Oral Answers to Questions

Baroness Keeley Excerpts

Tuesday 13th October 2015 Commons Chamber

[Alistair Burt]

In a way, the self-definition states its own problem: these are unidentified carers. I hope that the new responsibilities in the Care Act will encourage more people to come forward and that the greater work of carer support organisations, such as the one I preside over in Bedfordshire, Carers in Bedfordshire, will be able to identify more carers. We want more young people to come forward because, as the hon. Lady says, people are caring and they do not realise they are. We need a concerted effort all round to try to reveal them, so that more can be done.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

I am surprised that the Minister believes he is supporting carers in any way acceptably well. The recent personal social services survey found that 38% of adult carers now care for more than 100 hours a week but only one in five of those carers is getting support to take a break from caring. Government cuts have caused a funding gap in social care, which, it is estimated, will be £4 billion by 2020, piling additional pressure on those family carers, and the better care fund and integration will not, in themselves, fix that gap. When will Health Ministers admit that they have got this wrong and argue for more funding for social care, so that carers can get the support and respite breaks they should get?

[Alistair Burt]

Between 2010 and 2015, £400 million extra was found in order to provide respite for those who are caring for others. Any support that goes into local government, or indeed the NHS, is predicated on a decent economy and decent economic principles in order to fund it—I believe from what happened last night that that has been abandoned by the Labour party. We have to have the resources in the first place. That is what we are seeking to ensure and that is what the work is being done for.

Contaminated Blood

Baroness Keeley Excerpts

Monday 20th July 2015 Commons Chamber

[Ben Gummer]

NHS England has just announced a major package in respect of the drugs my hon. Friend mentions. I will ensure that my hon. Friend the Life Sciences Minister writes to her with further details.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

May I add my thanks to those already given to my hon. Friend the Member for Kingston upon Hull North (Diana Johnson) and add to her comments about the pressing need for a settlement? I recently learned of a constituent who contracted hepatitis C in the 1980s. The reality of his life is that the drug treatment he needs is not funded, although it is available in Scotland. He is looking at paying out £35,000 for a 12-week course of treatment and cannot get life insurance for mortgage purposes. He also talks about the stress and discomfort of the treatment he has tried. His life is on hold. This is a pressing matter. What can we offer him?

[Ben Gummer]

The hon. Lady is right to highlight that for some people this has been a fact of life for 30 years or more. Within a year of the publication of the Penrose report, we hope to provide a scheme that settles the concerns of many sufferers. That is a fast pace at which to move given the complexity of what is required, the five schemes already in existence and the many hundreds and thousands of voices that need to be heard in the short consultation we plan to hold.

Oral Answers to Questions

Baroness Keeley Excerpts

Tuesday 7th July 2015 Commons Chamber

[Mr Hunt]

My hon. Friend can tell them that when Labour Members opposed the Health and Social Care Act 2012, we were doing the right thing for patients, with 18,000 fewer managers, 9,000 more doctors and 8,500 more nurses, whereas the Labour party was posturing. We can see the results of that posturing in Wales, where more people wait for A&E, more people wait for their cancer operation, and 10 times more people are waiting for any kind of operation.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

The Secretary of State talks about having similar levels of care, but we do not have similar levels of safe staffing around the country. Peter Carter has said about the decision on NICE:

“If staffing levels are not based on evidence there is a danger they will be based on cost.”

Is my hon. Friend the Member for Wirral West (Margaret Greenwood) not right? NHS England should reverse that decision and let the independent body be the judge of safe staffing levels.

[Mr Hunt]

I gently say to the hon. Lady that we will not take any lessons in safe staffing from the party that left us with the tragedy of Mid Staffs. We have recruited 8,000 more nurses into our hospitals because we have learned the lessons of the Francis report. The important lesson in the report is that it is not simply about the number of nurses; it is about the culture in hospitals and making sure that nurses are supported to give the best care. We want to learn those lessons as well.

A&E Services

Baroness Keeley Excerpts

Wednesday 24th June 2015 Commons Chamber

[Mr Reed]

Everything that transpired in my hon. Friend’s constituency made the situation much worse, as many medical professionals have said.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

Is there not an extra pressure, with many trusts ending the year with deficits? Wythenshawe hospital, which is looking at a £3 million deficit, has decided to try to cut 33 district nursing posts, yet when the Health Committee looked at winter A&E pressures we found that it was important to hang on to district, community support and hospice nurses. Is it not just madness to force hospitals with deficits to cut district nurse posts?

[Mr Reed]

My hon. Friend puts her finger on the problem precisely. It is absolute madness, and it is happening at trusts throughout England, as their deficits edge up towards £1 billion for this financial year.

The number of patients waiting more than four hours each year has rocketed by more than 1 million, meaning that there are now almost four times as many people as there were five years ago waiting more than four hours. That is a damning record, and based on the performance over the previous Parliament five more years of the same will see almost 2.5 million patients each year waiting more than four hours by 2020. For the benefit of patients, medical professionals and the healthcare system as a whole, that cannot be allowed to continue.

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[Ben Gummer]

I am not sure I get the gist of the hon. Gentleman’s point, but I do think that the shadow Secretary of State for Health should propose the motion in an Opposition day debate on health matters. I hazard a guess that there has been a disagreement between the two shadow Ministers—perhaps a suggestion that one of them is using health debates as opportunities to grandstand. I hope that that is not the case.

I am slightly concerned that we are about to see another episode of the ongoing psychodrama which is the Labour party. We had the TB-GBs and then, when that very happily came to an end, we had the Miliband “Band of Brothers”—a disaster for that family but happily not for the country.

[Barbara Keeley]

On a point of order, Madam Deputy Speaker. I really wonder whether this is within scope. Is it at all orderly to be debating which Minister is answering or proposing a debate? This happens quite a bit in this House—for example, the Chancellor did not come last week. It is just not orderly to be starting off the debate in this way.

[Madam Deputy Speaker (Natascha Engel)]

I thank the hon. Lady for that point of order. I think the point has been made. Perhaps we can move on with the debate.

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[Ben Gummer]

It is a real delight to respond to my hon. Friend. It is a good thing for the shadow Minister and those living in England that they do not have to endure the experiences of people in Wales, which have, I am afraid, been inflicted on them by the appalling management of the Labour Government there, who chose not to invest in the NHS in the way that we did, in a time of constrained budgets across the public sector. I have to say to the shadow Minister that by concentrating on money—he cannot match the Conservative party’s commitments on that anyway—he misses the points around quality and safety, which are conjoined with money. If we go back to the Mid Staffordshire NHS Foundation Trust—[Interruption.] Opposition Members may groan, but they may wish to reflect on why Stafford hospital went wrong. It was within budget and was hitting its targets, yet at the same time it was killing people. Until that simple fact is remembered, and until we put quality and patient care first, we will not get the efficiency, as regards either care or money, that I am sure Members on both sides of the House wish to see.

[Barbara Keeley]

rose—

[Ben Gummer]

I am sure that the shadow Minister has come to the House without reading the speech in which my right hon. Friend the Secretary of State directly addressed the issues caused, in some trusts, largely by agency spending, which took place because of the chronic understaffing created by the previous Government, and put right by us. That led in part to the catastrophe at Mid Staffs. The shadow Minister has not read my right hon. Friend’s comments about limiting the salaries of highly paid managers in the NHS, or his comments about cutting consultancy pay. It is precisely that kind of action—including enabling chief executives of NHS trusts to control their budgets—that this Government are taking to ensure that, nationally and locally, we are living within our means.

[Ben Gummer]

I can guarantee that to the hon. Gentleman. On minimum staffing, it was in response to the Francis inquiry that this Government, in their previous incarnation, set the Care Quality Commission a specific target of doing something about minimum staffing. That did not happen before then. He understands that relationship between safe care and money. I just wish that he was able to explain it to his colleagues on the Front Bench, because if they went to the Salford Royal hospital, they would see how, through instigating safer care, it is saving £5 billion a year. It is by combining quality and efficiency that we get the double benefit of better care for patients and better returns for the taxpayer.

[Barbara Keeley]

rose—

[Tom Pursglove]

rose—

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[Ben Gummer]

My hon. Friend, and our hon. Friends in Northamptonshire, have worked hard together—as Northamptonshire MPs did previously on a cross-party basis—to find the best configuration of services for their county. It is a great shame that that model of cross-party working cannot be echoed or reflected across the House. In that vein, I would prefer it if the Opposition had come here to talk about plans for social care. They have two competing visions for social care. We sometimes hear thoughtful remarks from the shadow Minister for care and older people, but then there is the shadow Secretary of State’s repetition of the phrase about wanting a top-down reorganisation of the NHS around a social care model. None of that will deliver what we all want: an integrated NHS and social care model, which is what we are beginning the journey of creating. We are doing that by reflecting locally what local places need in terms of integration rather than creating a national model to which they have to adhere. Again, it is important to fix all this—

[Barbara Keeley]

Will the Minister give way?

[Ben Gummer]

I will after I have finished this comment.

It is important to put all this in the financial context. I have been through the Lobby with the shadow Minister and with many Labour Members who were in the previous Parliament. We went through the Lobby just before the election when we agreed to cuts in public expenditure in the first two years of this Parliament and the former shadow Chancellor committed the Labour party to cuts in local government spending. Difficult choices are forced on us by the catastrophe and chaos that we were left in 2010. Labour Members need to confront those difficult choices. They cannot have it both ways. They cannot, on the one hand, say that we need massive increases in payments for social care and, on the other, say that they are going to constrain public spending. The answer to that dilemma is surely to try to find a better way of integrating social care that I hope would see cross-party consensus rather than the politicking we have just seen at the Dispatch Box.

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[Ben Gummer]

My right hon. Friend never planned to close Lewisham hospital. I give the hon. Lady this promise: I will certainly come and speak to her about her constituency before anything happens—in fact, if nothing happens—because I care very much about the provision of secondary and tertiary care there. That also goes for my colleagues on the Front Bench.

Let me give the facts of what we are doing in funding better social care and integrated social care in the NHS. We are already transferring £1.1 billion of NHS spending into social care funding as part of the additional £8 billion over the next five years. That money will be for social care as well as the NHS. It is part of an integrated system that NHS England envisages. Through the better care fund, funded to the tune of £5.3 billion, we are funding the local integration of social care and health care. That will produce a different solution in Manchester than in Ipswich, and that is a good thing because those two places are different.

[Barbara Keeley]

Will the Minister give way?

[Ben Gummer]

I will.

[Barbara Keeley]

I thank the Minister for giving way eventually, because he has made a number of points about my local area. In Salford, we are moving heavily into integration—we are one of the better places in the country for that—but the work there is not assisted by a number of things. The better care programme funding is not extra funding. A large hole has been created, as in Lewisham, by cutting back on social care funding. Even at a smaller level, the closure of walk-in centres in Salford and the ending of active case management as efficiency cuts are made have not helped. All these things are part of the jigsaw. All we have seen is cuts.

[Ben Gummer]

Walk-in centre closures were supported by the hon. Lady’s hospital because that gave a safer service. I walked through the Lobby with her also. Because her party is unable to make a decision about money being spent on benefits and on the general budget for government, she would not be able to pledge any more than my party; in fact, she could only promise less funding for social care. She has to be straight with voters. Labour Members cannot have it both ways. They cannot spend money on the NHS, benefits and all the other things that they are pledged to increase funding on, and also claim to be the party of fiscal responsibility. It just does not hang together.

Oral Answers to Questions

Baroness Keeley Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Mr Hunt]

I thank my hon. Friend for raising that case and I will happily look into it. That is a perfect example of why we need to change the way we look after people with long-term conditions, such as dementia, out of hospital. If we can improve the care that we give them at home and give better support to people such as that man’s wife, we can ensure that the kind of tragedy my hon. Friend talks about does not happen.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

Unpaid family carers play a key role in the care of people with dementia, many with heavy caring workloads of 60 hours a week or more. Can the Health Secretary understand how fearful carers now are of talk of cutting their eligibility for carer’s allowance and will he fight any moves within his Government to do that?

[Mr Hunt]

I absolutely recognise the vital role that carers play and will continue to play, because we will have 1 million more over-70s by the end of this Parliament, and we need to support them. I hope that she will recognise that we made good progress in the previous Parliament with the Care Act 2014, which gave carers new rights that they did not have before.

Health and Social Care

Baroness Keeley Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Andy Burnham]

My hon. Friend anticipates me, because this is precisely the issue I am coming on to. Under the Lansley reorganisation, workforce planning went out of the window, and that led to today’s huge workforce crisis and hospitals being in the grip of private staffing agencies. That is the single biggest driver of the NHS deficit that I mentioned a moment ago, and I will talk about that shortly.

The Secretary of State gave us a pious warning about temperate language, yet this is the Secretary of State who today on the front page of The Daily Telegraph is saying that the NHS has enough cash and now must deliver:

“the time for debating whether or not”

it has enough money is over, it

“now needs to deliver its side of the bargain”.

Not for the first time, that is a statement by the Secretary of State that will have caused jaws to drop across the NHS. People will not forget the time he accused hospitals of coasting when they were in the middle of an A&E crisis, but even by his standards this was a staggering piece of spin.

The simple fact is that the NHS does not have enough money. In fact it is seriously short of money. It is facing a £1 billion deficit this year, with two thirds of hospitals in the red, which marks a major deterioration from what the Conservatives inherited in 2010, when there was a surplus of over £500 million.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

Are not some rather stupid decisions about to be made? Wythenshawe hospital has a £3 million deficit and is talking about cutting 28 district nursing posts. The Secretary of State said earlier that community resources are important. Of course they are, but if we are going to cut district nurses every time there is a trust deficit like the one at Wythenshawe, we are not going to get through another winter without a much more serious A&E crisis.

[Andy Burnham]

That is exactly the point. When we are in a crisis like this, short-term, knee-jerk cuts are made, which make the situation wrong in the long term.

When I raised these deficits in the election campaign, the Secretary of State said I was scaremongering, but just two weeks after the election the truth emerged. [Interruption.] He says I was, but we now know the truth. There was an £822 million deficit in the NHS last year, a sevenfold increase on the previous year. [Interruption.] The Secretary of State says he is dealing with it. That is not good enough. That is appalling mismanagement of the NHS. Financial grip in the NHS has been surrendered on this Secretary of State’s watch, and things are looking even worse this year. Far from scaremongering, these issues are real and should have been debated at the last election. The NHS is now facing a £2 billion deficit this year. As my hon. Friend the Member for Warrington North (Helen Jones) said earlier, that will mean cuts to beds, to staff and to services.

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[Barbara Keeley (Worsley and Eccles South) (Lab)]

It is a pleasure to follow the speeches of so many new Members, in particular the excellent speech of my hon. Friend the Member for Bristol West (Thangam Debbonaire), as well as another fine speech by the hon. Member for Eastleigh (Mims Davies), which we have just heard. Both those speeches were excellent expositions of the highlights of the Members’ local areas, and I was pleased to hear the commitment to carers that the hon. Member for Eastleigh has just made; I will expand on the issue of carers later.

I am delighted to have been elected by the people of Worsley and Eccles South to represent them in what is my third parliamentary term. There are 73,000 people in my constituency and I vow today to represent them all to the best of ability. Today, however, I want to talk about the 10,800 or so of my constituents who are unpaid family carers and part of the 6.5 million people who are carers across the UK. That is appropriate, because this year is the 50th year of the movement to support carers, and, as the hon. Member for Eastleigh has just said, next week is carers week. Carers week is a time when we celebrate the unpaid work of family carers, like the hon. Lady herself, and also a time when we should think about how we can better support those carers. Before I talk in more general terms, I pay tribute to Salford Carers Centre, which is part of the Carers Trust, and Salford Young Adult Carers project. I feel fortunate, as an MP in Salford, to know that the carers centre and the young carers project are providing such excellent support.

In April, when we were all busy campaigning, Carers UK published a survey of the state of caring. Over this Parliament, an estimated 10.6 million people will take on a new caring role for a family member or friend who is disabled, elderly or seriously ill, and the report tells us that we will not give them the support they need and deserve unless we make changes to ensure adequate care services and improved quality of care and, where we can, maintain and improve the financial support for carers.

It should be no surprise, after the last Parliament, that more than half of carers surveyed said they were worried about the impact of cuts to care and support services over the next year. They are right to be worried, because since 2010 Government cuts to local authority budgets have meant that more than £3.5 billion has been cut from adult social care budgets. Besides the quantity of support services available, which is important, family carers also worry about poor quality services. My right hon. Friend the Member for Leigh (Andy Burnham) rightly referred earlier to those terrible 15-minute care visits. Only just over a quarter of carers reported positive experiences of home care or respite care, and just over a fifth reported bad or terrible experiences of care, with the rest reporting mixed or fair experiences.

I say to the Minister, whom I am glad is in his place, that we should not be happy to hear that there is a lot of poor quality care out there. Poor care services mean that family carers have to take even more on themselves, with little respite from caring. Again, it is no surprise that six out of 10 carers told Carers UK that they were at breaking point. Caring can have a substantial impact on the health of the family carer. More than eight out of 10 carers reported to Carers UK that caring was having a negative impact on their health, and that figure is much higher for people caring for someone with dementia. Some 74% of carers report that they are struggling to get a good night’s sleep, and 47% are having difficulty maintaining a balanced diet.

Sixty thousand carers are affected by the bedroom tax. In the last Parliament, I introduced a Bill to exempt households with one extra bedroom from the bedroom tax if a carer in the house was eligible for carer’s allowance. While a disabled person who needs overnight care from a paid careworker or non-resident relative is exempt from the bedroom tax, they are hit by the tax when the care is provided unpaid by a partner or another carer living in the same house. That is unfair. Subjecting carers to the bedroom tax is illogical as well as unfair. One aim of the bedroom tax was to improve work incentives for working-age claimants, with the assumption that people should seek work or increase the number of hours they work to pay the bedroom tax. But for many unpaid carers that is not an option—entitlement to carer’s allowance means caring for someone for more than 35 hours a week, and Carers UK reports that 60% of those caring for people with dementia care for 60 hours a week. Clearly they cannot move back into employment without reducing their ability to care.

It is an insult to the 2.3 million people who have made the difficult decision to give up work so that they can care for a family member to be penalised further for that decision. Last week, I asked the Prime Minister to confirm that the planned £12 billion of welfare cuts would not include a measure to cut eligibility for carer’s allowance. He did not answer the question, and neither did the Health Secretary today. It is even more worrying for the 670,000 carers who get carer’s allowance that it is going to be cut.

I have not read all the Conservative manifesto, but I know that it said little about carers. It said only this:

“We will increase support for fulltime unpaid carers.”

I have suggested that this will mean ensuring sufficient funding for social care as well as for the NHS and improving the quality of the care services. It will also mean that carers should not suffer financial hardship as a result of their caring. Full-time family carers should not be subject to the bedroom tax, and carers should not be worrying, as they now are, about losing their eligibility for carer’s allowance. My party was committed to making it a duty on the NHS to identify carers—a measure that would help carers’ health—and I hope we can see that brought forward, if not by the Government, then in a private Member’s Bill.

I have raised today a number of issues of great importance to 6.5 million carers. It is time that their issues achieved more prominence in the House, and I will continue to raise them, as I have done today.