Health and Social Care

Judith Cummins Excerpts

Monday 27th February 2017 Commons Chamber

[Judith Cummins (Bradford South) (Lab)]

It is a pleasure to follow my hon. Friend the Member for Bristol South (Karin Smyth). We are here to debate the financial sustainability of the health and adult social care sectors. Although health and adult social care are almost inseparable, I will focus on adult social care for brevity’s sake.

Although the acute care and adult social care sectors face similar unprecedented pressures, adult social care is different in one important way. Unlike the NHS, which has the ear of the Chancellor and the Treasury, adult social care certainly does not. All the evidence in recent months has served only to confirm that. The Chancellor’s decision not to make one extra penny of new money available in his autumn statement was met with almost universal criticism from across the health and local government sectors, and his recent decision to introduce the adult social care precept is damning evidence that a desperately outdated view of funding remains strong in the Treasury.

Adult social care is delivered locally by local authorities, so the Chancellor views its funding as a locally devolved issue. The Government’s decision to pass the blame to local councils and to underfund adult social care is nothing short of moral cowardice. They are deliberately underfunding adult social care in my home city of Bradford.

What is most desperate is the Government’s abandonment of the hundreds of thousands of older and vulnerable people who are reliant on vital adult social care services, day in, day out. We are talking not about hypotheticals but about the care happening today, right now. Real people are struggling to get by in my constituency of Bradford South. Bradford is a relatively young city; nevertheless, the number of people in Bradford over the age of 65 has grown substantially. Between 2012 and 2015, an extra 4,500 people were living in the district, and the number of people in Bradford with complex physical disabilities has grown by 400.

My local council, Bradford Council, agreed its budget last Thursday. Like many others, it had the task of agreeing swingeing cuts to scores of community services. In recent years, it has reduced its budget by more than £218 million, and a further £82 million in cuts will have to be made by 2020. Adult social care, as the biggest service overseen by Bradford Council, faces the lion’s share of the looming budget cuts. A further £19 million of cuts will fall on the city’s adult social care sector. The Government are washing their hands of any responsibility. By 2020, the revenue support grant, which is the primary source of central Government funding to Bradford Council, will drop to zero—zilch; absolutely nothing.

The Government’s half-baked answer is the adult social care precept. In the next two years, the precept is expected to raise an extra £6.6 million in Bradford, but that extra money is dwarfed by the huge cuts to Bradford Council’s revenue support grant. More to the point, the extra £6.6 million is not even enough to meet the increased cost of adult social care that will flow from the Government’s so-called national living wage. Because of the unprecedented increase in demand, such bruising budget cuts are only the tip of the funding shortfall. It is expected that the cost of supporting increasing numbers of older people, coupled with larger numbers of working-age people living with disabilities, will mean Bradford Council will have to shoulder an extra £1.5 million, each and every year.

[Maggie Throup]

Will the hon. Lady give way?

[Judith Cummins]

I am nearly at the end of my remarks, and the hon. Lady has had her turn to speak.

What is beyond doubt is that the Chancellor must act in the upcoming Budget. He faces his greatest test in this Parliament. I hope that he and his Government do not disappoint. Time will tell.

Reducing Health Inequality

Judith Cummins Excerpts

Thursday 24th November 2016 Commons Chamber

[Judith Cummins (Bradford South) (Lab)]

Thank you, Mr Deputy Speaker, for calling me to speak in this important and, in my opinion, overdue debate. I thank the Chair of the Health Committee, the hon. Member for Totnes (Dr Wollaston), for initiating it, and I thank the Backbench Business Committee for allowing time for it.

I want to focus on an area of health inequality that receives disproportionately less funding than most others and, sadly, far less attention from Ministers than it is due. I am, of course, talking about dental and oral health inequality. Most people, when asked to describe what health inequality looks like in this country, would cite difficulties in seeing a GP, long waiting lists for treatment for common ailments, and the rationing of licensed drugs for those suffering from treatable diseases. I could, of course, go on. Most, however, would not immediately cite dental and oral health, although inequality in that area is just as widespread throughout the country as the many other important inequalities that Members have rightly highlighted today.

Let me underline my point by sharing with the House some unsettling figures that have caused me, as a Bradford Member, more than a few sleepless nights. Official figures reveal that five-year-old children in Bradford are four and a half times more likely to suffer from tooth decay than their peers in the Health Secretary’s constituency of South West Surrey. The number of children admitted to hospital for tooth extractions—they usually require a general anaesthetic—has risen by a quarter over the past four years. Shockingly, during the past year 667 children in Bradford alone have spent time in hospital for that entirely avoidable reason.

[Maggie Throup]

As someone who was born in Bradford, I can proudly say that, even at my age, I have only one filling. As with obesity, dental problems are often due to a lack of parental responsibility as well as environmental factors.

--- Later in debate ---

[Judith Cummins]

That is an interesting point. I shall deal with some of those issues later in my speech.

According to the latest figures, 32% of children in Bradford—nearly a third—have not seen a dentist for more than two years. Ideally, as Members will know, children should be given a check-up every six months.

Dental and oral health has been and continues to be the Cinderella of health service provision. It is seen as being “nice to have”—to be tackled once the good ship NHS has returned to calmer waters—and due for its much-needed extra funding only when the financial black holes elsewhere in the NHS have been plugged. Such inequality in dental and oral health is plain wrong. It is an unspoken injustice in today’s society, and the task of tackling it cannot and should not be kicked down the road like the proverbial can year after year.

Tooth decay is an almost entirely preventable disease. It is a scandal, without exaggeration, that tooth decay is the No. 1 reason for hospital admissions of children between the ages of five and nine. It is a scandal not only because it causes our children needless pain and suffering, but because, in this time of austerity, it wastes countless millions in NHS resources. However, its impact goes much deeper than that.

In an increasingly globalised and competitive world in which our children are expected to succeed at school, improve their skills and excel in internationally benchmarked exams, they all need to be healthy and energised to face the school day. Too often, however, pain arising from poor oral and dental health hinders their school readiness, impairs their nutrition and growth, and cripples their ability to thrive, develop and socialise with each other. A recent survey sadly confirmed that more than a quarter of our young people feel too embarrassed to smile or laugh due to the condition of their teeth. For our teenagers, the injustice is no less when they need to succeed and make their way in a competitive job market.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

In my constituency, I can tell the extent of someone’s poverty by the state of their teeth, so not only is there the issue of decay, but this is about not having the money to be able to get the necessary treatment—perhaps cosmetic treatment—which can then lead to embarrassment and a loss of confidence.

[Judith Cummins]

I thank my hon. Friend for making that valid and important point.

Disproportionate levels of poor oral and dental health, predominantly in deprived, low-income areas such as those in Bradford, hamper these young people from forging their careers. Survey after survey confirms that young people who suffer from poor dental and oral health face poorer job prospects. Dental and oral health plays, rightly or wrongly, an important part in selling ourselves in today’s competitive job market.

I have set out the depressing scale of the challenge, but what can we do—or, perhaps more accurately, what can and should this Government be doing—to tackle this scandalous health inequality? As I highlighted to the former Prime Minister Mr Cameron, when I challenged him about this inequality in my constituency and city, there are some simple steps that can be taken. The first of them is due to be implemented in the foreseeable future: a tax on sugary drinks. Although the Government’s final proposal was very much weaker than it should have been, it was nevertheless very much a welcome step in the right direction.

The Royal College of Surgeons faculty of dental surgery, a professional body that sees dental inequalities first hand in its day-to-day work, suggests a number of low-cost, easily deliverable measures that could readily be adopted by Government: tightening restrictions on advertising high-sugar products on television, for example by restricting advertisements before the 9 pm watershed; limiting price promotions in supermarkets for high-sugar foods and drinks, and excluding these products from point-of-sale locations such as checkouts and counters; and, most sensibly, limiting the availability of high-sugar foods and drinks in our school system.

Perhaps the most important measure that the Government could implement, as highlighted by the British Dental Association, would be to expedite changes to the current dental contract. Critical changes are long overdue, the first of which would be to incentivise preventive work through the contract. The second, and most important, would be to incentivise the dental profession to establish new practices in deprived areas. Such areas desperately need practices as people there typically face the least availability.

In my constituency, despite need being so high, there is a shameful shortfall of NHS dentist appointments. Very few NHS dentists have open lists, meaning that most people in search of dental treatment simply give up, and those who are determined end up finding a dentist outside the city boundaries. Surely that is not right. I understand that the Government hope to begin rolling out a reformed dental contract from 2018-19 onwards, but that simply is not soon enough.

I finish by asking a simple question: is it just and equitable that five-year-old children in Bradford, my home city, are four and a half times more likely to suffer from tooth decay than their peers in the South West Surrey constituency of the Health Secretary? I hope that the House agrees that the answer is no.

Dementia and Alzheimer’s Disease

Judith Cummins Excerpts

Tuesday 12th April 2016 Westminster Hall

[Judith Cummins (Bradford South) (Lab)]

Thank you, Mr Stringer, for allowing me the opportunity to speak in this very important debate. It is a pleasure to serve under your chairmanship.

I congratulate the hon. Member for Strangford (Jim Shannon) on securing the debate. I also congratulate the Bradford District Care NHS Foundation Trust on winning a national gold award for its work in the state-of-the-art dementia assessment unit at Lynfield Mount hospital.

The 850,000 people living with dementia today deserve to be properly supported to live dignified lives, but worryingly an Alzheimer’s Society poll found that 90% of people suffering from dementia felt that the support they received after diagnosis was inadequate, and 73% of GPs—the medical practitioners who arguably are on the front line in managing dementia in our communities—believe that our health and social care system is confusing for people with dementia and, importantly, their carers. As a society, we need to support dementia sufferers soon after diagnosis, so that they are properly prepared to manage their symptoms, especially as the symptoms will worsen as the illness progresses. They are best placed to plan and prepare their affairs, but they must be helped to do that. At present, those suffering from dementia are not properly supported by the Government.

As a society, we should also be supporting the legion of selfless carers across the country, who contribute £11.6 billion to the UK economy each year through that unpaid caring. Often, carers feel unsupported and isolated. We must ask ourselves as a society whether it is fair that those carers, contributing £11.6 billion in unpaid service each year, are allowed to feel unsupported and isolated.

That prompts the question: what more should the Government be doing? We are fortunate that there is no need to reinvent the wheel. An initiative run by the Alzheimer’s Society is already being piloted in communities. The carer information and support programme is aimed at family members and friends after a relative has been diagnosed with dementia. It involves attending information sessions in a group environment. The Prime Minister’s commitment, as shown by the “Prime Minister’s challenge on dementia 2020”, is commendable, and I am happy to place on the record my support, but the target date of 2019-20 is simply not ambitious enough. I therefore call on the Minister to commit in her remarks to exploring what extra funding can be made available now, not in 2019-20, to support the roll-out of the carer information and support programme to communities across our country.

National Minimum Wage: Care Sector

Judith Cummins Excerpts

Wednesday 23rd March 2016 Westminster Hall

[Judith Cummins (Bradford South) (Lab)]

It is an honour to serve under your chairmanship, Mr Rosindell. I, too, thank my hon. Friend the Member for Sheffield Central (Paul Blomfield) for securing this important debate.

As has been spelt out in the Budget debates over the past few days, the Tory Government’s stated goal is to make work pay, so I will spend a few moments examining their record, given that we are considering the 1.5 million care workers who day in, day out, do noble work caring for our elderly and disabled population.

A March 2014 National Audit Office report found that an astonishing 220,000 home care workers are paid less than the national minimum wage. The main reason that so many care workers fail to receive the national minimum wage is that, despite resounding court judgments declaring this practice illegal, hundreds of thousands of workers are still not paid for the time they spend travelling between visits. They are, disturbingly, only paid for the time that they spend with their clients. That would be unacceptable in any other line of work, but, quite wrongly, it is still common practice in the care industry. As a matter of decency, care companies should meet the amount that Parliament has legislated for as the minimum that workers should receive in their pay packet. Each and every worker should not fear that, at the end of the working week, their employer has short-changed them. The national minimum wage is simply not happening in our care industry, and that is a national scandal.

The Tory Government need to step up and take action to ensure fairness in our care sector. Thankfully, under the national minimum wage legislation brought in under a Labour Government, the Tory Government have inherited the necessary powers to take much needed and long-overdue action. To be specific, under section 12 of the National Minimum Wage Act, care providers as employers can be required to supply a written statement to each care worker, in which they should clearly set out the amount that the worker is being paid, the hours worked, and how that means that the employer is not short-changing them. With that in mind, I ask the Minister to commit to exploring the potential for introducing regulations under section 12.

At present, the work of many hundreds of thousands of care workers simply does not pay. They are still not guaranteed a national minimum wage. They are simply being short-changed, and that scandal must not continue.