National Insurance Contributions: Healthcare

Anna Dixon Excerpts

Thursday 14th November 2024 Commons Chamber

[Karin Smyth]

I agree with the right hon. Gentleman that his hospice, and the hospices in many of our constituencies, do great work. We are aware of the precarious situation that they have been in for a number of years, and we want to ensure that they are fully part of end of life care. He will know from his time in the Treasury that there are complicated processes, both in the Treasury and in the Department of Health and Social Care. When I talk about the normal processes for allocating money, I think he understands that well. We are mindful of hospices’ concerns, and we will continue to talk with them.

[Anna Dixon (Shipley) (Lab)]

Between 2013 and 2023, during the Conservatives’ time in government, the number of general practices fell from 8,044 to 6,419. Does my hon. Friend agree that it is a bit rich for the Conservatives to pretend now that they care so much about general practice, given that 1,600 practices closed on their watch?

[Karin Smyth]

My hon. Friend brings a great deal of expertise to the House from her work in social care, so she knows and understands the precarious nature of the sector, which we cannot stress enough. I do not know whether the Conservatives have actually read the report by Lord Darzi, but that report and its appendices give a really clear idea and diagnosis of the state in which the NHS and social care system was left. It will take a long time to rebuild it, and the sustainability of general practice and primary care is particularly problematic. That is why we took those actions in the summer, and why we will continue to support them and build up a neighbourhood health service.

Income Tax (Charge)

Anna Dixon Excerpts

Tuesday 5th November 2024 Commons Chamber

[Anna Dixon (Shipley) (Lab)]

I refer the House to my entry in the Register of Members’ Financial Interests.

This Budget rejects 14 years of Tory austerity for public services and instead begins a process of investment and reform to NHS and social care. The 4% increase to day-to-day spending, and a cash injection of over £25 billion into the NHS over two years, will make an immediate impact to improve patient experience. This Budget begins to make good on Labour’s election promise to get the NHS back on its feet and to address the issues laid bare in Lord Darzi’s damning report, which set out so clearly the mess left by the Conservative party: the highest waiting times on record and the lowest public satisfaction. I also welcome the much-needed capital investment to ensure that RAAC-infested Airedale hospital, which serves my constituents, gets funding for a new hospital. With Labour, promises made are promises kept.

But the money is not enough: we need to change the NHS so that it is more focused on improving health, with more care delivered in the community and close to home. Those changes will be set out in the 10-year plan for the NHS in the spring, and I welcome the fact that everyone will have the opportunity to contribute their ideas. Change means spreading best practice; examples include Grange Park GP surgery in my constituency. I was pleased to show the Secretary of State for Health and Social Care this great community-centred general practice, which delivers continuity for patients, group therapy sessions such as singing for lung health and on-site counselling.

Investing in primary care and community health services is vital to a strong NHS, but as the Secretary of State recognises, we also need to deliver with social care. Local authorities have sought to provide social care in the context of severe budget cuts imposed over 14 years by the Conservative party. The Chancellor’s Budget provides a £1.3 billion uplift to local authority budgets, including £600 million of new grant funding for social care. That money is hugely welcomed and much needed, as are the increases in the national living wage, which will lift thousands of care workers out of poverty. However, many non-profit care providers are already on the brink after 14 years of cuts to social care, and may be forced to hand back contracts if their higher costs are not reflected in the fees paid by local authorities. I urge Ministers to explore those challenges with care providers and local authority commissioners to ensure we have a strong foundation for our national care service.

It is right that we ask those with the broadest shoulders to pay their fair share in order to address the crisis in public services. I am confident that this Labour Government can and will restore the NHS, making it a service we can once again be proud of. That is why I support this Budget.

NHS Performance: Darzi Investigation

Anna Dixon Excerpts

Monday 7th October 2024 Commons Chamber

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

I will be brief. I think there is general consensus on Lord Darzi’s review of the issues facing the NHS, but in spite of what the shadow Minister says, staff morale is low, particularly when compared with 2010. It has never been so low. I express my gratitude to and solidarity with all the staff, clinical and non-clinical, for the work they do.

I will briefly focus on the key drivers. We have heard a little about them from the Health Secretary, particularly in terms of the Health and Social Care Act 2012. I sat on both the Bill Committees. I was aghast, having just come out of the NHS and having faced the issues. I just knew it would be catastrophic, and it was. It had an almost immediate impact on staff morale.

We must also recognise the impact of austerity between 2010 and 2018. NHS revenue budgets grew by just 1% each year—the lowest rate since the NHS was formed. That compares with growth of nearly 4% a year since then. In 2010, the Commonwealth Fund found that the NHS was one of the top-ranking health systems in the world. It was No. 1 for equity in access to healthcare; we are now ranked 10th. If we compare spending on healthcare, we are ranked 26th in the OECD. Austerity impacted not only the overall funding of the NHS, but the funding allocation formulas. The weighting for deprivation was slashed, so areas such as mine received less money, although we had greater health needs. Austerity also had an impact on other aspects of public funding and local government, and metropolitan areas such as mine were particularly badly affected. It stripped the support from people in need.

[Anna Dixon (Shipley) (Lab)]

I came into politics because of a desire to reverse growing inequalities in health and disability. In my constituency of Shipley, there is a 10-year gap in healthy life expectancy between those living in Wharfedale and their neighbours over the moor in Windhill. While lots needs to be done to tackle poor housing and poverty, there are things that the NHS can do. Does my hon. Friend agree that the NHS plan must prioritise prevention, as well as just treating sickness?

[Debbie Abrahams]

As a former public health consultant, I would obviously agree with my hon. Friend. I have similar health inequalities across Oldham. I was about to talk about the impact of other issues, such as social security cuts, which meant greater poverty, including in-work poverty and children from working families living in poverty. That has had a consequential impact on our health as a whole. We have flatlining life expectancy, and in areas such as mine, life expectancy has got worse. That impacts on our productivity and the wealth of our country.

I will briefly mention a couple of points that I know my right hon. Friend the Secretary of State recognises, and might want to consider. An annual report on the state of our health and the state of our NHS, presented to Parliament before each Budget, would pick up on the points that have been raised about cross-departmental impacts on health. We should have a prospective assessment of the impacts of the Budget and the Finance Bill on poverty and inequality, and subsequently on health and the NHS. That can be done; others are doing it. We should have a strategy to identify and address health equity issues in the NHS. We have seen a bit of that through covid, in the inequity around the use of oximeters. We should introduce something like “Improving working lives” for our staff. That had a massive effect on staff when I worked in the NHS. We need a clear commitment to the 1948 principles of the NHS, under which it is funded from general taxation, and a funding allocation based on need.

NHS: Independent Investigation

Anna Dixon Excerpts

Thursday 12th September 2024 Commons Chamber

[Wes Streeting]

NHS staff did not break the NHS—the Conservatives did—and this Labour Government will mobilise them to help fix it.

[Anna Dixon (Shipley) (Lab)]

It was great to see the Prime Minister speaking this morning at the King’s Fund, where I worked as director of policy for a number of years. In my constituency, I met a man who had been told he needed urgent surgery on his leg, but was still waiting 18 months later and had had to give up work. It is clear from today’s report that too many people have been stuck on NHS waiting lists and locked out of work. Does the Secretary of State share my view that a healthy nation is critical to a healthy economy, and will he work with his colleagues in the Department for Work and Pensions to deliver that?

[Wes Streeting]

My hon. Friend is absolutely right: the health of the nation and the health of the economy are inextricably linked. Under this Government, the Department of Health and Social Care is a Department for growth as well as a Department for health and care, and the Chancellor understands those linkages too. I can say to my hon. Friend and all of her friends at the King’s Fund—we were delighted to see them host the Prime Minister this morning—that unlike our predecessors, this Government cannot get enough of experts.

Government Policy on Health

Anna Dixon Excerpts

Monday 9th September 2024 Commons Chamber

[Wes Streeting]

It is entirely legitimate to ask questions, and it is also entirely legitimate for Government Departments to invite people with a wide range of experience and insight to advise on policy debates and discussions. That happens all the time. Where do we draw the line? Do we have to send compliance forms to Cancer Research UK before it comes in to talk about how we tackle cancer? Do we have to send declaration of interest forms to patients who want to discuss awful cases they have experienced?

Frankly, I find this pantomime astonishing. I am surprised that the shadow Secretary of State thinks this is such a priority that she should raise it on the Floor of the House rather than NHS waiting lists, ambulance response times, GP access or the state of social care. It is clear that the Conservatives have not learned why they are in opposition.

[Anna Dixon (Shipley) (Lab)]

I congratulate my right hon. Friend on taking advice from his predecessors. As someone who worked as a senior civil servant in the Department under Alan Milburn, I would like to echo my right hon. Friend’s comments about what a fantastic Secretary of State he was and speak to his record in that position. I also worked as a civil servant under the coalition Government.

Will the Secretary of State also be seeking advice from Andy Burnham who, as Secretary of State when Labour last left office, left record low waiting times and high public satisfaction?

[Wes Streeting]

My hon. Friend is absolutely right. How fortunate we are to be able to turn to every living former Labour Health Secretary, from Alan Milburn to Andy Burnham, and in every single one of those cases be able to draw on people whose record of delivery led to the shortest waiting times and the highest patient satisfaction in history. I can confirm to my hon. Friend that, both in opposition and in government, I have been talking to the Mayor of Greater Manchester. He is doing some brilliant work on prevention. I am really looking forward to working with all our metro mayors to tackle health inequalities across the country and to improve the integration of health and care services across the land.

Unpaid Carers

Anna Dixon Excerpts

Tuesday 3rd September 2024 Commons Chamber

[Wendy Chamberlain]

I am grateful to my hon. Friend. It demonstrates how prevalent caring is in our society when we have Members who have direct experience of it. Identification of carers, or people identifying themselves as carers, is a key issue that any strategy should address.

The then shadow Minister was right that we need a cross-Government strategy. This is not a new idea, because we have had such strategies before; the last one was drawn up all the way back in 2008, but the problems that unpaid carers face have not gone away. Unpaid carers are significantly more likely to be in poverty than the rest of the population. The most recent data available from the Department for Work and Pensions—the 2023 family resources survey—shows that just under a third of households in receipt of carer’s allowance are food insecure, compared with 10% of households as a whole. That is a huge difference.

To assess food insecurity, the survey asks the respondent whether in the past 30 days: they have has eaten less than they felt they should because of lack of funds; they have been hungry, but not eaten due to lack of funds; or they have lost weight due to not enough money for food. It also asks whether they or someone in their household has gone without eating for an entire day because they lack money for food. Further, the survey found that 13.3% of households in receipt of carer’s allowance—that is just more than one in every eight—had used a food bank in the previous 12 months, compared with just 3% of households overall.

[Anna Dixon (Shipley) (Lab)]

I commend the hon. Lady for her work to ensure that the millions of unpaid carers in the UK are both valued and supported. As has already been mentioned, I commend her for successfully bringing forward her private Member’s Bill, the Carer’s Leave Act 2023. Under that Act, carers have an entitlement to a week of unpaid leave. Does she agree that further action is needed to ensure that those carers juggling work and care can continue to stay in employment, avoiding the poverty trap that she describes?

[Wendy Chamberlain]

I absolutely agree with the hon. Member. My party’s policy is that carer’s leave should be paid. At the moment, we are formalising a system that already worked for people in asking for time off unpaid with the employer’s agreement, and potentially not taking sickness or annual leave. They are not getting remunerated for taking that leave, and I am cognisant of that.

Going back to my evidence on food banks, the research from the sector aligns with that survey data. The Joseph Rowntree Foundation’s 2024 report on UK poverty found that 29% of carers live in poverty. More than half of the carers who responded to the Carers Trust adult carer survey in 2022 said that they are struggling to make ends meet as a result of those caring responsibilities. As the hon. Member just said, one of the main reasons for unpaid carers being in poverty is that it is difficult to stay in work as a carer, especially full-time work.