May Adjournment

Debate between Edward Leigh and Jeremy Lefroy

Thursday 3rd May 2018 Commons Chamber

[Sir Edward Leigh]

It is a question of quality. Is it really necessary to have 30,000 people employed by the NHS, who have never been doctors or nurses and who have never met a single patient, earning over £100,000 a year? We of course need a level of good-quality management, but we must trust the people on the frontline. Whenever we talk to doctors and nurses they say, “Trust us. We are professionals.” They are the people that members of the public want to see. They are the ones with the vocation and the professionalism to look after us.

The hon. Lady makes a fair point and, like all arguments, we could take it to extremes, but in my view there are two models for the NHS. There is the traditional model that I grew up with in the 1950s and 1960s, and there is a newer model with evermore systems, targets, internal markets and the rest. My personal view—this may surprise the hon. Lady—is that the old-fashioned model probably worked better, because it put more competence and more control in the hands of nurses, doctors and consultants.

I am now going to say something that will probably be even more unpopular. I wonder why our Government are not prepared to bite the bullet and consider alternative funding for the NHS. With an ageing population, we must encourage people to put more of their own resources into their health. How are we going to do that? We could do it through general taxation and increase overall spending, but I have argued against that, or we could do what previous Conservative Governments have done. The Major Government and the Thatcher Government—I do not think the Major Government were particularly right wing—gave tax relief for people of pensionable age towards private health insurance. That is anathema to the Labour party, but it would actually put more resources into health. Most people of retirement age simply cannot afford private health insurance, because they pay for it from their taxed income. However, if we gave tax relief for private health insurance, as previous Conservative Governments have done, we would not be saying that we are against the NHS or devaluing it; we would be trying to encourage the people who are going to use healthcare more often to put more of their own resources into healthcare.

I am worried that if this massive real-terms increase in healthcare spending happens, we will be approaching the levels of health spending per head that we see in Germany or France. The fact is—let us be honest about this—that if we are going to be ill, we would much rather be ill in Germany or France. I know that the NHS is a kind of religion for many people, but the health services under the social insurance systems of France and Germany do work better. They cost more, but the people feel that they have real control over their healthcare. They pay large amounts of tax, but they feel that they have some kind of ownership of their healthcare—some kind of right. When something goes wrong, they are not just enmeshed in a vast bureaucratic machine; they believe that they have some right to treatment through social insurance. Indeed, in Germany, they do get that.

[Jeremy Lefroy (Stafford) (Con)]

My hon. Friend is making an interesting argument, and if I manage to catch Mr Deputy Speaker’s eye, I will talk about that myself. I want to bring to my hon. Friend’s attention a constituent of mine who had a baby in Germany, as a member of the armed forces, and then had one in the UK. She said that the experience in the UK was so much better than that in Germany that she would not recommend that anyone have a baby in Germany rather than the UK.

[Sir Edward Leigh]

I stand corrected, but I think it is a generally accepted fact. We all know from our friends and relations, and from public debate, that the health system in Germany is superb. I am sure there are glitches and areas where we might outperform it, but generally the system there works well.

The Government have to be honest in addressing how we will meet the needs of an ever-ageing population and the desire of that ageing population for ever-new levels of treatment. We have to devise new systems to encourage people to put more of their own resources into healthcare, as I do not believe we can do that out of general taxation.

Before I sit down, I promised to make a point about DFID. Nobody values the work of DFID more than I do. DFID is doing tremendous work throughout the world, but its budget—I say this as a former Chairman of the Public Accounts Committee—is under strain, not from underfunding but from an arbitrary link in legislation to a particular proportion of national wealth. The link simply does not work, and it creates all sorts of stresses and strains.

I am not suggesting to the hon. Member for Bristol West (Thangam Debbonaire) that we cut overseas aid spending; what I am suggesting is that we get rid of this arbitrary link in legislation and have the best, the most high quality, the most free from corruption and the best-targeted overseas aid budget in the world, which I am sure is our aim and what we are achieving in large areas. Imposing such an arbitrary device on spending, which must result in a splurge of spending towards the back end of the year, cannot be right.

--- Later in debate ---

[Jeremy Lefroy]

The hon. Gentleman is absolutely right, although I should say that that 96% referred to access to high-quality healthcare, rather than support for the NHS. I thought I should make that distinction. It may well be that the NHS has 96% support, but I was talking about access to high-quality healthcare.

The hon. Gentleman is absolutely right that diabetes, cancer and other conditions are clearly the issues. The health service has to adapt; I absolutely agree with my hon. Friend the Member for Gainsborough that it can be far too monolithic. Often, we see really good, inspired leadership that makes a real difference in some places—perhaps it even comes from those paid £100,000 a year—but in other places we see some very uninspiring leadership. It is often very much about who is taking on the challenges at the local level and what their motivations are. We clearly have a great deal more to do on that.

Time is short, so I shall move on from the NHS after one final point. I fully agree with the cross-party report published last week by my hon. Friend the Member for Grantham and Stamford (Nick Boles) and other colleagues from the Labour party and the Liberal Democrats. It contains 10 points on how to have a sustainable health system. I have been talking about most of those 10 points in this place for the past five or six years, so I would agree with them, wouldn’t I? Still, there is an awful lot in there for the Government to look at and perhaps take on. I return to the initial point: if we want high-quality services and a strong defence, along with funding for other issues of great importance to our constituents, we will have to pay a little more. The question is whether we pay that through a national health insurance system—a progressive system—through direct taxation or through contributions. Those questions have to be asked. I am in favour of a fully funded system, which may mean that we have to do it through the proposed national health insurance system.

The second thing I wish to talk about is General Electric, which is the largest private sector employer in my constituency. At the end of last year, it announced several hundred job losses, and the consultation on that is currently ongoing. It is a very serious situation. I praise General Electric and its predecessor, Alstom, for their investment in Stafford. They have built two new, modern, state-of-the-art factories, which will provide security for many people in my constituency.

For those facing the prospect of redundancy, it is vital both for them and their families, and indeed for the country, that we see how we can ensure that their skills—often very high skills—are best employed elsewhere. In that context, I want to raise again the matter of the Swansea Bay tidal lagoon, which I and other colleagues have been pushing for. If we are to have a power manufacturing sector in this country, we must be at the forefront of modern technologies, and that is one of them. I urge the Government to come forward with a positive decision on that as soon as possible.

My third point is a local matter. I am very glad to see two of my Staffordshire colleagues—my hon. Friends the Members for Burton (Andrew Griffiths) and for Cannock Chase—on the Front Bench at the moment. I know that they will probably agree with me on most, if not all, of these issues. We have already heard about potholes. Being a rural county, we have the same problems in Staffordshire. Potholes are not just an inconvenience; they are a menace. When cyclists go into potholes that are filled with water, they can suffer very serious injuries, as some of my constituents have. Cars suffers great damage, which brings loss either to the county if there is a claim or to the individual whose car has been damaged. We need to see more money put into that area, both at a local and a national level. After the winter that we have just had, it is a priority. I would like to see the Secretary of State for Transport coming forward with some supplementary funding for potholes for local authorities as soon as possible, because, as we already know, a stitch in time saves nine.

Bus services in rural areas are suffering. My hon. Friend the Member for Gainsborough did not mention this issue, but he has probably been affected by it as well. Clearly, we do not want buses running around empty and wasting a lot of money, but there must be ways of ensuring that our villages and small towns, which are becoming ever less connected with the major centres of population, see a reversal in the situation. We need innovative thinking. Perhaps we should go back to a situation in which councils, as in Nottingham, which runs a very fine public transport service, say, “We will have to step in and fill the gap to ensure that our communities are connected.”

Finally as far as local councils are concerned, I wish to raise the issue of breaks for carers. Carers across the country, and certainly in Staffordshire, perform an absolutely magnificent job. We need to ensure that they can have the breaks that they need, especially those who cannot afford them. They need to be able to get away from time to time. I welcome the fact that Staffordshire has supported such breaks and continues to do so, but the funding is too little. We need to see greater funding in this area and more innovative solutions to ensure that money is wisely spent and available to as many of our carers as need help.

Clearly, on the national scene, the debate is dominated by our leaving the European Union. I will not go into the principles on either side, but I will make points on four areas. Frictionless trade for the manufacturing industry in Stafford and the west midlands is essential. I was recently at the Honda factory in Swindon, and heard very clearly how important it is for us to have seamless trade, in and out, for components. The factory operates, as does almost all manufacturing industry in the automotive sector and others, a just-in-time policy. Such firms cannot have delays at borders.

Another critical area is data, as the Exiting the European Union Committee heard when we took evidence in the City of London. With the EU’s understandable fixation on data protection—we are, of course, putting that into our own law—the City is very concerned that we ensure that data issues are sorted out well in advance of our finally leaving at the end of 2020. It is vital that this is done, because data is at the core of not just financial services but every business.

Financial services companies have a concern about contracts that go beyond the end date of our membership of the European Union. That is a serious issue, because if we do not have the rules on contracts in place, there is a risk that contracts will not be able to be fulfilled and that people will not be paid such things as life assurance or pensions.

[Sir Edward Leigh]

My hon. Friend and I fought the last general election on a Conservative manifesto that stated in clear terms that we should leave the customs union. I hope that he shares my view that it is absolutely essential that we fully support the Government’s desire to leave the customs union, and that we have the right and the ability to make free trade deals with other countries.

[Jeremy Lefroy]

I absolutely agree that we need to be able to make free trade deals with other countries. The corollary to that is that we cannot be in the customs union, as my hon. Friend said. At the same time it is vital, as the Prime Minster has made clear, that we have frictionless trade and that our industries—not only manufacturing, but agriculture and many other industries—across the country can continue to operate without the hindrance and costs that might be caused by certain arrangements. I have every confidence that the Prime Minister and the Government will come up with the correct decision and conclusion, which may not be one that my hon. Friend and I are currently thinking of.

Strengthening Families

Debate between Edward Leigh and Jeremy Lefroy

Thursday 8th February 2018 Westminster Hall

[Jeremy Lefroy]

I am grateful to my hon. Friend. Given that Middlewich is not too far from where I live and where I represent, with her permission I would like perhaps to come and talk to that headteacher, to see what I can learn from the school in her constituency.

As I say, the situation needs to change, and the Department for Work and Pensions has begun to recognise that. The “Improving lives” report announced plans to put £30 million into a programme to help workless parents to resolve conflict through independent providers. However, that provision does not go far enough, because the need is not just among workless parents. A far-reaching, holistic, family-based approach to tackling children’s health is needed, as the example in Middlewich shows.

The recent Green Paper on children’s mental health is an important step in the right direction, and for the first time recognises the importance of parental relationships on children’s wellbeing and mental health, but we need to do more to support families. By incorporating couples therapy into NHS provision, children and young persons’ mental health teams would not be syphoning funds from where they are most needed, but redirecting them to where they will be most effective. Training would be required to enable professionals and frontline workers to be confident in identifying and treating the needs of the couple, alongside an efficient system of referral. The roll-out of family hubs would facilitate a collaborative and consistent provision of couples’ support in addressing children’s mental health. Alongside providing for those affected by mental health problems, that would also help to prevent the mental health problems from arising by providing relationship support and encouraging the involvement of fathers in the family.

Sometimes there is a reluctance to make such points. My hon. Friend the Member for Gainsborough (Sir Edward Leigh) talked about the reluctance to refer to faith and religious belief. I entirely support what he said, but also, in our western, perhaps individual-focused society, we do not recognise enough the support that the wider family, indeed the community, can give to families. When I was living with my family in Tanzania, we often came across a proverb that was originally in Igbo, a Nigerian language, but in Swahili is, “Inachukua kijiji kizima kumlea mtoto”, which means: it takes a whole village to raise a child. If we view a village as our community, we should not shy away from recognising that families cannot do everything, as I know from my own experience. They come under great pressure at various times. Parents are otherwise engaged, perhaps going through crises themselves. It takes a community.

In my constituency, and many others, we have an organisation called Home-Start, which works with troubled families. The problem is that Home-Start relies on volunteers who give their time. It takes professional co-ordination, but we find that the funding for that, which is frankly peanuts when one considers what else we spend money on, is often the first to be cut, as I found in my constituency. Local authorities who were very generous have been put under pressure and, because it is not a statutory requirement, will remove the funding. As a result, the whole service is put under pressure, and may even disappear. These are people working on a voluntary basis with families that are under pressure, and saving the state huge amounts of money, because those families might otherwise fall into needing extremely expensive services. In addition to the issue of mental health, which I have spoken about at some length, I ask the Minister to look at the possibility of making relatively small amounts of funding available to schemes such as Home-Start. We are talking about a few thousand pounds, or tens of thousands, in a whole local authority area. The total cost for the country would be pretty minor, and the savings substantial.

Finally, colleagues may disagree, but I have found the value of family time at meal times very important, as well as the value of not having television. I have never had television, either as a child or an adult, but if people do have a television, there is value in saying, “Well, it has its place, but it shouldn’t be the centre of family life, because it takes up so much time and stops people talking to one another.” I think we can extend that to social media. I was very encouraged to read in The Evening Standard last week of a school, I think in London, which has 10 commandments about the use of social media. That school is really improving the lives of the children, not by forbidding access to social media, but by saying, “Let’s put less emphasis on social media, and spend more time interacting with one another personally, face to face, rather than via small screens.”

We ought to spend more time together as families, and play more games together. Despite my distaste for games that take longer than half an hour, I have discovered a great game called Bananagrams, which is brilliant for families that enjoy that kind of thing. It is not something that the Government can get involved in, but schools and other organisations can provide opportunities and suggestions for families.

[Sir Edward Leigh]

Would it help Cabinet unity if they played Bananagrams?

[Jeremy Lefroy]

At the moment, I think one half of the Cabinet would be playing Bananagrams, the other Scrabble, but it absolutely would help unity. I would love the Cabinet to play Bananagrams together; it might be more productive than some of the conversations that are had from time to time.

In conclusion, the impact of positive family relationships and of family breakdown on mental health is a vital issue. I urge the Minister to look at the big picture on mental health, and at the relatively small initiatives that are locally based and enable communities to do their best through volunteering to support families that are under pressure.