Tobacco and Vapes Bill

Caroline Nokes Excerpts

2nd reading
Tuesday 26th November 2024 Commons Chamber

[Wes Streeting]

That is a very helpful intervention because it gives me the opportunity to say thank you to my counterparts in Wales, Scotland and Northern Ireland. This is a genuinely four-nations Bill, and through it, we have an opportunity to create a smokefree generation in every corner of our country.

I say to people who have an ideological objection to the Bill that if they believe in lower taxes, as they say they do, and in maintaining a national health service, as they say they do, they cannot duck this simple equation: an ageing population plus a sicker society equals more spending on the NHS, paid through higher taxes. The Bill is just one measure, but it will make a significant difference to the health of our society, and to the balance of that equation.

The question that opponents of the Bill must answer is this: if they want our health and care services to continue having to spend £3 billion every year on the symptoms of smoking, are they willing to accept that that means higher taxes or higher healthcare charges for their constituents? Are they happy for their constituents to shoulder the welfare bill for smokers falling out of the workforce? Those are the consequences of what we are voting on today. Higher taxes and higher welfare are not the Labour way.

There are arguments about liberty from those who oppose based on libertarian belief. They say that the state should not deny individuals the choice to smoke if they want to, but three quarters of smokers want to stop and wish they had never started. It takes a smoker an average of 30 attempts to quit before they manage it. By definition, an addict is not free; there is no choice, no liberty and no freedom in addiction. Nor is choice afforded to anyone inhaling second-hand smoke. Tobacco is not only highly addictive but uniquely harmful. Yes, some smokers can quit, but most who want to cannot. Those who have help to quit are three times more likely to succeed. That is why the Government are, as I said, investing £70 million in smoking cessation services—an investment that will pay for itself several times over—but prevention is better than cure, and that is why we are taking action, through the Bill, to stop the start.

In conclusion, this Bill marks the start of a decade in which we will shift the focus of healthcare from treatment to prevention; take serious action on not just smoking, but obesity; reform the NHS, so that it catches problems earlier and gives patients the tools that they need to stay out of hospital; harness the revolution taking place in life sciences; and fundamentally transform the NHS, so that it predicts illness and prevents it from ever taking hold. That is the future available to us, and it is the future we must realise if we are going to put our welfare system, health service and public finances on a sustainable footing. It starts with this Bill. Smokers are more likely to need NHS services, be admitted to hospital, drop out of the workforce and on to welfare, and need social care years earlier than if they did not smoke. By taking the measures set out in the Bill, we are putting the UK on the road to becoming smokefree, building a healthier, wealthier nation with a health service fit for the future and leading the world as we do so. I commend this Bill to the House.

[Madam Deputy Speaker (Caroline Nokes)]

I call the shadow Secretary of State.

Infected Blood Inquiry

Caroline Nokes Excerpts

Tuesday 19th November 2024 Commons Chamber

[Nick Thomas-Symonds]

I can indeed confirm that. The authority is working in a way that will allow it to scale up as quickly as it possibly can. The need for speed in delivering compensation payments is paramount.

Memorialisation will be really important in how we remember the victims of this scandal. Sir Brian Langstaff makes a compelling case about the need to recognise what happened to people, and for it to be recognised by future generations. Officials have begun the necessary work to respond to Sir Brian’s recommendations on memorialisation, and we recognise that this is an incredibly sensitive issue that we need to get right.

Sir Brian Langstaff’s recommendations call for fundamental changes to the way that politics and Government operate, and for one of the largest compensation schemes in UK history. That is entirely in line with the scale of the injustice that he has uncovered. Given the scale of the recommendations, I am committed to updating formally on them within the 12-month timeframe set out by Sir Brian Langstaff, but I assure Members of this House, and, indeed, the infected blood community, that we will drive forward this vital work. We will deliver the changes that are needed, which will stand as a testament to the bravery and determination of people who have been so badly failed.

I pay tribute to all those who fought so hard to bring us to this moment. Their efforts are monumental, and we commit again today to ensuring that they have not been in vain. I commend the motion to the House.

[Madam Deputy Speaker (Caroline Nokes)]

Before I call the shadow Minister, I wish to make a short statement about the House’s sub judice resolution. I understand that several legal cases relating to contaminated blood products have not yet concluded. However, given the public interest in this issue, Mr Speaker has exercised his discretion to allow reference to specific proceedings where necessary, as they concern issues of national importance.

I call the shadow Minister.

--- Later in debate ---

[Ian Lavery (Blyth and Ashington) (Lab)]

In the past three years alone, I have spoken in this House at least 10 times about the delays that the victims of contaminated blood have faced in obtaining the justice and compensation they deserve. Progress has been painfully slow and, as my right hon. Friend the Paymaster General said, there is much anger, frustration and mistrust for us to deal with, as it has not gone away. It has not been diluted by the general election, and those seeking compensation are rightly angry and mistrustful.

In May 2024, the inquiry found that more than 3,000 people had sadly died as a result of this scandal. Roughly one victim dies every two days, many without receiving compensation. I would not like to calculate how many people have died since I first spoke about contaminated blood in the House. My right hon. Friend mentioned further legislation and, between now and then, more people will sadly pass on as a result of this scandal.

I appreciate that my right hon. Friend has had only a few months to try to rectify the consequences of the previous Government’s slow response to Sir Brian Langstaff’s demands. Again, I urge my right hon. Friend to do everything in his power to ensure that the Infected Blood Compensation Authority hires the staff needed to address the challenges and to design the procedures required with the utmost urgency. I am sure that my right hon. Friend has got the message.

I have spoken in the House many times of my constituent Sean Cavens, who was one of the youngest people in the country to be infected with hepatitis C as a result of being given contaminated blood. He has campaigned tirelessly on behalf of fellow victims of the scandal. Many people have died waiting for justice.

At the current rate of settling claims, which is another huge issue, victims and others are concerned that many more people will die without seeing a ha’penny of compensation for themselves or their families. They question whether the Government are acting quickly enough, with only 270 claims expected to be dealt with by the end of the financial year and more than 4,500 claims in limbo. I share their concerns; I am not sure if that is good enough.

Sean is now 43 years of age. He was infected with hepatitis C and other viruses in 1983. He wonders where he fits in the selection process. He will not be alone in wondering whether he must simply hang on and hope to survive long enough to see justice done for him and his family.

While the scheme currently has no effect on payments made through the infected blood support schemes, that will cease to be the case in the new financial year. I hope my right hon. Friend the Minister will review that approach and extend the deadline, so that people who receive payments after 31 March 2025 do not see that deducted from compensation through the new scheme. Will my right hon. Friend the Minister consider that point?

Fundamentally, Sean and others are concerned that those currently on the infected blood support schemes are not automatically being offered the core route payment. They wonder why they cannot be offered a lump sum payment equivalent to payments up to the average life expectancy of 86. They are also concerned that the rates of compensation to be offered are rumoured—I emphasise the word “rumoured”—to be only 20% of current annual payments. I am sure that will be outlined by my right hon. Friend in his winding-up speech.

The uncertainty about the compensation scheme’s date of infection criteria is causing concern for victims. The burden of proof for those who were infected after screening for relevant viruses began is deemed by the Infected Blood Compensation Authority to be “higher”, but without any clarification on what that actually means in practice. Will the Minister provide such clarification? Screening began for HIV in November 1985 and for hepatitis C in September 1991, but for hepatitis B it was as early as December 1972. As I mentioned, Sean was infected with hepatitis B in 1983. He needs to know how that will affect his final compensation. For instance, will the IBCA take into account that the screening test for hepatitis B in 1983 is estimated to have been only 43% effective? Will the IBCA recognise that victims were treated for hepatitis C with the retroviral drug Interferon, which has well known serious side effects on patients’ mental health? Will that be reflected in their compensation?

Will the Minister confirm that Sir Brian Langstaff’s recent guidance, contained in his letter dated 13 November 2024, regarding the siblings of victims who deserve compensation, will be accepted by the IBCA and reflected in any compensation scheme that it designs? Will, as Sir Brian has recommended, any family member whose relationship was “so close” to the victim that damage to their own mental or physical health caused by witnessing their sibling’s suffering was “reasonably” foreseeable receive full compensation, if they were so damaged? It has been reported that the IBCA will only compensate siblings of victims if they lived with the victim in the family unit for a full two years. Will the Minister ensure that that arbitrary restriction is not contained in any IBCA compensation scheme?

Will the Minister confirm that the family of any victim who dies before his or her application to the IBCA has been completed will receive full compensation? There are indications that the IBCA interpreted the inquiry’s final report as saying the contrary—that it intends to pay only those who live long enough to receive a final reward. That cannot, in any way, shape or form, be correct. It is not fair and it is not just.

Will the Minister ensure that those who, as children, were purposefully infected with contaminated blood in the name of medical research are awarded enhanced punitive levels of compensation, to reflect the country’s abhorrence at such horrific criminal behaviour, carried out by medical professionals who had sworn to dedicate themselves to healing the sick? That is one thing I just cannot understand. The whole tragic scandal is an absolute disgrace, but it is really abhorrent that this great country of ours experimented on little children. Those children, many of whom have not survived, deserve the compensation. How much they should be awarded is obviously to be determined, as has been stated, but bearing in mind the abhorrent nature of what we have done as a nation, I ask the Minister to ensure it is enough.

The infected and contaminated blood scandal is just one of far too many injustices in the UK in recent decades, in which powerful people have treated institutional reputations, career prospects and, in a number of cases, profits as being more important than working-class lives. Hillsborough, Orgreave, the postal service Horizon scandal and Grenfell all share this shameful characteristic: each one sent out a message that ordinary working-class lives do not matter. The Minister can take this opportunity to show that this Labour Government think that the lives of ordinary people matter by ensuring that the victims of contaminated blood products receive just and meaningful compensation without any further unconscionable delay.

[Madam Deputy Speaker]

I call the Liberal Democrat spokesperson.

[Liz Jarvis (Eastleigh) (LD)]

I am grateful for the opportunity to speak in this incredibly important debate. I begin by paying tribute to all those who had their life destroyed by the infected blood scandal, and everyone who has campaigned for justice. They include my constituent Gary Webster. For those who are not familiar with his story, Gary was born with haemophilia, and at the age of nine he was sent to Treloar’s college, a specialist boarding school in Hampshire. His parents hoped that the school’s on-site medical facilities would enable Gary to lead as normal and happy a childhood as possible. All the boys at the school and their parents trusted the doctors who saw them implicitly, but in fact, the boys were being given contaminated factor VIII blood products imported from the US. Gary was in his final year at school when he was told that he had been infected with HIV/AIDS and hepatitis, and that there was no guarantee that he would be alive in six to 12 months. Of the 122 haemophiliac boys who attended Treloar’s between 1973 and 1986, 80 have since died.

The infected blood inquiry report by Sir Brian Langstaff found that

“deaths, illness and suffering were caused needlessly to people with bleeding disorders by…Treating children at Treloar’s with multiple, riskier, commercial concentrates, prophylactically and as objects for research”

and

“Treating children unnecessarily with concentrates (especially commercial ones) rather than choosing safer treatments.”

One can only imagine the pain of the survivors and all the families, and it beggars belief that it has taken so long for them to get justice.

The thousands of victims of the infected blood scandal and their families from across the UK have been waiting far too long for justice, accountability and compensation. The Liberal Democrats welcome the introduction of the infected blood compensation scheme. We are glad that it will bring the victims of this gross miscarriage of justice, including those who were infected and those who have been affected, closer to the justice that they deserve. It is crucial that this compensation scheme is implemented as quickly and effectively as possible. We are also backing calls by the survivors for a duty of candour on all public officials.

The infected blood scandal campaign organisation Factor 8 has highlighted that the guidance on the Infected Blood Compensation Authority website states:

“Should an eligible affected person die during the application process to the Scheme, their compensation award will not be paid. This is in line with the Inquiry’s recommendation.”

However, Factor 8 has examined the inquiry’s second interim report, and in the summary of conclusions, on page 14, at conclusion t), Sir Brian Langstaff says:

“Where an affected person who has not made a claim dies, the sums that they might have received if they had claimed should not become part of their estate.”

The key wording is

“who has not made a claim”.

Will the Government update their policy and ensure that all affected persons who make an eligible claim have their claim honoured? That is important for those affected who are elderly or ill, and are concerned that they may not live to see the end result of the claim process. I hope the Minister will look at that as a matter of urgency.

The infected blood scandal has highlighted the importance of robust blood safety measures and tools. Will the Government look into the merits of pathogen inactivation technology to ensure that no one else unnecessarily suffers from infected blood, and that we have a safe, reliable supply of blood products?

I spoke with Gary Webster on Friday, and as he put it,

“the whole process needs speeding up”.

After so many years of secrecy, deceit and delay, the Government must ensure full transparency about the progress of the scheme, and open, ongoing communication with all those affected. As for the families who have been impacted by this appalling scandal, please give them a national memorial, and reassurance that measures will be put in place to ensure that nothing like this can ever happen again.

[Madam Deputy Speaker (Caroline Nokes)]

I call Michael Payne to make his maiden speech.

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[Amanda Martin (Portsmouth North) (Lab)]

We must always remember that at the heart of any public scandal, there are people. So many of my hon. Friends this afternoon have told tragic stories, but also stories of courage and humility. Alongside other brave, courageous victims and their families, Becca, Jess and their siblings have campaigned for justice for people infected and affected, in loving memory of their father, Joe. Like me, they welcome the decisiveness and commitment from this Government. With families like them in mind, I would like to ask the Minister to outline when he expects the second set of regulations to be laid before Parliament, how victims and their families can continue to be involved and informed of progress, and how claims can be made.

[Madam Deputy Speaker (Caroline Nokes)]

I call the shadow Minister.

Income Tax (Charge)

Caroline Nokes Excerpts

Tuesday 5th November 2024 Commons Chamber

[Edward Argar]

I gave way to the hon. Gentleman earlier. I am afraid I want to conclude my remarks, because I am keen for others to have a chance to speak.

That offer to the Secretary of State stands. I am always happy to work constructively with him when he is willing to work constructively with me. He knows that we have done that before, not least as we emerged from the pandemic, when I was still a Minister in the Department.

Unfortunately, despite the rhetoric, I fear that the Budget was a missed opportunity that will not achieve the ambitions the Government have set out. As I have said, we cannot tax our way to growth, and without growth we cannot sustainably fund public services. I urge the right hon. Gentleman to be brave, to stand up to those in his party who would have him back down or water down reform, and to deliver a genuinely radical plan for the future of our NHS and for social care that works for those who work in it, but also, crucially, for all the people who rely on it. Our constituents deserve nothing less from him.

[Madam Deputy Speaker (Caroline Nokes)]

I call Kate Osamor.

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[Kate Osamor]

I thank the hon. Member for her intervention. I would add that it is important that patients, doctors and everyone else are listened to. I am assured that the Secretary of State will be listening to all voices.

NHS data is a public asset. Its management should be rooted firmly within the NHS, not placed in the hands of private interests, especially those controlled by an individual who is so hostile to the principles of public healthcare. Our NHS thrives due to the work of everyone in the system, from nurses to administrative staff and healthcare assistants, who each play a critical role in patient care. We must listen to all NHS staff, not just those in the highest-ranking medical roles, as everyone brings valuable frontline perspectives on improving efficiency, patient experience and accessibility.

I especially draw attention to the hard-working staff who provide out-of-hours services for our communities, often doing so on top of their normal hours. The Government must ensure that those professionals receive not only recognition, but the resources and support they need to continue serving our communities in this vital way. Staff in out-of-hours services often only work in such settings part time. However, they are often the last resort for people who are unable to get appointments with their GP or access the care they need.

We must also address the postcode lottery in healthcare. For various conditions, disparities persist in access to specialists, waiting times and outcomes in relation to area, ethnicity and gender.

The stark reality is that mental health services remain woefully inadequate. We face a mental health crisis, especially among young people, and this impacts on personal wellbeing and ruins life chances. We urgently need targeted investment in mental health services, and I look forward to supporting the Government in ensuring that the crisis in mental health support is treated with the seriousness it demands.

This Budget is a strong step in the right direction, but we must go further to ensure that the NHS remains public, that mental health is prioritised and that all NHS staff have a voice in shaping the future of our health system. I ask the Secretary of State to focus on all those areas, because I believe that if we have consistent investment throughout this Parliament, we can ensure that we make progress towards an NHS that works and in which everyone is able to access the quality and timely care that they justly deserve.

[Madam Deputy Speaker]

I call the Liberal Democrat spokesperson.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Caroline Nokes)]

Members will be aware that this is a very heavily subscribed debate, so a time limit will be coming, but not until after we have heard some maiden speeches. I call Juliet Campbell.

--- Later in debate ---

[Esther McVey]

I will carry on for a little longer.

To put that into context, it dwarfs the UK’s annual defence spend, which stands at £55 billion. This is money being wasted instead of being spent on public services.

And if all that was not bad enough, the Office for Budget Responsibility has downgraded its growth forecast to a measly 1.5% for the years running up to the next general election. So much for Labour saying this would be a Budget for growth. This Labour Budget has taken our country back to the 1970s, with crippling taxation, unsustainable levels of borrowing and the trade unions in control. The Budget has also broken virtually every economic promise Labour made during the election. In fact, even worse than the economic misery this Budget will bring might be the further mistrust in politicians it will cause.

Labour ruled out tax hikes on working people more than 50 times, and it ruled out changing the fiscal rules to fiddle the figures. Mark my words, on top of the betrayal of pensioners with the scrapping of the winter fuel allowance, this Budget will be a nail in this Government’s coffin, only four months after they secured a huge majority.

At the weekend, the Chancellor eventually came round to admitting that Labour will be taxing workers, but I am afraid that saying it now, having denied it at the general election, does not wash. It is way too late to be admitting it. All it has done is expose the fact that this Labour Government were elected on a false premise and therefore do not have a mandate for this Budget. [Laughter.] Laughing after not telling the public what they were going to do is why I certainly will not be supporting this Budget.

[Madam Deputy Speaker (Caroline Nokes)]

I call Lewis Atkinson to make his maiden speech.

[Lewis Atkinson (Sunderland Central) (Lab)]

It is pleasure to follow my hon. Friend the Member for Broxtowe (Juliet Campbell), who spoke movingly about her experience in the NHS, as well as the barriers she has ignored and, indeed, knocked down.

I start by paying tribute to my predecessor, Julie Elliott, who not only worked with commitment for Sunderland Central, but provided political leadership and mentorship across the north-east. Julie understood that organising and advocating on a regional basis is often the best way to deliver for our communities. I hope to follow her example. It is the honour of my life to be in the House of Commons representing the city by the sea that I love.

I am pleased that my first debate contribution is about the budget and the NHS, for what is our purpose here if not to improve the economic conditions of our constituents and the care available to those we serve? Health and wealth have always been linked—twin assets—as families like mine, forged in the Durham coalfield, know well. My grandparents were only able to toil at the pit, in the munition factory or in the home for as long as they were healthy. Working-class communities have always feared illness and injury, not just in its own right but because the resulting inability to work was disastrous for family finances. The introduction of the NHS and national insurance by the Attlee Government was intended to protect against such calamities. We have important work to do to repair and renew those civilising protections today.

The link between inequalities of health, wealth and power has been impressed upon me by the privilege of working for two decades in NHS North East. Whether managing dentistry, mental health or cancer services, I saw at first hand how the poorest generally experience the poorest health outcomes. I intend to spend some of my time in this place working to right that situation.

The qualities of innovation and hard work have always been the building blocks of Sunderland’s economy. From the introduction of glassmaking in Britain at Bede’s monastery of St Peter’s, through the education of lightbulb inventor Joseph Swan, to becoming the UK’s leading digital smart city, Sunderland has always been a home of innovation. We have always made things. For 600 years, that meant ships. At our peak, the people of Sunderland were hard at work “macking” a quarter of all ships produced globally each year, and we were likely dubbed “Mackems” as a result. Wealth from shipyards and pits built Sunderland, but such work often caused a thirst, so it was handy that the most popular stout in the country was produced in the centre of town, at the Vaux brewery, until the second world war interrupted production.

In that war, as in others before and since, the patriotic people of Sunderland answered their country’s call. This weekend, I will be honoured to play a small part in what is thought to be one of the largest Remembrance services outside London, reflecting the high number of veterans in our city and the sacrifices made by so many, including my constituents who served in Iraq and Afghanistan.

While the bravery and fortitude of Sunderland’s people has never been lacking, too often they have faced the headwinds of economic change without a Government on their side. By the end of my childhood, the pits, the shipyards and even Vaux had all gone. But the people’s spirit and an understated determination remained, and it is thanks to them that our city is now on the up.

I am not just referring to top-of-the-Championship Sunderland AFC, a football club that has provided me with more agony and ecstasy than even the Labour party has managed. Our Stadium of Light stands on the site of the Monkwearmouth colliery, but now instead of coal we produce a rich seam of talented players, such as Jill Scott, Jordan Pickford, Lucy Bronze and Chris Rigg.

I also celebrate the workers at the most productive car plant in Europe, Nissan, which although not in my constituency is the modern cornerstone of our city’s economy, continuing our advanced manufacturing heritage and skills.

Elsewhere around the city, where there was previously decline we now see new beginnings. On the banks of the Wear, we no longer have shipyards, but we do have the Crown Works studio site, ready to be transformed into a landmark film studio. Where the brewery once stood, we have cranes in the sky for Riverside Sunderland, the most ambitious city centre regeneration project in the UK. We have our excellent university, with particular strengths in media and healthcare, and we have a city that loves a good time, where growing hospitality and cultural businesses provide plenty of decent days and nights. It might be a show at the Sunderland Empire, a meal at one of our many excellent British-Bangladeshi restaurants, or a gig at one of our independent venues.

Where passion and identity are strong, there is music—and Sunderland is a music city. Having produced talent from Dave Stewart to the gone-too-soon Faye Fantarrow, our city’s artists reflect who we are, honour our proud heritage and point towards our bright future as an inclusive city.

Nowadays, we celebrate that Mackems are found in mosques and churches, our community centres, our gurdwara and our social clubs, and now there are even two Mackems in the Cabinet. All my constituents, no matter what their background, deserve a strong economy and quality public services. Because Sunderland was built on hard work, its people rightly expect nothing less from their politicians. It is in that spirit that I recognise the privilege of being in the House on behalf of our entire community. I will do what I can to serve them and repay the trust they have placed in me.

[Madam Deputy Speaker (Caroline Nokes)]

I call Adam Dance to make his maiden speech.

--- Later in debate ---

[Luke Myer (Middlesbrough South and East Cleveland) (Lab)]

On a point of order, Madam Deputy Speaker.

[Madam Deputy Speaker (Caroline Nokes)]

It is not the time to make a point of order.

I call Cat Eccles to make her maiden speech.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Caroline Nokes)]

Order. I propose to put a four-minute time limit on contributions after the next speaker.

--- Later in debate ---

[Bradley Thomas (Bromsgrove) (Con)]

It is not just public services that we need to focus on: the third sector provides vital services that many of our constituents rely on, particularly children’s hospices. I would like to highlight to the House the Acorns children’s hospice in my constituency, which provides vital support to many local families in a really acute moment of need. In 2019, NHS England decided to increase the children’s hospice grant—

[Madam Deputy Speaker (Caroline Nokes)]

Order. That intervention was far too long.

[Jess Brown-Fuller]

I thank the hon. Member for his intervention. He will be pleased to know that I am going to mention hospices later in my speech.

To fix the NHS, we must fix both the front and the back door. Taking the pressure off secondary care can only be achieved by properly funding primary care. That is why the decision to increase employer’s national insurance contributions is a significant mistake, as it risks worsening the crisis in the NHS and care sector. Increasing that rate will drive up GP surgery costs, significantly raising the annual expense of GP practices. Those practices are not eligible for the employment allowance that protects our small employers, so surgeries in Chichester and across the country will bear the full weight of that rise—a burden that they and my constituents simply cannot afford. Surgeries such as Southbourne surgery, Langley House surgery and Selsey medical practice have already reached out to me with concerns about their ability to continue providing services amid those financial challenges. They all agree that this increase will directly undermine patient access and care.

Charities have long suffered the burden of failing statutory services. Chichester boasts some of the most amazing charitable organisations, and one of the great pleasures of my role is to spend time with the people at the heart of those organisations. Charities such as Stonepillow, which works to prevent homelessness in our area, face an increase in costs of £125,000. I also visited St Wilfrid’s hospice after the Budget announcement—an incredible hospice that provides palliative care for hundreds of people every year, both in the hospice and in the community. It now faces an increased bill of £175,000—money that it needs to find annually, with only 17% of its annual budget covered by the NHS. I urge the Government to consider exempting the health and social care sector from the national insurance rise, so that the Treasury is not giving with one hand and taking with the other.

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[Mr Will Forster (Woking) (LD)]

I am surprised to be called so quickly, so thank you, Madam Chair. I was really pleased by the statement that the Secretary of State is looking at how to compensate those in the health and social care sector for national insurance rises. I have in my constituency Central Surrey Health, a not-for-profit, employee-owned group. It serves much of Surrey, and it stands to lose £500,000 as a result of the proposed changes. It delivers community services across Woking and Surrey, including most of the services in my constituency. It would be awful if we lost services as a result of measures introduced by the Government in a Budget that is supposed to invest in the NHS. I welcome the Government’s investment in the NHS, but they must not make the mistake of increasing national insurance on social care firms, health partners and GPs.

I am concerned about the elephant in the room: social care. Local authorities and our health system are really struggling, but social care helps to fix things. It is a more efficient use of our money to invest in social care and prevention than spend on primary care in hospitals. The Government are rightly investing in the NHS, but they have failed to invest in our social care system. Surrey county council is under huge pressure, and Woking borough council has effectively gone bankrupt. It is reported that without further support, almost 50% of local authorities could go under. If the Government do not invest in social care, I fear that they will make the mistakes that the Conservatives made, which we do not want. We need to invest in social care, so I hope that the Government will agree to a cross-party social care agreement that tackles those issues.

I want to touch on the cost of living. The Government have to turn around an awful record from the previous Government. They have introduced some good measures and have suggested that they would increase the tax threshold—something for which we have long campaigned —but I am concerned about the national insurance rises, which will hit small businesses hard. I met many small businesses this morning in Woking, and they are really concerned about the impact of those rises. I like the rhetoric from the Prime Minister and the Government about this being a Government of service, and a Government who want to promote growth. They are using the correct wording, but good rhetoric needs to be followed up with good announcements. The Government say that they are going for growth, but their actions do not support that. They are ignoring Brexit, they are ignoring social care, which undermines our local authorities, and they are undermining small businesses.

The Budget is better than the Budgets of the previous Government, but that is nothing to shout about. It should be a lot better for my constituents in Woking, and for constituents of Members across the House.

[Madam Deputy Speaker (Caroline Nokes)]

There will be a reduction in the time limit to three minutes after the next speaker. A note: when I am in the Chair in the Chamber, I am Madam Deputy Speaker, not Madam Chair; that is for Westminster Hall, or when the Chamber is in Committee. I call Richard Burgon.

Access to Primary Healthcare

Caroline Nokes Excerpts

Wednesday 16th October 2024 Commons Chamber

[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.

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[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?

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[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.

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[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.

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[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.

[Madam Deputy Speaker]

I call Ian Roome to make his maiden speech.

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[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.

[Madam Deputy Speaker (Caroline Nokes)]

I call Llinos Medi.

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[Madam Deputy Speaker (Caroline Nokes)]

I call Martin Wrigley to make his maiden speech.

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[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.