Healthcare on English Islands

Debate between Lord Hanson of Flint and Steve Barclay

Wednesday 27th June 2018 Westminster Hall

[Stephen Barclay]

I am keen to work with my hon. Friend on that, because the Government have prioritised their research and development budget, as I know from my time at the Treasury. A significant investment has also been made in health R&D. The NHS has an opportunity to combine its patient data with our world-leading universities and R&D to attract researchers, drive forward the most innovative approach on healthcare and translate that cutting-edge research into day-to-day care. That can be a frustration for our constituents; it is fine to have the research, but we need to roll it out to scale in a way that is meaningful for patients. The challenge of the Island’s geography is also a huge advantage to it. I do not know what percentage of its patients are taking part in research, but that may be an area for him to explore and for the Department to work with him on.

My hon. Friend also raised the potential of digital. He will be aware that the Secretary of State has asked Dr Eric Topol, one of the world leaders on the use of digital in healthcare, to undertake a report for the Department. My hon. Friend is right that rather than a patient having to be physically present in all instances, as was traditionally the case, there is scope to use digital much more for them to see a consultant online and for information to be sent digitally. I recognise that if the clinical commissioning group is in deficit, finding the headroom to invest in that technology becomes a trade-off and a challenge, but that is one of the opportunities that will be opened up by the Prime Minister’s investment in the NHS and it is an area that the 10-year forward view will specifically examine.

In terms of timing, the Island has a chance to look at how it can become a leader, what has been done with digital enablers and early adopters in the NHS, and in which areas it can lead on in technology. I will come on to the challenges of travel, but reducing the need for journeys is a more sustainable solution than seeking to subsidise them. Our starting point should be how we can use technology to reduce the need for as many journeys, rather than how we can subsidise more journeys. That offers significant scope.

On travel, I heard my hon. Friend’s remarks about the cost and its wider impact on families. There is a correlation with a separate debate we have had about car parking charges. Clearly, there are specific challenges related to travel, but as he also set out, it is quite complex, because there are already arrangements with the ferry companies and national schemes for subsidies and assistance that can be given to people who are financially challenged. It is a question of looking at how we can fit in with the existing schemes and what agreements can be reached with the companies concerned. I am happy to meet him to pick up on that specific point to better understand our current approach and what can be done, given the challenges. Again, the challenge of distance is not unique to the Island, but as he mentioned, there are certain features of travel to the Isle of Wight and the Scilly Isles that pose challenges.

As my hon. Friend will be aware, the NHS healthcare travel cost scheme provides financial help for travel costs for patients on low incomes who are referred. The scheme is part of the NHS’s low-income scheme, under which people are also entitled to free prescriptions and glasses. Under the scheme, the full cost of transport can be reimbursed by the NHS to eligible patients. Schemes are in place, but I hear the wider points that he has raised and I am happy to discuss them with him.

In short, my hon. Friend has set out that the Isle of Wight is ideally placed to be at the vanguard of the NHS’s approach as we move forward with the 10-year forward view, in embracing digital and integration and in looking at how to deliver place-based commissioning most effectively. There are some specific challenges with regard to its population and its geography in terms of travel. The interplay of those two things is another challenge in terms of efficiencies of scale and the services that are considered essential on the Island, which may be dealt with at a larger-population level elsewhere.

In the NHS more widely, as we move to a hub-and-spoke model and to more flexible population sizes, and as we look at place-based commissioning, the Isle of Wight has huge potential to be at the forefront, as my hon. Friend has set out. I am very happy to follow up this debate by meeting my hon. Friend, and to facilitate a discussion between him and NHS England, to ensure that we deliver what he has campaigned passionately for—the best healthcare for residents of the Island—and that the significant investment set out by the Prime Minister is maximised for his constituents.

The shadow Minister quite reasonably asked whether we were open to changes to the legislation. As he will be aware, the Prime Minister said to the NHS leadership in her remarks at the Royal Free Hospital that we are open to such suggestions if NHS leaders feel that changes are necessary. As part of the workings of the long-term plan, those leaders will need to look at what they need, and whether much of the integration—I know that the Mayor of Manchester supports the integration that is taking place in Manchester—can be done under existing legislation, or whether changes are needed, and if so, what those are. That will be part of the discussions with Simon Stevens and others in the weeks and months ahead.

[David Hanson (in the Chair)]

The hon. Member for Isle of Wight has the opportunity to make any concluding comments, should he so wish.

Modern Slavery Bill

Debate between Lord Hanson of Flint and Steve Barclay

Tuesday 4th November 2014 Commons Chamber

[Mr Hanson]

I will address the hon. Gentleman’s points in the course of my remarks.

You will know, Madam Deputy Speaker, that my hon. Friend the Member for Paisley and Renfrewshire North (Jim Sheridan) introduced legislation on gangmasters in 2004. I pay tribute to him, because that is effective legislation. It has protected workers in three key sectors—agriculture, shellfish collection and horticulture. It has done something all hon. Members should be proud of: it has driven out poor standards, protected work forces, and ensured that we do not undercut legitimate workers in those sectors.

My argument in new clause 1 is that we should give the power to the Secretary of State to extend that. Following the Government’s triennial review, they said:

“There is no change to the remit or funding of the agency”,

yet there is ample evidence that the agency should have its work extended, particularly following the Joint Committee on the Draft Modern Slavery Bill, on which a number of hon. Members present in the House served. The Committee considered a number of issues in detail, including the role of the Gangmasters Licensing Authority. In paragraph 189 of its report, the Committee states:

“There was consensus from our witnesses over the excellent reputation of the GLA…the GLA has been held in high regard as an example of good practice.”

In paragraph 190, it states:

“We heard from the Authority itself that there are limitations to what the GLA can currently do. Its Chief Executive, Paul Broadbent, told us that the GLA’s underpinning legislation was ‘good up to a point’, but did not provide for the GLA to carry out what he described as ‘hot pursuit’”.

The Committee said:

“Several witnesses made the case for widening the industrial remit of the GLA to other sectors where forced labour is prevalent”,

and that:

“The weight of evidence we received suggested that expanding the GLA’s powers and industrial remit would yield positive results.”

The Committee was comprised of Members of both Houses from all parties, but the TUC report, “Hard Work, Hidden Lives” concluded:

“The GLA needs to be extended to hospitality, construction and catering as these are usually small businesses that are open to abuse.”

Oxfam, which hon. Members will agree is a well-respected charity, has said:

“Gangmasters have diversified into sectors beyond the reach of the GLA where there is less regulation of labour standards.”

It concluded that

“the GLA’s remit must immediately be extended to the sectors of construction, hospitality, and…care”.

[Stephen Barclay]

When breaches by a gangmaster operating in a regulated sector such as agriculture are found by the GLA, would it be reasonable to assume that that same gangmaster operating in the hospitality sector is carrying out the same abuses, which therefore deserve to be investigated?

[Mr Hanson]

The hon. Gentleman puts his finger on the point the Opposition made in Committee. Gangmasters are diversifying. They are moving into horticulture, catering and the care homes sector. I do not want to ruin his reputation, but the amendments he has tabled have the Opposition’s support, because he has indicated that measures can be taken to tighten up how we operate the current gangmaster legislation.

In his original Bill, my hon. Friend the Member for Paisley and Renfrewshire North sought to protect people who are exploited, but such legislation is also about supporting legitimate businesses working in those sectors who find themselves being undercut by people who are operating sharp practices. What is good for the horticulture, agriculture or shellfish collection sectors should be good for other sectors, such as care homes and construction. New clause 1 does not specify that, but simply says that the Minister has the power to extend legislation. I hope we can give her the power and make the case, both up to the election and I hope in my case beyond it, for introducing changes to improve how the legislation operates.

[Stephen Barclay]

One reason why the Government have resisted such a measure is the view of the Secretary of State for Defence, who, as a Minister in the Department for Business, Innovation and Skills felt that we would be adding additional red tape. Aside from the fact that targeting criminals who abuse people is not the sort of problem on which the deregulation challenge should focus, does the right hon. Gentleman agree that going after those people is not red tape, because many of the large businesses would welcome the fact that they are not being undercut by those abusing the market?

[Mr Hanson]

The hon. Gentleman sits on the Government Benches, so I am not sure it is in order for us to agree again. The British Retail Consortium supported our proposals in Committee. This is not some kind of mystical issue; this will help to protect the work force, stop undercutting and protect legitimate businesses working in specific areas. What is good for the three sectors currently covered should be good for others too.

I do not just pray in aid Oxfam, the TUC and the Joint Committee. The Joseph Rowntree Foundation said:

“Many have called for extending the authority…of the GLA to cover all industries where there is known risk of exploitation and forced labour associated with labour providers. The evidence from the JRF’s programme points to the same recommendation.”

In Committee, I prayed in aid Andrew Boff, who is not a member of my party but the Mayor of London’s representative and deputy. In a report on slavery in London, he recommended strongly the extension of gangmaster legislation. That is very important, because we need to send a very strong signal on exploitation.

An answer to a recent parliamentary question revealed that the number of criminal investigations under the current gangmaster legislation has dropped from a high point of 134 in 2011, to 76 in 2013 and 65 to date in 2014. This information has come to light since the Public Bill Committee last sat. The Minister said in Committee that this was a growing problem. I would welcome her view on why the number of investigations into gangmaster activity has dropped over the four-year period.

The National Crime Agency, the general secretary of the Union of Construction, Allied Trades and Technicians, the Serious Organised Crime Agency, the leader of the Conservative group on the London Assembly, the Joseph Rowntree Foundation, the British Retail Consortium and the Ethical Trading Initiative have all said we should consider extending gangmaster legislation. New clause 1 would give the Minister the chance to do that speedily. I pressed her on this in and outside Committee. With due respect to her talent as a Minister, I do not think she has made an effective case for why we cannot extend it to the areas suggested by me and the hon. Member for North East Cambridgeshire.

I think there is a general consensus outside the House that exploitation is exploitation, be it in relation to shellfish or care work. We therefore need to look at this in an effective way. This is not, dare I say, a fly-by-night issue for the hon. Gentleman. He has pursued it over many months. His amendments do not deal directly with the matters addressed in new clause 1, but we sat on a Bill some time ago in the mists of this Parliament and he raised the same issues then. He has a real opportunity to ensure that his amendments enhance the 2004 legislation and build on the work of my hon. Friend the Member for Paisley and Renfrewshire North. He has our support, and if he wants to use that on his election address in due course I am sure that will be even better for him.

New clause 2 addresses protection from slavery for overseas domestic workers. The previous Government put in place a regime for migrant domestic workers who accompanied employers to the UK. The current Government changed the regime in April 2012. Overseas domestic worker visa holders are now tied to their original employer and the visa is not renewable beyond its initial six-month duration. We have had two-and-a-half years of the new regime since April 2012, and there is real concern that it has been detrimental to domestic workers and is causing real challenges in the system that need to be considered.

That is my view—I am open and honest about it—but it is shared by the Joint Committee that scrutinised the Bill, including Members in their places today who supported recommendations on a cross-party basis. Andrew Boff, the Conservative leader of the London assembly, is of that view, too. In his report on human trafficking, he said:

“I don’t think it intends to be, but the Government is actually licensing modern-day slavery… through their changes to tie a visa to an employer.”

There is cross-party support for the Government to review the issues covered by new clause 2. In agreement are a Joint Committee of both Houses of Parliament, comprising and dominated by Government members, the leader of the Conservative group on the London assembly, along with many organisations interested in this topic from outside the House—notably Kalayaan, which carried out a study on the impact of the Government’s proposals.

Kalayaan has thrown up some really concerning figures. Between 6 April 2012 and 3 April 2014, 402 migrant domestic workers registered with Kalayaan. Of those, 120 were tied to their employers and 282 had entered the UK prior to April 2012. There was a real difference between the way in which these groups were treated. The Minister said in Committee that it was a “small sample”. Yes, it is, but if that sample shows that 62% of overseas domestic workers on tied visas report being paid no salary at all, and if 85% of those on tied visas are not given their own room to sleep in, with 86% saying that their passports have been taken off them by their employers, 96% not allowed to leave the house unsupervised, 74% reporting having suffered psychological abuse and 95% paid less than £100 a week, the size of the sample is not the crucial thing. Whatever the size of the sample, real and difficult challenges are evident, and they can be traced back to the change in the granting of these visas in 2012.

The Joint Committee recommended in its draft Bill that we return to the position of April 2012—prior to the changes the Government made. That proposal was put in Committee, and there was a tie with nine votes to nine votes. Members of the governing party voted with other members of the Committee; some Members did not, which was their choice; some Members supported the draft Bill’s recommendations and voted against them in Committee, which was their choice. I believe, however, that there is a real consensus on ensuring that this issue is looked at in the other place. I hope the Government will consider it further. New clause 2 provides an opportunity to do so.

Let me move on from new clauses 1 and 2 to the other contentious and wide-ranging issue suggested by this group of amendments. My hon. Friend the Member for Slough (Fiona Mactaggart) raised this initially in Committee—the issues of how to deal with sex workers and prostitution and of how prostitution should be dealt with by society as a whole. My hon. Friend will undoubtedly speak to her new clauses. MPs do not need to look far into their inboxes to realise that a range of views are being expressed, including by the all-party group chaired by my hon. Friend the Member for Luton South (Gavin Shuker). My hon. Friend the Member for Hayes and Harlington (John McDonnell) has also filtered through a range of issues for Members to consider. People have different views about how to deal with this.

Let me put it on the record from the outset, however, that all the different views focus on the fact that there are around 80,000 people, mainly women and girls, involved in prostitution today. Nobody can deny that many of these workers carry out this work voluntarily, yet a lot of them are involved in sexual slavery, having got here through different routes. They are often pimped by people they know and can be trafficked by organised gangs. They are often extremely vulnerable, having been abused in the past. About 95% of women in street prostitution have problematic drug use; over half of women involved in prostitution in the UK have been raped and/or sexually assaulted; and the vast majority of those assaults are committed by people who have purchased sex from them.

According to recent statistics, there has been a recent and rapid increase in the number of non-British women selling sex on the street in a significant number of London boroughs. There are real concerns about trafficked women being exploited in on-street as well as off-street prostitution and about the fact that this exploitation is now being controlled and organised by criminal gangs. This is a real issue that the House needs to address.

A number of solutions have been proposed. The Nordic model, which is effectively the basis of the proposals from my hon. Friend the Member for Slough, looks at how we diminish street prostitution—particularly by making it an offence for people to buy sex. One argument put forward is that street prostitution has diminished by half and that the number of brothel businesses is also diminishing, or certainly has not increased. There is evidence of the flow of human trafficking having been slowed in Sweden because of that. In Norway there is evidence that that is contributing to the reduction in demand for and volume of prostitution. But we do not have to look far into our email inboxes to know that there are very strong views from people involved in the trade that that potential model and others could lead to further violence against those who are involved in the industry and/or to driving prostitution underground.

The Opposition have tabled new clause 22, which seeks to place upon the Government a legal responsibility to undertake a review of these issues in detail. We are seeking to deal with this matter effectively. We have said that within six months of Royal Assent the Government should look at all the discussion points that are before us today. The review would investigate the extent to which current legislation governing prostitution in England and Wales acts as an effective deterrent to demand for sexual services from exploited persons. It would look at the extent to which current legislation governing prostitution in England and Wales enables effective enforcement action against trafficking people and sexual exploitation, and at the very points made by my hon. Friend the Member for Slough in her amendments today: the legal frameworks for governing prostitution adopted by other countries within the EU, including Northern Ireland. The review would look at the examples of Sweden and of Norway to help inform the debate.

All of us will have different experiences in our constituencies about the impact and challenges of this problem and I am not intending to come to conclusions today. The purpose of new clause 22, effectively, is to give a spur to a wider discussion on the topic. I hope that the Minister can look at it in that way because there are strong views on how we deal with the issue. It is important to have a proper debate.

--- Later in debate ---

[Mr Hanson]

I do not think that we made a financial assessment of the value of the trade when I was a Minister. I know that it is being discussed currently, as part of other discussions relating to the Treasury’s contributions to Europe.

I do not want to be diverted, because we have only a short time available. I have tried to compress the material for a long series of debates into a fairly short contribution. Let me now sum up that contribution. New clause 22 concerns a review, and it commits the Government to nothing other than that review. There is a real case for extending the gangmaster legislation; new clause 1 simply gives the Secretary of State the power to do that, which I hope she will welcome.

I was pleased to hear the comments of the hon. Member for North East Cambridgeshire (Stephen Barclay). I think it important for us to revert to the April 2012 position in regard to overseas domestic workers for a number of reasons. I also think it important to stimulate a debate on the issues of prostitution and sexual exploitation, without reaching any conclusions yet, and that has been possible today through new clause 22.

I commend all three of our new clauses to the Minister. I hope that she will be able to deliver a positive response, but—as ever, Mr Speaker, you will have expected me to say this—in the event of her not doing so, I should like at least to reflect on the possibility of testing the House’s opinion in due course.

[Stephen Barclay]

I want to develop the theme of how we can make prosecution and enforcement quicker and easier. I am aware that a number of Members who wanted to speak earlier have not yet been able to do so, and I shall therefore keep my remarks short.

I want to speak about new clauses 16, 17, 18 and 19. Let me begin with new clause 16. At present, it is very difficult for police in areas such as Wisbech in my constituency to identify houses in multiple occupation. The presence of 20-odd people in a two-storey house often does not meet the legal definition of an HMO. One of the ways in which we can make life easier for the local police is to give them clearer powers and rights to inspect letting agencies, and require gangmasters to keep records in the form of rent books and tenancy agreements. At present, when there is a breach of a tenancy agreement, it falls to the tenant to bring a private prosecution. How realistic is that? How realistic is it to expect someone who has been trafficked, who does not speak English and who does not understand the law to bring a private prosecution against his landlord?

We need to make it quicker, easier and therefore cheaper for the police to identify concentrations of HMOs. They need to be able to go into those houses, establish whether the law relating to, for instance, rent books is being adhered to, and take action if necessary. That will necessitate rights of access to the records of letting agents, and a requirement that the Gangmasters Licensing Authority can then use for leverage in relation to gangmasters.

New clause 17 seeks to build on the lessons this House can learn from scrap metal merchants being forbidden from taking cash payments and asks how we can create an audit trail for financial investigators in terms of the known abuse around the minimum wage legislation and the way people are being paid. At present wage slips will often simply show that someone was on for one day—it could have been seven hours, it could have been 12 hours—and when payments are made, they are made in cash. Straight away, deductions are taken for accommodation and for vehicles, so the abused worker never actually receives that money. Often they are told when they come into the country that they are not allowed a bank account. Obviously that is erroneous information, but they do not know otherwise. New clause 17 therefore addresses how we can make it easier for the police to follow the money—follow that audit trail—so that once money goes into an account, it is with the worker and it becomes harder for the rogue gangmaster to deduct it at source, which is what currently happens.

New clause 18’s provision is, I fear, almost a well-worn theme. I had a debate on it in Westminster Hall in 2012 and 2013. The measure was being blocked by the Department for Business, Innovation and Skills, although I was told privately that the Department for Environment, Food and Rural Affairs was supporting it. The reality is that the Gangmasters Licensing Authority does not have the full range of tools available. It has draconian penalties available in terms of criminal sanctions, but they are almost never used because the standard of proof is high and the amount of time required is extensive.

To put this in context, do Members know how many inspectors the GLA currently has? It has 35 for the whole country. There is one covering the whole of Cambridgeshire and Lincolnshire. An inspector could spend their entire time just driving around my constituency, never mind the rest of the county and the two counties combined. The LGA has 35 inspectors and a budget of £4 million. We need only think about how much a supermarket makes in a week to see how well resourced the GLA is.