(6 years, 9 months ago)
Commons ChamberIt is a pleasure to have heard the maiden speech of the hon. Member for Banff and Buchan (David Duguid), and to follow other hon. Members, including my right hon. Friend the Member for Birkenhead (Frank Field) who opened the debate.
No one could object to universal credit’s ambitions to simplify the benefit systems, to smooth the passage into work, to make work pay and to reduce poverty, but so much has gone wrong in practice that it is hard to know where to start. The problems we are seeing are not just because of poor implementation; the problems have been designed in from the outset, despite repeated warnings from Opposition Members since 2011 that the programme was too ambitious, too risky, too complicated, too reliant on complex IT systems—complex for the claimant and for the Government—and did not go with the grain of people’s lives.
Let us start with the six-week wait. It is based on the assumption—I might go so far as to call it the prejudice—that the right and normal way for people to receive their income is to do so every month. That is not the case for many low-paid workers, as we know. It is also based on the assumption, as the hon. Member for Bolton West (Chris Green) mentioned, that people have savings in the bank. Hon. Members should ask themselves whether they could manage if their income suddenly dried up for six weeks or more, especially if it was the result of an unexpected and catastrophic event—losing their job, a partner leaving, their child becoming ill, or having an accident and not being able to go to work. It is unforgivable to put extra pressure on people on the lowest incomes in those circumstances. The six-week wait must be reduced. I recognise that exceptions can be made, but it is not clear that the system is working when such exceptions should be made. My constituent B, who was fleeing domestic violence, was told that she would not have to wait for the six weeks, but she still had no money after two weeks.
That leads me on to the problems with advance payments. My constituent K was not told until her third interview with Jobcentre Plus that such payments were available, and she did secure an advance payment. However, the repayment rate is punitively high, especially when it is combined with the recovery of other debts, such as those relating to council tax or utilities, and payments imposed by magistrates courts. Under universal credit, that can mean deductions of up to 40%, leaving claimants with insufficient money to live on. As a result, one lone parent in my constituency was left with just £100.67 per week to pay all her bills, which is £110 per month less than on the legacy benefit. How can that be right?
Such problems are creating debts and rent arrears: 80% of Trafford Housing Trust customers on universal credit are in rent arrears. The collection rate for arrears of under three months is 79.3%. Although the figure is much higher for arrears of over three months, at 96.4%, that is because mistakes in paying people’s benefit have largely been sorted out by that point or because they have debt relief orders in place. That is not because they have adapted to universal credit, but because other things are kicking in.
The problems are compounded by a complete lack of understanding in Jobcentre Plus about alternative payment arrangements—in other words, paying the rent directly to landlords. Trafford Housing Trust staff have told me that Jobcentre Plus staff do not understand this, will not talk to them about it, make mistakes in the calculations and make payments to claimants that should not be made to them but which are then promptly swallowed up by the bank and other creditors. In one case, an alternative payment arrangement was refused because the debt was deemed to be one of less than eight weeks when that was not the case. This reflected the fact that Jobcentre Plus calculate the claims over a 52-week period, whereas Trafford Housing Trust work out claims over a 48-week period.
Broxtowe CAB has told me that it is concerned about people who are on fluctuating hours, and those fluctuations and the lack of good co-ordination with HMRC are causing real problems for people on low wages who are in receipt of UC.
I am delighted that the right hon. Lady has raised that issue because it brings me neatly to my next point, which is about the particular problems that arise with the assessment period.
My constituent S received two lots of wages in one assessment period. Similarly, we can see how those with fluctuating incomes will have different levels of payments in different assessment periods. As a result, her universal credit was calculated as zero in the month she received two payments. In the following month, she received nothing in income, but by that time her claim had been cancelled. When the benefit was introduced, we were told that HMRC’s use of real-time information would sort out this kind of problem, but it did not do so. The failure was that of her employer to upload the data in time. The use of real-time information was a complete irrelevance, because the data were not in the system at all. In other cases, constituents who have been paid early—for example, because their employer provided an advance of pay before the Christmas break—have lost their award and their claim has been stopped. None of that is the fault of the claimant, but the DWP is utterly inflexible in its application of the assessment periods. What are Ministers doing about this? I am now being told that S’s case could actually have been treated more flexibly, but I was not told that when I first wrote to the DWP. It is now completely unclear to me and, more to the point, to my constituents what the position is on these problems.
Finally, I want to say something about the problems when claimants migrate from ESA to universal credit. In that circumstance, if they request mandatory reconsideration and then go to a tribunal, they will find that their ESA claim is cancelled. Even if they win their tribunal claim, it cannot be reinstated, and they are forced to remain on UC. My understanding is that that was not Ministers’ initial intention. Claimants are not being told, when a tribunal case starts, that they can have their ESA claim reinstated. In his summing up, will the Minister also address that point? This is putting further pressure on sick and disabled claimants who ought to be getting decent support from the benefit systems, but are not.
(11 years, 1 month ago)
Commons ChamberLet me begin by congratulating the hon. Member for Stretford and Urmston (Kate Green) on securing this debate, raising this important issue, and enabling us to discuss it for this very short period. It is not really a debate but a number of questions quite properly asked, no doubt many of which I will not answer, through no unwillingness on my part but because, as I always say, the usual rules apply. However, all questions will be answered, if not by me tonight then certainly by way of a letter. I thank the hon. Member for Strangford (Jim Shannon) for his helpful and interesting contribution. He has been good enough to provide me with a clipping. I believe that it is about kidney transplants and kidney donations, and I will make further inquiries.
As you will know and understand, Mr Deputy Speaker, this matter has come up by way of the fact that hon. Lady, as she explained, has a constituent, Natalie McCusker, who has had a lung transplant. We are all delighted that she was able to have that lung transplant.
As we know, the donation of organs is sometimes from a living source, to put it in crude terms. There are many examples of people who have made the most amazing sacrifices, often within families, to supply a kidney to a loved one so that they can live. There is, of course, the whole additional subject of what happens on death and the wishes of somebody in relation to their organs, and the absolutely amazing difference that that generosity after life can make to people. No doubt Natalie is a very fine example of that, and no doubt she and her family are profoundly grateful to the person who had the good sense to indicate that they were willing that on their death their organs would be donated. Then there is the great and often very emotional matter of the family deciding that they are all content for this to happen. There is nothing worse than when someone is taken from us when they die. It is very difficult for anyone in the medical profession—we have nurses who are specially trained in this—to approach the family in those profoundly difficult times and discuss the possibility of organ donation. The work of those nurses and other medical professionals is one of the reasons we have seen an increase in organ donation.
We all know the benefits of transplants and know that we need to do more to increase the number of organs donated. That would give many more people the opportunity to benefit from a transplant that could save their life or significantly improve the quality of their life. About 8,000 people are listed on the national transplant list waiting for a transplant. Many more could be listed if more donated organs were available for transplant. Many people wait months and years for a phone call telling them that a suitable organ has been donated and calling them in for a transplant. I am aware through my work as a Minister of some of those families and their anguish as they literally sit around waiting for that phone call, especially when it is a child who so desperately needs the transplant to, in effect, save or improve the quality of their life. For some, that phone call never comes and about three people—adults and children—die every day waiting for a transplant that could have saved their lives.
Given that the number of people needing organ transplants in the United Kingdom is greater than the number of donor organs available, there has to be a system to ensure that patients are treated equitably and that donated organs are allocated in a fair and unbiased way. Allocation is based on the patient’s need and the importance of achieving the closest possible match between donor and recipient, which is often very difficult.
All patients waiting for transplants are registered on the national transplant database. Rules for allocating organs are determined by the medical profession in consultation with other health professionals in health departments and specialist solid organ advisory groups. The blood group, age and size of both the donor and the recipient are all taken into account to ensure the best possible match for each patient, and the cardiothoracic advisory group is currently looking at improving the allocation of donated lungs to help to ensure equity and better outcomes for patients.
At present, lungs are allocated to the transplant centre based on the location of the donor, as the hon. Member for Stretford and Urmston said. The transplant centre will decide whether or not to accept the lungs and will select the most appropriate recipient. NHS Blood and Transplant is working with transplant centres to consider whether the current allocation system can be improved. It is considering whether it would be worth while implementing a national allocation scheme offering lungs and other organs nationally, rather than by centre. Other models are also being considered. NHS Blood and Transplant monitors the current allocation system closely to ensure that there is equity of access across the UK, and a recent analysis showed no statistical differences in outcomes across the UK in relation to lung transplant centres.
I appreciate that the Minister may not immediately know the answer to this, but does the equity of outcome apply not just to survival rates, but to waiting times?
As the hon. Lady has anticipated, I do not have the answer to that question in my brief, but I will make sure that she receives a proper answer.
Over the past five years, we have been strengthening the donation infrastructure by implementing the 14 recommendations of the organ donation taskforce, which were published in 2008. Is it not nice that in this sort of debate we can pay tribute to another Government of a different political persuasion? We are all united on this issue; it is not a party political issue and it is always a pleasure to take part in these sorts of debates.
The number of donor co-ordinators across the United Kingdom has nearly doubled. They are working closely with intensive care clinicians and families to identify potential donors and obtain consent. As I have said, it is difficult work but, goodness me, what a difference it can make when it is successful.
We have appointed clinical leads and established donation committees and chairmen in all trusts. This has driven improvement in hospitals, optimising the potential for organ donation. I am delighted that we have achieved an increase of 50% in organ donor rates and of 30% in transplant rates over the past five years, helping many more people to have the transplant that they so desperately need. We need to do more, however, to enable many more people like Natalie to receive the organ transplant that in many circumstances will save or enhance their life.
On 11 July, NHS Blood and Transplant published the new UK strategy for organ donation and transplantation. “Taking Organ Transplantation to 2020” sets the agenda for increasing organ donation and transplant rates to world-class standards over the next seven years by aiming to improve consent rates to organ donation to more than 80%—they are currently 57%—and transplant more organs and increase the number of people receiving an organ. The strategy calls for a revolution in public attitudes and behaviours, and emphasises the importance of individuals and families agreeing to donation. That important work needs to take place irrespective of someone’s background, ethnicity, religion, faith or whatever else. We need to ensure that more people in all parts of society sign up to donate their organs and that we are able to persuade people’s families to allow their organs to be donated upon death.
(11 years, 1 month ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
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I am very grateful for those comments. My hon. Friend is quite right that prevalence is now at about 20%, which is better than in many other countries. There is a very good debate to be had about whether we should take legislative action or change social attitudes. That is why I am so proud of our “Stoptober” campaign and the fact that we have had up to half a million hits on our website. Half a million quitting packs have been given out. It is a subtle combination of many factors. If only there were one silver bullet—but unfortunately there is not.
When the Minister publishes the analysis of the Australian experience, will she also publish an evidenced analysis of the number of avoidable deaths and illnesses that have resulted from the delay?
Well, I could say that the hon. Lady’s party, when it was in government, had 13 years to introduce such legislation. Indeed, I am more than happy to say that. If it was so simple to introduce standardised packaging, why did Labour not do it? It is not as simple as they now try to make out. Most importantly, I believe, Mr Speaker—and I do speak as a lawyer—you always want good legislation that is evidence-based. That is why I am more than content to support a delay, while we wait to see the evidence as it emerges from Australia.
(11 years, 4 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
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No. I am not going to go into all that in the short time that is available to me. We accept that waiting times are a problem—we are not trying to hide from that, and we are up for transparency—and I will address the data in a minute.
The hon. Member for Cheltenham (Martin Horwood) rightly identifies the seasonal nature of waiting times. He speaks with passion about changes in his constituency, and rightly so. It is right and proper that people who have such concerns, as other hon. Members have said, come to this place to champion the cause of the health service within their own communities, especially when it faces reconfiguration. He spoke about 111, which is an important thing to talk about when considering some of the causes that may contribute to the unacceptable failure to hit targets. I know that the data are being monitored on a daily basis by NHS England, and the deputy chief executive of NHS England is meeting twice a week to consider what is happening and to make sure that action is taken to ensure that any problems are addressed.
The hon. Gentleman makes an important point on the difficulty of filling posts, and I will write to him on that because I know it is a problem. I also know that action is being taken by some of the royal colleges, and it is probably best if I give a fuller answer, because he makes a very important point. Of course, I can say that the Keogh review is considering exactly the other problems that he mentioned. As the Secretary of State announced, the Keogh review, which has been alluded to, will report next month. All those matters will be reviewed by Sir Bruce, and it is much to be hoped that some positive forward-thinking will come out of that.
The hon. Member for Stretford and Urmston (Kate Green) raised various issues. I am particularly concerned that she says she is not getting the answers to the questions she has quite properly asked. I think there is sometimes a problem with hon. Members not going in the first instance to the actual hospital, trust or whoever it might be. Her point, and it is a good point well made, is that when she asked my Department, she did not get those figures, and I will make further inquiries.
Only today I saw a question from the hon. Member for Ashfield (Gloria De Piero) asking precisely what the figures are for her hospital in Sherwood and, as it happens, the hospital she and I effectively share, the Queen’s medical centre A and E department. I have given those figures, and I want to set the record straight because, in fact, for the same week last year in Sherwood, 75 people waited more than four hours; this year the figure is 266.
I have two points to make very quickly. First, I asked for data on all Manchester hospitals. I cannot be expected to go to each one, but, obviously, what is going on in every hospital in the city matters because patients will have to move from one to another if capacity is short. Secondly, I specifically asked for data on Trafford general hospital, which falls within the Central Manchester University Hospitals NHS Foundation Trust. The Minister told me in a written answer that data were not available, but when I approached the trust itself, it told me.
I know, and I do not understand why that is. I will absolutely make further inquiries, because it is nonsense that the hon. Lady did not get the data.
I will come on to address the points made by the hon. Member for Lewisham East (Heidi Alexander), but, on the data, it is important that we monitor such things. That is precisely why the Department of Health and Health Ministers are very much alert to what is happening in A and E. We share the concerns of hon. Members, which is why we have the Keogh review, why we are considering how to solve the problem and why we are looking at the underlying causes, which, in the short time available, I hope to address. I will ensure not only that the Ministers to whom the hon. Member for Stretford and Urmston has spoken read Hansard, but that a copy of this debate goes to NHS England, which I know also shares those concerns. NHS England also wants to hear about the experiences of hon. Members, and it is taking action to ensure that we are on top of this and, most importantly, that we do what we should do.
(11 years, 4 months ago)
Commons ChamberI am afraid that the hon. Gentleman’s question depicts a situation that I simply do not recognise. As I visit hospitals and other organisations, both in my constituency and across the country, I am told that there has been a huge improvement, especially in commissioning—[Interruption.] No, by front-line clinicians, who talk with enthusiasm about how the commissioning of services has improved because now at last the clinicians—those who know best—are in charge, and not, as has often been the case, faceless bureaucrats and managers.
15. When he expects to take a decision on the reconfiguration of hospital services in Trafford.
(11 years, 6 months ago)
Commons Chamber11. What the reason is for the time taken to produce the Government’s sexual health policy document.
This is an important document, which we want to get right. I anticipate that it will be published next month.
I certainly support the sentiment behind the hon. Gentleman’s question, and make it clear that I wanted to ensure that the document included the need for everybody to eradicate prejudice in all sexual health work. I was very keen to put that in the document, and I am sure he will join me in welcoming its publication, which will, we hope, be next month.
The under-18 pregnancy rate has fallen by 25% in the past 10 years. Will the Minister confirm that the strategy document will make it clear that it is important to protect specialist, dedicated sexual health services for young people, such as the Brook service at the Talkshop in Trafford in my constituency?