North Tees Hospital

Alex Cunningham Excerpts

Thursday 28th October 2021 Commons Chamber

[Alex Cunningham (Stockton North) (Lab)]

I am grateful to the hon. Member for Stockton South (Matt Vickers), my next-door neighbour, and to the Minister for agreeing to me making a short contribution to the debate. I congratulate the hon. Member for Stockton South on securing it. I am pleased to see him following in the footsteps of Lord Wharton and Dr Paul Williams in championing the case for North Tees Hospital.

The speech of the hon. Member for Stockton South was excellent. I did not agree with everything he said, but it certainly made the case that many of us have been making for some time that we must have a new hospital in North Tees. Last year, the then Secretary of State visited North Tees and learned for himself—I hope the Minister will too—not just of the challenges we face with an outdated hospital, but of the plans and systems being developed to drive change and better healthcare in our area, where health inequalities are some of the greatest in the country, as the hon. Member for Stockton South said.

I have been calling for a new hospital to be built in Stockton for more than 11 years after the planned one was axed by the then Tory-Lib Dem Government. I often wonder what the health of our area would be like if that hospital had gone ahead. I wrote to the Minister in February requesting an update on the possibility of funding for the development work. To his credit, he has acknowledged that he owes me a letter. I am also grateful that he met the chief executive officer and the then chairman of the trust at my request just before that.

I will give a few short reminders. In Stockton North, 7.4% of the population suffer from asthma, which is higher than the 6.5% in England. In England, the level of COPD among the population is 1.9%, which rises in my constituency to 3.1%. Men in the town centre of Stockton-on-Tees, in both North and South constituencies, live 18 years less than their peers down the road. That inequality is appalling, but not inevitable.

I believe that the Minister is a good Minister—I do not say that very often—who wants to help and who recognises our challenges, but we need action now. We ask him to come good. We challenge him to join the two Stockton MPs as a champion for North Tees and convince the Secretary of State and the Prime Minister that we and our people need that hospital. We look forward to good news soon.

[The Minister for Health (Edward Argar)]

I am grateful to my hon. Friend the Member for Stockton South (Matt Vickers) and the hon. Member for Stockton North (Alex Cunningham) for their words. Without prejudging what the application process for a future new hospital might come up with, in contrast to the hon. Member for Stockton North, I agree entirely with the words of my hon. Friend the Member for Stockton South in what was, as ever, an extremely powerful exposition, on behalf of his constituents, of the need for a new hospital. I congratulate him on securing the debate. He has been a tireless campaigner on behalf of North Tees Hospital ever since he entered this place, and he continues to be a great advocate for the people of Teesside and Stockton on healthcare and many other matters. They are extremely lucky to have him representing them in this place.

I am also grateful to the hon. Member for Stockton North for his kind words about me. I will bank that, though I may consider it an asset that needs to be renewed from time to time and not one that lasts in perpetuity. He mentioned how, when he raised the matter at Health questions earlier in the week, I said that I owe him an update letter. I undertake to write to him and to my hon. Friend the Member for Stockton South jointly to set out an update on the issue outwith the debate.

My hon. Friend was right to highlight that these have been incredibly challenging times for our NHS, including for the staff at North Tees Hospital and those across the trust and the country. I join him in expressing my gratitude to all of them for the work they have done and their dedication and commitment to caring for all his constituents and people across the region. I also pay tribute to him for the shift that he undertook at the hospital.

Before I turn to the substance of the case made by my hon. Friend, he kindly invited me to join him on a visit. I am due to bring my wellies to visit my hon. Friend the Member for Don Valley (Nick Fletcher), who secured a commitment for a visit earlier this week. If we can find a way to add that to the tour that it looks like I may be undertaking around the country, I look forward to visiting him and the hon. Member for Stockton North in the not-too-distant future.

[Alex Cunningham]

It’s only 100 miles away.

[Edward Argar]

Given that I have also committed to visiting places in Norfolk and—I think—Lancashire, it will be a pretty big tour. That is all I will say.

As I said, I commend my hon. Friend the Member for Stockton South on his campaign on behalf of the hospital and on the dynamism that he has brought to it and to this place. He set out clearly the context of the hospital in terms of his constituency and the healthcare needs of his constituents. Two things that he said in particular struck me as very powerful statements. First, he set out the difference in life expectancy at 64 years compared with over 80 just up the road. Secondly, I was struck by the age of the hospital—it predates my existence, so it almost certainly predates his as well—and the impact that the design standards of that time and the ageing of the hospital has on its operation and maintenance costs as well as physically keeping it functioning as an acute hospital.

The Government have made clear our commitment to levelling up outcomes across the country, and that will certainly extend to benefiting the people of his constituency. To level up effectively, we need to improve health outcomes, and we are committed to reducing health disparities between the most and least deprived areas of the United Kingdom. Yesterday, as my hon. Friend said, the Chancellor confirmed that the Government are backing our NHS with a significant capital settlement including £5.9 billion to cut waiting lists as well as for surgical hubs, community diagnostic centres and IT improvements. That will create a step change in the quality and efficiency of care up and down the country. Of course, giving people greater opportunity to get diagnosed and scanned earlier may lead to an increase in the need for services at his hospital and others as people have their illnesses identified and need to have them treated. I will turn in a moment to his powerful plea for a new hospital.

My hon. Friend also touched on the critical need for trusts to maintain their estates. We are pleased to confirm that the spending review continues to back trusts with significant annual operational capital investment to do that, enabling them to maintain and refurbish their premises. Crucially, that is with multi-year predictability and certainty. We all know how, in capital spending, the longer the settlement in years, the easier it is both to plan for it and to get a better deal for the investment from those being employed to carry it out. More broadly, we previously confirmed an initial £3.7 billion over the four-year period from spending review 2020 to make progress on the building of 48 new hospitals by 2030. Thirty of the hospitals already announced are due to be built outside London and the south-east. Of course that comes on top of additional funding to upgrade hospitals.

My hon. Friend is, as ever, passionate and persistent in putting the case for North Tees to be among these new hospitals, as is the hon. Gentleman. I reassure my hon. Friend that I never tire of having the opportunity to talk about this with him and having him putting the case to me; he is always very welcome to do so. I will turn shortly to the process and timelines for these additional eight new hospitals on top of those already announced, but first I want to highlight a little of the significant investment that North Tees and Hartlepool NHS Foundation Trust has seen in recent times.

That investment includes: £3.5 million as part of our 2020-21 critical infrastructure risk fund to help it address backlog maintenance across the locations of services in the trust; £3 million as part of our A&E upgrades fund for covid measures, including funding additional streaming capacity for the emergency department at the University Hospital of North Tees; and as part of our £200 million diagnostic investment to replace diagnostic machines that are more than 10 years old, the trust has received a new CT scanner that has been installed and operational since 2020 at University Hospital of Hartlepool.

Of course, we are aware of the need for further investment across the NHS estate, and that is why the Government have been doing ambitious work providing substantial capital investment to support the biggest hospital building programme in a generation. As my hon. Friend has already highlighted, the Government have launched the next phase of implementation for our hospital building programme. On 15 July we invited expressions of interest from trusts who wished to be considered for inclusion in the next wave. The deadline for submitting expressions of interest passed in early September and, without prejudicing the decision, I was pleased to receive a submission from the University Hospital of North Tees.

We are of course committed to a robust selection process for these next eight hospitals, and as such I am sure my hon. Friend and the hon. Gentleman will understand that I cannot comment on individual bids substantively while that selection is ongoing. The submission and assessment of expressions of interest is the first of a two-stage process for the selection of the next eight, to be followed by a more detailed process for long-listed schemes later in the year, considering schemes against multiple priorities, including: transforming services to deliver better, joined-up care; creating stronger and greener NHS buildings; and of course looking at need and the state of buildings that need to be replaced. Another key criterion is the fair allocation of investment by addressing levelling-up criteria. We aim to make and announce a final decision on the next eight hospitals in spring 2022.

My hon. Friend highlighted his concerns about private finance in the context of the legacy of the previous Labour Government and what that meant for his hospital trust. As he is aware, the Government have retired—that is the nice way of putting it—the private finance initiative used so extensively by previous Labour Governments, so, in future, new hospitals built for the NHS will no longer be privately financed. My Department continues to work with the NHS to do more to maximise the value of existing PFI contracts. I would encourage any trust concerned about their PFI contract to contact my officials for help. I continue to have discussions with Her Majesty’s Treasury more broadly and strategically about addressing the costly legacy of PFI in the NHS.

To conclude, I reiterate my gratitude, both to the hon. Member for Stockton North for the tenor in which he always approaches campaigning for his constituents and their hospital, but particularly to my hon. Friend the Member for Stockton South for the work he is doing to support the refurbishment of North Tees Hospital. As I said, he brings a passion and a dynamism to this place on behalf of his constituents, and I am very conscious of the fact that, terrier-like, he will not let go until he has achieved what he seeks to achieve on behalf of his constituents. I commend him for that.

The Government are committed to delivering their improvement programmes to hospitals and the NHS estate across the country and look forward to delivering the step change in the quality and efficiency of care underpinned by my right hon. Friend the Chancellor of the Exchequer’s announcements yesterday.

Question put and agreed to.

NHS England Funding: Announcement to Media

Alex Cunningham Excerpts

Monday 25th October 2021 Commons Chamber

[Alex Cunningham (Stockton North) (Lab)]

The new money is very welcome, but North Tees and Hartlepool NHS Foundation Trust is having to spend millions of pounds every year just to keep University Hospital of North Tees safe and operating. It is doing a grand job. But the Minister knows the facts of this: we really do need a new hospital in Stockton. So will the new one be announced any time soon?

[Edward Argar]

I am grateful to the hon. Gentleman. Everyone loves a trier in this place, particularly on behalf of their constituents. I have met him to discuss this, as he alludes to. I think I am overdue giving him an update letter on where we are. As he will be aware, we have had significant numbers of expressions of interest in the opportunity to be one of the next eight hospitals. We look forward to making an announcement on them in the spring of next year. I cannot say any more than that—but, as ever, he makes the point on behalf of his constituents.

Covid-19: Government Response

Alex Cunningham Excerpts

Thursday 21st October 2021 Commons Chamber

[Maggie Throup]

I thank my hon. Friend for that question. It is really important to make sure that people understand that, if they had their second jab six months ago, plus one week to allow for a bit of admin, they are eligible. They may get a text or a letter from the NHS, but if they do not, they can go online or phone 119 to book their jab.

[Alex Cunningham (Stockton North) (Lab)]

Some months ago, the Prime Minister rolled up to Billingham in my constituency for a picture opportunity that Fujifilm scheduled for the manufacture of the Novavax vaccine starting around now. Since then the Government have gone very quiet about this new product and we have recently learned that the thousands of people who volunteered to take part in the Novavax trials are being given alternative vaccines to ensure that they are properly covered. While Fujifilm has assured me that the delay in the vaccine being submitted for approval will not affect jobs in Billingham, Novavax cannot be bothered to respond to the local MP. The Government have already ordered tens of millions of doses. Can the Minister offer a progress report on the trials and approval process for Novavax?

[Maggie Throup]

First, let me say a huge thank you to everybody who came forward to take part in clinical trials. Without those volunteers, we would not be where we are today, having the amazing vaccines that are helping to save lives. To ensure that I have the absolute up-to-date information, may I write to the hon. Gentleman on the latest with regards to those specific trials?

Health and Care Bill

Alex Cunningham Excerpts

2nd reading
Wednesday 14th July 2021 Commons Chamber

[Alex Cunningham (Stockton North) (Lab) [V]]

We all know that the last top-down reorganisation of the health service was a disaster for our people and those who work in it, so I was quite excited to hear of the plans to sort it out. I must have been mad. Instead of bringing forward a Bill to deal with their own mess and sort out the health crisis they have created, the Government have introduced a hotchpotch, which will do neither and could make it worse.

The Prime Minister’s response to decades of regional inequality and underfunding of communities such as mine is pathetic. It seems that, instead of introducing robust proposals to reskill our people, invest in our services and tackle their homemade crisis in the NHS, the Government are telling us that an increase in al fresco dining and an extension to the service of takeaway pints are the answers. That sort of trite nonsense is downright insulting to people who live in constituencies such as mine.

People in Stockton North live shorter, less healthy lives than others in more affluent areas by virtue of geography alone. As Cancer Research UK has said:

“If the UK is to tackle inequalities and make sure no community is left behind…then health must be hardwired into the Government’s ‘levelling up’ agenda.”

If the Government are serious about levelling up for communities such as mine, they will have to take meaningful action to tackle the health inequalities that plague them.

In Stockton North, 7.4% of the population suffer from asthma, higher than the 6.5% who suffer across England. In England, the level of chronic obstructive pulmonary disease among the population is 1.9%; that rises to 3.1% in my constituency. There are other inequalities, too, and we need action now. Will the new Secretary of State come good where others have failed and provide Stockton with the new hospital it desperately needs?

Some 13.2% of adults in Stockton-on-Tees are smokers, and smoking-attributable hospital admissions and deaths are increasing, yet Government action to reduce smoking has generally stagnated. Measures in the Bill to tackle obesity are welcome, but smoking is the leading cause of preventable premature death, and yet there are no proposals to tackle it. The Bill represents an ideal opportunity to introduce a US-style “polluter pays” levy with tobacco control, as recommended by the all-party group on smoking and health, and which the Government promised to consider two years ago in their prevention Green Paper. The all-party group—I declare my interest as the vice-chair—has provided a model for this approach, and I am grateful to Action on Smoking and Health and others for their work. The all- party group published a comprehensive set of recommendations that would help the Government to achieve their ambition of a smoke-free 2030, including further regulatory measures to de-normalise smoking, but nothing has happened.

Cancer Research UK has estimated that, on current trends, we will not make England smoke free until at least 2037, and it will be longer for poorer communities. We need action now. The Government say that we need bold action; they should take it now. That is one step towards tackling inequalities that blight our country.

A Plan for the NHS and Social Care

Alex Cunningham Excerpts

Wednesday 19th May 2021 Commons Chamber

[Alex Cunningham (Stockton North) (Lab)]

On Monday, the Health Secretary told the House that he was looking at what more he could do to invest in the NHS on Teesside. I have been making representations on this for 11 years, including in conversations with the Health Secretary. To tackle the health inequalities in my area of Teesside, Stockton needs a new hospital, so when will he make good on his word on dealing with health inequality and build the new hospital that we need—a hospital that his Government cancelled 11 years ago?

Last month, the all-party parliamentary group for longevity’s report on levelling up health noted that health inequality between the north and south cost £13 billion a year in lost productivity. Indeed, even before covid-19, health inequalities in England were estimated to cost the NHS an extra £4.8 billion a year, so I was bitterly disappointed that the Queen’s Speech did not contain improved funding for public health. Cancer Research UK has said:

“If the UK is to tackle inequalities and make sure no community is left behind…then health must be hardwired into the Government’s ‘levelling up’ agenda.”

Let me give the Minister a sense of the scale of the problem we face, although these figures are from before the pandemic and will now be much worse. I will begin with lung health. In England, 6.5% of the population suffer from asthma; in Stockton North, that rises to 7.4%. The level of chronic pulmonary obstructive disease among the population is 1.9%. That rises to 3.1% in Stockton North, yet we have not seen the level of progress we need to tackle the inequalities in health. In fact, we are stagnating. The Government committed in the Prevention Green Paper to making England smoke free by 2030. They are on course to fail, but they could succeed by following the advice of Action on Smoking and Health and making the polluter pay. I ask the Minister: will she?

Turning to cardiovascular health, the level of coronary heart disease in England is 3.1%, but it is 4.1% in Stockton North. In England, 14.1% of people have high blood pressure; that rises to 16.2% in Stockton North. If the Government have learnt anything in the past year, it should be about maintaining good public preventive healthcare, but instead questions remain about the future of Public Health England. On mental health, 11.5% of adults in England have been diagnosed with depression. In my constituency, the figure is 16.1%. Mental health services were overstretched before the pandemic hit and many people face waiting for years. Some do not get any treatment at all. There is no sign of that pay rise for our NHS heroes in the Queen’s Speech either, and disappointingly, no sign of the long-promised blueprint for social care. It is time to address inequality in my constituency. Please Minister, give us the hospital that we need.

Oral Answers to Questions

Alex Cunningham Excerpts

Tuesday 12th January 2021 Commons Chamber

[Matt Hancock]

I am delighted that there is going to be a mass vaccination centre. I can give that assurance—we are working as hard as we possibly can to ensure that all the equipment is there. Everybody thinks about the vaccine—that is very important—but it is also about all the other things that are needed, such as the specialist syringes. The vaccine is so valuable that inside the syringe is a plunger that goes into the needle to squeeze the extra bit of liquid that would otherwise be left in the needle into someone’s arm to make sure that every last drop of vaccine is used. A whole series of other equipment is needed alongside the actual liquid of the vaccine. I will ensure that my hon. Friend the vaccine deployment Minister makes sure that the Stoke-on-Trent mass vaccination centre is up and running and ready for 25 January.

[Alex Cunningham (Stockton North) (Lab) [V]]

The covid-19 pandemic has further exposed and widened the tremendous health inequalities in Stockton, where healthy life expectancy is among the lowest in the country. It also has by far the highest number of covid cases on Teesside—now well in excess of 10,000. Secretary of State, when can we have a new hospital for Stockton to help to tackle those inequalities?

[Matt Hancock]

The importance of tackling health inequalities and levelling up parts of the country that have so much opportunity, such as Stockton, but need further support to unleash that opportunity is an incredibly important part of this agenda. On the hon. Gentleman’s precise question, we have discussed that issue before. As he knows, we have the largest hospital building programme in the modern history of this country. I look forward to continuing to discuss with him the extra infrastructure needed in Stockton.

Oral Answers to Questions

Alex Cunningham Excerpts

Tuesday 23rd June 2020 Commons Chamber

[Alex Cunningham (Stockton North) (Lab)]

My constituent Jonathan e-mailed me to say:“Today for the first time my partner will see our baby and hear their tiny heartbeat. However, I’m writing to you from the car outside as she attends our 12 week scan. I’m banned from attending due to government guidelines.”Jonathan says he is being robbed of enjoying these special moments with Emma, yet they can shop together, travel on public transport and even visit the beach. What does the Secretary of State have to say to expectant fathers like him?

[Matt Hancock]

Of course it has been necessary to have tight controls over visitors in hospitals during this crisis, because people picking up nosocomial infections in hospital has been one part of the epidemic that we need to get under control. My heart goes out to those many people who have made sacrifices, including the hon. Member’s constituent, and of course we always keep this under review.

Income tax (charge)

Alex Cunningham Excerpts

Monday 16th March 2020 Commons Chamber

[Edward Argar]

I set out in my remarks just now exactly where they would come from—from a variety of different sources. We have already seen, from the latest numbers for nurse recruitment, for example, many thousands more recruited in the last year. We are succeeding in delivering on our pledge, and we set out very clearly in our manifesto the timescales within which we would deliver.

That brings me to my third point—NHS services. I have said that I want the NHS to pursue two long-term policy goals to which my right hon. Friend the Secretary of State is committed. They are five extra years of healthy life and increased public confidence in the service. The coronavirus outbreak demonstrates that we have to target both. It is an explicit goal of our policy not just to tackle the disease, but to maintain public confidence. We take the same approach more broadly in healthcare. We want people to live healthier for longer, and we want people to be confident that the NHS will always be there for them, that it will treat them with dignity and respect, and that it will feel like a service, not an impersonal system. We want people to know, for instance, that they can always see a primary care professional whenever they need to. The Budget funds our manifesto commitment to create an extra 50 million appointments a year in general practice.

[Alex Cunningham (Stockton North) (Lab)]

I am grateful to the Minister for meeting me last week and very glad that I did not have to follow him into isolation. We had a good discussion last week and talked very much about those health inequalities and the necessity for more people to have more healthy years. I was grateful to him for being kind towards North Tees and Hartlepool and talking about a new hospital for Stockton. If there is a bit of capital to get that under way, I hope he will come up with it soon.

[Edward Argar]

The hon. Gentleman and, indeed, my hon. Friend the Member for Stockton South (Matt Vickers) are both strong advocates for Stockton and for the hospital there. I very much enjoyed our discussion. I am glad that the self-isolation rules are such that the hon. Gentleman did not have to follow me into it, but I am very happy, as I said when we met, to pick up on that discussion further in the future.

We also want people to know that the NHS will treat them fairly in their hour of need. That is why we care about hospital parking. Thanks to this Budget, from next month we will start the roll-out of free hospital parking more broadly across our hospital estate for disabled people, frequent out-patient attenders, parents with sick children staying overnight and staff working night shifts, delivering on our manifesto commitment.

WHO Framework Convention on Tobacco Control

Alex Cunningham Excerpts

Thursday 5th March 2020 Commons Chamber

[Alex Cunningham (Stockton North) (Lab)]

I am pleased to have this unexpected opportunity to speak in this important debate, and I congratulate the hon. Member for Harrow East (Bob Blackman) on securing it. My politics and his are far apart, but we are brothers in the cause of eradicating smoking. I pay tribute to his work as chair of the APPG and am pleased to serve as his vice-chair.

There are around 23,000 smokers in my Stockton North constituency, and 60% of them want to quit. Sadly, due to cuts to Stockton Council’s budget and to budgets across the north-east, councils in the area have cut stop smoking services by 10% in just two years. I will come back to that later.

Requiring tobacco manufacturers to pay into the smoke-free 2030 fund mentioned by the hon. Gentleman would provide sustainable funding to motivate the smokers in my constituency who want to quit, or who want to give quitting a go, and would fund the specialist support for those who need it. That would be the correct way forward, and it would provide the necessary transparency without the likes of PMI being given free rein to dictate or influence public policy.

I pay tribute to successive Governments for making tremendous progress. We had the smoke-free pubs and restaurants under Labour, and of course we have had the point-of-sale stuff under recent Conservative Governments. That all plays a part, but the extent to which smoking is reducing has continually slowed down and we need to accelerate it again.

Although this is a national issue, I will be parochial this afternoon and outline the challenge we face in my part of the world. In Stockton-on-Tees, 16.4% of the population smoke, compared with 16% across the north-east and an English average of 14.4%. Some 17.7% of women are smokers when their babies are delivered, compared with a national average of 10.6%, and that has significant implications for stillbirths, neonatal deaths and birth weight.

Those statistics hide the reality of what is happening in my constituency. In my inner-city wards, the prevalence of smoking, including during pregnancy, is much higher. Our leafy suburbs and nicer areas—perhaps I should say more affluent areas—bring down the average to that lower level of 16.4%. I do not know of many households in the town centre ward of my constituency in which people do not smoke, which is a terrible situation. We need targeted support for them.

The prevalence of smoking among adults in my area with serious mental health illnesses is 40%, which is actually slightly below the English average of 40.5%, but it still needs to be tackled. In 2018-19, there were 2,780 smoking-attributable hospital admissions in Stockton-on-Tees, which is a rate of 2,474 per 100,000 of population, notably above the English average of 1,612.

From 2016 to 2018, 1,013 deaths in Stockton-on-Tees were attributable to smoking, which is also significantly above the English average. There were 398 deaths from lung cancer and 325 deaths from chronic obstructive pulmonary disease, and over 80% of those disease cases are caused by smoking. Again, from 2016 to 2018 there were 23 smoking-attributable stillbirths in Stockton-on-Tees, which is above the per population average.

I have talked about the more affluent areas of Stockton-on-Tees, and the smoking rate among people in managerial and professional occupations is 9.3%. The rate rises to 11.7% among people in intermediate-level occupations and to 23.1% among people in routine and manual occupations. Men are more likely to smoke than women, with a smoking rate of 17% compared with 13%.

We have much to do if we are to do this, and we have to do it right, without allowing tobacco companies to play the sort of role proposed by PMI, because this is an issue of health inequality. A smoking rate of 16.4% in my constituency compares with 8.3% in mid-Suffolk, where the Minister’s constituency is located.

Like the hon. Member for Harrow East, I was concerned to hear least week that England is not on track to reach the 5% ambition by 2030. The 20-year difference between when the richest and poorest communities are expected to be smoke free shows that we are failing to support the most vulnerable in our constituencies. So does the Minister agree that the smoke-free 2030 ambition must be more than a headline target and that the Government must ensure that they will also deliver a smoke-free generation for communities such as mine in Stockton?

The hon. Gentleman mentioned illegal tobacco, so I wish to say just a few words about that. During the general election, I was on the Hardwick estate in my constituency, where a woman was standing at a door. I was walking up the path and then I realised that money was changing hands. The money changed hands and the door closed. When it reopened, someone had a package in their hand. I know what it was, but the woman saw me and said, “Just wait a few minutes.” She then said, “How can I help you?” I nearly said, “You could help by not operating an illegal tobacco operation”, but I was looking for their vote, so perhaps I prejudiced my principles on that occasion.

These things are happening day in, day out. My wife was a school nurse and she went to schools to talk about smoking. She used to deploy the economic argument, saying to the kids, “If you have so many cigarettes a week, it will cost you £10. Over a year that works out at £520 and that would take the family on a short holiday.” One day, a child put up his hand and said, “Miss, you’ve got the price wrong. They are only £3 a packet from—”. He named a person around the corner from where he lived. So it is clear that we still have a problem to solve and we have an education problem to deal with as well.

Finally, I know that PMI’s proposals for a “tobacco transition fund" in partnership with the industry have already been put to Parliament in a ten-minute rule Bill tabled by my former colleague Kevin Barron in the last Parliament. Kevin is a long-standing supporter of tobacco control, but he admitted to The Guardian that he had had discussions with PMI before tabling the Bill, that he now supported partnering with the industry and that he had spoken to Ministers about the proposals. Kevin was probably the greatest parliamentary campaigner, perhaps even better than the hon. Member for Harrow East, against the tobacco industry for nearly all his 36 years as an MP, so I was really concerned that he was prepared to work with a tobacco company, albeit with the best of intentions, to change the law. Although some people may have been convinced that PMI has been reborn as a public health champion, that is certainly not the case for the all-party group on smoking and health, and I hope the Minister will confirm that the Government agree on that. PMI’s attempts to whitewash its reputation are nauseating, in a company that continues to promote its deadly cigarettes to children and young people whenever and wherever it can get away with it.

So there is still much yet to be done, and I will be interested to near what the Minister has to say. I want her not just to rule out any sort of relationship with PMI, except perhaps taxing it a bit more, with no recognition of its bid to influence public policy; I also want to hear what the Government are now going to do, perhaps in replying to the Green Paper, to get us the resources we need into public health and elsewhere to start again and accelerate the number of people who quit.

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

I thank my hon. Friend the Member for Harrow East (Bob Blackman) for securing this important debate on the World Health Organisation framework convention on tobacco control. His passionate work on tobacco harms, including through his chairmanship of the all-party group, and the work of his worthy sidekick as co-chair, continues to keep us focused on what we have to do and on our goal of being smoke-free by 2030. I thank them for that. I agree with both of them that smoking is one of the most significant public health challenges that we face today and that, sadly, it is one that disproportionately affects disadvantaged groups, with the resultant impact on their health and their finances.

This year, the WHO framework convention is celebrating its 15th anniversary. Over those 15 years, the parties to the convention have worked towards a tobacco-free world. We have seen encouraging improvements in tobacco control worldwide, but there is still much more work to be done to protect the world’s population from the harms of a tobacco epidemic.

As a recognised world leader in tobacco control, the UK is firmly committed to the World Health Organisation’s framework convention on tobacco control—which I will now abbreviate to FCTC for all our sakes—and we will remain an active member. I thank my hon. Friend for continuing to remind us how important the obligations under the convention are. In answer to his direct question, we will remain fully committed to the convention and, importantly, to article 5.3 during the transition period and beyond. I can assure him, as my predecessor did, that we write to NHS trusts and local authorities to remind them of their obligations under article 5.3 to protect public health interests from tobacco industry interference. I am proud that, in the first global tobacco industry interference index, published last year, we were rated No. 1 for the work we do to protect health policy from tobacco companies, but I take on board the fact that we need to make sure we continue on that path.

It is estimated that at least 8 million deaths around the world every year are linked to tobacco—more than for AIDS, tuberculosis and malaria combined. Some 80% of the 1 billion smokers live in low and middle-income countries. That puts a huge strain on the development of those countries and their achievement of the sustainable development goals. There is high demand from such countries for help to implement tobacco control measures. That is why, as a global leader, the UK is providing support, via official development assistance, to the FCTC 2030 project, working with low and middle-income countries to support its implementation, with the ultimate aim of reducing the burden of tobacco-related deaths and diseases.

The project has received praise from countries participating, as well as from the global public health and development communities. It has also helped to raise the UK’s profile as a global leader in tobacco control, and is strengthening its global reach. Building on that success, we are increasing capacity within the existing budget to include several more countries to support over years four and five.

In the UK, smoking prevalence is at the lowest ever rate on record and is falling, but we are not complacent—as has been pointed out, the rate of decline is slowing. Around 78,000 people die every year in this country from smoking-related illnesses. As I said yesterday during the debate on health inequalities, and as my hon. Friend pointed out so eloquently, we know that the smoking habit particularly affects disadvantaged communities. We must end that, and our prevention Green Paper sets out the ambition to be smoke-free by 2030. That is undoubtedly a challenging ambition. The public consultation that closed in October had 1,600 responses—more than double the number we usually get—and it is taking some time to go through the analysis. We are analysing the proposals and developing our own response, which will be with Members shortly.

[Alex Cunningham]

I appreciate everything the Minister is saying. It is the 2030 target I am really interested in. The estimate a couple of weeks ago was that, with current programming, we are 20 years behind where we need to be. Will she tell us how we are going to achieve that target instead?

[Jo Churchill]

I thank the hon. Gentleman, and, yes, I will. There is a need to be smarter with what we do. As was stated, we will achieve the target in some communities, but not in others, so refocusing on where we have the problem must be part of the strategy. However, as I am sure my hon. Friend and the hon. Gentleman appreciate, I do not want to pre-empt what we publish in the Green Paper.

I acknowledge and thank my hon. Friend and the hon. Gentleman for the report by the all-party parliamentary group on smoking and health, which I have read and which sets out the group’s recommendations, including on the smoke-free 2030 fund. I assure them that the Department will speak to Her Majesty’s Treasury to discuss possible financial levers to support our smoke-free ambitions. However, I also expect that both of them—and particularly my hon. Friend, who is indefatigable in his lobbying on this matter—will lobby the Chancellor themselves.

Across the country, people are tackling the harms of tobacco every single day. During a recent visit to Tameside Hospital, I witnessed at first hand the commitment and dedication of healthcare professionals involved in the delivery of an innovative approach to reducing smoking in pregnancy. While the hon. Member for Stockton North (Alex Cunningham) was speaking, I was reflecting on the fact that many of the things that he was saying about his own constituency were very similar to those in this particular project. The prevalence within their local community to start with was much higher than average, and the people who were starting to smoke as a habit were of a much younger age. Therefore, by the time these young women were pregnant, they had been smoking for a longer period of time, making cessation more difficult. The project was thoughtful and holistic in terms of the agencies that it used, and the way that it wrapped around the young pregnant women. It actually reached out into their families, encouraging partners, mothers and other family members to support them. That gave the young women a great deal of motivation. I spoke to one young father who had not yet managed to quit his habit, but he had taken many of the messages on board, was not smoking in their home, and was actually attempting to change his behaviour for the long-term benefit of his future’s baby’s health.

This is a particular passion of mine. I believe that we give both people a much better, healthy start if we can tackle pregnant mums as a particular cohort, because, obviously, we not only help the mother, but, as my hon. Friend has said, help the future health of the baby and ensure that a health compromised by smoking in pregnancy is not something that then follows them through their lifetime. I spoke to those mums and partners about how using a joined-up approach could work and I would be delighted if my hon. Friend and the hon. Gentleman would talk to me further about the matter.

Social Care

Alex Cunningham Excerpts

Tuesday 25th February 2020 Commons Chamber

[Barbara Keeley]

I very much agree. We need to pay care staff the real living wage, provide them with training and end the use of zero-hours contracts.

I think it is clear enough that the Labour party believes that the current system is not working, and I am sure that the Secretary of State knows it too. Councils just do not have the funding required to deliver the care that people need, and they are faced with a stark choice—either they cut back on the quality of care, or even fewer people receive any help at all. Only a third of directors of adult social services think that their budget will be enough to meet their statutory duties this year, which means that thousands of people who approach their local authority for help with their care are turned down for support. Without investment and a plan, social care services will be pushed deeper and deeper into crisis. Expert report after expert report has pointed to social care being on the verge of collapse, and those reports make it clear that councils cannot deliver adequate adult social care provision without a sustainable, long-term funding strategy. Yet what we have seen from the Government, year after year, is short-term and piecemeal funding.

The Secretary of State may repeat, as his colleagues did yesterday, that the Government are allowing councils to raise council tax this year to fund social care services, but the Opposition know that council tax is a deeply unfair way to fund this vital public service. A 2% rise in council tax rates in Wokingham will raise twice as much money as it would in Knowsley. Even if we raised council tax by 2% every year, the Institute for Fiscal Studies says that by the end of the decade social care will make up over half of all local government spending. This means that other vital services will continue to be cut back. That is certainly the situation I see in my own local authority area.

[Alex Cunningham (Stockton North) (Lab)]

The shortage of resource and people in the system means that more responsibility falls on families. I know that my hon. Friend recognises the unsung heroes who are young carers—children who miss out on education, a social life and so much more to care for a parent or sibling. Does she agree that the Government need to do more to help to support organisations like the Eastern Ravens Trust in Stockton, which does so much to help these young carers to have a life of their own?

[Barbara Keeley]

Indeed I do. I am looking forward to the establishment of the new all-party group on young carers, but it is tragic, in a way, that we have to meet in new all-party groups to try to find some way of taking the burden from those young carers.

As local authorities struggle to fund social care, an increasing number of people are forced to take on the financial burden themselves. Some 143,000 people are currently faced with catastrophic costs of over £100,000 for their own care. Over the past three years, 9,000 people have asked their local authority for help after completely depleting their own savings to pay for their care. This means that people are having to sell their homes that they may have lived in for their entire lives to fund the care that they need. The Prime Minister has promised to stop this situation, but with no plan and no proposals for how he achieves that, it is likely that many more people will be put in this position going forward. The Government could drastically reduce the number of people faced with catastrophic costs for their care if they set a lifetime cap on care costs. The Government proposed a cap in 2013. They legislated for it, but dropped it in 2016. That cap would have gone some way towards reducing the number of people now faced with catastrophic social care costs. The Government’s own impact assessment showed that by this year 37,000 people would have benefited from the cap if it had been introduced in 2016.

But reform is not just about protecting housing wealth. It is important to do that, but reform also has to offer a solution to the people who are currently stuck in bed all day unable to get themselves dressed, or needlessly stuck in hospital. The solution that Labour favours is to offer free personal care to ensure that everyone is supported with the basic tasks regardless of their ability to pay. Free personal care was introduced by a Labour-led Government in Scotland in 2002, and it is ensuring that more people there receive publicly funded social care. Free personal care has been backed by the House of Lords Economic Affairs Committee and by charities and think-tanks.

We believe that it is vital that we push forward with this reform because progress to date has been far too slow. In October 2018, the Secretary of State talked about:

“The adult social care Green Paper, which will be published later this year”.—[Official Report, 17 October 2018; Vol. 647, c. 736.]

In 2019, we were told that there would be a Green Paper “that summer” that would set out the future of social care, but it never arrived. It was delayed twice before being dropped completely. Seven months ago, the Prime Minister stood on the steps of Downing Street and said that he had a plan to fix the social care crisis. There is still no sign of it. Perhaps this plan is in the same state as the promised Green Paper. The Government said that they would instigate cross-party talks on social care within the first 100 days of the election. We are now 75 days on and we have yet to hear from the Government on their proposals.

Labour is the only party, as it stands today, with clear plans for the future of social care. Labour’s plan for social care would close the funding gap, cap care costs, and introduce free personal care and improved pay and working conditions for care staff. In contrast, we have no action from the Government on social care. Councils are reliant on piecemeal funding announcements and raising ever higher levels of council tax, yet these measures leave them struggling to meet demand. So Labour’s message to the Prime Minister and the Secretary of State is clear: they need to put in the extra investment needed to stabilise the care system, introduce free personal care, bring back a cap on care costs, and develop a plan to improve the pay and working conditions of the care workforce. I want to make it clear that Labour will be happy to sit down with Ministers and talk them through our proposals, as the Prime Minister does not appear—at this point in time, at least—to have any plans of his own. I urge hon. Members to vote for our motion tonight to ensure that the Government have to finally meet their pledge to fix social care.

--- Later in debate ---

[Jackie Doyle-Price (Thurrock) (Con)]

I feel like I am in groundhog day. It is approximately two years since I responded to a very similar debate secured by the hon. Member for Worsley and Eccles South (Barbara Keeley). It is disappointing that we are still debating the very same issues that we were then. Of course, there has been much water under the bridge since then in our broader politics in that time, but in respect of social care, to coin a phrase, nothing has changed. The questions we need to settle are exactly the same as they were then. I say very gently that with Brexit done and with a majority Government, there is no excuse for continuing to kick this can down the road. It is time that we genuinely took action.

At the heart of this question, we need to establish to what extent the cost of care should be met by the individual and by taxpayers. We need to establish a consensus on the balance between those two. From my perspective, it is not fair that at the moment that cost is met almost entirely by individuals. Equally, it would be unfair for it all to be met by taxpayers when people have some assets. We therefore need to settle that question properly. I would also gently say that our politics has not been entirely honest about that. It is worth reminding the House that at the moment only £14,250 of capital is protected. As the hon. Member for Worsley and Eccles South mentioned, that means those with very long-term care costs, particularly those who suffer from dementia, can face catastrophically high bills. There are, therefore, very strong arguments for a cap.

There are other reasons why we have to grip this issue now. As the hon. Lady mentioned, local authorities cannot plan their long-term finances. That also brings a real threat to financial stability within local councils. It is fair to acknowledge the challenges within the care sector, too. Many providers are finding the marketplace challenging, not least because of workforce challenges, but also because local authorities are insisting on paying low rates for residential care. That brings with it an additional injustice—people who are deemed able to pay for their care find themselves paying higher rates for the same product than local authorities do for those who do not pay for their care. I think that is a major injustice in the system.

[Alex Cunningham]

Would the hon. Lady support the Government funding local authorities so that they can pay the proper living wage to careworkers?

[Jackie Doyle-Price]

The issue is that local authorities are commissioning care from local care providers and paying the rate that the individual resident is incurring. It is about what they are prepared to pay for that bill and not the local authorities paying living wages directly to employees. However, that is pushing the risk on to care providers, and we need to acknowledge that there will be workforce challenges for those providers. They will be competing more and more for people. While there is that downward pressure from local authorities on what they are prepared to pay and the upward pressure on wages, the risk is being borne by providers.

Part of the solution is also not just about who pays. We need to be a lot more imaginative about this. We all know that we will live longer—beyond 70—and that we will have more years in life in retirement. Just as we make plans for our pensions, we need to make provision for our homes and how we are going to live in old age. The simple fact is that our housing requirements when we are in our 40s and are raising a family are rather different from what we might require in our 90s. We know that falls are one of the biggest burdens on the NHS, so the fact that we are not encouraging people to make sensible lifestyle decisions about their homes is causing additional cost to the NHS, as well as, potentially, the need for more long-term residential care. One reason why we have that issue is that we have allowed, collectively over decades, so much wealth to be stored in our housing stock that we have encouraged people to behave in a way that makes them want to cling to it. I would like us to look more imaginatively at incentives through the tax system to encourage people to downsize and look at different ways of living. We want to use the planning system to encourage the development of retirement villages where people can purchase extra care.

[Jackie Doyle-Price]

I completely agree. That is exactly the kind of incentive that we should encourage. The longer that we can encourage people to live independently, the better their quality of life and the better it is for the taxpayer, because there will not be those ongoing bills. The point is exactly that as we live longer, we will spend many years in a condition of frailty, and that needs to be properly managed through the system.

Every parent, with the best will in the world, will wish to hand on as much of their assets to their offspring as possible, but that could also encourage behaviours that are bad for their health. I want my parents to realise the value of their assets rather than protect their inheritance for me. I am sure that most people would think that about their parents, but there is a lot we can do on the tax system and incentives to encourage families to manage those issues collectively and in a way that is good for people’s welfare as they become elderly and enables them to do more for their children.

It is high time that we tackled this issue. We should also not look at this entirely in isolation from the issues regarding working-age adults, which are also a major challenge for local authorities as they manage their finances in this area. We must look at the issue of people with learning disabilities and autism being increasingly placed in areas of long-term care. The issue is that, although we have been broadly successful in moving out people with learning disabilities through the transforming care programme, sadly the pipeline afforded by those people moving out has been filled by people with autism. The Government have to give a much clearer challenge to commissioners. When faced with people with complex needs, the first instinct should not be to put them in residential care. Too often we have seen how those kinds of placements do harm. We need to challenge local CCGs and NHS England to put much better care upstream by providing early diagnoses for people with autism and giving them the tools to protect themselves.

[Alex Cunningham]

On the workforce issues, surely the answer to the dilemma the hon. Member is describing is to have a professional, well-paid, well-trained workforce that can deal with people with the most complex needs in their homes and allow them to remain there as long as possible.

[Jackie Doyle-Price]

The key words the hon. Member just used were “in their home”. There is no public policy challenge that does not come back to having the right kind of housing solutions. Many of these issues arise from our not investing in the right kind of supported housing environments that would enable more people to live independently. That has to be part of the solution. Local authorities and the local NHS need to come together to commission the right kind of service.

As we are short of time, Mr Deputy Speaker, I will end there, but it is high time we gripped this once and for all.

[Liz Kendall (Leicester West) (Lab)]

We need three things to make our social care system fit for the future: access to good quality care for every older and disabled person who needs it; more support for families to look after the people they love; and better care jobs so that paid careworkers can afford to stay in work and support their families as they care for ours. I will take each in turn.

First, it is a disgrace that in the 21st century, in one of the richest countries in the world, 1.5 million older people are not getting the basic help they need to get up, washed, dressed and fed—that is one in seven of the entire population aged over 65—and that figure will rise to 2 million in a decade’s time unless the Government change course. It goes without saying that this is not good for the people who need support to perform the functions of basic daily living, but it is not good either for the taxpayer, as more older people end up going into hospital and getting stuck there when they do not medically need to be there, with all the knock-on consequences that has for hospital waiting times and NHS budgets. We have got to stop treating the NHS and social care budgets separately, because they are inextricably linked, and we have got to stop fixating on hospitals, because the care system of the future lies in the community and closer to home.

Secondly, we need to give more help to families. Many of the UK’s 6.5 million unpaid family carers face a desperate daily struggle to look after their older or disabled relatives. They often feel pushed to breaking point financially, emotionally and physically. One in three carers have to give up work or reduce their hours because they cannot get the help they need to look after their loved ones, so they lose their income, the economy loses their talent and the Treasury loses their taxes. How does that make any sense? We no longer think parents should be forced to give up work to look after their children, so why do we accept it for those caring for elderly or disabled relatives?

Many of us on the Opposition Benches believe universal childcare to be as much a part of our economic infrastructure as the roads and railways. That we are living longer means we need to see social care, too, as an essential part of our economic infrastructure. With so many people now looking after their elderly mums and dads as well as their own children, we need to be thinking about universal family care and leave to meet the realities of modern life, because families should never have to choose between holding down a job and caring for their own.

[Alex Cunningham]

I ought to have declared that I am a co-chair of the all-party group on carers. I am pleased my hon. Friend has mentioned unpaid carers. The Secretary of State took 19 minutes to acknowledge the existence of the millions of unpaid carers in our society. I wonder if my hon. Friend has any tips for the Government for how they could address their needs.

[Liz Kendall]

Unpaid family carers need family-friendly working arrangements so that they can balance their work and caring responsibilities; they need an NHS that recognises that their own physical and mental health could suffer too, and they need to know that we are there to support them. Rather than criticising families and saying that they should be doing more, we should acknowledge that many carers have not had a break for weeks, months or even years. We have to change that, because this is not going to happen to somebody else. This is going to happen to every single one of us here.

Thirdly, we need better care jobs. Paid careworkers do some of the most important work in the country, looking after the people whom we love, but many struggle on low pay and zero-hours contracts, with high levels of stress and little training. No wonder staff turnover and vacancy rates are so high, although the vast majority of careworkers say they love the work that they do. We need a comprehensive strategy to improve the pay, professional development and employment security of care staff, and we desperately need to increase the number of careworkers too. We shall need more than half a million more careworkers in a decade’s time, not to improve the care system by providing better quality or wider access, but just to meet increasing demand.

That is why the points-based immigration system announced by the Government will be a disaster. If we already need more than half a million extra careworkers just to meet levels of demand, how on earth will we cope with that new system? It will not be possible. I beg the Minister to meet me, and others, to discuss the development of a separate route into social care in the migration system of the future, because otherwise we simply will not cope.

None of those changes—improving access to care, more support for families and better care jobs—can be delivered on the cheap, but the truth is that families, the NHS and our economy as a whole cannot afford for us not take action. We need, first, an immediate and significant injection of cash into the system in next month’s Budget, and, secondly, a long-term plan for investment and reform. Any new funding system must work for disabled adults as well as older people. It must strike the right balance between individuals and the state. I, for one, strongly believe that we should pool our resources and share our risks rather than leaving people to cope alone. The system must also be fair across the generations. I do not believe that the working-age population should pay for all the additional costs of caring for our ageing population Wealthier older people will need to make a contribution too.

Alongside this funding reform must be a change in the way in which social care is provided, so that it is not just about time slots and tasks simply to keep people alive, but about offering great support how, where and when people want it, so that they can lead the lives that they and their families choose.

This radical reform of social care is just one of the changes that we must make to meet the needs of our ageing population, which is one of the biggest challenges that we face as a country. We need to change our housing so that it helps people to live independently at home for longer. We need to reform the world of work so that, as we live for longer, we can work for longer and more flexibly. We need to change our health services so that they keep people fitter and healthier for longer as we live for longer. None of those things will be easy, but if we want to meet the challenge of our ageing population and if we want to make Britain the best country in the world in which to grow old, we need to grasp this nettle, and we need to do it now.

--- Later in debate ---

[Liz Twist (Blaydon) (Lab)]

As I was preparing for this debate, I looked at last year’s debate and, as other hon. Members have said, it was like we have not moved on at all. We are repeating the same arguments, and nothing has really changed. What has changed, however, is that we are seeing increased demand for social care, whether domiciliary or residential, but local authorities’ ability to deliver that support is decreasing because of financial pressures.

Demand is continuing to rise. Age UK says that 1.5 million people aged 65 or over have an unmet social care need and believes that that could rise to 2.1 million by 2030 if the current approach continues. Last year, over half of the 1.32 million new requests for social care resulted in no services being provided. In my constituency, Age UK tells me that 3,012 older people have unmet care needs, and that 2,517 older people are providing the care that family members require. Of course, we must also recognise that thousands of unpaid care workers are providing support to people in their homes, and we must never forget that. I salute them for carrying out that essential work.

I will reiterate some of the points covered in the previous debate, because they remain central to this debate on social care. We need more money. We do not need the drip feed of a 2% increase in council tax, which in constituencies with a low council tax base, such as mine, will not produce anything near the money we need, compounding inequality and injustice. We need a substantial increase, and Age UK estimates that an increase of £8 billion is required over the next two years to stabilise the current system while we look at what will be provided in the future.

We need to look at the market for social care providers. The market is fragmented at the moment in both residential and domiciliary care, and most authorities have seen providers fail in both areas, meaning that they need to step in as an emergency measure to ensure that people get the help they need. We cannot continue with a market based substantially on price competition, because local authorities are forced to look for the lowest bids. We need quality services that deliver the things that people require and deserve. I would like to see more directly provided social care services, because that gives us control.

We must now develop a workforce strategy for social care. We have talked about that a lot in relation to the NHS plan and the future workforce strategy, but we need to look at it here, too. The social care workforce is predominantly female. They provide the most personal and intimate care to the people we love, and we must recognise the value of their work. They need proper pay. They need professional registration, which people working in the sector are considering. They need improved training and development if we are to recruit and retain the staff we need. We must put an end to carers travelling in their own time, to zero-hours contracts, and to 15-minute visits, which all of us would agree are completely outrageous.

[Alex Cunningham]

My hon. Friend mentioned the very personal nature of the care provided by prepared carers, but young carers also do this. They allocate medicines, and they even take their parents to the toilet or wash them. Does she agree that so much more needs to be done to recognise the role of young carers and to give them even greater support?

[Liz Twist]

I certainly agree that we must recognise the work of young carers, who do a tremendous job. We place huge pressure on them, and we thank them for their work. We must look after them, too.

We need a workforce strategy, and there is much more I could say. Others have already touched on the high cost of care for those with dementia, as opposed to a physical illness, and we need to do something in both the short term and the long term. We need a long-term, thought-through plan for providing social care to all those who need it.

We need a plan for social care that supports people when they need it and that cares for people when they need it. It should not just look after them mechanically; it should care for them. The Prime Minister said during the election that he has a plan. Well, let us see it and debate it, because we all know this action is long overdue.

--- Later in debate ---

[Paul Bristow (Peterborough) (Con)]

To begin, I would like to declare a couple of interests. My partner owns a communications consultancy that works in health and social care. Both my parents were nurses. My father managed residential nursing homes until he retired, while my mother was a deputy sister in a residential home, caring for people with dementia.

I would like to focus my remarks on those who work in social care and what we might do to improve the recruitment and retention of staff. In my mind, much of it lies in the value we attach to those who work in the profession. Many of my constituents work in social care, and the profession is just as important as our NHS in helping to support our community. Those working in care homes and in the community across my city and the country should know that they are valued, just as we value our hard-working doctors and nurses. I know how hard the staff in care homes work each and every day. It is often a job that goes without much reward. Pay can be low, and recognition is often lacking, but it is critical.

The National Audit Office estimates that 1.3 million people do these jobs. The Centre for Workforce Intelligence has suggested that an extra 660,000 careworkers will be needed by 2035 if we are to keep pace with demand for care. When we consider that more than a third of staff switch jobs or move out of the sector each year, we begin to see the challenge. Those are worrying figures for families who rely on this service. Why do we have a problem with recruiting and retaining social care staff? Pay is clearly a factor, but it is not the only one. Too often, the profession is held in low esteem, which makes it difficult for some providers to recruit and retain staff.

[Alex Cunningham]

I am pleased that the hon. Gentleman has used the word “profession” several times, because this is not only about training and qualifications but about status; that is a very important factor. I bang on about money for low-paid workers all the time. Does he agree that professional work deserves professional pay, not minimum pay, which the majority of careworkers seem to be on?

[Paul Bristow]

I accept what the hon. Gentleman says —pay is indeed a factor in the recruitment and retention of social care staff, but I also agree that it is not the only factor. Terms such as “low-skilled worker” are far too commonly used in relation to care staff. That language and perception need to be challenged. We need a greater emphasis on professional structures, career development and appropriate reward.

We also need to celebrate these roles and show how rewarding and fulfilling they can be. After all, this is about looking after people. These people are our grandparents, our fathers, our mothers, our uncles, our aunts and, in some cases, our children. One day it is likely to be us. I will never forget a constituent telling me about his job in social care. He said that each and every day, he got to look after, talk to and listen to people who became his friends, and he felt he was almost cheating by calling it work.