(4 years ago)
Public Bill CommitteesI beg to move amendment 10, in clause 2, page 2, line 12, leave out subsection (1) and insert—
“(1) No more than one call-in notice may be given in relation to each trigger event, unless material new information becomes available within five years of the initial trigger event.”.
This amendment would enable the Secretary of State to issue multiple call-in notices if material new information becomes available.
Rather late in the day, I will say what a pleasure it is to serve under your chairmanship, Mr Twigg. I am sure you are aware that we share an anniversary: we are among the few surviving Members of the 1997 intake—those happy days when Labour used to win elections. We came to this House in 1997 and have been here ever since.
The reason I emphasise that fact, Mr Twigg, is to underline just how many Bills you and I have sat on, led for the Labour party or been involved in over the years. I am unable to tot up the exact number but it is a considerable, and it is a great pleasure to be sitting on this Bill Committee. I have served on a large number of Bill Committees of late, the most recent being the Environment Bill Committee, which has just finished its deliberations. I was unable to be present for this Bill Committee’s witness sessions because I was finishing off the Environment Bill—well, trying to strengthen it rather than finish it off. I am grateful to my colleagues for asking a series of pertinent questions in the evidence sessions. We are all grateful for that and, indeed, to the expert witnesses.
I want to cite the amendment in the context both of the various Bills that have come through the House and of the witness sessions, which I have assiduously read, even though I was not present for them. I hope the Minister will accept that the amendment is entirely in line with the constructive way in which I hope we have gone about our business in this Committee. The amendment, which I shall unpack in a moment, strengthens not only the Bill but the ability of Ministers to do their job properly as far as its provisions are concerned. That is its intention.
The amendment seeks to replace subsection (1), which is a bald sentence:
“No more than one call-in notice may be given in relation to each trigger event.”
My time with Bills has taught me to look carefully through all of the different clauses to find the qualification. In my experience, tucked away somewhere in most Bills is a qualification. Sometimes it is about when a clause is to be implemented, sometimes it is a definition of the wording, and sometimes it is an additional provision that mediates the clause to which our attention was first drawn.
This clause has no such qualification. It is an absolutely straightforward statement. We have discussed trigger events to some extent in our evidence sessions, and they are elucidated and qualified in further clauses, as are call-in notices, but the fact that we get only one call-in notice per trigger event seems to be the central essence of this subsection. Our amendment seeks to put a question mark against whether that bald statement about the fact that we get one go per trigger event is the wisest formulation to have in the Bill.
The amendment makes a modest change to the clause, stating:
“No more than one call-in notice may be given in relation to each trigger event,”
and adding,
“unless material new information becomes available within five years of the initial trigger event.”
From his experience of many Bills, I wonder what the hon. Gentleman made of the provisions in clause 22 on false or misleading information that has been given to the Secretary of State, whereby if he has been given that information he can change a decision he has previously given and can therefore issue another call-in notice.
Yes, indeed. The hon. Member is quite correct to draw attention to clause 22, which concerns false or misleading information. It relates to where someone has, at the time of the trigger event, concealed or misled or sought to deceive those concerned with the trigger event about the nature of the event. I would suggest that that is a different case from what we are trying to establish today. It is not that anyone has tried to deceive anybody or maliciously mislead anybody at the time of the trigger event, but new material may come to light or become available within five years of the initial trigger event that might cause a further call-in notice to be introduced. According to the definition set out in the Bill, that looks like it might not be possible.
I thank my hon. Friend for giving way, and he is being very generous in doing so. He rightly talks about new material or information, but what about the evolving nature of geopolitical threats? There may well be countries that are not considered to be hostile actors now, but political changes one, two or three years down the line could have a massive impact on whether we see that country as a threat to national security. It could become a hostile actor.
My hon. Friend makes an important point, which was reflected in the evidence sessions on this Bill. I want to dwell on that briefly, because he makes a really important point. These matters are evolving. Not only that, but the nature of databases evolves. The nature of what we do and do not find out evolves. There are circumstances—my hon. Friend mentioned a particularly important one—where the Secretary of State could be excessively curtailed in the diligent pursuit of his role in terms of call-ins and trigger events if no amendment is made to this clause.
The expert evidence we received from Dr Ashley Lenihan of the Centre for International Studies at the London School of Economics gave rise to a couple of important considerations in terms of how evolving circumstances or new information might be important. Dr Lenihan made a very important point, similar to that made by my hon. Friend, when she stated:
“Dealing with the kind of evolving and emerging threats we see in terms of novel investments from countries such as China, Russia and Venezuela needs the flexibility to look at retroactively and potentially unwind transactions that the Secretary of State and the investment security unit were not even aware of.” ––[Official Report, National Security and Investment Public Bill Committee, Tuesday 24 November; c. 34, Q36.]
Speaking of existing databases, Dr Lenihan also stated:
“They do not cover asset transactions; they do not cover real estate transactions, which are of increasing concern, especially for espionage purposes.”––[Official Report, National Security and Investment Public Bill Committee, Tuesday 24 November; c. 35, Q36.]
I note that there has been a lot of concern in the United States more recently about real estate purchases in strategic locations, which may give rise to espionage or other national security concerns. As Dr Lenihan emphasises, existing databases do not cover such arrangements but might do in the future and might find it necessary to do so in the future. Under those circumstances, new information could well come to light.
Dr Lenihan also gave an interesting example—this is not strictly in line with our considerations today—of how information might come to light in a way not easily anticipated by those doing the initial call-in notice and trigger event. She referred to the purchase in the United States of a US cloud computing company, 3Leaf, which had gone bankrupt. Huawei—as it happened—quietly bought up the assets, employees and patents of that bankrupt company. That was not noticed at the time by the Committee on Foreign Investment in the United States regulators, because they did not pay attention to bankrupt companies, as opposed companies that continued to operate. That went quietly unnoticed, uncommented and unactioned until, Dr Lenihan informed us, a Government staffer happened to notice on his LinkedIn account that someone he thought had been partially running 3Leaf was listed as a consultant for 3Leaf for Huawei. He thought to himself, “How can this be?” Only through his attention and reporting back was that acquisition unravelled in the United States. No one was providing malicious information or seeking to mislead at the time. It was just that new information came to light, in that instance through surprising mechanisms. However, an important issue came before regulators and the security services. That emphasises that clause 22, important though it is, does not cover those sorts of circumstances and eventualities.
(8 years, 6 months ago)
Commons ChamberWe can all recognise that this Queen’s Speech contains a thin raft of legislation and that it is perhaps a Queen’s Speech in hiding for obvious reasons. It is certainly one that misses out many things that people might have thought would be included. It may not contain some terribly bad things, but we can ask a central question about it, following on from the thoughtful contribution by the hon. Member for Salisbury (John Glen). It is not just a question of changing services and ensuring we get the best out of them, because we need to think about who actually achieves the things set out in the Bills.
We should ask ourselves whether it is good enough to pass legislation and then say, “Get on with it; it is down to you. We have done our bit on the legislation, and it is your job now.” Here lies an increasingly central flaw in the roster of Bills presented for our inspection. They certainly do not come with any “how to do it” impact assessment. It is important to recognise that we can have good public services only if we have good public servants carrying them out. When it comes to many of the measures in the Queen’s Speech, one cannot say, “That is a good thing.” One should increasingly say exactly how to make it more than just a good thing, so that it actually becomes a good thing achieved.
The title of today’s debate is “Defending Public Services”, but there seems to be a disjunction between what a service can do and what is coming its way as a result of this and other recent Queen’s Speeches. We discuss this one against a background of a crisis in funding for the NHS. We know that the NHS simply cannot do what is required of it as a public service with its existing funding. Deficits are rising for hospital trusts, and it is not sufficient to answer, as the Prime Minister did in his opening speech, that it is necessary to do “more with less”. The people who are doing more with less are the public servants who have to carry out the services.
Statistics show the number of doctors per 100,000 head of the population between 2009 and 2015. There were 70 per 100,000 in 2009 and 65.5 in 2015. The same figures for nurses are 680 in 2009 and 664 today. That shows exactly what is happening. Public servants are doing more with less and continuing to have more and more piled on them with less and less resource—until, I suspect, the service starts to break down.
Social care is the other part of the health service revolution that we have debated today, but £1 billion has been taken out of social care budgets in the past year alone, with £4.5 billion taken out over the last five years. Local government is generally responsible for social care and social services, but councils have lost something like 79% of their direct funding between 2010 and 2020, with a further £3 billion of cuts announced in last year’s autumn statement.
The most deprived areas of the country, those with the most pressing concerns on social care and the most disadvantaged seem to suffer the worst cuts. How can it be that nine out of 10 of the most deprived areas are seeing cuts above the national average? We face a Queen’s Speech, on the other hand, that places substantial new requirements on those desperately stretched services in the areas of the country that need them the most. In my authority, by no means one of the most deprived parts of the country, £72 million has been cut from the budget since 2010, and there is expected to be a further £90 million a year by 2020.
The services that we seek to defend are, frankly, in a position of near starvation as they seek to provide us with the cover and the response to statutory responsibilities that we require. For example, the Queen’s Speech contains a requirement for further responsibilities to be put on local government and social care departments under the Children and Social Work Bill. This is what the Prime Minister said:
“So, in this Queen’s Speech we are saying to care leavers: you will get guaranteed entitlements to local services, funding for apprenticeships and a personal mentor up to the age of 25. All this will be included in our care leavers covenant, so that our most disadvantaged young people get the opportunities they deserve.”—[Official Report, 18 May 2016; Vol. 611, c. 26.]
Who could disagree with that? On the other hand, who could disagree with the people who are going to do those things?
I declare an interest in that my daughter is a social worker. I am very proud of her hard work in becoming a social worker in the first place and her dedication in carrying out her duties and responsibilities. I see her on a daily basis, so I can see the effect as her case load gets stretched and the authority has to cut corners increasingly just to keep the service going. These new requirements are going to be a huge strain on her; she will be one of the many people who will have to carry out this new piece of legislation as part of her local authority responsibilities. I know, by the way, who will get the blame if services fail because departments cannot stretch themselves far enough to take on those new responsibilities. It will not be the Government who presided over that near-starvation, but the poor social services departments that were worked into the ground while they were just trying to cope.
The Prime Minister spoke of the services that local authorities would provide, but they are decreasingly in a position to do so. New responsibilities are coming their way, not just for social care but for planning, as a result of the neighbourhood planning and infrastructure Bill, and for buses, as a result of the bus services Bill. Moreover, authorities apparently have an interesting future in connection with the devolution of business rates. It is being suggested that the local growth and jobs Bill will enable them to retain 100% of business rates, and who would disagree with that? I have championed the idea for many years. However, when it comes to who will implement the retention, there is as yet no indication of how business rate devolution will be married up with local equity. It appears that the authorities with the highest business rate bases will do much better than those in the most deprived areas which have much lower bases, and whose public servants will suffer as a result.
It has been announced that combined authorities will be handed powers from above, but they will be left with the same responsibilities and the same costs. How will they be funded? An authority that takes on devolved powers in south Hampshire, for example, will do so through a levy from a pooled business rate, which means that other authorities will have less money with which to support their already stretched services. I suspect that “more out of less” will not redound to the benefit of the public servants who are working in those authorities.
This is the central problem for our services. We can talk all we like about the sunny uplands, and about what shiny new words in shiny new pieces of legislation mean for people, but if those words are not followed by a commitment to make the services that will deliver on the promises work, they are hollow promises, and that, I think, is what this Queen’s Speech suffers from.
(8 years, 7 months ago)
Commons ChamberA tick in the box for duty of candour, which the report mentioned, was unacceptable—it must mean much more than that. The learning disability mortality review programme is important and will support local areas to review the deaths of people with learning disabilities, and use that information to help improve services. In time, it will also show at a national level whether things are improving for people with learning disabilities, and whether fewer people are dying from preventable causes. That review is already under way in a pilot in the north-east in Cumbria, which will help to inform us how the programme operates as it is rolled out. Plans are in place to roll out that review across all regions of England between now and 2018, with pilots commencing in other parts of the country between 2016 and 2017. That work has never been done before, and it is right that we are doing it now.
As the Minister and other hon. Members have said, Friday’s report makes grim reading for the many families and patients in the care of Southern Health NHS Foundation Trust. The Minister said that those failings are not isolated to that trust, but are on a much wider scale. In light of that, is he seriously considering a public inquiry that will get to the heart of the underlying factors in those matters? Patients and families who use this trust—some of whom are my constituents—must be reassured that those underlying issues are being properly considered and not brushed under the carpet.
It is vital that they are not brushed under the carpet, and I will come to that in a second. It is important to put it on the record that there are some positive aspects of this report, some of which relate to Southampton. I am sure the hon. Gentleman will already have seen those, with the trust being commended for its work on the community pathway. On the substance of his question, I spoke honestly a moment ago when I said that I really do not know at this stage whether an inquiry is the right thing to do. I am well aware of the seriousness of this matter, of the questions the families have raised, and of the fact that this has been going on for some time. The important thing is both to effect change and to find out what has happened. The CQC report—the extensive work that has already been done—is in depth, public and transparent. That may well have the answers that are required, but if not, something further may be needed, which is why I have an open mind on this. The most important thing is to give the reassurance that certain things have happened, which the CQC report cannot yet do because that is where the work is needed and where the work is going on now.
(9 years, 11 months ago)
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They absolutely do. One thing we must do better is signpost people to the different parts of the NHS, such as walk-in centres, urgent treatment centres, GP surgeries or A and E departments. That is why the 111 service is so important in giving that advice at the earliest possible stage.
Does the Secretary of State now regret the cuts inflicted on Southampton social care provision—they were draconian, disproportionate and possibly motivated by political football—given that Southampton city council has been unable to support the Southampton general hospital by moving people into social care and away from accident and emergency? Will he have a word with Communities and Local Government Ministers to get that put right?
(10 years, 1 month ago)
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A whole set of practices, of which that is one, result in people being paid less than the national minimum wage. That is why I wrote what I did very clearly in the White Paper on care and support and why, since leaving the Government, I have supported steps to have the guidance in place. I want to hear the Minister say in his response how that guidance will get traction on the ground in how local authorities behave.
The matter is important because we know that the care sector has among the highest rates of staff turnover of any part of our economy: 30% in some parts, and up to 19% to 20% in the care home sector. In the past 12 months, I have engaged with people from across the residential care sector while working with the think-tank Demos and looking at what we can do to address the issues that the right hon. Member for Oxford East has talked about. Domiciliary care workers are all too often hard done by, but we should not ignore those who work in residential care settings and are often paid barely above or even below the national minimum wage.
That is why we need HMRC to continue to engage proactively in this area and why I support the proposition that third parties, such as Citizens Advice, should be able to make referrals to HMRC so that it can trigger investigations when necessary. It is important to call out those who breach their obligations under the national minimum wage. When there is clear evidence that bad commissioning practices are making that happen, the Care Quality Commission should call out the chief inspector for those failures. I hope that Ministers will look at the powers available to allow inspections of local authorities in that regard.
We also need to pick up on the right hon. Gentleman’s point about how to raise public esteem for this work force. They have a deeply trusted role, even if the public are often sceptical because of the stories they hear. The role is important and responsible, and we do not properly honour and reflect that. That is why, in December, the Local Government Information Unit will publish further work looking at those issues and at what we can do to turn what is often seen as a temporary job into a permanent career with opportunities rather than one that goes nowhere, which is all too often how the sector is seen and treated.
There is an economic case for that, apart from the strong moral case that the right hon. Gentleman made. We have a generation in their 50s who are squeezed between caring responsibilities for their parents and their children. At the same time, they are expected to work and need to do so. We often stretch them beyond breaking point, and many leave the workplace. Supporting family carers more effectively and having reliable, cost-effective home care services is the right thing to do by them and by our economy. We recognise that in child care, but we have not recognised it in elder care. We now need to do so and to ensure that people want to work in the sector and see a future in it.
My final comments are about transparency. In my Demos work on the future of residential care, I and my fellow commissioners have said that several things need to happen. We need transparency in the way in which providers operate. There should be open-book accounting so we can see transparently how they are behaving in practice. We also need transparency in the CQC to provide clarity on the rates for care. There should be clear rates. The United Kingdom Homecare Association has produced a formula on its website, and it would be good if local authorities adopted it.
We also need more honesty about the long-term funding of the system, which is why we need the Office for Budget Responsibility to be given a new mandate for reporting on that so that there is more transparency and accountability in this place and we can hold Ministers to account on whether they are properly funding the sector.
During the right hon. Gentleman’s term as a Minister or in his work with Demos, has he reflected on the fact that reports have suggested that more than 1 million social care workers will be needed by 2025 to deal with increasing age and disability? Has he reflected on the impossibility of that goal being reached if the practices that we have heard about this morning continue—the turnover and loss of people in the sector and the inability to recruit people into it in future?
Yes and yes, which is why I made the point about the economic imperative and why we need to see the sector as an essential part of our economic infrastructure.
I wondered which Minister would respond to the debate. We tend to think of the matter as being about care, but it is also about the economy. It would be great to have Ministers from the Department for Business, Innovation and Skills engaged with the issue, given their responsibilities for the national minimum wage. It is a shame that BIS Ministers do not engage with the sector as much as they should to ensure that it develops as necessary, not least in terms of skills. The national minimum wage is where to start, but we must aspire to more. Demos’s work suggests that we need to move the sector to a living wage, which would mean real benefits for providers because it would drive down staff turnover, which would reduce the frictional cost of employing new people. That would be a saving for businesses and would reduce absenteeism. A study in London, where the living wage is being progressively introduced, estimated a 25% reduction in absenteeism, so there are real benefits to employers paying above the national minimum wage and actually paying a living wage.
For all those reasons, I welcome the debate. It is important, but it is also about recognising the overall quantum of funding going into adult social care—the hon. Member for Warrington North (Helen Jones) is absolutely right about that. I look forward to the Labour Front-Bench spokesman setting out what Labour’s spending plans are. We have heard about the plans for the health service, and the right hon. Member for Oxford East is right; we tend to talk about the health service and neglect social care. I hope that the shadow Minister will not neglect social care and will say what, within Labour’s spending plans, will deal with the funding issues in social care too.
(11 years, 6 months ago)
Commons ChamberI agree with my hon. Friend, but I would actually like a solution that happens as quickly as possible, provided the process is done properly. He will be pleased to know that the IRP report does say that the impact of suspending the review and thinking again should be borne in mind in respect of decisions that have already been made as to the siting of ECMO services, and I know that NHS England will be reflecting on that.
Does the Secretary of State appreciate the sheer difficulty in respect of recruitment, retention, planning and maintenance of an excellent service that has been incurred by the units affected, particularly the one in Southampton? Is he prepared to look at the possibility of providing additional resources to those trusts affected to enable them to maintain those excellent services during a continued period of uncertainty? Not only is it a continued period of uncertainty, but there has been continued oscillation between near certainty, uncertainty, no certain and possible certainty as a result of this interminable review and the way it has been conducted.
I actually agree with the hon. Gentleman: one of the biggest casualties of the length of time it is taking to resolve this very difficult issue is morale at the excellent children’s heart units that we have across this country, and recruitment is one of the biggest concerns in that regard. Resources are now allocated independently by NHS England, but I know that its priority is to ensure the safety of services.
(13 years, 5 months ago)
Commons ChamberSouthampton children’s services are located at Southampton General hospital, right in the middle of my constituency. The hard work undertaken by the large numbers of people who organised the petition presented at No. 10 yesterday—I and a number of fellow Members from across south-central England managed to get ourselves very wet helping to deliver it—showed not partisan fighting on behalf of a particular unit, regardless of its quality or the service that it represents, but genuine mystification that the process appears to have dealt so peripherally with Southampton’s role in the national roll-out of services. In 2010, Sir Ian Kennedy rated Southampton as provider of the highest quality service outside London, rating it particularly highly on paediatric intensive care and support for parents, and highly on training and innovation.
That mystification as to why such a unit should feature in just one of the options in the review was compounded by an examination of the background to that review. Indeed, perhaps the explanation for why Southampton appears to have been treated so peripherally can be found in the review itself. Of course it is important that the review should be completed, that changes should be made and that judgments be made on clinical grounds. However, I would suggest that it is not on clinical grounds that anyone should have forgotten that the Isle of Wight exists. That is the province of geographers rather than clinicians. If clinicians depend on the material in a review setting out the factors that will be taken into account in their final decision, much of their power in making that decision could be overthrown by what goes into that review in the first place.
It is not a clinical decision for the review to state that Southampton has two surgeons and undertakes 231 procedures, when in fact it will have four surgeons by this summer and undertake almost 400 procedures, as a result of, among other things, its excellent collaboration with Oxford, which my right hon. Friend the Member for Oxford East (Mr Smith) mentioned earlier, but which the review appears to neglect. If such a decision is made by the review, which appears to have got so many things wrong about the background to Southampton’s excellent services, the 250,000 petitioners who signed the petition that went to No. 10 yesterday will justifiably feel let down by the process, whoever conducts it. The national health service has a long and honourable record of stitching people up for the right reasons. If as a result of the review those 250,000 people end up feeling stitched up for the wrong reasons, they will have every right to feel very aggrieved indeed.