That this has happened to them through no fault of their own is not okay. We must provide carers with the support that they need, at the time they need it.
The Carers UK “State of Caring” report estimates that 1.2 million unpaid carers are living in poverty, and 400,000 are living in deep poverty. It also found that 75% of unpaid carers receiving carer’s allowance are struggling with cost of living pressures, while almost half are cutting back on essentials that they need to survive. That is the legacy of 14 years of Tory Government. While it is right that the review will look at getting a grip of the carer’s allowance overpayment issue, there is an urgent need for the Government to consider the broader question of how to provide wider support for unpaid or family carers. That includes support for carers on low incomes through universal credit, and through carer’s allowance.
While carer’s allowance is a devolved matter in Scotland, I urge the Government to discuss with the Scottish Government the position with respect to people in Scotland who are, or have been, receiving carer support payment while the DWP has been delivering it there on behalf of Scottish Ministers. We need a long-term vision for social care that considers how we best support unpaid carers. I know that our Government are committed to building consensus for the longer-term reform needed to create a sustainable care service.
Madam Deputy Speaker
No, I am standing now. Thank you. I call Steve Darling to make his maiden speech.
Steve Darling (Torbay) (LD)
Thank you, Madam Deputy Speaker. It is a great honour to stand here as the MP for Torbay. It is right and proper that I acknowledge the hard work of my predecessor, Kevin Foster. I also reflect on his predecessor, Adrian Sanders, with whom I worked for 18 years to support constituents in Torbay. I learned from Adrian how to put the community at the heart of all one does as a constituency MP. I look forward to building on that over this parliamentary term.
I want to thank Pam Bagnall, Hans Windheuser and Frankie Ranwell-Jones for their support at the general election. I also acknowledge the support of family members throughout my 30 years as a councillor. My mother Penny, who is here, my wife Mandy and my two sons George and William have been very, very supportive.
Other people who have been extremely supportive are the staff at Westminster, who have been an absolute delight to me and Jennie, who is planning to become the “leader of the o-paw-sition”. She is doing very well and living the true life of a parliamentarian: turning up in the Chamber and having a good sleep. She is also being a parliamentarian by making sure that she receives lots of love from wherever she can get it throughout the estate. The customer service that we have received stands in stark contrast to that in “Fawlty Towers”, for which Torquay is famous, but Members can rest assured that if they do choose to visit the English riviera, the service they receive will be of high quality.
What makes Torbay special? We have six blue flag beaches. We are somewhat challenged by the sewage in our seas, and I look forward to challenging and holding the Government to account on that particular issue. We are also a UNESCO-registered geopark, with Kents cavern at its heart. That is perhaps the oldest dwelling along the south coast of England, yet we have a wicked housing crisis in Torbay, which is, again, something that I look forward to challenging over this parliamentary term.
Torbay has been one of the wealthiest places over 100 years or so, but now we are somewhat more challenged. Oldway mansion is perhaps a prime example. It was modelled on Versailles and used as a hospital during the first world war, but it has seen better days, as has our hospital in Torquay, only 6% of which is considered standard A. We have had almost 700 sewage leaks in our hospital, affecting clinical services at times. I am shocked and horrified that the previous Government allowed our hospital to get into that state, and I cannot believe that the new Health Secretary will allow such a hospital to remain on the Government’s books unsorted.
The managing director of the steam railway in Paignton, John Jones, does something amazing every year for carers. Our “Train of Lights” service starts up in late November, and the first night is free for almost 2,000 carers. Families with disabled youngsters, foster families and those with care experience are all welcome. I thank John for doing that. That reflects what we are discussing today. I hope the Government will forgive the liabilities that some carers have. We need to enhance the payments and ensure that there is a guarantee of respite care.
I conclude by saying to the people of Torbay that this is the honour of my life, and I look forward to championing Torbay throughout the Parliament ahead of us.
Anna Dixon (Shipley) (Lab)
I thank the Liberal Democrats for choosing this important issue for debate. I congratulate several Members on their maiden speeches, particularly the hon. Member for Torbay (Steve Darling). It is wonderful to hear from him, and I am sure that his family is incredibly proud. I also welcome the House’s honorary canine Member, Jennie.
In my maiden speech, I said that carers would be the group of people for whom I would speak up in this place. For me, it is personal: my mother spent much of her life caring for my grandmother. I hope that, in time, I will be able to take up the fantastic work of the hon. Member for North East Fife (Wendy Chamberlain) as the co-chair of the all-party parliamentary group on carers. I served as a chair on the Archbishops’ commission on reimagining care. During that commission on the future of social care in England, we listened to unpaid family carers, who told us that they were stretched to breaking point. They give selflessly but at a huge cost to their own wellbeing, and, as we have heard in the debate, they make financial sacrifices, as caring can affect their ability to work. They must fight every day to get care and support for their loved ones. They do so with support from fantastic organisations, such as Carers’ Resource in my constituency.
In the “Care and Support Reimagined” report, we proposed a new deal for carers to ensure that they are valued and can give out of love and not necessity. However, as we have heard, they are being punished for trying to juggle care and work. Some 2.8 million carers are trying to do that but find that they are inadvertently breaching the earnings threshold, with the result that they face the issue of overpayments. As I have written to the Minister for Social Security and Disability, my right hon. Friend the Member for East Ham (Sir Stephen Timms), it a scandal that the last Government knew about that—there were NAO and Select Committee reports on their desks—but did nothing, so I welcome this Government’s having seized the issue and set up the independent review, and I look forward to seeing its recommendations.
I am glad that that is part of a wider review of support for carers. It is clearly a huge building block for a national care service. As we have heard, we cannot deliver a national care service without valuing the vital role that carers play in giving love to disabled adults and older family members. I am glad that we are righting that wrong.
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)
I will be brief. I support the motion and everything that has been said today, and I look forward to the Government’s response.
As many people know—including perhaps you, Madam Deputy Speaker—I am an unpaid carer for my wife Flora. With the salary that I receive as an MP, I can afford to do that. I care for my wife because I love her. She has been disabled for 25 years. I will talk about one aspect of the support that we get. When I am here in Westminster, a wonderful team of professional carers go and see my wife every morning, look after her and see what needs to be done. They are fantastic people, and I owe them such a big debt.
This is where I might try the patience of the House slightly, Madam Deputy Speaker, because I want to mention an aspect that is not helping those carers: the remuneration that they receive for mileage. In Scotland, carers get 61p per mile for the first 3,500 miles, and after 3,500 miles, they get 25p per mile. That is not good news given the vastness of my constituency—half the size of Wales, they tell me—and the mileage that carers have to cover. A lot of those wonderful people are saying, “Enough is enough,” packing up and calling it a day. In north-west Sutherland and Wester Ross in particular, we have an ageing population that desperately needs that kind of support, but carers are just giving up and going. It is not because they do not care for the people they are helping, but because they simply cannot afford it. The cost of running their cars is far greater than what they receive for the vast mileages involved.
Joy Morrissey (Beaconsfield) (Con)
My husband is a full-time carer for his mother, who has had three strokes. By looking after people in their homes and saving lives long term, carers make very large savings for the NHS. Given how much carers save the NHS in long-term out-of-hospital care provision, we should, as a cross-party endeavour, reconsider the compensation for mileage.
Jamie Stone
The hon. Lady makes a very wise point that demonstrates the interconnected nature of unpaid carers and professional carers, because the best solutions come when they work together.
I will conclude with this: we have a problem. It is perhaps not pertinent to the Minister who is before us today, but I hope that the Treasury will consider the issue of remuneration rates for mileages, perhaps with the Scottish Government. Those rates have not been revisited since 2011, and since then, we have had about 40% inflation. We can see what is wrong; let us sort the problem.
Daniel Francis (Bexleyheath and Crayford) (Lab)
I thank the right hon. Member for Kingston and Surbiton (Ed Davey) for bringing this debate today. I pay tribute to my hon. Friends the Members for Clwyd North (Gill German) and for Weston-super-Mare (Dan Aldridge) and to the hon. Member for Torbay (Steve Darling) for their maiden speeches.
First, I put on record my thanks to carers across Bexleyheath and Crayford and to fantastic local charities including Bexley SNAP, Bexley Voice, Bexley Mencap, Carers’ Support Bexley, Crossroads Care, Evergreen Care, Mind in Bexley, and Irish Community Services for all they do to support communities in my patch. Being a carer is often unexpected: we all see people who come to us when a loved one is diagnosed. As I referred to in my maiden speech, my wife and I knew at 12 days, when one of our children was diagnosed with cerebral palsy. Day to day, we see what it means to be a carer in the support we have to give her.
I have thought today about the pressures that exist: not just the mental health and caring pressures, but the pressures of managing the bureaucracy, such as applying for and renewing your freedom pass and blue badge; dealing with the administration of appointments at four different hospitals, in our daughter’s case; the constant appointments and calls to ensure your child’s wheelchair is working to support them; organising and constantly chasing for the correct equipment at home; reapplying for disability living allowance every three years; trying to find the respite to allow you a break and the ability to work; and exploring the minefield that comes with applying for a disabled facilities grant.
There is also the complexity of being an employer under the direct payments system: arranging shifts, issuing contracts, running payroll every month, paying insurance, calculating your staff’s holidays and ensuring the support is there, just to get—in our case—eight hours’ care per week. I have twice exhausted the complaints process with our Conservative local authority through stage 1 and stage 2 complaints. On one occasion, they did not pay our carers for six weeks; on another occasion, they did not make those payments at the national minimum wage. That all adds to the burden and pressure on carers.
In our case, we do not claim carer’s allowance, but I know at first hand the pressure of having to battle the system when it is not working for you. I hope that the review set up today will look at the issue of overpayments and at other issues that really need to be resolved for those on the frontline. As I have said previously, I will carry on pressing the Government to create a sustainable national care service that works for unpaid carers, sector partners and carer organisations. As part of that process, I will be supporting the Government’s amendment today as the first step to make things easier for carers in the years ahead.
Manuela Perteghella (Stratford-on-Avon) (LD)
I praise hon. Members for their excellent contributions and maiden speeches.
Unpaid carers are the hidden backbone of our social care system. Whether they are parents or grandparents caring for children with special educational needs or disabilities, individuals supporting a spouse or sibling, or those stepping in to care for a relative in need, those carers provide tireless support with little recognition or help. We have already heard from my hon. Friends and from Members across the House about the scandal of the carer’s allowance overpayments and their devastating impact on families up and down the country. In my constituency, countless carers are doing extraordinary work, often at great personal cost. Many are struggling to balance their caring responsibilities with their own health, their financial stability and—for some—even their jobs.
The weight of those responsibilities can be overwhelming, especially without access to proper support services such as respite care. We need a statutory guarantee of respite breaks for carers, because those breaks are essential for giving carers the time to rest and recharge so that they can continue providing vital care. At the same time, we cannot ignore the financial pressure that carers face. Carer’s allowance is simply not enough to live on: it is the lowest benefit of its kind, and it is unacceptable that carers—many of whom are unable to work due to their caring duties—are left struggling to make ends meet. We need to see a fair increase in carer’s allowance and an uplift of the thresholds, which would make a real difference for families in my constituency, ensuring that carers are not forced into poverty while looking after their loved ones.
If you will allow me, Madam Deputy Speaker, I also want to raise the issue of care provided by young people. In Stratford-on-Avon, many young people in full-time education are balancing schoolwork and studies with caring for a parent or sibling, often without the support they need to succeed in both roles. I would like young carers’ voices to be heard in the Government’s review of carer’s allowance: no young carer should be left behind simply because they have taken on the responsibility of caring for their loved ones. The Government must set an urgent timetable for reviewing carer’s allowance and simplify the system to show carers that they are valued for the essential work they do in today’s Britain.
Sarah Coombes (West Bromwich) (Lab)
For millions of unpaid carers in West Brom and around the UK, life is hard enough. They are the backbone of our care system, yet they are woefully under-supported and under-recognised. Taking care of someone is the most generous act of human kindness, but the former Government repaid those acts of service with hostile interviews and demands for repayments and by fighting carers in the courts. I welcome this new Government’s independent review, which recognises the invaluable contribution that carers make. The review will investigate the over- payment of carer’s allowance: how it was allowed to happen in the first place and, more importantly, how we can make sure it never happens again.
I know what it is like to witness the care that one person can show to another, whether that care is paid or unpaid. My grandmother—my nanny, as we called her—was looked after in the final years of her life in a care home. The team there provided tender care 24 hours a day, and they made life fun. My nanny was Irish, and even into her 90s, she was very partial to half a pint of Guinness, which the care home always provided. They always made St Patrick’s day good fun. That care did not stop when she finally passed away: when the cars went past the care home on the day of her funeral, all the staff were lined up with Irish flags to wave her goodbye. This Labour Government are going to give paid and unpaid carers the recognition, rights and pay that they deserve and create a sustainable national care service, and I am very proud to be part of that.
In my borough of Sandwell as a whole, the percentage of people providing over 20 hours of unpaid care a week is well above the national average, and for many people in my constituency, caring for their loved one is more than a full-time job. Those who are able to go to work find themselves having to restrict their hours for fear that they will inadvertently overstep the earnings limit. During the election, I met a woman in West Bromwich who was in exactly that situation: she worked as a cleaner in addition to caring for a family member. She was really struggling to make ends meet, but felt trapped, for fear of the penalty she would incur if she went even a few pennies over the earnings limit.
The motion tabled by the Liberal Democrats is right to condemn the previous Government for failing to address the scandal of repayments. Lots of carers were not even notified that they had exceeded the earnings threshold. For some, their allowance was stopped without warning, causing severe financial difficulties; others will spend years repaying, with the anxiety and stress that that brings. On top of all the other responsibilities that unpaid carers take on for their loved ones, they have been made to feel like criminals—can you imagine? As such, I support the Government’s intention to quickly get to the bottom of carer’s allowance overpayments and consider how we provide support for unpaid carers, many of whom have been pushed to breaking point just for looking after the people they love.
Josh Babarinde (Eastbourne) (LD)
Sophie, Clare, Oliver and Wendy are some of the most resilient people I know. They are all Eastbournians, they would all do anything for their families, and they are all carers. They are among the 9,415 carers in Eastbourne, and I promised them that I would use opportunities such as this debate to recognise their resilience and give them and their families a voice. Today, I strive to do exactly that. I strive to do it particularly with respect to the need for wider support to carers, which the motion mentions.
Sophie Ticehurst and her family care for Sophie’s 24-year-old brother Jack, who has autism and is non-verbal. They rely on the Linden Court day centre—which supports people with learning disabilities—for Jack’s care, but also for their respite; but the centre faces closure after years of Conservative underfunding, and it would be devastating for them if that went ahead. As would the proposed closure of Milton Grange day centre, particularly for people with dementia—again, down to the Conservative county council. That place serves as essential respite to Clare, whose 82-year-old mum benefits from its amazing care. Where is the care for the carers? We urgently need the Government to intervene to properly fund our local authorities, so that these essential care resources can be protected.
I also pay tribute to Oliver Davis, a young carer in my constituency. He is a 14-year-old Eastbournian, and since the age of eight has cared for his mum, who lives with significant cardiac issues and the long-term effects of a stroke. His mum said that
“he never complains about being a young carer.”
Oliver does us all proud. In fact, he also won a BBC Make a Difference award for being a young carer across Surrey and Sussex, and he also does the local charity Care for the Carers proud, which he works with to advocate for young carers like him.
Lastly, I want to mention Wendy Turner, a different type of family carer—a kinship carer, whom you know, Madam Deputy Speaker. She stepped up to take her two grandchildren into her care when she was 53, but she is short-changed by our system, which unjustly offers her a lower kinship care allowance than the local fostering allowance. That needs to change. Where is the care for the carers?
Our carers do so much to lift people up, but time after time, our system wears them down. Enough is enough, so I say to the Government: dignify their experiences with action; honour their stories with reform; and never take our carers for granted.
Madam Deputy Speaker (Ms Nusrat Ghani)
I do not want to be seen being too kind to a fellow Sussex MP, but kinship carers are indeed visiting here today.
Rachel Blake (Cities of London and Westminster) (Lab/Co-op)
I wish to mention an interest: my husband works for an organisation that allocates funding to Carers UK.
It really is a privilege to follow such thoughtful contributions, particularly those of Members who have shared such powerful personal testimony—my hon. Friends the Members for Bexleyheath and Crayford (Daniel Francis) and for West Bromwich (Sarah Coombes). I warmly welcome the fact that the Liberal Democrats chose to provide this opportunity for us to discuss this important issue. I pay tribute to the right hon. Member for Kingston and Surbiton (Ed Davey) for sharing his personal experience as a carer and rightly moving this issue up the political agenda.
I pay tribute to the Minister for Social Security and Disability, my right hon. Friend the Member for East Ham (Sir Stephen Timms), whose previous work chairing the Work and Pensions Committee did so much to highlight the injustice of the overpayment scandal. I am pleased to see him in his Government role, able to put into action all that work.
For the past 14 years, carers have been woefully let down by the Conservatives, and they have been let down today by their completely inadequate defence of the overpayment scandal. After decades of cuts, too many are on the waiting list for local authority care, and local authority services have been called upon time and again to do more with less. Carers like Shirley Islam, one of the 500 registered unpaid cares in the City of London, who met me to highlight her experience as a carer, have borne the brunt of that failure; as have carers from Westminster Rethink Mental Illness, who I also spoke with recently. I look forward to working with local residents on this issue.
Nowhere is the previous Government’s failure to administer basic services more evident than when it comes to carers. Under the previous Government, the Department for Work and Pensions saddled thousands of carers with unnecessary financial burdens at a time when they had more than enough on their plate, including the 34,000 carers who received fines of up to £20,000. So today they need to hear these words: “We are sorry for the injustice and indignities you have suffered under the previous Government. We will do everything that we can to put them right. Thank you for your work and service.”
At the election, the Prime Minister promised a politics that treads more lightly on people’s lives, so I am glad that in today’s announcement the Department has scrapped the planned replacement of cash payments to carers with vouchers. We should not be telling carers how to spend their own money.
I eagerly await the announcement of a national care service, as promised in our general election manifesto, and I know that my constituents do too. I look forward to the publication of the Government’s review and the delivery of much-needed and long-awaited justice.
Olly Glover (Didcot and Wantage) (LD)
I commend my right hon. Friend the Member for Kingston and Surbiton (Ed Davey) for introducing this debate. I echo his call for an end to unfair overpayment claims as a result of the earnings limit, and for a comprehensive review of support for carers. I will now share some stories about carers who I have met over the years, or who are in my constituency.
As a volunteer for the Motor Neurone Disease Association, I have seen the toll that that terrible disease takes on families and their carers. Many of the people who get MND are elderly and they see their lives change from a relaxing retirement with their partner after many years of work to one person having MND and their spouse becoming a carer. That is very challenging for people who have led self-sufficient lives and lose their mobility and independence.
It is also important, as my hon. Friend the Member for Stratford-on-Avon (Manuela Perteghella) said, that we consider the experiences of the next generation of carers. Sometimes motor neurone disease can affect much younger people. One person I supported was a single parent with a four-year-old child. I saw the impact that caring responsibilities can have on children and young carers; even where really good care arrangements are in place, there is still the physical and emotional toll of being an unpaid carer.
In Oxfordshire we have 12,000 young carers; the Be Free Young Carers charity supports around 650 of them. It has been estimated that families that have a young carer earn £5,000 more than those who do not have a young carer, but while contributing huge economic benefit, young carers are one and a half times more likely to have a long-term illness or special educational needs.
A child I am calling Katie registered with Be Free Young Carers in March 2023. She cares for her twin sister, who has autism. In April 2023, Katie attended a one-to-one session that enabled her to open up about how she was feeling and the support she needed to continue her schoolwork. Later that year, Katie’s dad was diagnosed with MS, which added further pressure and led Katie’s sister to try to take her own life. After such a series of events many children would have struggled, but Katie has coped and is doing well. She has attended 13 respite trips over the past two years, including the young carers’ festival, and has a lovely group of friends. She is also a member of the charity’s youth panel. She has spoken about the Be Free Young Carers charity on local television news.
It is vital that we support all carers, including young carers such as Katie. I commend the motion to the House.
Chris Vince (Harlow) (Lab/Co-op)
As I have already mentioned a few times in this place, carers played a significant role in my journey to this Chamber. I worked at first hand with young carers for two and a half years until I was elected. I really welcome the use of the term “family carers” in this debate, because the charity I worked for was called Action for Family Carers. I always welcome an opportunity to speak on this issue. I recognise that young carers are not eligible for the allowances that we are talking about, but I beg this Chamber’s permission to mention the subject in this debate and at every opportunity.
In my job supporting specifically young carers, I saw every day the toll that caring takes in day-to-day life. I recognise that all carers have been given a raw deal, pushed to their limits—their breaking point—in looking after people they care about and love. Since I was elected to this place, I have heard from carers who have suffered a massive amount of anxiety due to the pressure put on them because of the overpayments scandal—people whose lives have changed, who have given up careers to become carers for their loved ones, and of course young people who do not even consider going on to higher education because of the anxiety leaving their cared ones behind would cause. This cannot go on. The situation is not only untenable but unworkable, and above all it is damaging to those who we rely on in our most vulnerable moments.
That is why I welcome wholeheartedly the Government’s announcement today that they will launch an independent review of the carer’s allowance overpayments, led by an expert in the matter. This review will cut through the mistakes made under the last Government, lay bare what we can learn and help us to avoid these mistakes in the future. There is no simple solution to improving the situation for unpaid carers, but this announcement shows a clear commitment to finding the best way to improve it for as many as possible for as long as possible. I will say it again: carers are unsung heroes, and we owe it to these unsung heroes, whose contribution is often understated and unappreciated, to do this. Carers are the backbone of our society, and this review is an important step in repaying our debt to them.
Mr Joshua Reynolds (Maidenhead) (LD)
Carers in my constituency have told me how they feel undervalued and invisible. They provide essential care to their loved ones, yet their contributions are rarely recognised.
There are carers such as Harry—a resident in my constituency who provides care for his son—who feels that the work he does is taken for granted. Harry cares for his son because he wants to be there when his son needs him, but he is not given the recognition he deserves. He receives £81.90 a week in carer’s allowance, but when Harry’s hours were extended at work by just 30 minutes a week to allow one of his colleagues to get to work on time after they had finished the school run—something that Harry was of course happy to agree to—he had no idea that, despite informing the DWP and being told that it was all okay, he would be accidentally overpaid carer’s allowance. Then the threat of fines and prosecution came from the DWP. To say that it added unnecessary stress to Harry’s life and his son’s life is a really large understatement.
The health and wellbeing of carers is a critical issue for us, and many carers experience physical and mental health issues due to the demands of their caring responsibilities. There are carers such as Margret in my constituency, who cares for her 25-year-old son with learning disabilities. With her caring responsibilities, she is no longer able to work. She found the balance between her paid job and her unpaid job too much to handle. Margret tells me how she rarely gets out of the House without her son. She has lost her network of friends and now feels isolated. Carers such as Margret struggle to access the respite care they need due to high costs and the lack of availability.
The Liberal Democrats believe that every carer should have access to regular and high-quality respite care, and we want to introduce a statutory guarantee of regular respite breaks for unpaid carers, because carers are the backbone of our society. They provide essential support to their loved ones, often at great personal cost, and the Liberal Democrats want to ensure that they receive the support they need when they need it.
Mary Kelly Foy (City of Durham) (Lab)
I thank the Liberal Democrats for using this Opposition day for this important issue. I also thank Durham County Carers Support for the work it does across the county.
This topic is very personal to me, because I was a parent carer for my daughter Maria for 27 years—the whole of her life, in fact. Maria lived with severe cerebral palsy and needed round-the-clock care. I also have two younger children, so I totally understand the issues of exhaustion, stress and fear, as well as the tremendous joy of looking after a loved one.
The north-east is a region of unpaid care, with 10.1% of the adult population in the 2021 census providing unpaid care for more than 50 hours a week. As we have heard, it is women who are doing the hard graft. The “Women of the North” report, which I encourage the Minister to read if she has not already done so, states that many women who support family or friends do not even identify as carers. They just get on with it, regardless of the effect it has on their health and wellbeing. Women in their 50s are providing more unpaid care than the national average. In fact, they are contributing £10 billion-worth of unpaid care to the British economy each year. Again, this is higher than the national average, making the carer’s allowance scandal all the more infuriating.
Reflecting on my own experiences, when Maria was 10 and her siblings were eight and nine, we decided that I would go to university. I must have been mad, I know. That was for my own personal development, and in the hope that I would get a decent job in the future. Unfortunately, that meant I was not getting carer’s allowance any more. The course was classed as full-time, but there were actually only nine hours of contact time, so I had plenty of time to look after Maria as well. Not only was I not earning, but I lost that tiny allowance. I was trying to better myself for the future, and it was a struggle. We went into debt, it was something we really could have done without. I therefore welcome the comments by the Minister, and I welcome the fact that the Government will work collaboratively with those on the frontline, because that would have meant an awful lot to me.
I have one final comment: I want the Government to crack on with this policy as soon as possible, because unpaid carers cannot wait a minute longer, especially those in the north.
Sam Rushworth (Bishop Auckland) (Lab)
May I begin by expressing my appreciation of the family carers in the Bishop Auckland constituency? According to helpful researchers in the Commons Library, one in seven of my constituents provides at least an hour of unpaid care each week, and over half of them are eligible for carer’s allowance. Nationwide, as we have heard, our army of family carers is the equivalent of a second NHS.
I agree with the criticism made by the shadow Secretary of State that we must not risk opening the door to fraud, and it is precisely because I believe in the welfare state that I think it must always be watertight and widely perceived as fair. However, I am concerned that in a huge number of cases—I am inclined to believe that it is the majority of cases—overpaid carer’s allowance is the result of inadvertent error.
As others have said, this is a complicated benefit and when so many stressed family carers find themselves having to pay back large sums of money, there must be some onus on the Government to take responsibility. This issue is so widespread that I think every MP in this place will have been contacted by constituents facing hardship. These are decent, honest people who work hard, who serve their families and communities and who ask for little, and they feel as though they are being treated like criminals while the Government have become the nation’s biggest debt collector.
If I may, I will briefly raise a specific issue that two of my constituents have raised with me. They are being required to pay back thousands of pounds because of inadvertently earning just above the earnings threshold. However, as they have pointed out to me, carer’s allowance is counted as income in universal credit claims, so had they not claimed it, they would have received more in universal credit. I gently urge the Minister to consider this point as part of the review, as people are not only being pushed into hardship due to being made to pay back overpayments, but may actually be worse off on aggregate than if they had never claimed.
Anna Dixon
My hon. Friend rightly points out that this is a huge cause of stress to people. Not only that, but carers are actually leaving work, limiting their hours and not taking on additional responsibilities. Will he join me in calling on the shadow Secretary of State to apologise to the 134,800 carers who have outstanding carer’s allowance overpayments to a total value of £251 million?
Sam Rushworth
This sits among the many injustices that the new Government have to deal with, and I think an apology is in order.
In conclusion, I welcome this Government’s review. I think there have been some excellent contributions from all parts of the House, with some really serious issues raised such as students losing their eligibility to claim, my constituents’ point about universal credit and the points about respite care and young carers, and I do not think anyone has even mentioned kinship carers. I hope that this review will take account of all these things so that we can deliver a fairer deal for Britain’s army of unpaid carers.
Nesil Caliskan (Barking) (Lab)
I thank the right hon. Member for Kingston and Surbiton (Ed Davey) for securing this important debate. I have almost 10,000 constituents in Barking who are unpaid carers, providing a vital and caring backbone for the community. My constituency has one of the highest numbers of carers in the country, and we know that if those individuals stopped caring and delivering their vital role, our overstretched care system would crumble and the economy grind to a halt. Perhaps most importantly, the most vulnerable people in our communities would stop receiving the care and compassion that they get from their relatives and friends.
But carers do not stop, because they care about their friend or family member who needs that support. Whether it is a young carer looking after a parent, or a daughter or son looking after their elderly parent, such care is vital in our community. Instead of a system that provides them with a safety net to help with the additional costs that come with caring for someone, the system the Government have inherited is a real mess. We are in a situation where our constituents face bills from the DWP landing on their doorstep.
The current carer’s allowance system is cruel, with a punitive cliff edge that forces unpaid carers to choose between earning a basic income or caring for their loved one. It means that if a carer goes over the earnings allowance by £1, or indeed by 1p as we have heard in a number of speeches, they are forced to pay back the full amount that they received, which could be a figure in the thousands. Instead of a system that understands the need for flexibility, given the nature of being a carer and the realities of trying to fit paid work around that, often with zero-hours contracts and earnings that change from week to week, the system penalises carers and threatens them with criminal prosecution. It is just another broken system left by the previous Government that this Government have to sort out, and another part of the foundations of our country that we will fix to rebuild Britain.
As I stand to speak on this important topic, I think of the 10,000 carers in my constituency. Vital work will now progress, and hopefully it will be concluded swiftly by the Government, so that carers never have to choose between earning a proper income and caring for a loved one.
Richard Foord (Honiton and Sidmouth) (LD)
The Secretary of State for Work and Pensions was on the radio this morning, and I listened to her on the BBC describing how
“the benefit system can have a real impact on whether you incentivise or disincentivise work.”
I heard from her that this new Government intend to incentivise work, and in that we wish them well.
I wish to highlight the case of a constituent of mine, Amanda Jennings from Ottery St Mary, who reached out to me pleading for support. She is a mother and a full-time carer for her adult son who has severe autism. Amanda was recently notified by the Department for Work and Pensions that she owed almost £2,000 dating back to 2019, due to carer’s allowance overpayments. To compound that stress, a civil penalty was imposed. Her problem was that she had been receiving wage slips giving an hourly rate, and the payments were processed by an external payroll agent, so she did not have a reliable monthly income like we do.
Despite raising queries and assuming that the DWP was receiving up-to-date information, she was accused—wrongly—of misreporting her income. The consequences for her family have been severe. Her son, who had re-entered education after years of disengagement, has dropped out, and her own health has deteriorated. She is not alone—more than 40,000 people nationally face similar financial penalties for minor income discrepancies. The Liberal Democrat stance is plain: carers should not be punished for minor unintentional breaches of income thresholds. The current system is rigid and punitive, with a cliff edge that does nothing at all to incentivise work.
Earlier, I heard the former Secretary of State talking about the business of clawback, and whether it could be done retrospectively. Looking to the past, perhaps he needs to be reminded that with the furlough scheme, the previous Government failed to claw back millions and millions of pounds—indeed, the Public Accounts Committee reckoned £2.3 billion—that was incorrectly paid to employers whose employees continued to work while they were receiving furlough money. It is just like the former Government to go after the people at the bottom of the pile who are most in need, when it is the people who have been described today who most need the support. I hope that the Government will make the most of the independent inquiry that I am glad they have set up, and ensure that any changes incentivise work and make work pay.
Ben Coleman (Chelsea and Fulham) (Lab)
This has been an extraordinarily interesting debate. I pay tribute to everybody who has spoken and thank the would-be official Opposition for having secured it. In my constituency of Chelsea and Fulham, we have nearly 7,000 unpaid carers, a quarter of whom provide more than 50 hours of care a week. I know many of them, and I know what a vital, tough job they do for their loved ones, as well as the value that carers bring to this country’s economy—many speakers have touched on that. I also know that carers deserve to be treated with kindness, but instead have been treated with cruelty. My hon. Friend the Member for Bexleyheath and Crayford (Daniel Francis) touched on the local cruelty that he has experienced from his Conservative council, but nationally, through a mixture of official incompetence and political indifference, carers have been treated cruelly.
Let us be clear: the Department for Work and Pensions cocked up here and cocked up badly. When carers told officials dealing with universal credit that they breached earnings limits, officials did not necessarily pass that on to those officials dealing with carer’s allowance. When carer’s allowance officials were alerted to breaches, they did not act, in many cases for months. They did not look at their emails, so payments were allowed to build up, as has been remarked on, to as much as £48,000. Then the Department for Work and Pensions swooped in, threatened prosecutions and penalties, and in many cases did not listen to perfectly reasonable explanations. It brought in a technical solution that failed to sort the problem out. Why? Because it was woefully under-resourced. Those at the top of the Department for Work and Pensions have never properly apologised for the cruel system that they allowed to be maintained for so long. Why did they not do that? It is simple: they took their cue, as people in the civil service do, from those above them—from their political masters, the Ministers.
The shadow Secretary of State was asked by the would-be Leader of the Opposition whether he had ever asked officials how much overpayment was fraudulent. From his response, I suspect it was a question that he never asked. Why did he not ask that, and why did he fail to publish the DWP report from 2021 on the overpayment crisis until just before the election? I suspect the answer is that he was more interested in covering up than in finding out what was going on and sorting out the problem.
I am delighted that the Labour Government are now sorting this out. The review is a start. As many Members have said, there is much more to be done to support unpaid carers, but they will no longer be hung out to dry by a cruel, incompetent, indifferent Government, and that has to be a good thing.
Matthew Patrick (Wirral West) (Lab)
There are many honours in this role, and one is to be able to take part in important debates such as this and hear the expertise and passion of hon. Members across the House. I will start by paying tribute to the many carers who do incredible work in my constituency. At times of immense need, they step in, day after day, supporting family members and making such an important contribution to those they love and to our community. Our country simply would not function without them and their contribution, and I wish to share my immense gratitude to those carers from my area and beyond. Their selflessness and dedication makes this scandal all the more unfair, with carers pushed to breaking point and stress piled on stress. Sadly, like too many issues, this crisis was totally ignored and left to grow by the previous Government.
At Wirral carers’ week earlier this year, I met carers who have been impacted by this issue, and I know the anxiety it has brought them, as they have had to juggle their caring responsibilities with the uncertainty it has brought. Stability is long overdue. Carers need to know that lessons will be learned and that the mistakes of the past will not be repeated.
I welcome the Secretary of State’s announcement that she will launch the independent review into carer’s allowance overpayments, led by the disability rights expert Liz Sayce. We all wish her well with that important review. I also welcome the announcement by the Minister for Employment of the launch of a pilot to support carers further. With these steps, I truly hope that carers feel valued and listened to, that the issues they feel are important are brought to light and that there is support for them. I welcome today’s announcement, and I hope that with it, our brilliant carers know that this Government are on their side.
Madam Deputy Speaker (Ms Nusrat Ghani)
We got everybody in who wanted to participate, so well done. We now come to the Front Benchers. I call the Liberal Democrat spokesperson.
Alison Bennett (Mid Sussex) (LD)
I start by congratulating those hon. Members who made their maiden speeches this afternoon. The hon. Member for Clwyd North (Gill German) gave a brilliant description of her time teaching and the inspiration she provided to her pupils. As someone who grew up in Gloucestershire, I say to the hon. Member for Weston-super-Mare (Dan Aldridge) that his town was our destination of choice for seaside days out. My hon. Friend the Member for Torbay (Steve Darling) represents another seaside town, and he and the honourable Jennie are both dear to the Liberal Democrat group.
I pay tribute to the work of my hon. Friend the Member for North East Fife (Wendy Chamberlain) in bringing forward her private Member’s Bill in the last Parliament on unpaid carer’s leave. We are truly proud of her achievement in bringing that into law as the Carer’s Leave Act 2023. I also thank my right hon. Friend the Member for Kingston and Surbiton (Ed Davey) for all his work on care and carers, and for bringing this debate to the House today.
The carer’s allowance scandal has been overlooked for years. It is astonishing that it has taken a Liberal Democrat Opposition day for this critical topic to finally receive the attention it deserves. The fact that we have had to bring this debate today—late in 2024, after a change of Government and five years after MPs looked into the carer’s allowance scandal and concluded that there was no evidence of mass fraud—is shameful and a stain on the legacy of the previous Conservative Government.
The Conservatives failed to take the action needed. The Conservatives failed to tackle the cultural problems at the DWP. The Conservatives failed to care about carers. Today, Members from across the House have given voice to unpaid family carers, whom we should be thanking, rather than punishing. We have heard about how the DWP’s actions left people feeling insulted, bullied, harassed and crushed. That is not right. We should be lifting up these people. We should be thanking them, not hounding them, for the love and care they give to their loved ones.
The population of my Mid Sussex constituency is older than the average. Across the country, the population is ageing. We cannot shy away from the fact that we will as a society increasingly rely on carers. Just because care often happens in homes—in private and behind closed doors—that does not mean that it is not important or that we can ignore it. I welcome the Government’s announcement on commissioning an open and transparent report to review the carer’s allowance overpayments, but questions remain. Will the Minister stop the shameful attempt to recoup overpayments? Will there be an amnesty on pursuing past overpayments? Will they consider tapering carer’s allowance? Will they consult on whether 35 hours of care a week is the right threshold for claiming carer’s allowance? How will they set about changing the culture of the DWP, so that people never feel like criminals simply for caring for their loved ones while trying to work to pay the bills?
It is disappointing that the Government are seeking to amend our motion to delete what carers are crying out for. After years of Conservative neglect, we cannot afford yet more dither and delay. As my hon. Friend the Member for Chichester (Jess Brown-Fuller) said, unpaid carers save the taxpayer an astonishing £162 billion a year. The Government’s financial worries would stretch far beyond the current £22 billion black hole were it not for those unsung heroes. That is not just a statistic; it represents a profound debt of gratitude that we owe to those who provide care. The social, emotional and financial value that unpaid carers bring to our communities cannot be overstated. This afternoon, Members from all parts of the House have made that point loud and clear.
Carers are not just caregivers; they are a lifeline giving support that our healthcare system would struggle to replace. There is, however, a danger in viewing care as merely transactional. Care is far more than just fulfilling a basic physical need; it is about enabling individuals to achieve their potential and live fulfilling lives—lives that they deserve to enjoy. Family carers support loved ones in ways that help them thrive, not just survive.
I close by thanking the Government for their response today and for engaging so constructively in this debate. I thank the charities that advocate for carers for the vital work they do. Most importantly, I thank the 5.7 million unpaid carers across the country for all that they do, day in, day out, with love and compassion. They are the very best of us. We see what carers do, we hear what carers are saying, and I and my Liberal Democrat colleagues will continue to speak up for them in this place.
The Parliamentary Under-Secretary of State for Work and Pensions (Andrew Western)
I am pleased to be able to respond to this vital debate, which in both tone and importance has been one of the best I have heard in my two years in this place. I also add my thanks to the right hon. Member for Kingston and Surbiton (Ed Davey) for bringing forward the Opposition day motion today, because this issue is clearly of concern to many Members, and they are right to be concerned.
The right hon. Member is one of many right hon. and hon. Members to have made important contributions and spoken with great passion on this crucial issue. The hon. Members for Salford (Rebecca Long Bailey) and for Carshalton and Wallington (Bobby Dean), my hon. Friend the Member for Hertford and Stortford (Josh Dean), the hon. Member for Harpenden and Berkhamsted (Victoria Collins), my hon. Friends the Members for Wirral West (Matthew Patrick), for Harlow (Chris Vince) and for Paisley and Renfrewshire South (Johanna Baxter), the hon. Members for Stratford-on-Avon (Manuela Perteghella) and for Maidenhead (Mr Reynolds) and others rightly spoke about the important role that millions of family carers play in providing support for disabled or elderly relatives who need care at home. I echo those comments and add my own tribute to all family carers. Much of their tireless work goes unseen and unrecognised.
Like other Members, I am privileged to witness glimpses of carers’ dedication through my correspondence and through events I attend in my constituency. Running through today’s debate was an underlying and understandable anger at the position we inherited from the last Government, whereby family carers trying to do the right thing have been left with staggering overpayments, often running into thousands of pounds. As my hon. Friend the Member for Birkenhead (Alison McGovern) set out earlier, we are making sure that we understand precisely what has gone wrong so that we can put the system right for the long term. Our family carers deserve no less.
Many Members, including the hon. Members for Eastleigh (Liz Jarvis) and for North East Fife (Wendy Chamberlain), my hon. Friends the Members for Shipley (Anna Dixon) and for Bexleyheath and Crayford (Daniel Francis) and the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone), and of course my hon. Friend the Member for City of Durham (Mary Kelly Foy) and the right hon. Member for Kingston and Surbiton, spoke about their own experiences as carers or the work they do locally to support organisations helping family carers. I grew up watching my grandmother care for my grandad, struggling with Parkinson’s disease, before later seeing my mum, one of the many hidden carers up and down the land, care for her mother—my nana—in her final years battling Alzheimer’s disease.
None of us in this House is blind to the work that carers do. They are fortunate to have some wonderful advocates. Those include their MPs, as we have seen today, but also organisations such as Carers UK, the Carers Trust and the Learning and Work Institute, to name but three. The Minister for Social Security and Disability, my right hon. Friend the Member for East Ham (Sir Stephen Timms), and I have already met a delegation of carers and Carers UK, and he will be doing so again shortly. He will also meet separately with the Carers Trust and the Learning and Work Institute, because we are determined to ensure that the voices of family carers and the organisations supporting them are at the heart of everything we do.
I also want to pay tribute to the hundreds of DWP staff, largely based in the north-west, who provide financial support to a million family carers through carer’s allowance, day in, day out. The Government will spend record amounts to support unpaid carers. Real-terms expenditure on carer’s allowance is forecast to rise from £4.2 billion in 2024-25 to just over £4.7 billion a year by 2028-29.
I turn to some of the other points raised during the debate, with apologies that time will permit me to address only some of them. Let me take the opportunity to congratulate and pay tribute to my hon. Friends the Members for Clwyd North (Gill German) and for Weston-super-Mare (Dan Aldridge) and the hon. Member for Torbay (Steve Darling) on their excellent maiden speeches. They painted vivid pictures of their constituencies and I feel certain that they will go on to make significant contributions in this place.
On the wider points, I will begin with the question of the adequacy of carer’s allowance, set as it is at £151 per week. Carer’s allowance will be increased in April 2025 by the consumer prices index to help ensure that it maintains its value. As well as carer’s allowance, carers in low-income households can claim income-related benefits such as universal credit and pension credit. Those can be paid to carers at a higher rate than to those without caring responsibilities through the carer element and the additional amount for carers respectively. For example, over 750,000 carer households on universal credit can already receive an additional £2,400 a year through the carer element. That said, the House should be aware that issues beyond the scope of the independent review announced today are not being ignored; this is merely a first step towards progress. The Government are also looking at the broader question of how to provide the best possible support for family carers, although I do not want to pre-empt that work today.
Let me turn to the question of a taper, which was raised by a number of right hon. and hon. Members. At the moment, introducing a taper in carer’s allowance would significantly complicate the benefit, with awards having to be adjusted manually on a weekly basis for some of those declaring earnings. That would add to administrative costs and could mean more fraud and error. Those also receiving universal credit would need to have that adjusted if their payment of carer’s allowance changed because of an earnings taper rate. A taper could be introduced only following significant changes to the IT system that supports payment of carer’s allowance. For the moment, therefore, it is not possible.
On the potential writing off of overpayments, which was at the heart of many of the excellent contributions that we heard, an overpayment can occur through fraud, or through claimant or official error. The Secretary of State has an obligation to protect public funds and ensure that, wherever possible, overpayments are recovered, but determining what best we can do to support those who have accrued overpayments is within the scope of the independent review, as is how such overpayments occurred and what we can do to ensure that we take all the steps we can to reduce the risk of such incidents happening again.
Let me turn briefly to the comments of the shadow Secretary of State, the right hon. Member for Central Devon (Mel Stride). He listed the many interventions that the last Government supposedly made to improve the lot of carers—seemingly including the private Member’s Bill of the hon. Member for North East Fife—but after 14 years of Conservative government, we see carers who find themselves in heartbreaking situations having racked up huge overpayments. However, the right hon. Gentleman correctly set out the incredibly complex nature of the carer’s allowance system, with allowances for legitimate expenses, pension contributions and so on, and why resolving this matter is therefore not straightforward. That is why the independent review is the correct mechanism and next step to fully understand what went wrong and why, and how we can put things right. I welcome his support for the review.
Many colleagues referred to the role that family carers play in easing pressure on the social care system, and indeed in supporting our economy, and they were entirely right to do so. I acknowledge everything that carers do. They are heroes. We appreciate how much society relies on unpaid carers, we recognise the challenges they face and we understand the need for change. Supporting carers is both a moral and an economic imperative, so we will help carers stay in paid work, we are spending record amounts on carer’s allowance and we will sort out the overpayments scandal we inherited. That is why we have announced the independent review today: so that, together, we can rebuild the trust that has been lost and ensure that those who offer comfort, dignity and support to the ones they love are given all the help they need in return. I hope right hon. and hon. Members will acknowledge that work today by supporting the Government amendment.
Question put (Standing Order No. 31(2)), That the original words stand part of the Question.
Access to Primary Healthcare
(2 days, 6 hours ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
18:57 - The House divided: - Ayes: 80 / Noes: 337 - Question accordingly negatived.
Madam Deputy Speaker (Ms Nusrat Ghani)
I inform the House that I have selected amendment (a), tabled in the name of the Prime Minister.
I call Helen Morgan.
Helen Morgan (North Shropshire) (LD)
I beg to move,
That this House regrets that the NHS has been plunged into crisis by years of neglect by the previous Government, leaving far too many people waiting weeks to see a GP or unable to find an NHS dentist, and children and adults waiting months or even years to receive the mental health care they need; believes that everyone should be able to access high-quality primary care services when they need them and where they need them; condemns the previous Government for presiding over a fall in the number of full-time equivalent fully qualified GPs and NHS dentists in the last Parliament; further regrets that the Government has not yet set out a plan to invest in primary care at the level needed to meet demand; calls on the Government to boost access to GPs, NHS dentists and community pharmacists; and further calls on the Government to give everyone the right to see a GP within seven days or within 24 hours if they urgently need to and to guarantee access to an NHS dentist for everyone needing urgent and emergency care.
It is a real honour to open this debate on the Liberal Democrats’ first Opposition day for 15 years. Primary care is the front door to the health service, but for too many people at the moment, that door is closed. Whether they are waking up and dealing with the 8 am calling frenzy to get a GP appointment, frantically ringing every dental practice in their area for an NHS dentist, or turning up at their local pharmacy to pick up a prescription for their loved one or themselves and finding it unexpectedly closed or the medicine out of stock, primary care is in terrible trouble and it needs fixing urgently. That is not only to make lives better for the people who are suffering because they cannot access the primary care they need, but to allow the NHS to function more efficiently. Accident and emergency is not a decent substitute door to the NHS.
I am an asthmatic and as a young person I had quite serious asthma. I can remember when primary care was absolutely there for me in the middle of the night. On lots of occasions when I needed help, my dad did not have to take me to the hospital in an ambulance. Somebody came to me with a nebuliser and got me sorted out within a couple of hours, and then we all went back to bed. Now, that is not an option for a lot of people. The NHS is in a crisis, and that is causing pain and suffering unnecessarily.
The crisis is also costing far more than we can afford. It is costly because early intervention and dealing with people in their community or at their home is so much more efficient than taking somebody to hospital, even if that is in a private car. And it is costly because it causes people genuine pain: the BBC reported that in Oswestry in my constituency this year, a man removed his molar with a pair of pliers because he could not find an NHS dentist. But it is also costly because people are unable to access work, and that is costing the economy. Polling commissioned by the Liberal Democrats showed that one in four people had been unable to go to work while waiting for a primary care appointment. That is not good for an economy that urgently needs to grow. We need urgent investment in primary care—in doctors, dentists and community pharmacists—to save people from having to go to hospital.
Adrian Ramsay (Waveney Valley) (Green)
On pharmacies, a new report from Healthwatch England reveals a worrying picture of pharmacy closures and reduced hours hitting older people and rural communities the hardest. NHS Norfolk and Waveney integrated care board, which covers much of my constituency, has reported the highest number of hours lost per pharmacy. Does the hon. Lady agree that we urgently need a national evaluation of pharmacy funding, including the size, role mix and distribution of the pharmacy workforce?
Helen Morgan
That is an important point. In my constituency, carers who go to pick up prescription medicines are finding that the pharmacists are not there because they are relying on locums. The pharmacy funding problem needs to be addressed as a matter of urgency, and I will say more about that later.
Growing the economy is so important that we need to get people off the waiting and referral lists and back into work. Liberal Democrats believe that people should be in control of their own lives, not “chained up” at home, unable to get out of bed, because they have no access to healthcare. They should be able to get the help that they need, when they need it, in their own homes and communities.
Let us start with GPs. The Liberal Democrat manifesto—it was well received, which is why there are so many Members sitting behind me on these Benches—called for the right to see a GP within seven days or 24 hours if the situation is urgent, and for those aged over 70 or with a chronic health condition to have access to a named GP. Those rights are extremely important. People who go to the same GP for more than 15 years have a 25% lower chance of dying than those who have seen a new GP in the last year. Primary care networks tell me that their inability to deliver continuity of care because of the shortage of GPs is one of the problems that worry them most.
Tim Farron (Westmorland and Lonsdale) (LD)
My hon. Friend is making a brilliant introductory speech. Is she aware that perhaps only a third of those leaving medical school and seeking to go into general practice are able to find jobs, partly because the additional roles reimbursement scheme—which does exist—cannot be extended to enable some of those would-be GPs to be recruited? Is it not mad that although we are creating enough potential GPs through medical school, we cannot give them jobs because of the funding mechanisms that this Government inherited from the last one? We are losing them from general practice, and, in some instances, losing them from the country altogether.
Helen Morgan
My hon. Friend is entirely right. I believe that the Government are taking steps to address that, but he has made an important point about the need for flexible GP funding. A general practice may have money to spend on professionals and need more fully qualified doctors to deal with its patient list, but can only spend that money on another pharmacist or another nurse. That is a ridiculous situation, and I am pleased that the Government are dealing with it.
Helen Morgan
No, I will make some progress.
People do much better if they have access to continuity of care, but 8,000 more GPs are needed to deliver the rights that we laid out in our manifesto. We do not shy away from the fact that that is an ambitious objective, and we accept that it cannot be achieved through training and recruitment alone: we need to retain and incentivise our existing workforce. As I said earlier, seeing people in their communities avoids hospital admissions and saves money. Unfortunately, although the Conservatives promised us 6,000 more GPs in 2019, we ended up with 500 fewer. That is why people are so frustrated. According to the findings of research carried out by the House of Commons Library, GP funding has fallen by £350 million in real terms since 2019. As a result, not only are people struggling to gain access to basic care in their communities, but there is a postcode lottery when it comes to availability of that care.
In the area where I live, which is covered by NHS Shropshire, Telford and Wrekin, the number of fully qualified GPs fell from 280 in 2016 to 242 in 2023, despite an increased and increasingly ageing population with a much higher level of demand, while 43% of patients are waiting more than 28 days for non-urgent appointments. The Darzi report showed that the number of people waiting for long periods for appointments is rising throughout the country: it is a national issue. We know that from our own doorstep conversations.
Members might ask me, “Where are you going to get 8,000 more GPs from? That is a big number.” Apart from training new ones, we should value greatly our experienced ones. A recruitment and training programme is one idea, and, as my hon. Friend the Member for Westmorland and Lonsdale (Tim Farron) pointed out, using the dentists we have trained properly is extremely important, but we also need to focus on retention and incentivising our existing GPs, to ensure that we hold on to valuable experience and valuable patient continuity.
Let me move on from GPs to local pharmacies. Pharmacy First was a great idea of the previous Government —I am willing to give them credit—but pharmacists are under huge strain. According to the Darzi report, some 1,200 have closed since 2017, and spending under the community contract has fallen. Tomorrow I am going to visit Green End pharmacy in Whitchurch, in my constituency, which wrote to me:
“As an independent pharmacy, we’re unable to keep on absorbing costs with losses on dispensing.”
The pharmacy is struggling because it is making losses on the drugs that it gives out on prescription. Given that it is a small, independent pharmacy, it does not have a massive shop from which to make profits to subside that work.
In 2023, Community Pharmacy England warned of
“systemic pharmacy funding cuts of at least 25% in real terms since 2015.”
That has led to a postcode lottery of access, and to many pharmacies being unable to have a full-time pharmacist and relying on locums, which has led to a really poor and insecure level of service. That is impacting on people who just need to go and pick up their prescription and get on with their day.
Wendy Chamberlain (North East Fife) (LD)
The NHS is devolved in Scotland, but the UK Government have responsibility for continuity of supply of medications. I have constituents with attention deficit hyperactivity disorder who have been waiting for up to a year to secure that continuity of supply. Does my hon. Friend agree that we need to see more action from the Government, who should be proactive in that regard?
Helen Morgan
That is a really important point. A lot of people in my constituency have contacted me for help with drugs—for example, to deal with ADHD. People need to be able to access important medication readily.
We must not forget the dentistry element of primary care. A generation of children are at risk of poor oral health because of the mess in which dentistry has been left by the previous Government. Tooth decay is the biggest cause of children being admitted to hospital, with over 100,000 admitted since 2018. That is totally unacceptable. Some 4.4. million children have not been seen by an NHS dentist in the last year, according to the House of Commons Library.
Dentistry is really important for children—they have to keep their teeth for the rest of their lives—but this issue affects adults too. My constituent Ron Kelly, who is 62, is disabled and lives in Market Drayton. Members who have been around a while might know that it is not easy to catch a bus to anywhere from Market Drayton. He has not been able to find a dentist since 2019, and my caseworkers have rung every NHS dentist in our constituency. None of them is taking on new patients, so even if he was able to use the bus, he would not be able to find an NHS dentist in North Shropshire at the moment.
Office for National Statistics data released last week shows that, in the midlands, 99% of people who do not have an NHS dentist, and who are trying to find an appointment, cannot access one—99%! It is just unbelievable in a modern country in the 21st century.
Lisa Smart (Hazel Grove) (LD)
My hon. Friend mentions the challenges that many of our constituents face when trying to get access to NHS dentistry. I am thinking about some of my own constituents who have talked to me and, indeed, shown me their home dentistry results. [Hon. Members: “Urgh!”] Yes. Does my hon. Friend agree that we should learn from good practice that is taking place across the country? My Hazel Grove constituents were struggling to find dentists, but because of some reallocation of existing funding in Greater Manchester, new appointments have been made available. Does she agree that we should look at good practice to learn what can be delivered elsewhere across the country?
Helen Morgan
Flexibility of contracting is critical, and learning from best practice elsewhere in the country will help to address the problem.
I want to highlight how silly it is that people cannot find an NHS dentist when they need one, because NHS dental funding is actually going unspent. In Shropshire, Telford and Wrekin, the area I know about, £1 million was clawed back in 2022-23 because dentists were unable to spend the money allocated to them; they do not have enough staff to work the contracts with them. I met someone last year who had not had a day off work—we were in October by that point—and he had to hand back his contract. The Government have proposed golden handshakes, but I have heard on the ground that they do not work, certainly in Shropshire. We need a reformed contract, flexible commissioning, a proper statutory requirement for workforce planning, and the ability for dentists to use their funding to manage their own practices in a way that allows them to make a bit of money out of treating patients on the NHS.
I also want to highlight the public health grant cuts by the Conservatives and how important it is to reverse them is. It is a complete false economy to cut programmes that help with oral health and prevent poor teeth and future dental problems, when we could spend the money up front so that it would cost far less in the future.
Helen Morgan
I will make some progress now, if that is okay, because I am conscious that lots of people want to get in and make full speeches.
We have called for a guarantee for urgent and emergency dental care. Check-ups for those people who are already eligible and those needing check-ups before things such as chemotherapy and surgery were also in our manifesto. It is only going to be possible to offer those guarantees if we deal with the issues in the dental contract and the flexibility of commissioning.
Primary care is the front door to the NHS, as I mentioned at the beginning, and Lord Darzi pointed out in his report that that is where we should be investing. At the moment, money is flowing to secondary care—to hospitals—yet most people’s experience of the NHS is with their doctor or dentist. We must ensure that that first point of call is a good point of call, and reduce the numbers of people going to A&E. That is so much more cost-effective, but it is also so much better for those people who could manage their health condition without a crisis and without ever having to go near a hospital.
We should also think of the knock-on impacts on those hospitals. We all have horror stories of ambulances queued up outside hospitals because so many people are in A&E and so few people can flow through the hospital. The issues around that are complex, and they link in to social care as well, but the reality is that if we can treat people in the community, we will save the lives of people who need emergency care. This is absolutely fundamental: we need investment in our GPs and in dental and pharmacy contracts because we cannot afford not to do it.
Shockat Adam
In addition to pharmacists and dentists, I would like to mention my profession. Optometrists can really play a role in reducing the strain on primary and secondary care.
Helen Morgan
I thank the hon. Gentleman for his intervention. That is an important point and I apologise for not making it in my speech. Optometry is really important, and as somebody who spends their whole life looking for their other glasses, I can absolutely appreciate his point.
The Minister for Care (Stephen Kinnock)
Should’ve gone to Specsavers! [Laughter.]
Helen Morgan
Other opticians are available, but I did!
The Liberal Democrat manifesto suggested solutions to these problems, and they have been well received, as I mentioned before. We have a record number of MPs, and that is because we put this issue front and centre of our election pledge. I urge the Government to reverse the catastrophic state that the NHS has been left in by the Conservatives, to take our ideas on board and to invest in primary care as soon as possible.
Several hon. Members rose—
Madam Deputy Speaker (Caroline Nokes)
Order. Before I call the Minister, I must respectfully point out that a huge number of Members wish to speak, and that interventions from Members will only eat up the time available to colleagues and, in some instances, themselves. I call the Minister, Karin Smyth, to move the amendment.
The Minister for Secondary Care (Karin Smyth)
I beg to move an amendment, to leave out from “Parliament” to the end of the Question and add:
“; welcomes the urgency with which the new Government commissioned Lord Darzi to conduct an independent investigation of the NHS in England; recognises that within weeks of taking office the Government invested £82 million to recruit 1,000 newly qualified GPs; notes the Government commitment to tackle the dental crisis by providing 700,000 urgent dental appointments and recruiting new dentists to the areas that need them; approves the Government’s commitment to expand the role of pharmacies and better utilise the skills of pharmacists and pharmacy technicians; and welcomes the Government’s commitment to further reduce unnecessary bureaucracy as care shifts from hospital to community.”
I recognise that many people want to speak, so I will be as brief as possible. I begin by thanking the hon. Member for North Shropshire (Helen Morgan) for starting this debate. I think she spoke for us all when she said that she spent a lot of time looking for her glasses— I recently decided to go for the varifocal option just to avoid that problem. She also spoke for us all when she said that we all know how great it is when primary care is there for us. I am proud to have worked with primary care across the piece in south Bristol for many years. Although the hon. Lady and I are on opposite sides of the Chamber, I think we can agree that the last Government broke primary care at the same time as they were breaking the NHS.
Throughout my time in opposition, and in my first three months in government, I simply have not met or spoken to a GP, a pharmacist, a dentist or, indeed, anyone else working in primary care who has said, “Everything is going swimmingly. My patients are happy, and this is exactly what I signed up for.” Lord Darzi’s review tells the same story and sets out an enormous charge sheet, and we still have not heard whether the Conservative party agrees or, indeed, whether it will apologise. The list is far too long to repeat in full. Hospital workforces and budgets have shot up, yet full-time equivalent GP numbers have been allowed to shrink by over 1,500 over the last seven years.
Promises to shift resources to the community have been repeatedly broken, and our primary care estate is not fit for purpose. Shockingly, one in five general practice buildings is older than the NHS itself.
Daisy Cooper (St Albans) (LD)
The Minister may be aware that I lobbied Health and Treasury Ministers in the previous Government for the best part of a year and a half to review outdated Treasury rules that prevent GP practices that want to move from staying within a city centre—the outdated rules force them to move to ring-road locations, away from the populations they serve. Will the Minister look at this issue with fresh eyes, with her new glasses, and work with Treasury colleagues to review these outdated rules?
Karin Smyth
I thank the hon. Lady for her assiduous work in opposition. Looking at the capital estate is one of my favourite new responsibilities, and our commitment to a neighbourhood service means that we need to bring services together. We need to look at this across the piece, to make sure that primary care is provided where it is needed. We often hear about hard-to-reach groups, but I do not think they are that hard to reach. Frankly, services are sometimes located in the wrong area. One of our key commitments is to shift services into communities, and the neighbourhood service programme is part of that.
Just three in 10 NHS dentists are accepting new adult patients, and geographical inequalities are vast. More than 1,200 pharmacies have shut their doors for good since 2017. Again, the record speaks for itself: public satisfaction with general practice has fallen from 80% in 2009 to just 35% last year. If there is any reason why the Conservative Benches are empty, it is because dissatisfaction with access to primary care is so stark, as we learned in July’s general election.
It is absolutely clear that primary care is broken, but NHS staff working in primary care did not break it; the last Government did. They cut funding for the community pharmacy contract, they failed to incentivise enough dentists to perform NHS work, and they pursued a disastrous top-down reorganisation of the NHS, with which we are still living.
The last Government might have broken the NHS, but it is not beaten. NHS staff remain as passionate, dedicated and skilful as ever, and this Government will work in lockstep with them, their counterparts in social care and local partners across the country to fix the NHS.
Karin Smyth
I am tempted, but I know that many of the hon. Lady’s colleagues want to speak, and I am sure she is on the list.
Fixing the NHS will take years of discipline and hard work, and we are in this for the long haul. However, we must first clean up the mess we inherited, and that work has begun in earnest. We have found the funding to recruit an extra 1,000 GPs this year as our first step towards fixing the NHS’s front door and making the system more flexible.
Dr Evans
One of the keys to delivery is the GP partnership model, which is the mechanism by which they are set up. The Secretary of State, who is now in his place, said in 2023 that he wanted to phase out the GP partnership model, although he later reneged on that position. It would be interesting to hear what the Government now perceive to be the best model for delivering primary care, as that is really important for GP partners.
Karin Smyth
I wish the hon. Gentleman well with his own access to a GP at the moment. We are committed to working with the profession on the best way to organise primary care. The critical point is that primary care, however it is organised in neighbourhoods, is there for our constituents when they need it. It is not there now. The model is not working and has not worked over a period of time. It has merits, as we have said, and we are continuing to talk to people. I have worked in the sector for a number of years, so I understand the point the hon. Gentleman makes.
Karin Smyth
No, I want to move on. I will take one more intervention from the Government Benches at some point and then it is all fair, but I want to allow time for hon. Members to speak.
In our first week, we pledged to increase the proportion of NHS resources going into primary care, and in our first month, the Government made a down payment on that pledge, providing GP practices with their biggest funding increase in years. But we are not just increasing funding; we are also cutting the red tape that stops many staff doing their jobs.
Some GP practices currently have to fill in more than 150 different forms to refer patients into secondary care services. They are spending as much as 20% of their time on work created by poor communications with their secondary care colleagues. That is totally nonsensical in 2024 and it has to change.
Time spent doing needless paperwork and bureaucracy means appointments lost for patients, which is why we have launched a red tape challenge to bulldoze bureaucracy and free up GPs to deliver more appointments. It will be led by Claire Fuller and Stella Vig, established leaders in primary and secondary care. They will check with staff what is working well and what needs to change, so we can take the best of the NHS to the rest of the NHS.
Initiatives like Consultant Connect in south London allow GPs to talk to mental health consultants in real time, reducing the number of referrals they have to make by 40%. Delivered across the country, such schemes could save thousands of hours of time and create thousands of new appointments—that is what our red tape challenge is all about.
We want to help patients see specialists faster. Starting in November, 111 online will pilot directly referring women with a worrying lump to a breast clinic. That means faster diagnosis for cancer patients and more GP appointments freed up, which is better for patients and better for GPs.
On dentistry, as the hon. Member for North Shropshire outlined, we inherited an NHS dentistry system in disrepair thanks to 14 years of chaos, failure and neglect. As we have to keep reminding Conservative Members, it is a national scandal that tooth decay is the leading cause of hospital admission for five to nine-year-olds. We all see that in our constituencies. The last Government broke their relationship with the British Dental Association, as they broke so many relationships. During the election campaign, we pledged to meet the BDA immediately upon taking office to start rebuilding the relationship, and that is exactly what we did.
The BDA is right that the last Government’s dentistry recovery plan did not go far enough. We are keeping parts of it that are the right solutions, including the golden hello and some other measures, but we want to go further to deliver an NHS rescue plan that gets dentistry back on its feet. We are working around the clock to end the truly Dickensian tooth decay that is blighting our children. As well as our additional urgent appointments for all ages, we will work with local authorities to introduce supervised tooth brushing for three to five-year-olds in our most deprived communities. We will see the difference getting them into healthy habits can make, protecting their teeth from decay and ending the national scandal the last Government presided over.
On pharmacy, previous Governments dithered and delayed, failing to find a sustainable and long-term funding solution. NHS England is working with the sector to assess the cost of providing pharmaceutical services, and we look forward to seeing its outcome. Consultation around this year’s funding and contractual arrangements with Community Pharmacy England did not make it over the line before the election was called, so we are looking at that as a matter of urgency.
We want to continue to make it easier for pharmacists to take referrals and support people with common conditions, using prescribing skills to treat a wider range of conditions and patients. Pharmacists are highly skilled people in our communities. Allowing patients to get the care they need in the community, saving time and freeing up GP appointments by using the skills of pharmacists, will be really helpful for the wider system.
Those are our first steps. Primary care is central to the three big shifts that underpin our ten-year plan to make the NHS fit for the future, taking it from analogue to digital, from sickness to prevention, and from hospital to community.
We will soon begin a public consultation that will be the biggest listening exercise in NHS history. I look forward to taking part in that and I urge all right hon. and hon. Members, their constituents, and staff across primary care to tell us what is working and what needs to change. We will use their responses to take the best of the NHS to the rest of the NHS and build a neighbourhood health service.
Technology will help doctors, dentists and pharmacists meet demand for same-day appointments, giving patients a digital front door to end the 8 am scramble. Big data will end the cruel postcode lottery of health inequality, so that we can take screening, checks and care directly to the communities that need it most, intervening early to prevent ill health and deterioration. We want colleagues from across primary care to come together with their partners in social care and mental health to work in lockstep, as one team, to treat patients in the comfort of their own homes, which is where those patients want to be. That is the neighbourhood health service that we want to build. That is the future that our constituents want to see.
In the interests of time, Madam Deputy Speaker, I will conclude. Our constituents were let down by the previous Government. They were let down by broken promises, underfunding and a failure to listen to patients and staff. We will repair the damage. We have already begun investing in GPs and pharmacies to fix what is broken. We will cut the red tape, speed up treatment, and build a neighbourhood health service that works for everyone. The NHS may be broken, but it is not beaten. We are determined to rebuild it for our people, our communities and our country.
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
As a doctor myself, I wish to start by recognising the substantial work ethic and expertise of my primary care colleagues and thank them for all that they do.
Saying what is wrong with the NHS is very easy; solving problems takes much longer and is far more difficult. Rather than the next few hours being filled with constructive ideas, I expect that we will simply hear complaints about the challenges faced by the NHS, perhaps some party political jibes and a wish list of promises and the things that people want to see, but no concrete plans on how to deliver them beyond more money. I hope that I am wrong about that, but I suspect that I am not.
Our NHS is facing significant challenges. We have an ageing population with more complex health needs, a rising demand for services and a rapidly growing population. We also have the legacy from the pandemic, which many are quick to forget. Although we were the first country to deliver a vaccine, there are many persistent problems stemming from the pandemic. Let me give the House an example. Before the pandemic, in 2019, there were 54 women who had been waiting more than a year to see a gynaecologist, but due to the reduction in elective activity during the lockdown, by the time the pandemic was over that number was more than 40,000. This is, of course, replicated across other medical specialties. Although my secondary care colleagues have been working extremely hard to reduce those numbers—and, indeed, they have fallen—the individuals concerned will, on average, visit their GPs more while they are waiting and that inevitably puts more pressure on primary care services.
The simple truth is that we gave the NHS more money than it has ever had and, as a result, it has delivered more clinical activity than ever before, but the ageing population, the rising demand for services and the legacy of the pandemic have meant that, in places, that has not been enough. Many people are not being seen as quickly as we would want them to be.
The previous Labour Administration did not do enough to train new doctors, and the reality is that we cannot train one overnight. The Conservative Government built five new medical schools, and the graduates of those medical schools have recently started work. The Secretary of State says that he will double the number of medical students. That is an item on his wish list with which I agree, but I do have a few questions. Will he build new medical schools, expand the old ones, or do both? If he is going to build new ones, where will he build them? [Interruption.] The Minister for Secondary Care is talking about primary care. I believe that doctors are a part of primary care.
The UCAS deadline to apply for most medical school places to start next autumn was yesterday, so when does the Secretary of State expect these new places to be available and those new students to start? On the broader primary care workforce, we expanded the number of primary care professionals in GP practices, such as dietitians and physiotherapists, and we delivered 50 million more GP appointments last year than in 2019. We also saw the launch of Pharmacy First, which delivered more care in the community while easing pressure on GP appointments. I was pleased to hear the Liberal Democrat spokesman acknowledge the success and the benefits of that programme.
I have a few questions for the Secretary of State. The Conservatives produced the first NHS workforce plan. Can the right hon. Gentleman say whether he will proceed with those plans or write a new one? What are the timescales for his plan? In the spring Budget, we had the NHS productivity plan, with £3.4 billion to improve NHS productivity. Does the right hon. Gentleman still intend to follow that? The Minister for Secondary Care said that she was recruiting 1,000 GPs. Can the Secretary of State tell us how many have been recruited so far?
The Secretary of State and I also agree on the ability of technology to improve NHS services.
Ben Coleman (Chelsea and Fulham) (Lab)
As a new Member, I am learning how this place works, so I am interested to see how much you expect the Labour Government to have achieved in 100 days. Why is it, after 14 years, that you left the country with the longest waiting lists ever and small children having to get their rotten teeth seen at A&E? What can you say that is helpful to us in understanding why the failure of 14 years of Conservatism took place, and do you feel any remorse about that?
Madam Deputy Speaker (Caroline Nokes)
Order. Before I call on the shadow Minister to return to the Dispatch Box—
Ben Coleman
I apologise, Madam Deputy Speaker. I used the word “you” instead of “the hon. Member”.
Madam Deputy Speaker
Yes, several times. It is not me; I have never been a Health Minister. I reiterate that interventions will have to be short. I will be imposing a time limit, as we have to hear from an enormous number of Members this afternoon.
Dr Johnson
I thank the hon. Gentleman for his intervention. I have talked about the challenges the NHS faces. I will come shortly to the achievements of the Labour Government so far in the Department of Health and Social Care.
Turning back to technology, I was saying that I agree with the Secretary of State on how technology can improve NHS services. Over the last few years, in my professional capacity, I have seen improvements in making communication between primary and secondary care and within secondary care much more efficient. As a patient, I have used the askmyGP service, which is an excellent way to communicate with a GP, particularly for working people. I have also used the NHS app, which millions of people have downloaded and which has huge potential. I hope he intends to build on that potential and harness the benefit of AI for diagnostics in particular.
The Secretary of State and I also agree on the importance of prevention. It is vital to make the NHS accessible to those who need it, but it is even better if people stay healthy in the first place. Before the election, he was supportive of measures to protect children from the dangers of vaping—measures I campaigned for actively. In fact, he was quite critical that it had not been done sooner, as in some respects was I. Given that the legislation has already been written and that it passed both Second Reading and Committee stage with the support of his friends on the Labour Benches, why is it taking him so long to produce a tobacco and vapes Bill? Can he guarantee that he will deliver it, like a present, in time for Christmas—for clarity, I am hoping for this Christmas?
The Secretary of State for Health and Social Care (Wes Streeting)
Have you been naughty or nice?
Dr Johnson
I have been a good girl, thank you, Secretary of State.
Furthermore, can the Secretary of State explain how cancelling dozens of new hospitals will reduce pressure on general practice? Can he explain how cutting the winter fuel payment for millions of pensioners will help the NHS? The End Fuel Poverty Coalition predicts that Labour’s winter fuel payment cut will result in an additional 262,000 pensioners needing NHS treatment because they are cold, resulting in a great deal of suffering and millions of pounds of additional cost to the NHS. Does he agree with that assessment? I have asked repeatedly, in both oral and written questions, if the Government will conduct a proper impact assessment of the policy on the NHS and on the wellbeing of vulnerable older people. Will he commit to producing and publishing such as report?
Further on the issue of prevention, the right hon. Gentleman will know that folic acid supplementation can prevent neural tube disorders, such as spina bifida and anencephaly. The previous Government brought forward regulations on the matter. What conversations has the Secretary of State had with the Department for Environment, Food and Rural Affairs about ensuring that that work is continued?
Our approach to dentistry was also underlined by prevention. We introduced the Health and Care Act 2022, which gave the Secretary of State the power to introduce water fluoridation schemes. Those powers have since been used to extend existing schemes, particularly in the north-east of England. Does the Secretary of State intend to continue that work and exercise the powers the previous Government gave him? He knows that I am passionate about dentistry. I have raised the issue many times in the House, including by securing an Adjournment debate on dentistry in Lincolnshire. It troubles me greatly that children are coming to hospital for multiple dental extractions due to rotten teeth. It is worth noting that the issue is not a shortage of dentists overall or, as the hon. Member for North Shropshire (Helen Morgan) says, a shortage of money, but a shortage of dentists doing NHS work rather than private work specifically.
The previous Government were encouraging dentists to take up NHS work with a range of measures, including golden hellos for dentists in underserved areas, dental vans going out to rural communities, and tie-ins for new dental graduates. We were also in the process of broader contract reform after a small change in the units of dental activity rate when we went into the election. Let us look at Labour-run Wales in comparison. Wales is delivering only 58% of pre-pandemic dental activity. It is burdened with the highest proportion of NHS dental practices not accepting adult patients and the longest waiting lists in the UK. One in four Welsh residents is currently on a waiting list. The new Secretary of State for Wales has said that the Government “will take inspiration from” Labour-run Wales on dentistry. Given their woeful record in office, I sincerely hope that that is not the case.
Before the election, when I listened to the Secretary of State for Health and Social Care say that Labour had a plan to reform and modernise the NHS, I believed him, but in Monday’s debate on the Lord Darzi report, we uncovered that his plan was not really a plan at all, but a list of desired outcomes and a proposal to make a plan if he got into office. It is unclear how long this plan will take to develop. The Minister for Secondary Care said that it is a listening exercise like we have never seen before, but how much will that cost, and had Labour not been listening already?
Mike Martin (Tunbridge Wells) (LD)
Why did the previous Government shift funding from secondary care to primary care, despite saying that they would do the exact opposite?
Dr Johnson
Essentially, because there is more clinical acute need in primary care hospitals. Given the choice, with one amount of money, between saving a life and preventing a problem for later, it is inevitable that money gets shifted towards acute care. That is where the pressure is, but I agree with the hon. Gentleman that we need to work harder to prevent people from becoming ill in the first place.
Ellie Chowns (North Herefordshire) (Green)
On that point, will the shadow Minister give way?
Dr Johnson
No, I will not give way again, because I know that you will give me eyes if I do, Madam Deputy Speaker.
Labour has spent 14 years in opposition. The Secretary of State has had plenty of time to consider what he would do if he gained office, so, further to the intervention of the hon. Member for Chelsea and Fulham (Ben Coleman), what have the Government achieved in 14 weeks to help the health of the nation? I will tell you, Madam Deputy Speaker. They have opened the Department’s doors to their Labour mates. They have awarded an inflation-busting pay rise to junior doctors without negotiating any modernisation or productivity reform in return. They have overseen GPs entering industrial action and nurses rejecting their pay offer. They have scrapped the social care costs cap. They have produced a report of selected statistics with no policy recommendations. They have broken their manifesto pledge to deliver the new hospital programme. They have taken the winter fuel payment from millions of vulnerable pensioners. They have even stopped the children’s cancer taskforce.
That dire record, underlined by the Labour legacy in Wales, fills me with huge trepidation for the future of the NHS. I hope that when the Government’s plan eventually comes, it is a good one, for all our sakes.
Laura Kyrke-Smith (Aylesbury) (Lab)
I hear from many constituents in Aylesbury who are struggling to see their GP. For some, this is a frustration—a repeated one. For others, it is a tragedy. I sat with a constituent who shared a heartbreaking story about a missed cancer diagnosis because it was impossible to get an appointment.
The reasons for the challenges are clear, as the Minister set out. In Aylesbury, two additional factors are creating particular pressures. First, many new housing developments have been built in the last 14 years without the necessary services to accompany them—for example, the promised GP surgery in Kingsbrook that was never built, adding pressure to other surgeries, such as Poplar Grove. Secondly, there are high levels of deprivations in parts of Aylesbury. The well documented link between poverty and ill health leads to patients having increased and complex physical and mental health needs that GP surgeries are not funded or equipped to meet.
Let us be clear about the cause of these challenges, which are not the fault of patients, who like all of us are just trying to stay in good health, or of GPs, who often work incredibly long hours in a system that lets them down and wears them down. The problem is the broken system that this Labour Government have inherited after 14 years of Conservative government.
Let me turn to the solutions. The early steps that we have taken are a clear signal of our intent: the ending of the junior doctor strikes, the red tape challenge that the Secretary of State launched with NHS England, and the measures that we took within weeks of being elected, including finding £82 million of additional funding to enable the immediate recruitment of 1,000 more GPs. I know from the GPs I am in touch with that that has made a real difference.
There is still much work to do. I will highlight three areas of necessary focus. First, we must expand the range of care available in the community. GP surgeries waste time referring patients to hospital-led community services when they know that they could treat those patients directly but do not have the funding or permission to do so. Meanwhile, patients tell me that they have had to go to A&E for minor issues because there is no support closer to home. Our ambition for an expanded range of support and services through neighbourhood health centres is absolutely right, and we are getting straight to work on that.
Secondly, on technology, I hear time and again of GPs spending hours trying to make referrals to and from the hospital, battling IT systems that are not intuitive and do not speak to each other. Meanwhile, patients tell me that they cannot fathom why there is not a better system for booking appointments. There are great pilot schemes that could be rolled out more widely. At the GP surgery in Edlesborough in my constituency, for example, a carefully designed AI chatbot answers patients’ questions where it can, and helps GPs to prioritise which patients to see.
Thirdly, we need a firm emphasis on prevention in public health by driving up public awareness of health risks. On a recent visit to the main mosque in Aylesbury, for example, I saw a stand with information about diabetes. That is exactly the right way to get the right information in front of people. Once public health risks are identified, we must empower patients to manage their own health as best they can. As Vernon Sharples, a mental health nurse in my constituency, said to me:
“There is too much prescribing, too much emphasis on being ill, and not enough emphasis on being and staying well.”
To me, taking public health, including mental health, seriously, and building a society that understands and promotes wellbeing to keep people healthy before they need to seek treatment with a GP, is what a good preventive approach looks like.
Achieving that vision will take a long time, and change cannot come soon enough for people in my constituency who so desperately need to see their GP today or tomorrow, but we have started as we mean to go on, and we will not stop until we have achieved the change that we so desperately need.
Several hon. Members rose—
Madam Deputy Speaker (Caroline Nokes)
Before I call the chair of the Health and Social Care Committee, I inform the House that there will be time limits of three minutes on Back-Bench speeches and six minutes on maiden speeches.
Layla Moran (Oxford West and Abingdon) (LD)
The challenges facing the NHS are no secret. In my new role as Chair of the Select Committee, I have begun to meet key stakeholders. The list of things that we need to consider is enormous. I pay credit to those who stood for the Committee, and welcome those who made it on. I understand that Conservative members have been chosen, but I do not yet know who they are—I ask them to forgive me if they are here. I look forward to cracking on.
I will start by highlighting to Ministers a few of the reports by the previous Committee, which I urge them to look at. One is on dentistry and another on pharmacies —and they are from 2023 and 2024, so they are extremely current. There is a note of frustration in the dentistry report as it points out that it makes the same recommendations that the Committee had made 15 years prior. I hope that this Government will take our Committee’s recommendations extremely seriously. Such cross-party recommendations are made thoughtfully—we are here to help.
Today, I will focus on the GP crisis. Another Committee report from October 2022, for which I take no credit—it was done by the previous Committee, so credit should go to its previous Chairs and members—points out what we already know: GPs are overstretched and patients are frustrated. The British Medical Association reports that a single GP now manages an average of 2,282 patients, a significant increase on 2015 figures. I know that there are even more acute numbers across the country. That has led to longer waiting times and difficulty in accessing care. One of my constituents wrote to me about his wife, who was struggling to book a GP appointment. The surgery does not even take phone calls—or at least that was what she thought. It opens an online form for a few minutes at 8 am, and as soon as the appointments are gone, it closes the form. We then called the practice, which pointed out that patients could ring, although it seems that that message is not getting across to those patients.
That experience is being felt across the country, but I do not blame the GPs, because they are trying their very best. The Royal College of General Practitioners found that over 40% of GPs might leave within the next five years, with stress being a key factor, and the crisis in general practice affects the entire NHS. When patients cannot see a GP, they often turn to A&E, worsening pressures on emergency departments. GPs play a vital role in managing long-term conditions and co-ordinating social care at both ends of that flow of patients. Without a functioning general practice system, the entire healthcare ecosystem suffers.
So what can be done? The Committee made four main proposals, which I hope Ministers will include in their 10-year plan. First, we need to urgently increase the number of fully qualified GPs in the system. That means more than just training them: retention is also key. Secondly, we must embrace and improve digital health solutions, undertaking a full review of all primary care IT systems from the point of view of clinicians and patients. We also have to accept that for some people, digital just does not work.
Dr Luke Evans
I was a member of that Committee and helped to author that report. One of the key things that we want to see from the clinical perspective is the ability to join up the IT side, so having a place to share technology is really important. For example, every GP practice suffers with the question of how to set up its appointment system, yet bizarrely, if I wanted to set up as a GP on my own, there is no centre of excellence to say what is the best way to do so. Does the Chair of the Health and Social Care Committee agree that it would be valuable if we had a single point of expertise that each practice could ask, “What’s the best solution that you’ve seen elsewhere in the country?”
Layla Moran
I thank the hon. Gentleman for his work on the previous Committee. The GPs I have spoken to point to that report as describing what they would like to see done, so all credit is due to the ideas that have come out of it.
The third area I wish to mention is prevention, which is at the heart of the Darzi report. That report makes it clear that focusing on prevention and early intervention will relieve pressure on the NHS in the long run.
Finally, I want to talk about continuity of care, which was a key theme—indeed, an entire chapter—in the Darzi report. It makes it clear that seeing the same GP over a long period leads to fewer hospital visits, lower mortality and less cost to the NHS. This is not about some sort of nostalgic harking back to the way things used to be: if we want to solve what is, in my view, the biggest thesis question in the NHS today—the productivity issue—we need to be looking at interventions such as that. Continuity of care within GP practices, understanding the whole person and the whole family, is one of the ways the report identified of making GPs’ time more productive.
The challenges are immense, but not insurmountable. We owe it to our healthcare professionals and, most importantly, the patients to fix this crisis, and I look forward to working collaboratively with my new Committee members to help the Government do so.
Mr James Frith (Bury North) (Lab)
Some of us newly elected or returning MPs have only just got our accommodation and offices sorted out, so I commend the Government on the speed with which they have got surgeons back to work, resolved the doctors’ strike, reviewed and assessed the crisis and made announcements for a decade of national renewal. They have also affirmed the view that our NHS should be treated not as a shrine or beyond question, but as something that must be returned to deep service to our country and play its part as a health and economic public service.
Lord Darzi’s review for the Government highlights the critical issues in the NHS and the state we are in, and particularly the underfunding of primary care. It has been neglected in favour of a creeping trend towards hospital services, under the failed principle of leaving it late—the crisis mode setting that applied across our public services under the last Government. By design, people ended up in A&E because of a failure to plan for GP and primary care, with 16% fewer GPs than other high-income countries. The review also points out significant health inequalities, with deprived areas historically receiving insufficient resources. In Bury North, child poverty is up to 43%, densely concentrated in just three of our nine wards. Life expectancy for those living in Bury North ranges enormously: the difference in life expectancy between North Manor and East Ward is five years for women and nearly seven years for men.
Dr Beccy Cooper (Worthing West) (Lab)
Public health interventions cost only a quarter of the amount that clinical interventions do to add an extra year to life expectancy, so does my hon. Friend agree that the reduction of the public health grant was an appalling false economy and should be restored, as soon as finances allow, to at least 2015-16 levels of funding?
Mr Frith
My colleague makes a valid point; I defer to her knowledge of the public health system.
The distance of a mile or so has a huge impact for the men and women living in east Bury. I urge those carrying out the Government review to see how, in constituencies like mine, specific interventions could address those deep health inequalities and identify the work we need to do to resolve that impoverishment in densely populated areas and that ingrained health inequality. I urge the Government also to adopt multidisciplinary care models and shift care closer to home to address these issues—a sentiment that I know Ministers share.
Taking a wider view, the funding formulas are outdated and an update is long overdue. That update should take into account the weight of funding pressures for areas such as mine, with a mix of economic and demographic inequality, including the fact that so much of the revenue that our local authority raises is immediately swallowed up by adult care and the disastrous special educational needs system—a symptom of the crisis mode mentality under the previous Government.
The Government have wasted no time, investing £82 million to recruit a thousand newly qualified GPs and addressing the dental care crisis with 700,000 urgent dental appointments. The Government also aim to expand the role of pharmacies—a measure I hugely welcome—to reduce the burden on our GP and hospital care, and crucially also for those living with chronic illness or conditions. A boost to the engagement patients can have with health decision makers via the NHS app and an improved trusted status for healthcare professionals will boost this too and reduce the bureaucracy in our caring system.
There is a well known saying in good hospitals, “The best hospitals keep people out of them and get people out of them.” This principle strikes at the heart of what has gone wrong in recent years. The problems in A&E, emergency services and waiting times stem from a failure over the past 14 years to design by this doctrine. The key to resolving those issues lies in primary care—preventing people from needing hospital services in the first place and enabling faster discharges when they do. That is where the focus must be.
Wera Hobhouse (Bath) (LD)
Today I speak as chair of the all-party parliamentary group on eating disorders. Eating disorders are a national emergency. Hospital admissions have risen by 84% in the past five years, while more than 80,000 sufferers are stuck on waiting lists while their condition gets seriously worse.
Eating disorders are treatable, but the treatment must be timely and appropriate if sufferers are to make a full recovery. Early diagnosis is crucial. According to the charity Beat, approximately 1.25 million people in the UK have an eating disorder, and I am sure that many of my colleagues have either a friend or family member or know about a constituent who is suffering from an eating disorder. The sooner a person with an eating disorder accesses the right treatment, the more likely they are to recover. When eating disorders are left undiagnosed or poorly treated, they can be killers.
Eating disorders are the mental health disorder with the highest mortality rate, and there is still a stigma surrounding them. There are still too many who think that having an eating disorder is a choice. What a terrible thing to say about people who are suffering from an illness—that it is a choice. Only 6% of people with an eating disorder are underweight, yet some eating disorder services—and GP services—still only offer treatment to patients depending on their body mass index. Many eating disorder sufferers are told that they are not thin, or not thin enough. Others are told, once they return with an even lower BMI, that they are too sick or their condition is too complex to be treated. That happens only because too many sufferers are left untreated when full recovery was perfectly possible.
Wera Hobhouse
I would rather not, because too many people want to speak.
NHS waiting times are one of the biggest barriers to treatment. At the end of 2023-24, more than 10,000 children had entered treatment for an eating disorder, but 12% of those were made to wait over three months for treatment—three times the target for a routine referral. Missing the target waiting time standard can severely harm the progress of a child’s recovery. Even more shockingly, an access and waiting time standard for adults does not even exist.
I will continue to work tirelessly to improve eating disorder care, in particular by fighting for improved access for treatment and for more suitable treatment options for individual patients. We on the APPG have commissioned an inquiry, and I hope the Government will carefully listen to the recommendations. In 2024, no one should be condemned to a life of illness, nor should anyone die of an eating disorder.
Several hon. Members rose—
Madam Deputy Speaker (Caroline Nokes)
Order. Before I call the next speaker, I am going to give some helpful guidance to Members still wishing to speak: interventions are only going to eat up your own time and that of others, and may well see you put to the bottom of the list.
Josh Fenton-Glynn (Calder Valley) (Lab)
I am glad that this debate has been called. Across the House, stories of failings in primary care are too familiar and, frankly, too distressing. The Darzi report makes it clear that since the announcement in the late 2000s of the so-called left shift—the shift from hospital care to care in the community—we have seen the number of people treated in hospitals rising. Indeed, 58% of the NHS budget is now spent on hospitals compared with 47% in the late 2000s. As Darzi said, there is no left shift, just a “right drift”.
Let us be clear: GPs work hard and do a fantastic job. Just a few weeks ago, I visited the fantastic Hebden Bridge group practice in my constituency. The 13 doctors conduct about 2,000 appointments a week, and while they are fantastically efficient, that is taking its toll. The General Medical Council’s national training survey—I used to be proud to work on that report every year—found that 68% of GP trainers said they always felt worn out at the end of the day. This is simply unsustainable.
We see the impact of the unsustainable model and the underfunding in our constituencies every week. In my constituency, the Calder community practice in Todmorden closed with over 2,800 patients on its books because there simply was not anyone able to take it on. The Darzi report makes it clear that we need to prioritise primary care and care in the community. The left shift must not be a slogan, but create real action. It cannot be right that, last year, 2,000 patients each day were admitted to hospital for something that could have been treated elsewhere and closer to home.
I look forward to supporting the Government amendment, and to working across the House week in and week out to make sure that we rebuild the NHS and get it the support it needs.
Ellie Chowns (North Herefordshire) (Green)
The Darzi report made it very clear that our NHS is under- funded, overstretched and too hospital focused. That has also been a focus of today’s debate so far. I welcome what I heard from the Secretary of State, in last week’s debate on the Darzi report, about investment and reform, and a shift from hospital to community and from sickness to prevention. We all want those things, but they will not happen without more investment, and without a crucial reform in the way the NHS is funded. We have seen a drift towards an increasing focus on acute services and on hospital services at the expense of investment in preventive healthcare and the primary services that we all recognise are so needed, and that my constituents in North Herefordshire so desperately want. They want to be able to see a GP, and they want to see the community frontline services that will save their health, and will save the NHS money, in the long run.
Can the Minister assure me that she and her colleagues have been doing everything possible to urge the Chancellor to make available the billions of pounds of investment in the NHS that are necessary to bring us back up to scratch in comparison with our peers? Darzi said that we are underfunded in comparison with similar health services. Will she assure me that the Government are considering putting in place some sort of mechanism to protect funding for primary and community care, and indeed to ratchet it up over the years? The way things happen at the moment is that hospitals constantly overspend and those overspends are constantly plugged, which is why the money is going more and more into hospitals and less and less into primary care. Will we get the billions of pounds of investment in the Budget that we need, and will we get that protection and ratchet mechanism for primary care funding that is the only way to ensure that the extra doctors, extra appointments and so forth are delivered?
Deirdre Costigan (Ealing Southall) (Lab)
There is an old Irish saying, “Your health is your wealth”, and all the money in the world and all the nice things mean nothing if we do not have our health. Too many people in my constituency do not have good health—10% have diabetes, which is higher than the London and UK average, and the rate of preventable deaths is almost 14% higher than the England average. Time and again when I knock on doors across Ealing Southall, people tell me three things: they cannot get a GP appointment when they need it; they cannot see a doctor face to face; and if they are lucky enough to see a doctor, they never see the same one twice. With long-term conditions such as diabetes, not seeing the same doctor is damaging the health of my constituents. They are getting sicker, and they end up relying more on expensive hospital services. In Southall, emergency hospital admissions are 47% higher than the England average. Why can’t my constituents get to see a doctor? For starters, there simply aren’t enough. North-west London has a ratio of one GP for every 2,268 patients—a lot worse than the UK average.
We have had 14 years of the Conservative party running our NHS, and it is clear that it has run it into the ground. It started with a big-bang approach and the disastrous top-down reorganisation of the NHS. That caused so much damage that even they recognised it in the end, and they had to dismantle many of the changes a few years later, but not before the rot had set in. Since then, their approach has been like moving the deckchairs on the Titanic. All they can come up with is piecemeal tweaks and small pilots that never seem to amount to anything. In the meantime the NHS ship is slowly sinking.
Lord Darzi’s independent and honest report found that patients have never been more dissatisfied with the services they receive. I can only take the empty Conservative Benches as proof that they are finally embarrassed about it. We must also ask why Conservative Members have been happy to preside over 14 years of decline in our NHS. Is it because they want it to fail, or to replace our NHS with a privatised American-style insurance system? The mask slipped during covid when they fast-tracked their private healthcare mates and handed them multimillion pound contracts for often dodgy personal protective equipment. Was that the future they have in mind for the NHS? That is not what the public wanted, and it is why the public voted them out. My constituents in Ealing Southall are already impressed by the new Government’s approach. They know that the damage to the NHS is so deep that it cannot be fixed overnight.
Your health is indeed your wealth, Madam Deputy Speaker. The last Government frittered away that wealth, gave it to their private healthcare mates, and squandered it on damaging and costly reorganisations. This new Labour Government will turn the page on over a decade of Tory decay and help us all to live longer, healthier lives.
Ian Roome (North Devon) (LD)
I have spent most of my working life in the NHS, but speaking for the first time in the House, I must start with a confession: as some of the northerly Members will recognise from my voice, I was not born in the west country. It is now 35 years since I was posted to what was then RAF Chivenor on the beautiful north Devon coast, while serving in the Royal Air Force. At the time, my flight sergeant at RAF Laarbruch in Germany told me that going to north Devon would probably turn out to be an adventure. I confess to the House that I do not think this place is quite what he, or I, had in mind.
First, I want to thank my family, friends, and all my supporters over the years— especially my two-year-old grandson Clayton, who probably won me one or two votes—as without them I would not be here. My constituency is fortunate to be famous for its stunning landscape and areas of outstanding natural beauty, with beaches, moors, farmland and forests that draw countless visitors every year. Farming and tourism sustain many of our rural communities, with historic market towns such as South Molton, set in rolling countryside, giving way to stunning seaside destinations such as Woolacombe, Instow and Braunton.
Chivenor, where I was so lucky to be posted all those years ago, is now home to the Royal Marines Commando Logistic Regiment, and my area has a proud military history. Now-famous surfing beaches, such as Woolacombe and Saunton sands, were once used as training grounds to prepare allied forces for the Normandy landings. Behind the natural beauty, the challenges that my area faces are stark. Like many rural and coastal constituencies, it suffers from low wages, which are nearly £100 a week less than the national average, and an acute housing shortage that prices younger people out of our communities or prevents them from starting a family in North Devon, as I did.
Even in the 2020s, parts of my constituency still face real deprivation. In some parts of Ilfracombe, for example, the proportion of young people attaining level 4 qualifications is barely above 25%, while life expectancy is 10 years lower than other parts of Devon. Out of uniform, I joined the NHS, starting out as a mental health nurse at North Devon district hospital—the most remote acute hospital in mainland England—visiting patients across unique communities, such as Combe Martin and Lynton, and eventually leading the campaign to build a chemotherapy and day treatment unit. My area suffers from shortfalls in important medical services such as pharmacy, nursing and, in particular, dentistry. Our hospital now has intensive care units and operating theatres that are approaching 50 years old and are desperately in need of investment from the new hospital programme.
However, I have been astonished by the possibilities on offer in my constituency. Numerous coastal seats across the south-west, mine included, stand to benefit massively from investment in floating offshore wind in the Celtic sea. Clean energy, an extended supply chain and high-paying jobs could be a shot in the arm for the economy of the great south-west. I pay tribute to my predecessor Selaine Saxby, who identified how that massive opportunity could, if done right, benefit the region for decades to come.
North Devon district hospital will soon be home to a £1.4 million clinical research centre that will lead groundbreaking studies into heart conditions, joint problems and osteoarthritis. Few people know that Barnstaple, where I live, is also home to Accord Healthcare, a pharmaceutical group that manufactures a staggering 10% of all the medication used in the NHS and is a vital part of this country’s critical supply chain. It has just announced a new, groundbreaking, orally administered medication for prostate cancer. That is hot off the press this week and may benefit as many as 40,000 cancer sufferers, and it is among the first medications of its kind. Another remarkable firm, Systems Engineering and Assessment, or SEA, has just won a £135 million contract to supply cutting-edge defensive countermeasure systems to the Royal Navy. Thanks to its hard work and some innovative engineering on an industrial estate in my constituency, young people will be kept safe as they serve their country in uniform.
My constituency is one of hidden opportunities around every corner. We must seize them. It is an immense privilege for me to be North Devon’s voice in this place, and I intend to do it justice.
Andrew Lewin (Welwyn Hatfield) (Lab)
It is a privilege to follow that powerful maiden speech. I am certain that the hon. Gentleman will do his constituents proud, as he did in his time serving in our armed forces.
I welcome this debate. After 14 years of Conservative government, our health service is in a critical condition. In my constituency, the drive from the centre of Hatfield to Welwyn East takes about 10 minutes, but the difference in life expectancy between the two areas is now 10 years. The responsibility for the crisis sits not with our wonderful healthcare professionals, but squarely with the previous Conservative Government. I have spent as much time as I can with our NHS heroes, and I recently saw the professionalism of our paramedics at first hand after joining a shift with Daisy and Jake in the East of England ambulance service. They were a credit to their badge, and I am pleased to say that I got through blue lights okay. But GPs are battling a backlog—in my constituency more than 2,000 people have been waiting more than a month for a local appointment—dentists are withdrawing from the NHS, including in Peartree ward in Welwyn Garden City, and, invariably, the most vulnerable are the most seriously impacted. As the Darzi report made clear, people experiencing homelessness attend A&E four times as often as the general population and are eight times more likely to need in-patient care, all at immense cost to them and the overall NHS budget. We will only rescue our health service if we reform primary care, and that is why this debate is so important.
Despite rising demand, 5% fewer nurses were working in the community in September 2023 than in September 2009. The NHS Confederation is clear that spending in primary and community settings has a superior return on investment compared with spending on acute hospital services, and Darzi was clear that it “therefore makes sense that” there should be a “fundamental strategic shift” to the community.
Innovative work is out there. In my constituency, the Hospital at Home service run by East and North Herts NHS trust is particularly powerful for those over 80 who need rehabilitation and care, but for whom the best place for that is their home and not the hospital. The shadow Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson), said that she was not expecting to hear new ideas, but they are out there, and it is the job of our Government to embrace them and take them forward. I have every confidence that this Labour Government will do that. The party that founded the national health service has a clear vision for the future —from analogue to digital, from hospital to communities, and from sickness to prevention.
Llinos Medi (Ynys Môn) (PC)
Diolch, Madam Deputy Speaker.
I am deeply grateful to the committed NHS staff who deliver exceptional care in hugely difficult circumstances. Health is of course devolved to the Welsh Government, but people on both sides of the border will recognise the struggle to see their GP, increasing waiting lists, and the dire state of A&E services.
Waiting lists for hospital treatment in Wales reached a record high this year, and NHS dentistry is non-existent in many parts of Wales. In my constituency, Valley Dental will soon become the fourth practice to withdraw NHS services since late 2022. Between January and December 2023, only 44.8% of people in Wales received treatment through an NHS dentist, and in north Wales that figure was 36.6%. Despite that, the Secretary of State for Wales has hailed Welsh NHS dentistry as a model of success.
Following a long campaign by Plaid Cymru, the north Wales medical school recently opened its doors at Bangor University, despite previous claims by the Welsh Labour Government that there was “no case” for it. I hope the Government will be receptive to our new campaign for a dentistry school at the university, which would secure high-quality jobs for north Wales and provide more dentists for an area beset by shortage.
At the Labour party conference, the Secretary of State for Wales announced that patients from Wales could receive NHS treatment in England, and vice versa, under UK and Welsh Government plans to reduce waiting lists, yet the Welsh Government Cabinet Secretary for Health and Social Care categorically ruled out giving patients the option to travel to England for more treatment. My party obtained freedom of information responses from three NHS bodies, two in England and one in Wales. All three said they had received no correspondence from the UK Government or the Welsh Government regarding the proposal. Perhaps the Secretary of State could explain to the House what the plan means for patients in Wales.
Fourteen years of under-investment and the creeping advance of privatisation have placed a heavy burden on our NHS. Pursuing the same tired route will not deliver the thriving and improved health services that we all want to see for staff and patients.
Natasha Irons (Croydon East) (Lab)
Of all our public services, our NHS is the one that unites us the most. It is in the room that our children our born in. It is there when our parents get old and when we receive the worst possible news. It is there for us no matter who we are, what we do or what we earn. Our NHS belongs to us all. The previous Government inherited an NHS that was working, with the highest satisfaction levels and lowest waiting times in its history. The state of the NHS today, where 2.8 million people struggle to contact a GP every month, demonstrates their utter contempt not just for this precious institution, but for the people it serves.
There can be no greater example of the previous Government’s failure than the declining health of our young people. Last year, the number of under 18-year-olds on waiting lists for paediatric care in England soared to a record high of over 400,000. As Lord Darzi’s report shows, our children are some of the sickest in Europe, with the highest rates of obesity, diabetes, and poor oral and mental health. Under the previous Government’s watch, 40% of children lost regular access to a dentist, the number of children waiting more than 52 weeks for community health services hit 94% in just two years, and one in 5 children is estimated to have a mental health problem but is unable to access the right treatment.
The previous Government failed our children from head to toe. That is reflected in the experience of young people in my constituency, where they and their families wait months and sometimes even years for support. Parents are desperate for help, young people are desperate for healthcare and everyone is desperate for hope.
Labour has fixed our NHS before and under this Government we will fix it again. Following Lord Darzi’s report, the Prime Minister has recognised the need to change our health service, and has set out this Government’s intention for a 10-year plan to change our NHS. Our Health Secretary has already committed to putting in the extra resources we desperately need for primary care, including £82 million of investment to recruit 1,000 newly qualified GPS, and to finally reform the broken dental contract to get more dentists into the communities that need them.
Unlike the previous Government, we will fight for our NHS. We will not allow primary care services to continue to be overwhelmed. We will not leave patients rotting on waiting lists, and we will not let our children be the sickest in Europe. We will fix our NHS. We have fixed it before, and we will fix it again.
Madam Deputy Speaker (Caroline Nokes)
I call Martin Wrigley to make his maiden speech.
Martin Wrigley (Newton Abbot) (LD)
I congratulate my hon. and gallant Friend the Member for North Devon (Ian Roome) on his maiden speech. I start by thanking my long-suffering family, especially my children Zoe, Sam and Emily, who have been truly supportive throughout everything to get me to this place. Let me express my thanks to the amazing team in the constituency who worked so hard to get me here as well.
It is an honour to have been elected to represent my constituency of Newton Abbot, an area that I have called home for some 25 years. I tend to find that people in Westminster either ask, “Where is Newton Abbot?” or they say that they know it well through personal experience. We are on the south coast of Devon between Exeter and Torbay, between the sea and the gateway to Dartmoor with the Rivers Teign and Exe. The constituency name reflects our largest market town, but it could add Dawlish, Teignmouth, Kingsteignton, let alone the many villages from Starcross, Kenton, Bishopsteignton, Abbotskerswell, Ogwell, Denbury, Ipplepen, Broadhempston and many more.
I have been wondering what to tell hon. Members about my constituency. Perhaps the creative and innovative people, including Newton Abbot’s own Ollie Watkins, the members of Muse, or Peter Cross, usually seen at England rugby fixtures with his resplendent cross of St George hat and coat. Or the history of Brunel’s engineering of the coastal railway, today’s mining of ball clay or, previously, the granite used to rebuild London bridge, the British Museum and others, quarried from Dartmoor and transported via the Templer Way—a tramway itself created from granite—all shipped via the port of Teignmouth. Or the story of Dawlish violets, Jane Austen’s visits, Keats’ poem or how Dawlish became the home of black swans. Perhaps the protected shores of the Exe estuary and Dawlish Warren, home to many thousands of wildfowl and wading birds each winter. Suffice it to say, the area is steeped in history, fame and natural beauty. Members will find much more than Devon cream teas and scones—with cream and jam the right way up, of course.
Growing up in a Royal Navy family, we moved around an awful lot. Moving to Dawlish was a natural choice, but I suspect it was also my parent’s influence that caused me to set my sights on this place. In the 1950s, they met in Downing Street when my mother worked in Churchill’s office. My father told us stories of racing to the parking place outside No. 10 in his old MG.
Speaking of previous politicians, I pay tribute to my predecessor, Anne Marie Morris, and her dedication to the constituency. Her maiden speech told of the waves gently breaking over the trains on the Dawlish seawall. The 2014 storm, however, showed us that the force of the sea and the increased storms due to climate change were both serious and urgent. Since then, Network Rail has constructed a new seawall, rebuilt the station and more. However, it was the catastrophic cliff collapse near Teignmouth that caused the longest interruption of rail services, cutting London off from the south-west peninsular. We are still waiting for funds to be confirmed for that work. Climate change is a real and present threat to us on the coast, and we cannot stop it with just flood defences and mitigations. We must do everything we can to reduce the use of fossil fuels and carbon dioxide emissions.
Turning to healthcare, Devon has both an ageing population and fewer hospital beds per head of population than the national average. Local hospitals are falling into disrepair and are often overlooked in the model of care. It was during my first week in this place that I heard from the local NHS trust that it was cancelling the planned new Teignmouth health and wellbeing centre that would have replaced the crumbling hospital. Due to increased costs and a recent cap placed on its capital budget, bizarrely because of revenue overspend, the project was cancelled. The new centre was to have become the home to local GPs and local NHS services. I did write to my pen pal, the Secretary of State, but have yet to hear back.
In the meantime, I am working with the GPs to help them secure a new home and avoid putting primary care for 18,000 patients in jeopardy. Teignmouth hospital is still under the threat of closure, despite housing many NHS and voluntary sector services. Meeting recently with Volunteering in Health at the hospital with my right hon. Friend the Member for Kingston and Surbiton (Ed Davey), we saw how its model of wraparound care had been copied internationally and that Singapore was now rolling it out as global best practice.
As an engineer and a Liberal, I know that we do not need to accept broken systems. We can fix them, and by empowering people we can build a brighter and better future. I will do everything I can in this place to fix systems and help my constituents, and help to protect the beautiful constituency, the environment and its biodiversity as long as I am here.
Dave Robertson (Lichfield) (Lab)
I congratulate the hon. Member for Newton Abbot (Martin Wrigley) on his excellent maiden speech. I am sure he will be a fierce advocate for the people of Newton Abbot and the surrounding area over the coming years. I look forward to working with him.
I am very glad to be able to speak in this debate, because primary care is an important issue that affects all our constituents. During the election campaign, it was absolutely the No. 1 issue that came up on the doorstep across Lichfield, Burntwood and the villages in my constituency.
We are effectively here to discuss the centralism and poor decision making that typified the last decade and a half of incompetence by the Conservative party on primary care. There can be fewer more obvious examples of that than the fate of Burntwood health and wellbeing centre in my constituency. The building was home to a GP surgery serving almost 5,000 residents in the town. The contract for the surgery expired in March last year, but no replacement facility was ready for that date. The surgery could not move, which meant it had to close. The building itself is still in use by the integrated care board and the practice was happy to seek an extension, but that was not allowed by NHS England.
As a result, more than one in eight people in the town have had to be redistributed to other surgeries because a process in London did not allow organisations in Staffordshire to deliver the best solution for my constituents. It is centralist and wrong. It was wrong then and it is wrong now, and it needs to change. Even worse still is that the proposed replacement facility, originally scheduled for completion in October 2023—last year—is nowhere near ready. We are expecting planning permission sometime in early 2025 and who knows when it will actually be completed.
This is such an important issue for my constituents in Burntwood, as we all know the potential knock-on effects that delays in accessing primary care can cause. The staff at the remaining surgeries are doing all they can to support the community, but at some point increased patient rolls like this cannot be mitigated. It is one example of the challenges people face in seeing a GP. It is not the only one in my constituency and very far from being the only one across the whole country. It cannot be fixed overnight; 14 years of it going wrong will take longer than 14 weeks to fix. However, I applaud the Health Secretary for going as far as he has so quickly: cutting red tape to allow 1,000 new GPs to be taken on and commissioning the Darzi review of the NHS so that this party, the one that created the NHS, can ensure that we build a health service that is fit for the 21st century.
Madam Deputy Speaker (Caroline Nokes)
I thank the hon. Gentleman for not using all his time. I call Tom Gordon to make his maiden speech.
Tom Gordon (Harrogate and Knaresborough) (LD)
Let me begin by congratulating my Liberal Democrat colleagues on some fantastic maiden speeches, which have given me a lot to live up to. While I am on the subject of thanking people, let me confess that I committed a cardinal sin at my election count: I reeled off my Oscars award-style speech recognising everyone who had played a part in the previous 30 years of my life, but importantly forgot to acknowledge my agent—the worst thing that any political candidate or Member of Parliament could do. I have not yet lived that down.
Still on the topic of thank-yous and acknowledgements, I want to thank my Tory predecessor, Andrew Jones, for his hard work as a valued constituency MP, which many people mentioned throughout the election campaign, and for his work in securing bathing water status for the River Nidd.
This may seem a little too obvious, but the two principal towns in my constituency are Harrogate and Knaresborough. Knaresborough does not like coming second, for a good reason: it is the older town, an ancient market town featuring a fantastic castle and the Nidd gorge, with a view over the River Nidd. It has a strong sense of community, and I encourage anyone who has not heard of the Knaresborough bed race to google it after my speech—it is a truly unique event.
Harrogate is a famous old spa town. It has been renowned for its healing waters, which have drawn people from all corners of the globe, including the Russian aristocracy and—previously—its royal family. Agatha Christie turned up there after a nationwide manhunt. It is a place of intrigue, but in more recent years it has become a place of culture, a cultural gem in the north. We have the fantastic Harrogate international festivals, whose annual calendar ranges from literature to art and everything in between. We also have RHS Garden Harlow Carr—we are a flower town, and have won many awards at both regional and international bloom festivals.
We also have Harrogate Convention Centre. A little while ago, before I was born, Eurovision was hosted there. One of the most frequent suggestions that comes up is that I should launch a campaign to get Eurovision back. That relies on our getting millions of pounds of investment into the convention centre, something for which I have already been campaigning. This is probably a little-known fact for those on the Government Benches, but we will have something almost rivalling Eurovision next March, namely the Liberal Democrat spring conference—and the Glee Club will be in town!
As well as the towns of Harrogate and Knaresborough, my constituency contains a wide range of villages, but what interests me is the people—it is the people who make our area so fantastic. It is that Yorkshire grit, determination and resilience that really make our area shine. Let me give the House a few bits and pieces of potted history, featuring some famous and some more infamous folk from my part of the world. There is Mother Shipton, Knaresborough’s answer to Nostradamus, who was made something of a pariah and cast into a cave, and called a witch to boot. To this day, the cave is one of the biggest tourist attractions in the area. On the more infamous side, we play host to the childhood home of no friend of this place, Guy Fawkes; the less said about him, probably, the better. We also have more modern and contemporary people, such as the Lionesses’ Rachel Daly, and Olly Alexander as well. One person who sticks out in the history books is Blind Jack, who is said to have been the founder of modern road building. He built kilometres on kilometres, or miles and miles, of turnpikes centuries ago, and rumour has it that North Yorkshire council might get around to repairing them some time soon. As I have said, it is the people who make my constituency great.
Let me now reflect on the topic of today’s debate. I think the reason health is so important to us is that in those moments of desperation, worry and anxiety when we reach out and go to that frontline of primary healthcare—when we see our GPs—we are truly human. Looking back at some of the more formative moments of my life and experience, my life has been changed when I have gone to a GP.
It is apposite that I am giving my maiden speech today, during Breast Cancer Awareness Month. People have been wearing lot of fantastic bright pink outfits to highlight that cause. The reason I got involved in politics is that the day before I started my master’s degree in public health, my mum was diagnosed with breast cancer. Fortunately, she has recovered and is fine now, and I have even made her a Lib Dem councillor in Wakefield— she has not yet forgiven me for that. When we were going through that experience, I dropped down to doing my degree over two years so that I could look after her and my little sister, who was just five at the time.
We know that being able to access healthcare is the most important factor in getting a good outcome. Fortunately in our case, my mum was fine, but the complications of having gone through lots of surgery and chemotherapy still live with her today. As someone who lives with a chronic condition—earlier this year I was diagnosed with ulcerative colitis—I know that getting through the door to see a GP can be the biggest barrier to getting a diagnosis, treatment and support.
I would not be here without my constituents. It is an honour and a privilege to have been elected to represent the people of Harrogate and Knaresborough, and I shall do my best, whether it be on health, culture and tourism, or whatever wonderful fortunes and opportunities await me.
Alice Macdonald (Norwich North) (Lab/Co-op)
I congratulate the hon. Member for Harrogate and Knaresborough (Tom Gordon) on his cultured and moving speech—and on delivering it without notes, which is always very impressive.
I am pleased to have the opportunity to speak in today’s debate. I come from a family that is rich with GPs—primary caregivers who are the bedrock of our NHS. My grandad, aunt and uncle were all GPs, and my cousin is a qualified GP too. Over the generations they have served, times have got harder and pressures have grown. Under successive Conservative Governments, we saw decades of under-investment and mismanagement, and a lack of long-term planning, which has left primary care on its knees. Indeed, during the election campaign we had to fight to save our NHS walk-in centre, which has become important for so many people in my constituency —I am glad to say that we succeeded. However, as the Health Secretary said when he visited Lionwood medical practice in Norwich North, “The cavalry is coming”; in fact, it has arrived. We know that the task is monumental, but as the party that created the NHS, Labour knows how to fix it.
I welcome our 10-year plan, which has primary care at its heart. It will make sure that we shift from hospital to community, and from sickness to prevention. Because of the black hole in funding that we have been left by the Conservatives, we know that money is tight, but we have already taken action by investing £82 million to recruit 1,000 newly qualified GPs.
Of course, primary care refers to dentistry too. My county of Norfolk has been allowed to become a dental desert—or, as the Secretary of State has said,
“the Sahara of dental deserts”.—[Official Report, 23 July 2024; Vol. 752, c. 506.]
A recent ONS dentistry report states that 99.7% of new patients in East Anglia cannot access NHS dental care, which is shocking and totally unacceptable.
I note that many pregnant women are unable to access the free NHS dentistry care to which they are entitled. In fact, brand-new data from the British Dental Association and the Women’s Institute shows that nearly 1.5 million NHS dental appointments for pregnant women and new mums have been lost since the start of the covid pandemic. I ask the Minister to focus on what we can do to improve women’s access to dental care, because dentistry is a feminist issue too. I welcome our plans to rescue NHS dentistry, and I will continue pushing with colleagues across Norfolk—I can see the hon. Member for North Norfolk (Steff Aquarone) in the Chamber—for the dental school that we so desperately need.
Let me finish with the Health Secretary’s own words: “The cavalry is coming.” We will fix the NHS and make sure it is fit for purpose.
Dr Al Pinkerton (Surrey Heath) (LD)
For my constituents in Surrey Heath, access to primary care—whether GPs, dentists, pharmacies or optometrists—has increasingly become a postcode lottery. Vast dentistry deserts—maybe not of Saharan scale—have opened up across Surrey Heath, with residents simply unable to find an NHS dentist with an open list for them or their families. When a list does open up, it almost immediately closes again due to the overwhelming demand. Today, families are being forced to seek private provision for their dental care—if they are able to stretch their finances that far—or they simply forgo dental care altogether. During the recent election, I even met a constituent who had resorted to an amateur tooth extraction because of the lack of affordable dental treatment locally.
The postcode lottery extends to GP services too, although the issue of access takes on a slightly different form. Surrey Heath has some excellent and much-loved GP practices that are working hard to put the experiences of users first, but others have booking systems, triage mechanisms and approaches to communication that leave patients feeling anxious and frustrated.
I pay particular tribute to the surgery in Lightwater, a village in my constituency. Residents regale me routinely with stories about the fast, efficient and friendly telephone service it provides, the availability of on-the-day appointments and the generally high quality of the service. It is little wonder that residents from miles beyond Lightwater are so desperate to move their registration to that particular well-run surgery.
Some other surgeries, however, are not so highly praised. They are criticised for their impersonal online booking systems and inappropriately long waiting times for appointments, sometimes requiring patients to wait a month or so to see a GP. This is not just poor practice; it has real-life implications for the health outcomes of patients and for the economy, as residents take longer to be seen, longer to be treated, longer to recover, and longer to get back to work than if they had been seen earlier. Online booking systems risk creating a digital barrier to entry for our most vulnerable residents. It cannot be right that those requiring healthcare might be dissuaded from seeking it because of the complexity of approaching their GP, or because they do not have, cannot afford or cannot operate the technologies required to book an appointment.
Our local pharmacies, too, are under huge strain, and I commend the incredible local independent pharmacies who look after communities across Surrey Heath so well. I am incredibly pleased that we are having this debate today, not only to talk about the challenges of primary healthcare but to highlight some of the great practice that we can see within our communities. We need to support our local pharmacies, which deliver so much care and support, and we need, as the Liberal Democrat manifesto proposed, to enshrine the commitment that patients can see a GP within seven days—a commitment underpinned by an associated commitment to train and recruit thousands of GPs every year.
Dr Beccy Cooper (Worthing West) (Lab)
The Darzi review has effectively shone a spotlight on the key issues that GPs and all in the healthcare profession have experienced over the past 14 years. It rightly highlights the detrimental impact of austerity and the increased pressure that the pandemic put on an already stressed service. It also draws attention to the ongoing excellent work that is being done by NHS staff across the country in spite of, rather than because of, the facilities, systems and processes that are not fit for purpose and must now undergo intelligent reform. Primary care is an essential part of our health system. It is where prevention meets treatment, and GPs can effectively undertake secondary prevention to keep people well for longer—for example, people with chronic conditions such as diabetes and hypertension.
As a public health consultant, I want to fight for our GPs and make sure that they have the resources they need, and I want to highlight three things today. I often speak to the Royal College of General Practitioners, and we are in sync on these three things. The first is the long-term workforce plan. It is due for review next year. It has been underfunded in previous times, and we have to look at the modelling that is in the workforce plan now. If we are moving from a hospital model to a community model, we have to look at the rate of increase that we expect in our GP service. It currently stands at 4% for GPs and 49% for hospital consultants. This is in no way to denigrate my colleagues who are hospital consultants—they are incredibly important—but we need to review this workforce plan. I know that the Public Accounts Committee was looking at this issue prior to the election. As a new member of the Health and Social Care Committee, I will encourage the continuation of that work.
Secondly, we spoke earlier about a mixed model of GP provision and how that will work. In my constituency, the Worthing integrated care centre is due to open very soon. It is part of a neighbourhood model, where GPs will work with other healthcare professionals to provide a holistic wraparound service. As has been demonstrated in this Chamber today, there are already partner practices that are working effectively. This is about the interaction between neighbourhood hubs and those partner practices. It is pragmatic politics to get those to work, and work well, for our GP colleagues.
Finally, we have talked about the national retention strategy. GPs are currently leaving in their droves, and even though many people are coming forward as GP trainees, it has been said in this Chamber that we must ensure that we retain our GP colleagues. This issue is particularly acute in deprived areas. As a public health consultant, I know that health inequalities are one of the major issues in this country. In order to address that, and to ensure that prevention is writ large for those areas of health inequality, we must make sure that we are retaining our GP colleagues in those areas.
Manuela Perteghella (Stratford-on-Avon) (LD)
Access to NHS dentistry is deeply affecting my constituents in Stratford-on-Avon, with many communities facing what can only be described as dental deserts. We have seen dentists leaving NHS services in recent years, leaving residents with limited options. In some cases, my constituents are waiting months for an appointment, are forced to travel significant distances to see an NHS dentist or, worse, are told that they must pay privately or go without. Some have resorted to emergency care, and others have even attempted DIY interventions.
The lack of access to NHS dental appointments can have serious long-term health implications. Dentists can detect conditions such as oral cancer, diabetes and osteoporosis during routine appointments. We have heard that across the country, 4.4 million children have not seen an NHS dentist in the past year, which is shameful.
The situation is worsening in my area, with more NHS dentists opting out of the system because the current dental contract is unsustainable. It is not a surprise that patients are being removed from NHS lists, exacerbating the crisis. Recent research by Healthwatch, based on a series of national polls, shows that disabled people and those with long-term health conditions are more likely to avoid going to the dentist because of the cost.
The Liberal Democrats’ dental rescue package proposes investing in additional dental appointments, reforming the broken NHS dental contract and ensuring that everyone in need of urgent or emergency care can access an NHS dentist in their locality. We should give our constituents the right to register with their local NHS dentist. I therefore urge the Government to act now before the crisis deepens even further.
Danny Beales (Uxbridge and South Ruislip) (Lab)
The fundamental promise of our NHS is that it is there for all of us whenever we need it, no matter how much we earn, where we live, who we are or what part of the health system we need to access. Unfortunately, after 14 years of Conservative government, that promise has been broken. It was particularly disheartening not to hear any contrition or reflection from the shadow Minister.
Despite the hard work of NHS staff, waiting lists are at record highs and patient satisfaction is at record lows. The NHS is near breaking point. We all knew this going into the election, as we heard it from our constituents— I certainly heard it from mine in Uxbridge and South Ruislip. Even so, the findings of the Darzi review are still incredibly shocking.
Primary care, as Liberal Democrat Members have said, is the front door to our NHS, but that front door is increasingly being slammed shut in the face of our constituents, and the effects are being felt. Fifty years of progress on cardiovascular disease is in reverse, progress on cancer outcomes has stalled, and cancer survival rates in the UK are falling behind comparable countries.
There is a lot to do, and it will take time to do it, but I am reassured by the Minister’s comments that this Government are taking the matter incredibly seriously. I welcome the Secretary of State’s focus on the three critical shifts needed to modernise our health service, and particularly primary care: from analogue to digital, from hospital to community, and from sickness to prevention. These shifts will not only improve value for money in our health service but will ensure that everyone in our communities lives a longer, healthier life.
We have heard today of the importance of GPs, particularly family GPs. GPs are seeing more patients than ever before, yet the number of qualified GPs relative to the population is falling. This strain will only be exacerbated as populations grow and age. I welcome the Government’s commitment to GP recruitment, with £82 million being invested in 1,000 more GPs.
The shadow Minister spoke about the capital investment pressures on the Government, and we certainly want to see capital investment in hospitals—including Hillingdon hospital in my constituency—but primary care capital investment is also needed to unleash potential capacity.
We have heard from Liberal Democrat Members, as well as Members on the Government Benches, about dental deserts and the need to improve access to dentistry. I welcome the Government’s commitment to engage with the British Dental Association. I know one of the Secretary of State’s first meetings was with BDA, and I look forward to hearing the outcome of those discussions.
Lastly, on community pharmacies, I met representatives of local and national pharmacy groups in my first few weeks as an MP. Pharmacies are incredibly well placed to take the pressure off GP services. Pharmacists are trained, professional and ready to go. I welcome the Government’s plans to create community pharmacist prescribing services to utilise the skills of pharmacists.
I will end as I started: there is a lot to do to rebuild and reform our NHS, so that it is there when we all need it. We have done it before and we must do it again.
Luke Taylor (Sutton and Cheam) (LD)
I am in general agreement with others about the state of the NHS. The NHS was a Liberal idea, delivered by the Labour party, then broken by the Conservatives. The attendance among Conservative Members at today’s debate shows just how much interest they have in trying to fix it. The Liberal Democrats will act as a responsible, constructive Opposition and work with the Government to fix the NHS’s many problems.
Joy Morrissey (Beaconsfield) (Con)
On that point, will the hon. Member give way?
Luke Taylor
No, I will not.
Solving the crisis in access to primary care matters not just to patients facing traumatic situations, but to our GP surgeries, which are striving to do their best under the most difficult of circumstances. Our hard-working GPs dedicate years to training and work hard at what they do because they are passionate about being there for their patients. For too long they have been let down, and it is our job now to give them the means to continue doing their remarkable job.
We know the difficulties. Too often, appointments are not available, and patients and staff experience frustration and conflicting priorities when attempting to access services. For patients, that often means resorting to dialling 111, or even 999, and attending A&E when issues escalate. That puts further pressure on our already overstretched NHS emergency facilities, which too often have to deal with issues that could have been fixed by preventive primary care if patients could have accessed it in a timely way.
GPs in Sutton and Cheam tell me that requests for appointments are triaged because of the level of demand. Decisions have to be made to prioritise patients with increasingly complex needs, often with very little information available. Unsurprisingly, that is affecting GPs’ mental health and making it increasingly difficult to retain experienced staff, further eroding the ability of practices to keep up with demand.
The ask from GPs in my constituency is simple: the Minister must act quickly to increase their budgets, and offer certainty to allow them to plan ahead financially after a sustained period of real terms cuts in funding. That will allow them to hire and retain more staff at competitive wages during this cost of living crisis, lower the collective workload and treat more patients more effectively.
It is not enough to simply offer more training places, or incentives to train, if surgeries cannot employ the GPs who are already qualified and available. That is a particular problem in my constituency. If the NHS cannot compete with the private sector on pay, or with overseas Governments, who attract our doctors with improved conditions, a lower workload and possibly even better weather conditions—legend has it that there are places that have even more sunshine than Bournemouth —then it cannot hope to retain GPs. We must make it easier for foreign students who have studied and qualified in the UK to get the right to remain after their course, should they wish to do so.
As the new Government search for ways to boost growth, I say that it is here in front of them. There is no better investment in our future growth than good-quality primary healthcare, keeping patients healthy, able to provide for themselves and their families, and living healthy and fulfilling lives.
Jen Craft (Thurrock) (Lab)
I begin by reflecting on the version of the NHS’s foundation set out by the hon. Member for Sutton and Cheam (Luke Taylor). I was unfamiliar with that, so I thank him for that history lesson.
The fate of our GP services is felt nowhere more keenly than in Thurrock, where we have the highest ratio of patients to GPs in the country. At a coffee afternoon a few weeks ago in Aveley, in my constituency, where the local medical practice has perhaps the highest patient load of the entire area, we discussed some of the issues facing the community, as well as the solutions. It was a microcosm of this debate. People thought they deserved to be able to see a GP, but my constituents, particularly those in Aveley, showed a bit of common sense about what they could expect after 14 years of a Conservative Government running their healthcare services into the ground. They know that they do not always need to see a GP. They know that sometimes a face-to-face appointment is not necessary. However, they also want to know that the healthcare they need is there when they need it. GPs at the meeting had a similar reflection—they want to be able to spend the time that they have with their patients, not form filling, not running around bureaucracy, and not referring back to secondary providers. They want to spend their time delivering the best medical care possible.
A great example of community healthcare is provided by Orsett hospital, our local community hospital. What it does it does very well, providing blood tests, dialysis and so on. People can get the care they need on the doorstep. However, the hospital has been under threat of closure for as long as I can remember. I was born there, and since then its services have been taken away one by one.
We have a healthy scepticism in Thurrock for neighbourhood health hubs. We have been promised them for a number of years, but, thanks to a combination of Conservative Government incompetence and Conservative council incompetence locally, we no longer have the money to provide them. In my constituency, out of the three healthcare hubs that we have been promised, all we have so far is a hole in the ground in Tilbury, one of our most economically deprived areas.
I said earlier that some solutions also came out of that discussion. If we are to turn around primary healthcare, we need buy-in from our population. People need to know what services are available to them. They need to be in charge of their healthcare, including their preventive healthcare. They need to know what is coming up on the horizon for them and how they can take steps to change outcomes for themselves. I conclude by welcoming this Labour Government’s approach to turning around the NHS towards a preventive and community model.
Liz Jarvis (Eastleigh) (LD)
I am so pleased that we are having this very important debate this afternoon.
Like my hon. Friend the Member for Stratford-on-Avon (Manuela Perteghella), I wish to highlight the issues facing dentistry. Eastleigh is facing an acute NHS dental crisis, with many of my constituents unable to access basic dental care. By the end of 2023, more than 48% of children in Hampshire had not been seen by an NHS dentist in the previous two years. According to the NHS website, only a third of dentists in my constituency are taking on new NHS patients. I have heard from residents who are desperately trying to find an NHS dentist, but, after calling surgery after surgery, they cannot find one taking on new NHS patients.
Some 62% of adults in Hampshire have not been seen by an NHS dentist in the past two years. That leaves them with very limited choices: go without any treatment at all, try to find the money for private treatment, or resort to DIY dentistry. One resident told me that their NHS dental appointment was cancelled at very short notice, with no alternative offered, because their highly skilled dentist from Poland left after Brexit and now there is no NHS dentist available at his local practice.
Another constituent told me how his dental practice is struggling to keep appointments, and now has only one NHS dentist available, and that is on Saturdays only. Patients are being asked to sign forms agreeing to private treatment at NHS prices, without the protections that they would usually receive under NHS care.
The previous Government pushed NHS dentistry to the brink of collapse. I hope the new Government will reverse that trend by increasing investment in dentistry, using unspent funds to increase the number of NHS dental appointments and removing VAT on children’s toothbrushes and toothpaste to make oral health more affordable. As a local NHS dentist told me, the dental contract is not fit for purpose. His colleagues are leaving the NHS in droves.
My constituents in Eastleigh would benefit from an emergency rescue plan for NHS dentistry. Proper investment to tackle this crisis would offer more NHS dental appointments and deliver free check-ups for children. This is the kind of direct action that we need to prevent more children from suffering and to ensure that everyone, regardless of their income, can access high quality dental care.
Alex McIntyre (Gloucester) (Lab)
May I congratulate hon. Members on their wonderful maiden speeches?
The challenges facing primary care services in our country were set out in damning detail in Lord Darzi’s report after 14 years of Conservative mismanagement. I thank the Secretary of State for bringing that report so quickly to the House and getting on with the job of making our NHS fit for the future.
From knocking on doors in Gloucester, I know that access to a GP and getting an NHS dental appointment remain two of the biggest challenges facing my constituents. I recently held a cross-party meeting with councillors in Tuffley and Grange wards in my constituency about the challenges that residents are facing in getting a GP appointment. I know that we have issues with accessing dentists in particular, with more than 2,500 patients per dentist. That is despite the fact that frontline workers in our NHS are working harder than ever. Retention in our workforce is a key issue, so will the Government look at family-friendly policies to ensure that we retain as many frontline key workers as possible?
I was surprised to hear the shadow Minister speak about prevention, because during 14 years of Conservative health policy they seem only to have prevented my constituents from getting access to the healthcare they needed. Prevention is important to this Government’s strategy for health; it is better for patients and it gets them easier access to the care they need and better health outcomes. It is also better for the taxpayer and far cheaper than going to the hospital when it is too late.
I am pleased to see the Government are already taking action—but we have to get this right. There is a principle in the NHS of getting it right the first time, and I am pleased to see and hear that the Secretary of State and his team are taking time to listen to our health service in putting forward our 10-year plan to get the NHS back on its feet and fit for the future. Our NHS may have been broken by the Conservatives, but it is not beaten. It is always in debt to the frontline staff, and we all owe them a personal debt of gratitude.
I welcome the plan to tackle red tape in primary care and ensure that we focus on patient care and delivering the best care. I welcome the work towards recruiting 1,000 newly qualified GPs. We are bringing back the family doctor and we are ringing in 700,000 more urgent dentist appointments. We will fix the mess that we inherited from the Conservative party, but it is important to my constituents that we get it right the first time. The Government are getting on with the job of doing that.
Sarah Gibson (Chippenham) (LD)
I will cut to the chase. The state of NHS primary healthcare in my constituency is depressing. I would like the Minister’s help with three local issues: first, with NHS dental care provision in the light of the Hathaway dental practice’s closing its doors to NHS patients on 1 November; secondly, the stalling of a proposed medical centre in Calne for more than four years due to delays by the ICB; and thirdly, the decision to refuse a licence for a new pharmacy in Corsham. However, given the shortage of time, I will concentrate on the urgent matter of the closure of a dentist’s surgery.
As everyone in the Chamber is aware, dental services are broken. People are pulling out their own teeth and then being rushed to the NHS to deal with a problem that is everywhere. However, integrated care boards across the country are underspending millions on dentistry. Chippenham comes under the Bath and North East Somerset, Swindon and Wiltshire ICB, and according to a freedom of information request to the British Dental Association, that ICB dental underspend amounts to £4.2 million. I mention that because there are several hon. Members here with the same ICB. My constituents are horrified. We are about to lose yet another NHS dental practice on 1 November, in part due to recruitment challenges but mostly because of the dental contract system.
In my first weeks as an elected Member for Chippenham, I attended a briefing on preventive healthcare with the Secretary of State and I felt reassured that the issue was being looked at. However, three months have passed and I have seen nothing concrete from the Government about a reform of the contracts or even a proposed consultation timeline. I implore Labour’s health team to urgently review the NHS dental contract system and stop dental healthcare being a privilege.
The ICB repeatedly says it will come back to me and the practice owner tells me they cannot get this to work. Truthfully, I am at a loss. The Government, along with the Care Quality Commission and my local ICB, say they are doing something, but nothing seems to happen. I implore the Government to work with Liberal Democrat Members, who want the best for our NHS. We agree that a more preventive approach is needed. So much is broken and we need to put it right together now, before it is too late.
Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)
First, I must declare, as the shadow Secretary of State for Health and Social Care, the right hon. Member for Louth and Horncastle (Victoria Atkins), reminded me last week, that I am a surgeon. I have, therefore, an interest in this matter, but so do we all. The last Government should be truly ashamed of themselves. I see but one remaining Member—a colleague of mine—sitting on the Conservative Benches. General practice has been badly neglected. The public could see that. Surely the Government must have known it. Certainly patients could see it, given their scramble on the phone at 8 o’clock, hoping not to be at the end of the queue for one of the very few appointments with one of the very few doctors.
During my career, I have seen the number of hospital doctors and consultants increase many times, but we have seen very little increase in GP numbers, and now we live with the consequences: too many exhausted GPs, many leaving the profession altogether or retiring much too soon, and now the spectre of a two-tier GP system, as private GP services expand rapidly all over the place. We can, and will, do better than this. We already are doing better, with plans to recruit many qualified GPs without jobs into practices without doctors.
Today, we must look after our GPs as never before. We will move much of our care out of our hospitals and into the community, but it is on GPs that we will depend to achieve that. GP services will expand to provide community investigations, facilities, specialist and surgical services, and much more, as we rightly adopt the new Government’s agenda of moving care out of hospitals. We must ensure that GPs have the very best IT and technology. We must connect the GP IT with the hospital IT, so that I can see the same record as the GP; the nonsense of typed letters and fax machines should end completely.
I am, however, optimistic. Scientific advances continue to astonish us. We know what we have to do, and we have the determination to do it. Doctors and patients will support this. Let us get to work. General practice is the best of the NHS, and we must support it.
Edward Morello (West Dorset) (LD)
In my constituency of West Dorset, as across the country, community pharmacies are being asked to deliver more and more primary care services, increasingly acting as an alternative to GP surgeries. They are delivering vital healthcare services such as health consultations and vaccinations; however, the funding model for community pharmacies is outdated and insufficient, and does not reflect the expanded role that they now play in our healthcare system.
Community Pharmacy England reports that one sixth of pharmacies could close within a year, and the National Pharmacy Association estimates that the average pharmacy will lose £43,000 this year. This is being played out writ large in my constituency. Lyme Regis has recently lost its last remaining high street pharmacy. Our Beaminster and Sherborne pharmacies are reporting six-figure annual losses due to the unsustainability of the funding framework—a funding model that, as the Pharmaceutical Services Negotiating Committee suggests, does not account for the higher operating costs in rural areas, as well as wild fluctuations in medicine prices that can result in pharmacies losing money on every prescription issued of certain drugs.
Community pharmacies also have to operate within a system whereby they get compensated only for consultations that lead to prescriptions being issued. That leads to a perverse focus on patients where a medicalised outcome is most likely. I urge the Government to re-evaluate the funding model for community pharmacies. We need a system that recognises and rewards the broader role that pharmacies now play, particularly in rural areas. Pharmacies are delivering critical health services, yet they are being financially penalised because the funding system is still based on an outdated model. If we continue on this path, we risk losing these vital community assets.
Pharmacies in rural places such as West Dorset cannot survive on the current funding framework. They are a lifeline for many of my constituents, and without immediate action we could see further closures, which would leave vulnerable populations without access to vital healthcare services.
Chris Webb (Blackpool South) (Lab)
At 10 years below the average for England, life expectancy in my constituency is the lowest in the country for men and women. Lord Darzi’s recent report pointed out that people in the most deprived areas of England are twice as likely to wait more than a year for non-urgent treatment. Those problems are compounded by poor-quality housing, low income and insecure employment, which are particularly pronounced in my constituency. That is evident in the casework that my constituency office receives. One man, whose son got in touch with me recently, has been waiting years for a simple hernia operation, and it has impacted on his mental health. It has led to the son fearing that his father could take his own life.
Physical health inequalities contribute to poor mental health and the crisis surrounding it. Chris Whitty’s 2021 report on health in coastal communities detailed the alarming rates of diagnosed severe mental illness in my home town of Blackpool. There were over 500 hospital admissions for intentional self-harm in 2018-19, suicide rates among men were the second highest in the country, and 3,000 people have a severe mental illness.
I recently had the opportunity to meet staff and patients at the Harbour in Blackpool, a modern mental health hospital with fantastic facilities. However, the 154-bed facility is hugely oversubscribed, and patients are routinely sent hundreds of miles away to receive hospital treatment, putting undue pressure and stress on their families. The lack of mental health beds has a knock-on effect on Blackpool Victoria hospital, where the 60-person A&E facility has held up to 188 patients—waiting, at one time, 50 hours to be seen. Those waiting times have been normalised, but they can mean the difference between life and death. The number of hospital admissions for children with mental health problems in my constituency is around 60% higher than the national average.
I urge the Minister and the Secretary of State to consider the model of mental health support championed by charities in my constituency such as Counselling in the Community, an award-winning mental health charity led by its incredible founder and chief executive officer Stuart Hutton-Brown. It uses the skills of trainee counsellors, giving them invaluable career experience while acting as a lifeline for its service users. Empowering such charities to expand their work, rather than relying on the private sector to plug the gap in the NHS, is a great model that will enable us to put money back into the community rather than into the pockets of private providers, and offers better value for money.
Those problems are distilled in Blackpool. I am encouraged by the Government’s recognition of the challenges—I know that the Minister’s Department is prepared to face up to them—but sadly, in Blackpool, they are all too apparent.
John Milne (Horsham) (LD)
The ongoing crisis in GP access is as acute in my constituency as elsewhere. That is not simply because there are more patients, but because today’s patients have greater health challenges and need to see their GP more frequently. That is why simple comparisons with GP ratios from the past do not work. We need a health service capable of meeting today’s needs, not those of 20 years ago.
In Horsham, it has become routine for surgeries to fill all available appointments within minutes of opening. Relatively junior staff are obliged to spend the rest of their time saying no to frustrated, anxious and—not infrequently—angry patients. The danger is that we might enter a spiral of decline whereby demoralised staff leave, piling more pressure on to those who remain and scaring off replacements before they have ever had a chance to settle. We must get working conditions right, and that cannot be achieved in a state of permanent understaffing.
We must also get more from the services that we already have. Unleashing market forces on the NHS, and setting pharmacies, GPs and hospitals against each other, was a mistake. Effectively, they are in commercial competition to provide more of the treatments that pay well and less of those that do not. Only integrated care boards are in a position to take a holistic view of patient provision, but that is not really happening yet.
There are any number of alarming statistics relating to our health service, but I will conclude on one that is a bit more positive. As mentioned by one of my colleagues earlier, studies by the University of Cambridge and others suggest that where patients are seen by the same GP over 15 years, the average mortality rate declines by 25%. That is a remarkable level of improvement, more than could be expected from almost any other intervention. Let us give GPs the space to do their job properly, and let us support this motion.
Joe Morris (Hexham) (Lab)
I want to speak about some of the challenges I experience when I am out in my constituency. Whether before the election or since, whether I am out in Throckley in the western reaches of Newcastle or in Otterburn, Bellingham or Wark in the Tyne valley, the inability to get a decent GP appointment is continuously raised with me as one of my constituents’ greatest frustrations, and they appreciate the sheer scale of the task that this Government have inherited.
One of the things I want to gently ask of the health team on the Front Bench is that when we look at building the community health service that we so desperately need, we consider that our rural communities in particular have suffered from health services being hollowed out for 14 years. If people are forced to go on public transport and it takes hours to get between small towns and villages, the barrier to a GP appointment becomes all the bigger. That was communicated to me throughout the election in visits to wards that I do not think Labour canvassers had knocked in before. Many residents of Hexham raised it as one of the primary reasons for switching to the Labour party, and it is why I am stood here as Hexham’s first ever Labour MP.
Five out of the seven dentists in my constituency are not accepting new patients. That crisis is particularly acute in the western part of Newcastle, in Callerton and Throckley—it has been raised with me multiple times on the doorstep—and the devastating impact of that crisis on families and on people’s mental health, as well as their physical health, has been illustrated by many of the contributions from across the House. The absolute disgrace of people getting visibly emotional when talking about their struggle to secure a dentist’s appointment in 21st-century Britain is one of the many badges of shame that the Conservative party should wear as it considers its future. I note the empty spaces on the Conservative Benches.
Ultimately, I want to pay tribute to the GPs and frontline staff who work tirelessly to deliver healthcare across my constituency and further afield, but also to emphasise that the challenge facing the NHS has never been greater, particularly in rural areas. The NHS has been brought to its knees by 14 years of mismanagement and complacency, and we now need to rise to the challenge. I am confident that this health team and this Government will do so.
Sarah Dyke (Glastonbury and Somerton) (LD)
We know that primary care has been struggling—struggling to meet targets, keep up with demand and help the population remain healthy. Those difficulties are particularly acute in rural areas such as Glastonbury and Somerton, where primary care faces specific issues such as recruitment, retention, and access to services. GPs serve a crucial and multifaceted role in healthcare, but they are all too often inaccessible in rural areas. Last year in Somerset, 21% of GP appointments took more than two weeks from booking to appointment—higher than the average wait in England —and 7% of appointments took well over a month.
GPs play a crucial role in serving people’s mental health, as well as their physical health. The Environment, Food and Rural Affairs Select Committee’s report on rural mental health concluded that NHS mental health services are not fairly accessible for rural communities. A one-size-fits-all approach does not fit everyone; appropriate services should be developed to serve rural communities. To help mend the mess left by the Conservatives, the Lib Dems want to give everyone the right to see a GP within seven days, or within 24 hours if urgent, with 8,000 more GPs to deliver on that commitment. Rural communities also suffer from poor access to public transport, which makes it more difficult to access services, and poor rural broadband, which makes it hard to access online services. It is clear that cross-departmental work is needed to address the challenges rural people face in accessing mental health support. Those hurdles must be factored into the national strategies that are focused on addressing mental health.
We must look at how pharmacists can ease the pressure on GP services, but they too need urgent support. Between April 2015 and June 2024, there was a net loss of 1,200 community pharmacies—1,402 closures and only 179 openings. The rate of pharmacy closures in Glastonbury and Somerton is, shockingly, near double the national average. Community pharmacies provide an essential high-street service in rural market towns, but many have now simply gone.
The Liberal Democrats believe that we need a clearer, more sustainable long-term funding model for pharmacies, and we must build on the Pharmacy First approach to give patients more accessible routine services and ease the pressure on our GPs.
The new Government have spoken out about our crumbling public services, but now is the time to act. My constituents cannot wait.
Steff Aquarone (North Norfolk) (LD)
Countless times on the doorstep during the general election campaign I discussed primary care with people in North Norfolk, and the damning legacy of the last Conservative Government means that almost everyone in my area has their own story. Stories of people who are waiting four weeks to see their GP about anything non-urgent; of people whose oral health has declined so much that they are no longer able to smile; of people who are worried for the supplies of vital medicines. The primary care crisis is acutely felt in North Norfolk, and I am glad that it is the Liberal Democrats who will be pushing this Government to bring forward solutions.
Residents in Blakeney are set to lose their rural branch surgery at the start of next month despite overwhelming efforts to save it. Many people who live in Blakeney rely on that surgery and have based their independent living plans around it. Surgeries are key community assets and people will genuinely suffer if they are lost. It is why I have been proud to support our call for a small surgeries fund, to give financial stability to surgeries like that in Blakeney. I hope that today the Minister can tell us whether the Government would support that.
The dentistry crisis is another of the biggest issues for North Norfolk. The hon. Member for Norwich North (Alice Macdonald) reminded us that the Secretary of State for Health and Social Care had described Norfolk as the Sahara of dental deserts. I have been pleased with the progress we are making, working with the integrated care board in the months since my election, safeguarding services in Holt and Wells, and pushing forward the case for a new dentistry school at the University of East Anglia. I have enjoyed working with my colleague the hon. Member for Norwich North on that. This issue matters to people like my constituent Alan. He receives no state support despite his wife being unable to work, and when they needed urgent dental treatment he was forced to dip into his small savings. It cannot be right that when someone pays in to the system all his life, it simply is not there when he needs it.
These problems are deeper-rooted. Mental health services do not have the networks to really reach people in rural areas. Our small surgeries are vital because of our lack of public transport infrastructure, our GPs struggle to find new partners because of ballooning property prices, and our pharmacies and hospitals cannot attract the specialists they need because there is not the housing. The solutions to these problems in primary care require an holistic approach, so I hope that the Government are taking steps to stop these problems being siloed.
All Liberal Democrat MPs are champions for our left-behind local health services. I urge the House to support the motion and show that we mean business about bringing our primary care services, like those in North Norfolk, back from the brink.
Dr Danny Chambers (Winchester) (LD)
Every Member who has spoken, from whichever side of the House, has spoken eloquently about their constituents’ difficulties accessing primary care. As the Lib Dem mental health spokesperson, I want to focus on some potential initiatives that will help solve those problems.
There is a really good initiative in Winchester that recognises the many socioeconomic problems that contribute to poor mental health. The poorest 20% of people are twice as likely as people on an average salary to experience mental health issues. So in that fantastic initiative, local NHS mental health services are working with Winchester Citizens Advice to help people with mental health issues deal with troubles like debt, monetary issues and housing issues. It is saving a huge amount of NHS resources. Analysis showed that for every £1 spent on the initiative avoided about £40.06 in costs, and people were less likely to have to engage with mental health services again. I would be really keen for the mental health team, if they are willing to do so, to meet me and the team in Winchester that has come up with this initiative, because it really could be rolled out over the rest of the country.
When we discuss community mental health, we often talk about community mental health hubs, for which the Liberal Democrats have been calling for a long time, so that we can proactively engage with people at risk of mental health issues. We know what those demographics are. We target physical health screenings at the demographics that are likely to suffer from those diseases, and it is the same with mental health. We know that military veterans and their families, women one year after giving birth, the LGBT+ community and other demographics are at a higher risk of experiencing mental health issues, and we could be engaging with these people much more proactively through community mental health hubs to ensure that they do not end up needing to access primary healthcare.
Finally, although this relates to secondary care, we must acknowledge the long waiting lists for those who go to their GP and are referred for mental health treatment, because they are huge and people can wait for months or for over a year. In that time, people can end up going to A&E, which takes a lot of time and resources, and costs the taxpayer a lot of money. GPs in Winchester tell me that they spend a huge amount of their time dealing with people already on waiting lists for referral who have come back again because they need help in the meantime, so that would really help free up primary care.
Ian Sollom (St Neots and Mid Cambridgeshire) (LD)
I thank everyone who has contributed to the debate, and there have been a lot of excellent speeches. In my first contribution in this House, in the debate on Lord Darzi’s investigation last week, I raised the challenge of delivering primary care under a funding model that has failed to take account of growth in Cambridgeshire. I am going to reiterate that, and I will take every opportunity to reiterate it, because it is a gross injustice in Cambridgeshire, and other Members have noted it in their own areas of growth. As well as taking action on the unfair funding model, I would urge the Government to provide mechanisms to pump-prime those areas of growth, so that new services can be commissioned ahead of time to deliver those services as people move in, much as we see with other services such as schools.
My hon. Friend the Member for Horsham (John Milne) mentioned a Cambridge University study showing the benefits for patients of continuity of care. I think this will be a real focus of the new Chair of the Health and Social Care Committee, my hon. Friend the Member for Oxford West and Abingdon (Layla Moran), and it should be brought forward by the Government to ensure better outcomes for patients. The study also showed that, when patients see the same doctor, they do not need to see that doctor as frequently over the course of their treatment, so it is a win-win. We are seeing benefits not just for patients, but for NHS services and ultimately benefits for us all. Again, the Cambridge study showed that those benefits are felt most for older patients, which is why the Lib Dems have been campaigning for everyone over the age of 70 to have access to a named GP. To get that continuity of care, I really urge the Government to set an ambitious target, as the Lib Dems have done, to drive forward the strategy of getting continuity of care, improving outcomes for patients and improving outcomes and productivity for the NHS.
Chris Coghlan (Dorking and Horley) (LD)
The NHS dental contract is so flawed that it punishes dentists for overperforming, so they cannot meet patient demand even if they are ready and willing to do so.
During the election campaign in my constituency, I was struck by how many dentists contacted me to tell me that the system is broken. One dentist took me for a coffee in Dorking, and she told me that she had quit as an NHS dentist because the sums simply did not add up. It was costing her more to treat NHS patients than she was receiving under the NHS contract. That is why so many dentists are leaving the NHS contract. As we have heard from so many hon. Members, the consequences for children in particular are devastating, because they end up at A&E.
Just last week, a constituent contacted me to tell me that they had been unable to afford private dental care for broken teeth, so they had accessed a cheaper teledentistry company. The result was a botched job, with them having permanent ligament and bone damage. This crisis will end only when we reverse the previous Government’s cuts to dental care, because everyone should be able to access affordable high-quality dental care. The Liberal Democrats have a plan to fix our dental deserts, and I urge Members to support the motion.
Mr Joshua Reynolds (Maidenhead) (LD)
In my constituency, the proposed GP health hub on Reform Road has been cancelled. The land that is needed is owned by the local council, of which I am a member, as is declared in the Register of Members’ Financial Interests, and the council was ready to sell it. However, after a long wait, Frimley integrated care board scrapped its plans because of rising costs and interest rates. That leaves a significant gap in our healthcare infrastructure. With thousands of new homes being planned and built, we need GP facilities to match, but with the ICB pulling out, it is Maidenhead residents who will suffer.
Residents in Binfield in my constituency have no better luck getting a GP appointment, with local GP surgeries saying, “Don’t bother trying to ring at 8 am, you will not get an appointment. Don’t even try.” St Mark’s hospital in my constituency is a cornerstone of our local community, and 25 years ago it was the local Liberal Democrats who battled to bring the urgent care centre to St Mark’s in Maidenhead. However, at the beginning of the pandemic the walk-in centre was closed on what we were told was a temporary basis. To date it is yet to reopen, and no matter how much we have tried, we have been told that the system is good enough without it.
I am a local lad from my constituency, and when I was at primary school I fell over and hurt myself, and my mum hobbled me to St Mark’s. Within an hour, they had done an X-ray, put me in a cast and sent me on my way home on crutches. Compare that with the situation now, with residents telling me time and again that they struggle to get the care that they need when they need it. Grandchildren who have had a bang on the head turn up at St Mark’s to be told to go to Wexham Park in Slough, where they have a 15-hour wait in A&E. Children cut a finger open, and instead of being able to take a five-minute trip up the road, they have to endure a 60-minute rush-hour drive to Slough.
Walk-in urgent care centres are beneficial for our local communities because they allow us to take the pressure off A&E and the major hospitals and provide that care locally. It is not a difficult concept. Allowing people to get the care they need, see their GPs or pharmacists, and use the walk-in centre at St Mark’s will mean fewer people in accident and emergency, saving hospital admissions, freeing up beds for those who need them and, importantly, saving the NHS money.
The Liberal Democrats and our hard-working local champions will always be there for the NHS and champion primary care. We are committed to reversing the decline in GP numbers and ensuring that all our communities have access to the primary care they need when they need it. The challenges are significant, but they are not insurmountable, and with the right policies and funding, we can turn the tide on this and get people the care they need.
Caroline Voaden (South Devon) (LD)
I feel as if we are playing a game of Top Trumps with who has the worst dental services, but services in South Devon have been so badly neglected by the Conservative Government that we live in one of the worst dental deserts in the UK. NHS dentists in Totnes, Dartmouth, Brixham, Paignton and South Brent have closed, leaving thousands of my constituents, many suffering severe dental pain, with no choice but to pay extortionate private dentists for help.
One of my constituents said:
“My daughter is 18, a student at college, and I am on ESA. We lost our NHS dentist 2 years ago in Totnes. We took the decision to go on a basic payment plan that gives us one check-up and hygienist visit as I have gum disease. We can’t really afford it. On a visit to the dentist today we were hit with a £160 bill for a small filling that my daughter will need. I had to pay £80 upfront. This is our food money for the next 2 weeks gone, and will be the same again when she returns for her appointment in October. We will have to use the food banks to eat this month.”
Another told me she has a regular infection in her wisdom teeth that requires constant antibiotic treatment, and she has been told that it will cost £5,000 to remove them, or she will have to wait two more years for NHS treatment.
The state of dentistry in South Devon is absolutely shocking. There are currently no dentists taking on new NHS patients—not one—in a constituency of more than 300 square miles. It is shameful that there are not more Conservative Members on the Benches beside me to hear this. People in Devon and Cornwall are waiting 1,441 days on average just to register with a dentist. That is four years. The new Government have talked about the benefits and importance of preventive healthcare, and nowhere is that more clear than in dentistry. It is not just about filling cavities and giving someone a nice smile. We know there are links between gum disease and cancer. A poor oral microbiome can increase the risk of stomach and colorectal cancer.
We also know that visits to the dentist as a child increase the chance of a lifetime of good oral hygiene. Liberal Democrat research has shown that in the past five years, more than 100,000 children have been admitted to hospital with tooth decay. That is absolutely not what our hospitals need after 14 years of neglect from the Conservatives and with a system that is completely overwhelmed. The Government must immediately renegotiate the NHS dental contract. Has the Minister considered increasing the units of dental activity to stabilise dental practices immediately, before more of them go under? The Government must guarantee appointments for all those who need a dental check before commencing cancer treatment or chemotherapy, and they must support preventive dental healthcare. Preventive care will always be less costly than the extensive treatment required later in life if people do not get into good habits at a young age.
Anna Sabine (Frome and East Somerset) (LD)
Before I make some brief comments about dentistry, I must say that some Government Members seemed genuinely confused about our claims that the Liberals had anything to do with the founding of the NHS. I urge them to google the Beveridge report.
My grandfather was a dentist, so as a child I was privileged enough to have access to dental care as and when I needed it, although when I was eight I did fall down the stairs at his surgery and break my arm while he was doing my dad’s fillings, so possibly his health and safety was not as good as his dentistry. Many children nowadays do not have the same access to dentistry as I did as a child. In the past year in Somerset, the percentage of children seen by a dentist was just 42%, when the English average is more than 55%. The percentage of adults seen in the past two years is still only 32%.
The Darzi review revealed that only about 30% to 40% of NHS dental practices are accepting new children and adult registrations. That is leaving many with no option but to go private. My constituency of Frome and East Somerset is also considered a dental desert. It is predominantly rural, which means that access to services is even more limited. The lack of public transport means that accessing dental services is difficult already, and with practices not taking on new patients, they are pushed even further afield. I had an email from two constituents from Frome earlier this month. They have been unable to see an NHS dentist for four years due to a lack of availability for new patients. They said in their email that
“it not only affects our oral health, but contributes to broader health issues that can arise from neglecting dental care”,
and they are anxious about potential long-term impacts.
Getting a dentist appointment should never be as hard as it is now, and I urge support for our motion to help reduce dental deserts and rescue NHS dentistry from disaster.
Olly Glover (Didcot and Wantage) (LD)
I congratulate my hon. Friend the Member for North Shropshire (Helen Morgan) on introducing this debate. I echo her call on the Government to boost access to GPs, NHS dentists and community pharmacists. In my Oxfordshire constituency, the growing number of people moving into the area has not been matched by an increase in GP, dentist or pharmacy services. Indeed, frustration with the terrible Conservative track record on these health issues was a major factor in my election to this place in July.
In Great Western Park in Didcot, where more than 5,000 people now live, there lies a site ready to be developed into a GP surgery, and there is money from the developers to build it. However, the local NHS body responsible for building it and providing the doctors, nurses and other support staff sadly has struggled to marshal the resources to do so. I call on the Government to prioritise supporting NHS bodies and to provide the mechanisms for bringing forward primary healthcare.
Meanwhile, many people in my constituency, particularly in Didcot, often cannot see a GP without the early morning telephone rush that my colleagues have articulately summarised, hoping to get one of the precious slots. At the GP surgery in Didcot at which I am registered, it is even a challenge to get an online appointment, with a two-minute window granted once a week to try to fill in an e-consult form—a process that generally defeats me for non-urgent matters.
Like my colleagues, I hear from dentists in my constituency that the funding they receive for their NHS patients is barely enough to break even. It is no wonder that private dentistry dominates in my constituency, from Wallingford to Grove, Wantage and Didcot. As my hon. Friend the Member for Winchester (Dr Chambers) articulated, mental health services—particularly child and adolescent services—are also under strain.
All of these services need better support, so I call on the Government to take action and recognise that, as Lord Darzi said in his report, improving access to primary healthcare will significantly relieve pressure on A&E and, indeed, the need for cancer treatment by enabling earlier diagnosis and therefore proactive intervention.
Freddie van Mierlo (Henley and Thame) (LD)
I very much welcome this debate. GPs are rightly pillars of our community—doctor remains one of the most trusted professions, perhaps unlike ours—but I want to mention some of the other key professions in the primary care sector, including practice nurses, who dedicate their lives to working on behalf of our residents.
Right now, practice nurses are working hard to deliver flu, covid, RSV and shingles jabs to many of our residents. They are the unsung heroes who keep primary care going, but their number is declining due to wage constriction. New nurses looking to boost their salaries often opt for hospital-based care because they can improve their pay packet with unsocial hours payments. Mental health nurses, healthcare assistants and social prescribers also provide essential services, and we must not forget receptionists, who bear much of the public’s frustration after 14 years of failed government. They have my thanks.
GPs are in crisis. The Tories let waiting times soar and failed to deliver a new framework contract for GPs in time, leading to industrial action. I am very concerned that in my area we have sleep-walked into a two-tier health system, with long waits for those who cannot afford private care and access for those who can. In Henley, we are seeing the first fully private GP practices and many people going for jobs with corporate insurance plans. There are now routinely four-week waits in places such as Thame, Benson, Watlington and Chalgrove, where we have seen significant housing growth. As my hon. Friend the Member for Didcot and Wantage (Olly Glover) mentioned, developer funds have been collected, but in Oxfordshire they are not being released in time to deliver the infrastructure that is needed.
I want to highlight the impact of those waits on some of the most vulnerable people. I recently spoke to my constituent Suzannah Windsburrow, a tenacious campaigner with learning difficulties, who highlighted to me just how important timely access to healthcare is for her. The collective impacts of a lack of access mean that people with learning disabilities die earlier than those without one—23 years earlier for men and 27 years earlier for women.
I very much welcome the Liberal Democrat commitments on health, and I encourage the Labour party to copy our manifesto—honestly, we won’t mind—including our commitments to ensuring that people can see a GP within seven days or, if it is urgent, 24 hours; to 8,000 more GPs; and to providing a named GP for people over 70. I also hope that Labour will copy our very important policy on delivering mental health professionals in schools.
Claire Young (Thornbury and Yate) (LD)
Given the time constraint, I will skip some examples, such as Thornbury health centre and Three Shires medical practice, which are already safely lodged in the Secretary of State’s inbox. Instead, I want to focus on the inter- dependence in the primary care system—an ecosystem in which strains in one part have knock-on effects in others—and to illustrate that with an example from my constituency.
This summer, I met a community pharmacist in Abbotswood, an area with significant health inequalities. He raised the same concerns about the flawed funding formula for pharmacies that we have heard today, but he has an additional challenge: the next-door GP surgery, with which his pharmacy has had a symbiotic relationship for many years, has been incorporated into a larger group. The other surgeries are in another urban area some miles away and difficult to access by public transport, and the local surgery now offers patients only limited hours. Understandably, many of them are switching to surgeries in central Yate, which has an impact not only on the viability of that local GP surgery but on the community pharmacy, which is missing out on the Pharmacy First referrals that it might have expected. Also, once people have travelled into town, generally they will use the pharmacies there. If that pharmacy is unable to continue, people will miss out on its many valuable preventive services: monitoring medications, providing services to those with diabetes and administering vaccinations. That will increase pressure on GPs and our hospitals.
The pharmacist also commented on the impact of the dental desert in my area, as in others around the country. People cannot access NHS dentistry, which leads to other health issues not being picked up. I want to stress that the Government cannot fix just one part of the system—they have to look at the system as a whole. That is what the Liberal Democrats recognised in our manifesto. I urge the Government to look at our plan for the NHS and work constructively with us to fix all aspects of primary care.
Mr Gideon Amos (Taunton and Wellington) (LD)
I mainly want to talk about dentistry, but first let me support the comments of my hon. Friend the Member for Glastonbury and Somerton (Sarah Dyke). GPs in my constituency are leaving at an alarming rate, which is a problem of great concern across Somerset.
We have heard about the Sahara desert; if Norfolk is the eastern Sahara, Somerset and Devon are the western Sahara of dental deserts. More than half the children in Somerset did not have access to an NHS dentist last year, which puts Somerset in the worst-hit 5% of local authority areas in the country. The picture for adults is pretty similar. I set up a survey back in 2022 to draw attention to the lack of dentistry in Taunton and Wellington. Official NHS figures show that in 2015, the majority—56%—had access to an NHS dentist, but that has gone down to only 32% this year.
As has been said, 99% of people who need an NHS dentist cannot get one. That is a totally unacceptable situation and a primary care time bomb because, as we have heard, the biggest cause of hospital admission for children under six is tooth decay. Also, oral cancers are on the rise year on year, and without early detection by dentists, that will only get worse. Just as the social contract under which people felt that they would get care is broken, so is the dental contract itself. I urge the Government to tell the House how soon they will repair the dental contract and when they will increase the units of dental activity payments so that the contract works. We need a timescale for addressing that.
My constituent Kathryn had been with her NHS dentist for 20 years. Like so many others, she lost them when that dentist withdrew NHS treatment. But unlike many other people, Kathryn is undergoing treatment for secondary breast cancer, the side effects of which mean that her doctor has instructed her to have regular dental treatment. She is now using her hard-earned savings to pay for that dental treatment because it is not possible to get it on the NHS in Somerset. It is disgraceful and totally unacceptable that cancer sufferers are using their hard-earned savings to repair the damage of the legacy of appalling NHS dental services left by the last Government.
Max Wilkinson (Cheltenham) (LD)
There was a reference earlier to history and the origins of the NHS; I contend that having that debate is akin to two bald men fighting over a comb, given how far back in history it goes. I am allowed to make that joke, as is the Minister for Care, the hon. Member for Aberafan Maesteg (Stephen Kinnock).
I stand today to place on record the shocking state in which the last Government left Cheltenham’s NHS, but I will start by saying thank you to the nearly 3,000 people in Cheltenham who have signed my petition to ensure that Cheltenham gets the GP surgery it needs as our town grows. GP waiting times in Cheltenham are variable, but they are often far too long. That is not because GPs are not working hard—one I spoke to recently told me that they were seeing dozens of patients a day. Of course, when it gets that intense, it is beyond the level at which most humans can cope with the processing of information. That is a safety issue. We owe a great debt of thanks to our GPs.
Other Members have mentioned the dentistry desert. I research regularly on the internet and there are no dental practices I can find that were taking new NHS patients in Cheltenham. That is regularly the case. [Interruption.] The hon. Member for Gloucester (Alex McIntyre) is shaking his head because many of my residents end up going to Gloucester on the odd occasion when they are lucky enough to find a place for one of their children. Most of the time, there are no spaces for adults. Regularly, people in Cheltenham are referred as far away as Worcestershire for new dentistry. That is shocking.
This all creates tension in A&E, as we have heard. In 2013, Cheltenham’s A&E department was downgraded to an overnight nurse-led service. In May 2015, when the Conservatives started governing alone, 684 people waited more than four hours to be seen at Cheltenham and Gloucester’s A&E departments. In May 2024, when the general election was called, that number had ballooned to 5,668 people waiting more than the target time. That is absolutely shocking. The increased pressure has been caused in many cases by people’s inability to get dentistry and GP appointments.
Local campaign group REACH—Restore Emergency At Cheltenham General Hospital—was formed to oppose that downgrade, and my two predecessors fought the downgrade. Their best efforts, I am afraid, have not yet borne fruit. I will join them, but it is now acknowledged by most people in Cheltenham that it is possible our A&E department will never be reinstated with 24/7 doctor-led care. The current set-up puts pressure on our hard-working GPs and A&E. It cannot be allowed to continue.
In the spirit of constructive opposition, we will work with the Government on solving these problems.
Mr Lee Dillon (Newbury) (LD)
Thank you for calling me in this important debate, Madam Deputy Speaker.
In west Berkshire last year, we experienced a 31% increase in four-week waits for GP appointments compared to 2022, indicating that more patients are struggling to access medical care. That is compounded by us having the lowest pharmacy provision in the country, with 7,200 patients per pharmacy compared to the national average of 4,600.
Last week, I met constituents to hear about their experiences of healthcare services. One shared their frustration at seeing a GP only to be told that their issue fell under the remit of a pharmacist. Then the pharmacist told them that it fell under the remit of the GP. That is, unfortunately, not a unique experience, with 24.2% of people reporting a poor experience with GPs. That is why services such as Healthwatch West Berkshire are so important.
The current governance model for partner GP surgeries also needs to be addressed to help maintain their very existence, in particular by de-risking leases in strategically important estates. I hope the Government will look at the general practice premises policy review of 2019 and implement its findings to ensure that leases are assigned to NHS bodies. That will help with the retention of more GPs, which will in turn improve health outcomes for patients.
The public were sick and tired of our failing NHS. That is why, in July this year, they prescribed the Conservatives with a much-needed period of opposition— hopefully a repeat prescription. I hope we can now start a treatment plan to get our NHS back to full health.
Ben Maguire (North Cornwall) (LD)
I congratulate all those who have made excellent maiden speeches today. I also congratulate the handful of Conservative Members who came out to try to defend their indefensible record on the NHS.
When it comes to NHS dentistry, constituencies such as mine are some of the worst affected by the dental deserts all around the country that we have heard about today—the shocking legacy of the Conservatives. As my hon. Friend the Member for Dorking and Horley (Chris Coghlan) and others have said, we must have NHS dental contract reform now—no more delays, no more excuses.
One in five dentists have left Cornwall since 2019, and the number of urgent dental cases is spiralling out of control. I am not exaggerating when I say that upset, distressed parents contact me every single day about their children’s rotting teeth. They cannot find NHS dentists, and they are completely at a loss. Only last week, a panicked and anxious parent called Georgina got in touch with me because her daughter Phoebe, just 10 years old, was in need of emergency dental care, and had already missed a lot of school as a result. She needed to have a rotting tooth removed, but her mother could not find an NHS dentist, so instead she was sent to the Treliske hospital. Just a few days later, Phoebe was urgently admitted to A&E with extreme facial swelling. She was taken into surgery, where the rotten tooth was removed after much pain and distress. Her face had swollen to the size of a tennis ball, and she has now been off school for weeks.
The stress and anxiety that this experience caused Phoebe—who, by the way, has complex special educational needs—her mother and the rest of the family was completely unnecessary. If Phoebe had just been given a place with an NHS dentist, the strain on the family and, importantly, the hospital that treated her would have been avoided entirely. During the election campaign, a teacher from Wadebridge admitted to me that she had resorted to using pliers to extract a rotten tooth, as the alternative was to receive treatment as far away as Nottingham. More than 100 children were admitted to hospital with tooth decay in Cornwall last year alone. The House needs to come together and ensure that the problem of dental deserts that we have heard about all day today is solved once and for all. What kind of society are we if we allow our children —indeed, people of all ages—to suffer like this?
Clive Jones (Wokingham) (LD)
As we heard from my hon. Friend the Member for North Shropshire (Helen Morgan), general practice is the front door of the NHS, yet communities in my constituency, such as in Arborfield Green, go without any local primary care provision. This is an area that is growing by thousands, and my constituents expect to have access to GPs who provide timely and appropriate care. The unfortunate truth is, however, that there simply are not enough GPs.
We know where the fault lies. The Conservative party’s underfunding and poor workforce planning have led to a service in crisis, jeopardising the standard of care that patients receive. GP numbers have fallen, and £350 million has been cut from general practices in real terms since 2019. Each GP in my local ICB are is now responsible for, on average, 534 more patients than in 2016, and nearly 80% of GPs say that their workload is impacting patient safety. It is clear that this is not a sustainable system, but, sadly, we never hear an apology from those on the Conservative Benches—of whom there are five at the moment.
I would be grateful for the Minister’s view on the call from the Royal College of General Practitioners for an explicit reference to primary care infrastructure in the national planning policy framework. This, it argues, would strengthen the ability of local planning authorities to hold developers to account on social infrastructure, such as GP surgeries. I hope that the Minister will ask his colleagues at the Ministry for Housing, Communities and Local Government to consider the Royal College’s response, in order to ensure that places such as Arborfield do not lose out any longer, and to ensure that as Wokingham continues to build to Government guidelines, we have more GPs to cope with all the extra patients that the new building will bring.
Monica Harding (Esher and Walton) (LD)
I am proud to speak today about our NHS, which looks after my constituents in Esher and Walton—young, old and in the middle—every day. But after years of neglect and failure by the previous Government, my constituents too often struggle to access primary healthcare, which we believe should be a right. The NHS was denied necessary reforms and resources, and it has not been prepared for an ageing population with increasing rates of chronic and complex conditions. The extra strain is demonstrated in the ratio of patients per GP and in the daily lives of my constituents, who suffer long waits or are unable to get appointments. I recently received a letter describing how a GP appointment for a constituent’s elderly mother was cancelled at short notice and had not been rescheduled after a month, despite several emails. Problems like this are far from being one-offs.
In my constituency, residents often struggle to get same-day GP appointments, and too many wait more than a week. Our personal citizen contract with the NHS is implicit in being British, but that contract is fraying. Being able to access a GP in a timely manner is an essential expectation that my constituents still have, which is why enshrining the Liberal Democrat guarantee of access to an appointment within seven days as a right in the NHS’s constitution is so important. It reflects the duty of the Government to ensure that one’s local GP is always accessible.
The excessive wait times are intimately connected with the Conservative failure to recruit and retain GPs. In the previous Government’s 2019 manifesto, they committed to recruit more than 6,000 GPs; instead, there are fewer GPs than there were five years ago. Since then, however, the population has continued to rise and age, and conditions have become more complex. The broken Conservative promise—yet another failure—means that in the last eight years, the number of patients per fully qualified GP in the Surrey heartlands has risen to 2,163, even though the UK has one of the lowest ratios of doctors to people, recently ranking 22nd out of 33 OECD countries. Even when people can get an appointment, it is often not with a GP, often unknowingly.
As my hon. Friend the Member for Westmorland and Lonsdale (Tim Farron) pointed out, the policies pursued by the previous Government, including the restrictions on the recruitment of GPs under the additional roles recruitment scheme, have resulted in incidents of GPs in Esher and Walton being offered voluntary redundancy, even as residents struggle to get an appointment. Our most vulnerable patients have a particular need for security and stability, and this belief under- pins the Lib Dem conviction that everyone over the age of 70 or with a long-term physical or mental health condition—
Madam Deputy Speaker (Judith Cummins)
Order. I call the Liberal Democrat spokesperson.
Jess Brown-Fuller (Chichester) (LD)
Today marks the first Liberal Democrat Opposition day in this House for 15 years, and we have dedicated it to the topics that are fundamental to constituents up and down the country: carers, the provision of care, and the NHS. As the Liberal Democrat spokesperson on hospitals and primary care, it is my honour to close today’s debate and to pay tribute to the many excellent contributions from my hon. Friends and hon. Members across the House.
I commend my hon. Friends the Members for North Devon (Ian Roome), for Newton Abbot (Martin Wrigley), and for Harrogate and Knaresborough (Tom Gordon) for their passionate tributes to their constituencies in their maiden speeches. I also pay tribute to the hon. Members for Worthing West (Dr Cooper), for Bury St Edmunds and Stowmarket (Peter Prinsley), and for Hinckley and Bosworth (Dr Evans), who bring such valuable knowledge to the Chamber during debates on healthcare.
Our NHS was once the envy of the world. The care, compassion and accessibility that it offered were unparalleled. Sadly, after years of Conservative mismanagement, our NHS and care sector are in crisis. Every day, thousands of patients face agonisingly long waits, often in terrible pain, while trying to see a GP or get an appointment with a dentist. Lord Darzi’s report highlights the fact that primary care services are heavily underfunded, which is leading to unnecessary hospital admissions. There are clear economic benefits to investing more in primary care. With the first Budget of the new Government due to come to the House soon, I remind the Chancellor that every £1 spent in primary care is estimated to save £10 in urgent and secondary care.
In my constituency of Chichester, people are deeply worried about accessing GPs, a concern echoed throughout the general election campaign and reflected in my surgery appointments with residents. The public’s trust in the NHS has been eroded due to the consequences of poor Conservative management. As my hon. Friend the Member for Esher and Walton (Monica Harding) pointed out, the Conservative Government promised 6,000 more GPs in 2019, but instead GP numbers have fallen by almost 500 and GP practice funding has been cut by £350 million in real terms since 2019.
Healthcare is not a luxury; it is a necessity. As Liberal Democrats, we believe everyone should have a legal right to see a GP within seven days, or within 24 hours if it is urgent, so we would pledge to recruit 8,000 more GPs to deliver on this promise. We also want those over 70 and those with long-term conditions to have access to a named GP, ensuring continuity of care, which helps to prevent unnecessary hospital admissions. As the Chair of the Health and Social Care Committee, my hon. Friend the Member for Oxford West and Abingdon (Layla Moran), mentioned, continuity of care is vital for patient trust and staff morale.
This is not the first time I have mentioned this in the Chamber to the Secretary of State, but the collapse of a not-for-profit GP federation serving Chichester and the south coast last month was a stark reminder of the system’s fragility. Patients’ appointments were cancelled, services were threatened and 130 staff were left unpaid. The collapse was due to the erosion of contract values with primary care networks and NHS Sussex. When GPs are sitting in my surgery telling me they want to work but they cannot, with no reassurance that they will be paid for the work that they have done, something has gone terribly wrong.
Dental care is another critical area within primary care. We have heard today about dental deserts across the country. During this afternoon’s debate, I began trying to list every Member who mentioned their dental desert and I gave up. It was shocking to hear the statistics and the harrowing case studies from across the House. The Liberal Democrats are calling for a dental rescue package that includes investment in more dental appointments, reforming the broken NHS dental contract and using flexible commissioning to meet patient needs. Workforce planning for health and social care must also be written into law, ensuring that we have enough dentists to meet demand.
Lastly, we must reverse the Conservatives’ cuts to public health grants, in order to support preventive dental care, including oral health programmes and promoting healthy eating choices, which will reduce the pressure on our NHS dental services. The Government have an opportunity to turn around a decade of Conservative chaos and mismanagement of our precious NHS and to give primary care the attention and focus it deserves, and we will work constructively with them to ensure that patients in Chichester and across the country get the care that they deserve.
The Minister for Care (Stephen Kinnock)
This really has been a vibrant and powerful debate. I thank the Liberal Democrats for using their Opposition day constructively to shine a searing spotlight on the challenges that our constituents face. Hon. Members made a series of outstanding contributions, but I thank in particular my hon. Friends the Members for Aylesbury (Laura Kyrke-Smith), for Bury North (Mr Frith), for Calder Valley (Josh Fenton-Glynn), for Ealing Southall (Deirdre Costigan), for Welwyn Hatfield (Andrew Lewin), for Croydon East (Natasha Irons), for Lichfield (Dave Robertson), for Norwich North (Alice Macdonald), for Worthing West (Dr Cooper), for Uxbridge and South Ruislip (Danny Beales), for Thurrock (Jen Craft), for Gloucester (Alex McIntyre), for Bury St Edmunds and Stowmarket (Peter Prinsley), for Blackpool South (Chris Webb) and for Hexham (Joe Morris) for demonstrating why our party always has been, and always will be, the champion of the NHS.
I also congratulate the hon. Members for North Devon (Ian Roome), for Newton Abbot (Martin Wrigley) and for Harrogate and Knaresborough (Tom Gordon) on their excellent maiden speeches. It is quite shocking to note, however, that in spite of the vital importance of this debate to our constituents, there was not a single contribution from the Conservative Back Benches. [Hon. Members: “Shame!”] Not only do the Conservatives refuse to apologise for the last 14 years, but they have run for the hills. Their silence truly speaks volumes.
Labour Members deal with facts and the unvarnished truth. On the subject of today’s debate, the list of facts illustrating the appalling neglect and incompetence of the last 14 years is truly as long as my arm. If I were to pick out just one statistic to summarise the last 14 years, I might choose that the most common reason for children aged five to nine being admitted to hospital is tooth decay. It is a truly Dickensian state of affairs. I could also point to the UK’s decreasing GP numbers, as there are 1,500 fewer compared with seven years ago, against the backdrop of a rising population. Or I could pick the collapse in patient satisfaction from 80% in 2009 to a shocking 35% last year. Or I could single out the fact that more than 1,000 pharmacies have shut their doors since 2017, and that almost six pharmacies a week have left the market in the last year.
The charge sheet is so long that a month of debates in this Chamber could not cover the profound damage that has been done by 14 years of short-termism and sticking-plaster politics, and by the botched top-down reorganisation in 2012. The reality is that the Tories doused the house in petrol and covid lit the match.
John Slinger (Rugby) (Lab)
The reaction to a proposed ward closure in my local St Cross hospital in Rugby shows how concerned the public are about the health system after 14 years of underinvestment by the last Government. In this case, however, the closure is because patients are being cared for closer to home. Does my hon. Friend agree that bringing more services into the community, and into smaller hospitals such as the one in my constituency, is integral to managing present and future demand, and to putting our NHS on a sustainable footing?
Stephen Kinnock
My hon. Friend is absolutely right. This strategic shift from hospitals into the community will be vital and central to our 10-year plan for the future of our health and care system.
Primary care is the NHS’s front door, but the Tories spent 14 years bricking it over. Now it is walled off to millions of people across our country, so it falls to this Labour Government to tear down that wall. We know that there is not a second to waste, not least on mental health. It is unacceptable that so many children, young people and adults are not receiving the mental health care they need. We know that waits for mental health services are far too long, and we are determined to change that. We will recruit 8,500 additional mental health workers across child and adult mental health services, we will introduce a specialist mental health professional in every school, and we will roll out Young Futures hubs in every community.
We will reopen the front door to the NHS by rebuilding general practice on the firm foundations it needs to get the service back on its feet and fit for the future.
Munira Wilson (Twickenham) (LD)
As well as needing more GPs, our GPs need decent premises from which to deliver high-quality care to patients. Park Road surgery in my constituency has been looking for new premises for more than a decade—it serves 13,000 patients out of an old Victorian house—but there simply is not the budget, and the processes are too complex. Will the Minister commit to both looking at the bureaucracy and pressing the Chancellor for more capital investment in primary care?
Stephen Kinnock
As the Darzi review shows, one of the most egregious examples of the neglect and incompetence of the past 14 years is the underspend on capital. We are clear that a number of premises across the country can be repurposed, and that the bureaucracy needs to be cleared out of its way. As the Prime Minister said earlier this week, we will have a mission about smart regulation and clearing the bureaucratic barriers to change.
We are also cutting red tape so that GPs spend less time pushing paper and more time face-to-face with the patients they serve. We are working to bring back the family doctors and to end the 8 am scramble. We have done more for primary care in the last 14 weeks than that lot did in the last 14 years.
On dentistry, we will introduce supervised tooth brushing for three to five-year-olds in deprived areas, ending the national scandal of tooth decay. And we are rebuilding the bridges that the Conservatives burned with the British Dental Association. I have already met the BDA, and we will deliver a rescue plan that gets NHS dentistry back on its feet, with 700,000 additional urgent appointments, starting as soon as possible, in those parts of our country that need them most.
Amanda Martin (Portsmouth North) (Lab)
Given the shocking state the last Government left us in, is it not good that the grown-ups are now in the building and that we have seen the urgency needed in the NHS, commissioning the Darzi report and investing £82 million, alongside making our commitment to tackle dentistry, use pharmacies and reduce the unnecessary burden?
Stephen Kinnock
I thank my hon. Friend for her intervention. I pay tribute to my right hon. Friend the Secretary of State for getting the strikes sorted within a week of us taking power—what a change that has made. We will reform the dentistry contract to make NHS work more attractive, boost retention and deliver a shift to prevention.
On pharmacies, as my hon. Friend the Member for Bristol South (Karin Smyth) made clear, we will shift the focus of our NHS out of hospital and into the community, empowering more pharmacists to prescribe independently, and freeing up GP appointments for those who need them most. That shift from hospital to community is vital for demand management in the primary and acute sectors.
On the whole, this has been an excellent debate, but I find it absolutely extraordinary that not a single word of humility or contrition was uttered by the official Opposition. Where was the apology for the fact that they spent 14 years bringing our NHS to its knees? Where was the mea culpa for the way in which they spent 14 years scapegoating the workforce, dodging the tough questions and passing the buck? Where was the acknowledgment of the fact that they called the election and ran away from their £22 billion black hole and from the multiple crises in our public services?
While the Conservative party continues to live in a parallel universe, we on the Government Benches are living in the real world. We are honest about the scale of the challenge, and we are up for the fight. While the mountain before us is daunting, we are not daunted. Instead, we are focused on the future, reform and rebuilding, and on shifting from hospital to community, from sickness to prevention, and from analogue to digital. Let us roll up our sleeves and get to work.
Question put (Standing Order No. 31(2)), That the original words stand part of the Question.
CCTV cameras along river banks in city centres
(2 days, 6 hours ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate
Rachael Maskell (York Central) (Lab/Co-op)
I rise to present a petition concerning CCTV cameras along river banks in city centres.
On 20 September 2023, Leah Bedford tragically died after entering the River Ouse, and is deeply missed by her family and friends. She was just 16 years old. I am grateful to her auntie, Jayne Reynolds, for her fortitude in campaigning, out of this tragedy, for significantly better river safety, and specifically for better surveillance along river banks, together with better lighting. I wholly support her, and the 1,428 residents of York who signed paper and electronic petitions to call for change.
The petition states:
“The petitioners therefore request that the House of Commons urges the Government to take immediate action to ensure that all riverbanks in city centres are well lit and have CCTV cameras so that riverbanks are monitored to prevent fatalities and the film is made available to the relevant authorities if people go missing or bodies are found in the river.
And the petitioners remain, etc.”
In honour of Leah Bedford, I bring this petition to the House.
Following is the full text of the petition:
[The petition of Jayne Reynolds,
Declares that all rivers in city centres should have CCTV cameras along their full length within city centres; further declares that local authorities should fund these; and notes that riverbanks should be well lit and filmed by day and night so that interventions can be made if people are near the river to prevent fatalities and so that families can learn what has happened to their loved ones when people go missing or bodies are found in the river.
The petitioners therefore request that the House of Commons urges the Government to take immediate action to ensure that all riverbanks in city centres are well lit and have CCTV cameras so that riverbanks are monitored to prevent fatalities and the film is made available to the relevant authorities if people go missing or bodies are found in the river.
And the petitioners remain, etc.]
[P003011]
Flooding: Bedfordshire
(2 days, 6 hours ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Blake Stephenson (Mid Bedfordshire) (Con)
I rise in Flood Action Week to raise an issue that is front-of-mind for so many of my constituents. The flooding in September devastated homes, farms and businesses right across my constituency and those of hon. Friends across Bedfordshire. Indeed, my home in Shillington was flooded. Two months-worth of rainfall in 24 hours caused considerable damage to property and risks for people, especially the elderly or vulnerable, so I thank all the first responders and council workers who worked tirelessly to support my constituents.
Rachel Hopkins (Luton South and South Bedfordshire) (Lab)
I congratulate the hon. Member on securing this Adjournment debate during Flood Action Week. Constituents of mine were also impacted by the flooding across the county. Last week, I met representatives from the Fire Brigades Union, who said that over 400 calls had been taken in seven hours on flood-related issues alone. I pay tribute to them. Does he agree that there should be recognition of firefighters who carry out flooding rescue, which they do alongside all their other duties even though it is not a statutory service?
Blake Stephenson
So many people across so many organisations, including fire and rescue, worked tirelessly to protect our communities. I associate myself with the hon. Lady’s comments about the support provided by our local police and fire and rescue services.
Mid Bedfordshire is not an area at obvious risk of extreme flooding—unlike other parts of the county, we lack major rivers beyond the River Flit—but our soil types range from the thin sandy soils of the Greensand ridge to poorly draining clay soil, each of which presents its own flooding challenges. Our winters are getting wetter, and I know that many families will, like mine, look at the damage done by those floods and worry that such flooding will become the norm.
Richard Fuller (North Bedfordshire) (Con)
I congratulate my hon. Friend on securing this debate, which is important for residents of Bedfordshire. He talks about not having rivers in his constituency, but in North Bedfordshire we are blessed with two. Although this flooding was an extreme event, flooding issues have been persistent in places such as Harrold, Clapham and Great Barford, and, most recently and quite devastatingly, in Tempsford and Wyboston in my constituency. Does he welcome the initiative taken up by the Mayor of Bedford, Tom Wootton, to get a comprehensive approach from all the different agencies that can help residents with their flood response, and does he agree that that is a model for assessing flood risk in Bedfordshire?
Blake Stephenson
I absolutely agree. I would love to join any of those meetings with Mayor Tom to support those efforts in my wards of Wixams and Wootton.
Jim Shannon (Strangford) (DUP)
I commend the hon. Gentleman, to whom I spoke beforehand, for securing the debate. A conversation that people sometimes have is about the co-ordination between different departments, as the hon. Member for North Bedfordshire (Richard Fuller) alluded to. If the flooding of roads and housing development areas is known about in advance, could better co-ordination improve things for our constituents? For many people, it might simply be about having a sandbag available. People need to know those things; maybe that would help.
Blake Stephenson
Certainly, one of the lessons that I have learned from the flooding in Mid Bedfordshire is that many statutory bodies are involved in flooding response and resilience. We need to work harder to ensure that those organisations work together. It is so important that the Government, local authorities and others learn the right lessons from those floods, and I hope that this debate can play a role in guiding that conversation.
First, let me reflect on the direct impact on constituents in Mid Bedfordshire. Hundreds of residents have taken the time to describe for me the huge losses that they have suffered, and I thank them for taking the time to do so while trying to recover from flood damage. Emma from Marston Moretaine, who filled in my recent flooding survey, told me:
“Our property was completely soaked front and back. We saw water rise, and beside the path at our house there was gushing water! We had to call for help. Water came in through the sides and foundations, and in the end there was nothing we could do.”
Caroline from Flitwick also took the time to share her experience:
“Severe flooding of my property requiring full water removal from my home and severe repairs. I am currently staying with family but having to relocate for a minimum of 6 months whilst repairs are done.”
Rita from Harlington explained that
“We had internal flooding start at 9.30 am with sewerage coming up from a manhole cover inside our garage. We contacted Anglian water by 10 am. We couldn’t shower or flush the toilet as it was gurgling back up! Then the rains came—the front drive was a deluge. We had neighbours helping with buckets and pumps trying to get the water off our property. It was a fighting battle—the water reached the front door and came into the property.”
Being flooded is not just an inconvenience: it is expensive, and it is heartbreaking for families to see their valuables—some of them irreplaceable—washed away. Shortly after the flooding, I took the time to visit dozens of local businesses, including Disco-licious in Gravenhurst, Maulden Garden Centre and The Dog House day care centre, which is also in Maulden. Those businesses, together with many others, have experienced severe financial losses, and in some cases have seen many years of hard work and investment washed away before their eyes.
Our farmers have been some of the worst hit, with severe and significant flooding reported at several local farms, including at Moreteyne’s Retreat, a smallholding that has been impacted hugely by floodwaters flowing from the A421. In the aftermath of that flooding, I have learned that 74% of the UK’s floodplain is agricultural land. Flooding can destroy whole crop yields, wasting months of work and threatening the livelihoods of our farmers, in many cases at the same time as they see their homes devastated by floodwaters.
Sir John Hayes (South Holland and The Deepings) (Con)
My hon. Friend has mentioned landowners and farmers. He will be well aware of the internal drainage boards, which do such vital work to protect land and require the resources to do so. The previous Government committed £75 million to drainage boards, but we have yet to see that money delivered by the current Administration. We also need a long-term solution to the funding of IDBs, so that local authorities are not put under undue pressure by having to fund those drainage boards themselves.
Blake Stephenson
I thank my right hon. Friend for making that point. He has stolen my thunder, because I was going to make that exact point later in my speech, so I will skip over it when I get to that section.
Blake Stephenson
Perhaps I will say it again. England has suffered its second worst harvest on record, with persistent wet weather, and waterlogged fields risk putting our farmers out of business over the medium to long term.
Robbie Moore (Keighley and Ilkley) (Con)
My hon. Friend is making an excellent speech. Building on that point, many of our farmers—not only across Bedfordshire, but across the whole of the country—are facing their second serious crop losses in a growing period. Does my hon. Friend agree that it is incredibly frustrating that, despite the last Conservative Government having allocated £50 million through the farming recovery fund, many farmers who urgently need that money—money that was guaranteed to get out of the door—are not yet receiving it from the new Administration?
Blake Stephenson
My hon. Friend is exactly right: it is very frustrating. I know that constituents who farm in my constituency are incredibly frustrated that funding will not be made available.
The persistent wet weather is a disaster not only for farmers, but for all of us, because it impacts yield and quality, resulting in higher food prices and threats to national food security. The Government need to take action, recognising that farmers in Bedfordshire are businesspeople, but also that they provide a public benefit by taking flooding that would otherwise flow into our towns and villages. I hope the Minister will work with colleagues to design a scheme to properly recognise the contribution our farmers make by allowing their fields to flood, and to remunerate them for that contribution.
Our local councils—as a councillor myself, I refer Members to my entry in the Register of Members’ Financial Interests—have done fantastic work to support residents. They have been forced to pick up the pieces and the bill to manage the response, and now to put things right. They have not got everything right—far from it—but they have stepped up during this emergency and provided significant resources to keep people safe, particularly the most vulnerable. Our households, businesses, farmers and councils now need the Government to step up and do their bit by releasing funds to support our communities to recover and improve resilience. The Minister has discretion in this area, and I was surprised to receive a response to a written question this afternoon suggesting that the flooding was not at a sufficient scale to be considered exceptional enough to release recovery funding—perhaps the Minister will address that point in her closing remarks. I am concerned that the Government fail to appreciate the significant but localised impact of this particular flooding event. My constituents want, and deserve, support.
Perhaps the most high-profile victim of our recent flooding was the A421, which was closed for weeks after more than 60 million litres of water collected in a dip in the road at Marston Moretaine. National Highways has worked hard around the clock to reopen the road, but as we look at lessons learned, significant questions must be asked about how we got here—how a major A-road, connecting Bedford to the M1, built this century, can have been built down into the ground in a historic floodplain, which of course is prone to flooding. It was designed in such a way that it regularly floods a little, but was built with flooding mitigations insufficient to deal with the kind of flooding that could become all too common in the years ahead. As this Government look to build similar infrastructure in the years ahead, we must heed the warnings of the A421 and build in a way that is protected from not the flooding of yesterday, but the flooding of tomorrow.
Roads are not the only area where problems with ineffective infrastructure have exacerbated the impact of flooding on my residents in Mid Bedfordshire. The blocked drains reported right across Mid Beds in places like Lower Shelton, Flitwick, Cranfield, Harlington and Maulden significantly increase the likelihood of surface water flooding. Clearing the drains regularly, if not the sole solution, represents common sense to my constituents and is a quick answer to mitigate at least some of the risk. They want to see the schedule of maintenance improved materially. Leaves fall every autumn and block drains, not every three years, and utility companies dig up roads and fill drains with mud and tarmac, only to leave them to be cleared by the council in its three-yearly cycle. This simply is not good enough, and it is putting property and lives at risk.
I therefore call on the Government to urgently consider introducing a new statutory duty on local authorities to clear drains and culverts regularly, backed by central funding at the Budget to ensure that councils have the resources they need. I also urge the Government—this is the point that my right hon. Friend the Member for South Holland and The Deepings (Sir John Hayes) raised—to look at the way that internal drainage boards are funded, to ensure that they have the resources they need to manage local flood risks. I ask the Minister to commit to meeting me and interested colleagues to discuss how that might be achieved.
Mr Peter Bedford (Mid Leicestershire) (Con)
In Leicestershire, we have a lot of landowners who should be doing more to help alleviate flooding. Unfortunately, local authorities have very limited powers to compel them to act. Does my hon. Friend agree that more needs to be done to bolster the power of local flood authorities, which are invariably upper-tier councils?
Blake Stephenson
I thank my hon. Friend for that intervention. I agree that that is something the Government should be looking at.
During the recent flooding, I was appalled to learn that drains and sewers in the new town of Wixams were overloaded with surface floodwater. Seventeen years after construction began in Wixams, the drainage infra- structure should be adequate to accommodate many more houses than have so far been built. I urge the Minister to join me in pressing Anglian Water to take urgent action to expand its sewerage and drainage infra- structure.
Wixams is merely the most obvious example of a problem that residents are seeing repeatedly with development. House by house, development by development, infrastructure is failing to keep pace. While an individual development might not be enough to overwhelm the system or cause knock-on flooding impacts, the accumulated weight of development is creating huge problems across the country—including in Maulden in my constituency, where development has crept gradually up the slope of the Greensand ridge, resulting in water having fewer places to stop and soak, so that it instead surges down into the village. While the flooding infrastructure for these new developments might in theory be sufficient for planners to justify development, planning is failing to cope with the demands placed on it by multiple and interconnected developments, which is piling pressure on to networks and our natural environment.
With the Government set to review the planning system and ask for our towns and villages to take thousands of additional homes, I implore the Minister to work with colleagues to deliver reforms that require flooding authorities to take a wider systems view of the impact of developments. We need to ensure that housing targets do not put the delivery of new homes over the habitability of housing stock, or the safety and sustainability of our communities.
Alistair Strathern (Hitchin) (Lab)
I thank the hon. Gentleman for giving way, and for securing such an important debate not only for his constituents, but for all Bedfordshire Members present. The point he is making is really important, and is felt keenly by my residents in Langford, on Southland Rise, where the failure of flood prevention measures put in place as part of a new development meant that several of them have had catastrophic flooding in a very short space of time over the past few weeks. Does he share my view that not only is consideration of flooding risk through local and national planning frameworks clearly in need of review, but we need to ensure that measures are in place for robust enforcement, to ensure that the flooding mitigation measures that are included in new developments actually work as it is claimed they should?
Blake Stephenson
I thank the hon. Member for his intervention. That story is felt and heard all across Mid Bedfordshire, and I agree with the points he made.
As a starting point, I would like the Government to consider urgently introducing secondary legislation to bring into effect schedule 3 to the Flood and Water Management Act 2010. The Minister smiles, so she perhaps has a point to make on that when she winds up. I understand from a recent answer to my written question that the Minister wants to be mindful of the impact of over-regulation on developers, but building homes in a way that increases the flooding risk in our towns and villages does nothing to alleviate the housing crisis.
We must also consider the benefits of nature and nature-based solutions. Natural upstream solutions would help capture water and absorb some of the worst impacts of flooding. The Bedford and Milton Keynes waterway park is a great local example of a project that has the potential to remove water during flooding—and, indeed, to deliver water when it is most needed during droughts—and we must press ahead and deliver it at pace.
In addition, we need the Government to look again at their plans to designate inferior-quality areas of the countryside for development, and instead commit to a bold strategy of restoring nature, and in so doing, creating natural flood defences for our towns and villages. In our towns and villages themselves, I would like the Government to commit to a natural regeneration programme, using trees and nature to create sponge cities by enhancing drainage to prevent surface water flooding.
I will conclude with a final lesson that I hope the Minister will reflect on. My constituents were disappointed that, while she took the time to visit those in nearby Leighton Buzzard and to observe the impacts of flooding there, our towns and villages in Mid Bedfordshire received no attention from the Government at all. With a major road closed and a substantial number of houses and businesses impacted, had the flooding in Mid Bedfordshire been concentrated in a single major urban area, I have no doubt that we would have attracted some specific focus.
I have raised questions with the Minister and the Department that remain unanswered. I urge the Government to remember that rural areas are impacted by flooding too, and that they should be properly served by this Government, not an afterthought.
The Parliamentary Under-Secretary of State for Environment, Food and Rural Affairs (Emma Hardy)
Thank you, Madam Deputy Speaker, and it is a pleasure to see you in the Chair. I thank the hon. Member for Mid Bedfordshire (Blake Stephenson) for securing the debate on this important matter, and everyone who has contributed to the discussion.
I start by sincerely expressing my sympathy with all the individuals whose homes and businesses have been impacted by flooding. I may have previously shared with the House the impact on me when, in 2007, the city that I represent was flooded. It is a story for another day, but I was teaching at the time, and when the floodwater came in we had to evacuate. Flooding has a devastating impact on people for a long time afterwards, including on their mental health, so I am very sympathetic to the hon. Gentleman as a victim of flooding himself. I realise it is not easy at all.
As the hon. Gentleman mentioned, more than 1,000 properties were flooded following recent heavy rain across central and southern England. The effects were felt particularly in communities in Bedfordshire, Northamptonshire, Oxfordshire, Shropshire, Buckinghamshire and north-west London, but more than 22,000 properties were protected by existing flood defences. As he said, I visited the Leighton Buzzard area in Bedfordshire on 26 September to meet volunteers and local residents and see at first hand the impact of the flooding there.
I know many people are now facing months of disruption and upset. I was particularly struck by one of the ladies I met, who was in tears when I went into her home. She showed me what had been her beautiful home, in which she had lived for over 20 years and on which she had spent a lot of time, and how it had just been ruined by the floodwater coming in, which she found absolutely devastating. The hon. Gentleman is right to point out how this impacts on vulnerable people. I heard stories of an elderly lady having to be rescued and taken away from her home. I absolutely pay tribute to Humberside fire and rescue service. Sorry, not just Humberside— I am so used to saying that—but all the fire and rescue services for their work in rescuing people.
I also thank the hon. Gentleman for joining the call that we had with the Environment Agency, which is something new that I have tried since becoming a Minister. It would simply be impossible for me to visit everywhere, so I want to find other ways to be as open and accessible as possible, which is why we tried this call. We had about 50 Members of Parliament on the call, and it was a way for hon. Members to get information directly from the Environment Agency, so I am grateful that he joined it.
Sir John Hayes
The Minister and I worked together when she was on this side of the House, so I know she is true to her word. My hon. Friend the Member for Mid Bedfordshire (Blake Stephenson)—very nobly, I thought—suggested that we ought to have a meeting about IDBs. This is a critically important issue for many parts of the country, and I am sure that a small delegation of colleagues could, in the spirit that the Minister has just described, have a very productive discussion. Would she agree to that?
Emma Hardy
The right hon. Gentleman is so difficult to say no to. How infuriating—I have experienced this before. Yes, we will. That will be fine. I will be attending the internal drainage board conference, so after I have met people there, I am happy to meet a delegation to talk about IDBs. I can already hear my private office saying, “You’ve agreed to another meeting, Minister”, and telling me off.
Tessa Munt (Wells and Mendip Hills) (LD)
I was part of the call to which the Minister referred on 30 September. I am an MP in Somerset, and we requested a meeting. We have the benefit of the Somerset Rivers Authority, which I believe is unique in the country. We need to wrestle with how we enable the Environment Agency, the internal drainage board, the council, the rivers authority, and every other agency to address the problem of flooding for people in Somerset as well. Will she please ensure that her officials make that meeting happen?
Emma Hardy
Absolutely. As the hon. Lady will be aware, the flooding happened during recess and we have been back just one week. It is all noted down, and if I make a promise I stick to it, so we will have that.
There was also innovation in the incident response from the Environment Agency—I found this quite interesting, but that is perhaps my inner geek coming out. It launched drone flights over the flooded area to assess and monitor where had been flooded, and looked for where there were blockages and fallen trees in some of the waterways. It was then able to send people out to remove them. I thought that was a clever way of covering as much area as possible, especially in large rural areas, to see where it needed to solve a problem.
I reiterate the Government’s thanks to the Environment Agency local responders and many others who worked tirelessly to help communities across the country deal with the local floods. I also pay tribute to our farmers, as this is the worst two years in a row of harvest that they have faced, and I realise the impact that that has had on the mental health of many of them. I accept the frustration around the farming flood recovery fund, and I am afraid I will have to give an equally frustrating answer, which is that until the Budget is announced, there is not much more I can say on that matter, although I realise that that will not offer people the reassurance they want at the moment.
Where I can offer reassurance is that I know the National Farmers Union was keen to consider how the formula is calculated when it comes to assessing where flood defences are built. At the moment is based on the number of properties protected. I want to look at that formula—I know that has been called for over a long time—to see whether it is still the formula that we need, and I have committed to doing that with the NFU.
I pay tribute to a few of the volunteer groups I met in Bedfordshire, including the Bedfordshire local emergency volunteers executive committee, and particularly a lady called June Tobin, and Graham Mountford, who were fantastic. It was brilliant to see how well the volunteer organisations are embedded in the emergency response by the Bedfordshire local resilience forum. I was also impressed by the work of AMYA and what it is doing to get young people involved in volunteering. Many young people were volunteering at Meadow Way community centre, especially two impressive young teenage girls who told me that they wanted to come and help in the community. They were there making tea and coffee for everybody, and I thought that they deserved a special mention in my speech. I am sure the hon. Member for Mid Bedfordshire also found many wonderful examples of people helping.
As has been mentioned, it is Flood Action Week—what a week to be talking about flooding. If you will indulge me for a moment, Madam Deputy Speaker, I wish to reiterate a few safety messages around Flood Action Week. We are urging the public to know and understand their flood risk, and to please sign up for flood alerts. If there is one thing each Member of Parliament can do it is encourage our constituents to sign up for flood alerts. If people have the time, that means they can get prepared. We would also like people to look at preparing a flood kit, and have medication and essentials if they are going to be away from home or asked to evacuate at short notice, as well as thinking about what will happen with pets. The Environment Agency has extensive guidance on what we can do to try to improve our flood resilience.
There was an event today, which I hope many Members were able to attend—the Environment Agency and Flood Re’s parliamentary drop-in. If people were unable to attend, I am sure they can email out the information for Members to communicate to constituents.
I reassure the hon. Member that flooding is one of DEFRA’s five key priorities. The honest truth is that we have inherited flood defences at their worst since 2010. The condition rating of key flood defences in England is at 92%. That is the lowest it has been in 14 years, which is clearly concerning as we go into another wet winter, as has been mentioned. Because of that, we have been moved £36 million extra to the urgent repair of some of those flood defences, and we also have mobile assets— have 275 mobile pumps and 25 km of mobile flood defences. By using knowledge around long-term forecasts, we want to get those mobile resources into the areas required, but the situation is definitely far from ideal. The previous Government’s flood investment programme was unfortunately behind schedule and over budget. I am urgently reviewing it to ensure we have a flood programme that is fit for purpose, and as has been mentioned, I have been looking at how the formula works.
The hon. Member mentioned one of my favourite words, which is SUDS, or sustainable urban drainage systems—only people with this level of geekery get excited about that—as well as schedule 3 of the Flood and Water Management Act 2010. I am pleased he pointed out that it dates from 2010 has still not been enacted. It is important that we look at sustainable urban drainage. As he mentioned, the Ministry of Housing, Communities and Local Government is doing a review of how the whole planning system works, and it will come as no surprise to him that I am pushing from the DEFRA end of things on how we can ensure that the homes we build are flood-proof now and in the future and, importantly, do not contribute or add to flood risk within an area. Those are two important issues.
The priority for the hon. Member is his constituency, but we must bear in mind that water is a tricky thing that does not obey constituency or national borders. Therefore, as has been pointed out, if we want to tackle flooding, sometimes the answer is literally further upstream. I enjoyed hearing him mention natural flood management solutions, which are another thing I get excited about. We have a nature crisis, so if we can deliver something that not only delivers protection from flooding but increases nature, is that not a wonderful thing to do? I am a huge fan. I do not think the answer to everything should always be more concrete, although at times of course we need those hard flood defences. It is important to look at a catchment-based approach to how we handle this, where we can look at slowing the flow in some areas or moving water out more quickly in others.
The hon. Member also mentioned the A421. I was stuck on that road as well. After visiting the flooded area in Leighton Buzzard, I realised I could not get a lift back to London, because Euston station was shut. I ended up trying to get a lift from someone up to Peterborough to make my way back up to Hull, and I was stuck on a diversion from the A421. I feel his pain as a fellow victim of that particular closed road.
The Environment Agency estimates that £3.5 million will be invested in Bedfordshire to increase flood resilience. As the hon. Member rightly said, for many areas surface water is the problem, so many of the schemes provided will be small-scale surface water solutions. [Interruption.] Am I getting the nod to hurry up? Okay, I will speed on. We can continue much of this discussion at a later date.
To conclude, I reiterate that this Government will act to ensure that people are better protected from flooding in the first place. We are determined to turbocharge the delivery and repair of flood defences, to improve drainage systems and to develop natural flood management solutions. We are investing more than £1.25 billion this year to scale up national resilience through building new and improving existing flood defences. The Government are reviewing the existing programme to get it back on track, after the pace slowed due to the impacts of inflation and delays in the supply chain.
The flood resilience taskforce, which we set up and which has already met, includes the Department for Environment, Food and Rural Affairs, the Ministry of Housing, Communities and Local Government, the Home Office, the Cabinet Office, the Environment Agency, the Met Office, local resilience forums, the mayoral office, emergency responders and the National Farmers Union. It will meet again in January. Emergency services, the EA, local authorities, voluntary organisations and Departments stand ready to support affected communities in any future flooding. Flooding is personal and a priority for me, and I will work tirelessly to make our communities more resilient to flooding.
Question put and agreed to.