Enterprise Bill [Lords]
Debate between Bill Esterson and Baroness Keeley(8 years, 8 months ago)
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Bill Esterson
I thank the hon. Gentleman for his intervention. The hon. Member for Kensington (Victoria Borwick) asked the Minister about zoning and whether London could be a single zone, but why stop at London? Why not designate England as a single zone, given that that is exactly what would happen because of the domino effect of the proposal?
Barbara Keeley
My hon. Friend is making a very good speech. The Trafford centre is a large shopping centre situated next to my constituency. It attracts an enormous amount of traffic, so if it extends its hours my constituency will never get a moment’s peace. Moreover, building work on the Government’s motorway project can take place only when the Trafford centre is not busy. [Interruption.] It is not my council. If the Trafford centre opens 24/7, the logistics will make things impossible for my constituents.
Bill Esterson
There are similar examples up and down the country. My hon. Friend is absolutely right.
Let me turn to some of the evidence we have been given in the lead-up to this debate. During the Olympics, convenience stores experienced a fall in Sunday trade of up to 7%. There was also a displacement of trade to different times of the week, but, instead of an increase in overall trade, there was a slight fall. The Government assumption that people will have more money to spend just because the shops are open longer does not bear scrutiny once we start to look at the evidence.
Meanwhile, the extra Sunday hours would increase costs in those large stores that stay open longer, and while there will be some displacement from convenience stores to larger retailers, as happened during the Olympics, there will be little or no overall increase in trade to pay for the increased cost in most shops.
Health and Social Care Bill
Debate between Bill Esterson and Baroness Keeley(12 years, 8 months ago)
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Barbara Keeley (Worsley and Eccles South) (Lab)
I want to speak in support of the motion, which notes the e-petition and declines to support the Bill in its current form. As has been said but deserves repeating, the Conservative-led Government have no democratic mandate for the Bill; quite the opposite, given the Prime Minister’s promise that
“with the Conservatives there will be no more of the tiresome, meddlesome, top-down re-structures”
of the NHS. Yet this reckless and unnecessary top-down reorganisation will cost £3.5 billion, which could be spent on patient care.
Already in my local area and many others, patients are losing services, waiting longer and receiving poorer treatment than before. Salford primary care trust has ended its active case management service for people with long-term conditions—the service had been both popular and effective. NHS budget cuts have meant that a community matron service was ended in a local area.
The Select Committee on Health recently dealt with the impact of the NHS reorganisation in its report on public expenditure—my right hon. Friend the Member for South Shields (David Miliband) quoted it. The report concluded:
“The reorganisation process continues to complicate the push for efficiency gains...it more often creates disruption and distraction that hinders the ability of organisations to consider…effective ways of reforming service delivery and releasing savings.”
Cuts are having a direct effect on treatment. A staff member of the local branch of the Parkinson’s Disease Society told me recently that NHS cuts mean that GPs and pharmacists are switching to cheaper brands of drugs for patients with Parkinson’s, many of which are much less effective. One person was admitted to hospital. She became ill following a switch to a cheaper, less effective medicine. The hospital staff told her that she should be “firm with her GP” and insist on the more expensive brand.
The Bill brings competition into the NHS at a level that is unhealthy and unwanted. The PIP breast implants saga showed us the dangers for the NHS of a vast increase in private provision when regulation of medical products for use in surgery is so poor. In January, 14 consultants, GPs and public health experts wrote a letter to The Times about the expansion of private provision and the issues arising from PIP implants. They warned that the Health and Social Care Bill
“provides much less protection for patients should their provider fail than is available to people booking package holidays”.
With PIP implants and private surgery, there was a strong marketing sell to patients of the benefits of surgery but little information about risks, and little or no interest in aftercare. That is an important warning. We know that there are potential health issues with metal-on-metal hip implants, yet there will be pressure on patients waiting for a hip or knee replacement to go for private surgery to avoid the waiting lists that we know are building up.
The Bill risks creating a two-tier NHS and a return to the long waiting lists experienced under Conservative Governments in the 1990s—the Government have already watered down guarantees on NHS waiting times. I recall meeting a patient in 1997 who had been waiting up to two years for vital heart surgery, yet more recently in my constituency I have met people whose lives have been saved in a matter of days by the rapid diagnosis and treatment of cancers.
A number of local GPs have written to me calling on the Government to drop the Bill because they feel it undermines the bond of trust between doctor and patient. One GP told me:
“The reforms are being made on the cheap. GPs are being asked to do the work of the PCTs with half of the funding and all of the blame when problems arise. The Bill drives a wedge between primary and secondary care.”
That GP actually supports the theory of clinicians being given more input and supports a reduction in bureaucracy, but says that the Bill “does the exact opposite” because it introduces new layers of bureaucracy such as the clinical senate. He says that people coming in
“are doing so at different levels of understanding…leading to confusion.”
He feels that, ultimately,
“it will be the patients who will suffer…no one has asked the patients what they want.”
Bill Esterson
My hon. Friend describes a GP in her constituency, but a GP in mine described his concern to me. He said that he is there to be a doctor and wants to care for patients, and that he does not have the expertise to be a manager. That is the overwhelming concern of his colleagues around the country. Does she agree that that is the danger of that part of the Bill?
Barbara Keeley
I very much agree. Only quite recently have GPs expressed such concern. I have never known GPs to come to their MPs in numbers, as they are doing, to complain about the implementation issues they are already finding. As I said, the GP I quoted supported the idea of GPs being more involved with decisions about patients, but he now thinks that the Bill is
“simply a mask for a cost cutting exercise…a way to deal with the NHS on the cheap. A way of farming out support systems…e.g. clinical support, into the private sector.”
He says:
“More money will be taken out of the NHS and put into the private sector.”
The hon. Member for South West Bedfordshire (Andrew Selous) asked us to trust the wisdom of our GPs. That is a damning indictment by a Salford GP, and one that I believe is echoed by GPs up and down the country. Trusting the wisdom of my local GP, I urge hon. Members to support the motion.
Oral Answers to Questions
Debate between Bill Esterson and Baroness Keeley
Bill Esterson (Sefton Central) (Lab)
20. What recent discussions he has had on domestic energy bills with representatives of the six largest energy companies.
Barbara Keeley (Worsley and Eccles South) (Lab)
21. What recent discussions he has had on domestic energy bills with representatives of the six largest energy companies.
Education
Debate between Bill Esterson and Baroness Keeley(13 years, 11 months ago)
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Bill Esterson (Sefton Central) (Lab)
The abolition of the education maintenance allowance is one of the issues that have caused greatest concern in my constituency. One of my constituents from Thornton wrote to me to say that he has signed the petition in the name of my hon. Friend the Member for Liverpool, Wavertree (Luciana Berger). He wrote:
“I am writing to you in my capacity as an employee of a large FE establishment in North Liverpool”—
and as one of my constituents. He continued:
“I have recently become increasingly alarmed at the ConDem’s plans to scrap Educational Maintenance Allowance for FE students. Given recent developments in the HE sector and last week’s student protests in London, it would seem that scrapping of the EMA is simply another plan to further undermine the education sector as a whole and, in many cases, to deprive learners of their right to an education. Although the abandonment of the EMA may have a lesser impact in more affluent areas, its effects will be felt much more in areas such as your constituency where an above-average number of learners are indeed in receipt of EMA. The ConDem’s plans to ‘bolt on’ a much lesser amount to the Discretionary Learner Support Fund will of course minimise the number of learners in receipt of financial assistance, and learners may be faced with finding other means of supporting themselves, and I have no doubt that some of these means may be less than legal.”
Barbara Keeley (Worsley and Eccles South) (Lab)
My hon. Friends are making a good case for the education maintenance allowance, but does my hon. Friend share my concern about young carers? College principals might not even know that some of their students are young carers, who need the incentive that EMA can give them to keep attending and to struggle on with their caring work load as well as their education.
Bill Esterson
Young carers are one of a number of vulnerable groups for whom EMA is especially important, and its loss would hit them and those who depend on them particularly hard. I hope that the Minister will consider that point among others.
My constituent told me that some of the means by which students will support themselves might be less than legal. He said that that was
“an opinion that I have heard in person on more than one occasion from students themselves”.
I have also heard similar comments about the potential of drug dealing as a source of income for students who lose EMA. I thought his was a balanced and responsible view of the impact of EMA from a member of staff with much experience.
The principal of Hugh Baird college in south Sefton, Jette Burford, also wrote to me saying that 84% of young people at the college currently receive EMA; that there is a clear indication that it has become a key part of the family income for those families; and that its discontinuation is very likely to impact on the participation rate locally. Ms Burford mentioned both the impact of losing the EMA on participation and attainment, and the fact that many students depend on it for help with their transport. When she wrote to me she did not know that Sefton students were likely to lose their free travel passes because Merseytravel has had its budget cut by two thirds.
EMA is essential for many students from low and middle-income families when it comes to travel, books, equipment and food, and its loss will make it very difficult for students to continue to study. EMA is a means-tested allowance of between £10 and £30 per week. Some 635,000 learners received at least one EMA payment in 2009-10, and about 80% of those received the full £30. That means that the people receiving the £30 come from low-income families on less than £20,800 per year. The loss of EMA for students from such low-income households will create a big hole in family incomes, which college principals have commented on.
EMA was introduced by the previous Labour Government to help with the cost of books, travel and equipment, and payments are made on the condition that students attend classes regularly. The evidence from colleges is that the incentive to turn up on time has worked well, and the evidence in Merseyside is that those on EMA outperform by 7% those who are not in receipt of it. Research by the Institute for Fiscal Studies gives a similar result.
The Department for Education is stopping new EMA at the end of this month, before it has alternative arrangements in place. The Department plans to stop paying the EMA in July 2011 to existing 16 to 18-year-old students who will be halfway through their courses. That means that EMA will be completely gone by July 2011—an unseemly rush. EMA has been widely credited with helping to create a big increase in the number of young people going on to college in the last seven years. The IFS revealed that EMA increased the proportion of 16-year-olds in full-time education by 4% and the proportion of 17-year-olds in full-time education by 7%.