Bus Services Bill [Lords]

Debate between Andy Burnham and John Pugh

3rd reading: House of Commons & Report stage: House of Commons
Monday 27th March 2017 Commons Chamber

[John Pugh]

I rise to speak in support of new clauses 2 and 3 in my name and also new clause 1.

Both my new clauses are basically about coherence; neither is about dictating to local authorities, as was mischievously suggested by the Secretary of State on Second Reading. I am not trying to dictate to local authorities what they should do. Both of them are also obviously about concessionary travel for young people, which has been a thorny issue throughout the passage of this Bill.

Support for young people’s transport is variable, as the hon. Member for Bexhill and Battle (Huw Merriman) said, and worsening. Since 2008, 50,000 16 to 18-year-olds have had free transport withdrawn—a 42% drop, I believe. Two thirds of local authorities no longer provide free transport to 16 to 18-year-olds, and the price of bus passes for 16 to 18-year-olds varies incredibly across the country, ranging from £230 to more than £1,000. The number of transport authorities offering concessions right across their area has dropped since 2010 from 29 to 16, and 10 authorities have no arrangements that benefit the older age groups. The roll of shame of authorities that do not offer any concessionary fares for young people comprises Cheshire West and Chester, Halton, Warrington, Lincolnshire, Nottingham, Peterborough, Bracknell Forest, Oxfordshire, Portsmouth and Slough.

The situation is hardly good and the impacts are fairly obvious. The hon. Gentleman mentioned the impact on educational progress. According to the Association of Colleges, a fifth of students consider dropping out during their course, and often the reason is transport costs or, if the cost is not foremost in their mind, transport difficulties. There is an impact on students: a survey by the National Union of Students shows that two thirds of further education students pay more than £30 a week for transport—a lot of money for a young person. There is a clear impact on traffic congestion and pollution—the hon. Gentleman mentioned that, too—as more young people get a car, perhaps sooner than they should, or rely on parental transport, which affects congestion at all the wrong times in most towns. There is also an impact on educational choice—I emphasise the hon. Gentleman’s point that the worst affected are probably residents of rural areas and poorer students generally.

Within the system are clear anomalies that need to be resolved. We raised the age of compulsory education, but local authority transport obligations remain very much as they were.

[Andy Burnham]

I agree with everything the hon. Gentleman says about the withdrawal of concessionary support for young people, but does he concede that the withdrawal of the education maintenance allowance under the coalition Government made the problems for young people much worse?

[John Pugh]

The right hon. Gentleman might be surprised to learn that EMA was mentioned in my notes, but for some reason I omitted to mention it just then. He has drawn attention to it, and I dare say it was a factor.

Another anomaly in the system—this is where new clause 2 comes into its own—is that while we all accord parity of esteem as between the academic route and the technical route, and the apprenticeship route is now being sold fervently by almost all Government Members, apprentices do not really get a look in: an apprentice aged 16 to 18 gets a bare £4 minimum wage. We want to make the apprenticeship route more attractive, and there is some evidence that where schemes are introduced, they are highly successful. Anecdotal evidence suggests that the MyTicket scheme in Liverpool city region improved attendance quite appreciably. Developing transport in line with the apprenticeship system is very much a part of the city region agenda, which the hon. Member for Blackley and Broughton (Graham Stringer) touched.

The aim of my new clauses is relatively modest. They would not change the character of the Bill, which I broadly support. Essentially, they oblige local authorities to take a broader view of the environmental and educational impacts of transport policy.

Mental Health

Debate between Andy Burnham and John Pugh

Thursday 14th June 2012 Commons Chamber

[Andy Burnham (Leigh) (Lab)]

I begin by giving my apologies to the hon. Member for Loughborough (Nicky Morgan) for missing the beginning of her speech, and by congratulating the Minister on his excellent and thoughtful speech, to which I can hopefully add something.

I have high hopes for the debate. I hope it will help us to confront a major paradox: how can a subject that is so central to the big public policy challenges we face as a country—the challenges are not just of public health provision, but of worklessness, benefits, the criminal justice system and addiction—still exist on the fringes of our national debate, getting so little airtime and attention? As other hon. Members have acknowledged, the House, sadly, rarely applies itself to mental health. Perhaps that reflects our national stiff-upper-lip tendency not to talk openly about mental health, which in turn might help to explain why our public services are designed for the 20th century rather than the 21st.

[John Pugh]

The right hon. Gentleman seems to be forgetting that we had appreciable mental health legislation in the last Parliament—the Mental Health Act 2007.

[Andy Burnham]

I am proud of the improvements we made in the last Parliament, but I did not come here today to say that everything the previous Government did was right and wonderful. I will talk a little about those improvements, but given my failure to sing about Labour achievements, I am grateful to the hon. Gentleman for doing so.

We are reticent to talk about mental health as much as we should. There is a complacency in the public debate—that is not to make a political point, because it involves hon. Members on both sides of the House. The complacency goes throughout the civil service and the Government. To reflect on my time in government—not just in the Department of Health, but in the Treasury and the Home Office—it is remarkable how few submissions or meetings I had relating to mental health, given that it underlies the spending of hundreds of millions of pounds of public money. Indeed, £105 billion is the estimated cost of the full burden of mental health to this country.

That complacency is not shared by everybody and I congratulate the hon. Lady on introducing this debate. We have heard two unbelievably powerful speeches, from my hon. Friend the Member for North Durham (Mr Jones) and the hon. Member for Broxbourne (Mr Walker), to which I will turn at the end of my remarks. My hon. Friend the Member for Hackney North and Stoke Newington (Ms Abbott), who leads on these matters for the shadow health team, has rightly pointed out how mental health lies under the whole public health challenge. We will soon introduce Labour’s public health review.

We are beginning to wake up from our complacency. I am leading the debate for the Opposition to show that that comes from the top. We see the mental health challenge as central to health policy. Indeed, I made a point of making my first speech on returning as shadow Health Secretary on the subject of rethinking mental health in the 21st century at the Centre for Social Justice.

I must be honest: I shared the complacency about the mental health debate, or perhaps did not give it enough attention, but two things changed that when I was a Health Minister. First, I spent a day work-shadowing an assertive outreach team in Easington. I will never forget what one of the team told me about the early ’90s, when the mines closed and GP referrals for support were piling up on clinic desks, but there simply was no support to offer people. She said that that lay behind the social collapse in those mining communities. People facing difficult times were given no help.

A second thing made me think differently. When I became Health Secretary in June 2009, I inherited Lord Bradley’s report into mental health problems and learning disabilities in the criminal justice system. I will never forget sitting in my office at Richmond house reading that about 70% of young people in the criminal justice system have an undiagnosed or untreated mental health problem. If that is not truly shocking to every Member and does not make us do something, frankly nothing will. That was the moment that changed how I thought, and I have tried to follow it through ever since.

I mentioned that we had a public service designed for the 20th century, rather than the 21st century, and I want to illustrate that point with reference to my own constituency. The world that gave birth to the NHS was a very different place. When the NHS was set up, Leigh, like Easington, was a physically dangerous place to live and work in. Working underground exposed people to coal dust, explosions and accidents, and people had no choice but to lock arms, look out for each other and face the dangers together—that is how it was—and that spirit of solidarity was carried over into the streets above.

Like many places in this country, then, Leigh in the ’50s was a physically dangerous place but emotionally secure, because people pulled together. In the 21st century, however, that has completely reversed. We now live in a physically safe society—our work does not generally expose us to dangers—but it is emotionally far less secure than it was for most of the last century. The 21st century has changed the modern condition. We are all living longer, more stressful and isolated lives, and have to learn to cope with huge and constant change. Twentieth-century living demands levels of emotional and mental resilience that our parents and grandparents never needed, yet the NHS does not reflect that new reality; essentially, it remains a post-war production-line model focused on episodic physical care—the stroke, the hip replacement, the cataract—rather than the whole person. That is the issue to confront.

The demands of this society and the ageing society require a change in how we provide health and social care. We need a whole-person approach that combines not only the physical but the mental and social, if we are to give people the quality of life that we desire for our own families. That one in four people will experience a serious mental health problem makes this an issue for all families and people in the country. It also means that mental health must move from the margins to the centre of the NHS.

I shall say a couple of things about that necessary culture change. How can it be that an issue that causes so much suffering and costs our society so much still accounts for only a fraction of the NHS budget? It cannot be right. We also have to consider the separateness of mental health within the NHS. This has deep social roots—the asylum, the separate place where people with mental health problems were treated, the accompanying stigma and suspicion about what went on behind those four walls. Essentially, we still have the same system in the NHS, with separate organisations—mental health trusts—providing services on separate premises. That maintains the sense of a divide between the two systems and raises a huge health inequalities issue.

The wonderful briefing that Mind, Rethink and others have prepared for this debate contains this startling statistic: on average, people with severe mental health problems die 20 years earlier than those without. What an unbelievable statistic! Why is that? It is partly—not completely—explained by the separateness within our system. If someone is labelled a mental health patient, they are treated in the mental health system, and consequently their physical health needs are neglected.