Oral Answers to Questions
Debate between Clive Betts and Andrew Murrison(9 months, 1 week ago)
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Dr Murrison
I thank my right hon. Friend for his question—I knew he would get Capita in there somewhere. He will be familiar with the Engage to Recruit programme, which is currently underway and having some success in getting soldiers to recruit soldiers. That is probably why, as I touched on in my earlier answer, we are now seeing some extremely promising recruiting figures, including in January—the best figures for six years.
Mr Clive Betts (Sheffield South East) (Lab)
LGBT Veterans Independent Review
Debate between Clive Betts and Andrew Murrison(11 months, 2 weeks ago)
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Mr Clive Betts (Sheffield South East) (Lab)
On 9 May 1996, I spoke in this House about the case of John Beckett, one of my constituents. He was a young man who had been in the Royal Navy for five years and was going to train to be an officer. Along with three other young men, he was discharged for being gay. All he had done was to have a civilian gay relationship, about which we had told his padre and his commanding officer, and it was sufficient to have him discharged. We can try to undo the wrongs that were done to John Beckett and others at the time. I know that John got another job afterwards, but can the Minister possibly believe it is right that someone who committed no crime—all he did was offend against the bigotry and prejudice of those who discharged him—will potentially have to suffer financially for the rest of his life for what was done to him? Surely, when we come to look at compensation, the principle ought to be to not merely to rectify the hurt and the prejudice of the time, but to ensure that people do not lose out financially for the rest of their lives.
Dr Murrison
That is why Lord Etherton has made his recommendations on financial awards. The structuring of that is yet to be determined, but I just want to manage expectations—as I suspect my Canadian counterparts managed the expectations of the Canadian community—about the quantum. I do not want people to think that all that financial loss will be restored to them—it would be unwise of us to suggest that.
The hon. Gentleman mentioned padres. I hope that he reads the Government’s response to the report in full. If he does, he will see that there is a specific section relating to chaplaincy, and contrition on the part of chaplaincy about how some of its practitioners behaved during that period, which I think did them no credit at all. I am very sorry to hear the testimony that he has just given. I encourage his constituent to engage with the front door that I am launching today.
Middle East Peace Plan
Debate between Clive Betts and Andrew Murrison(4 years, 10 months ago)
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Dr Murrison
I certainly can do that. We have lost no opportunity to condemn that behaviour. Every time we speak to our Israeli interlocutors we hammer this home: it is completely unacceptable and it must stop.
Mr Clive Betts (Sheffield South East) (Lab)
Any successful peace plan is likely to need land swaps based on the 1967 borders, but does the Minister accept that those swaps have to be agreed by both parties? When looking at the map that is proposed for a Palestinian entity, does he not see fragmented bits of land, joined in some cases by a very narrow corridors? Does he not see a map that is completely unsustainable and one where those corridors could be cut at any time by Israel at a moment’s notice?
Dr Murrison
I certainly agree with the hon. Gentleman that any land swaps need to be agreed—that is self-evident. I am also surprised at how the map looks. It is a challenging map to examine and one has to understand the geography on the ground in some intimate detail in order to get to grips with it. Sometimes simple maps are the best, are they not? I am no cartographer, but the map that has been produced is quite a challenge to understand.
Health and Social Care
Debate between Clive Betts and Andrew Murrison(7 years, 9 months ago)
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Mr Clive Betts (Sheffield South East) (Lab)
The Communities and Local Government Committee is currently undertaking an inquiry into the funding of social care. We have not produced our reports yet, so anything I say should be taken not as the Committee’s considered view but as some of my own reflections on the evidence we have heard so far. I hope it will not be too long before we can provide a report for Members to look at on the immediate issues of social care, and then, in due course, we will go on to look at the longer-term issues as well. We have taken evidence from a variety of different organisations, including councils, care providers, directors of social care, the Nuffield Trust, and the King’s Fund. Carers and care providers, as individuals, have related their personal experiences to the Committee.
As a constituency MP, it is not terribly surprising to have heard what I have heard today. Unfortunately, as an MP, like everyone else here, I am sure, I see only the tip of the iceberg of problems. Cases about the nature, and number, of social care failings have undoubtedly been increasing in my surgery, my postbag and my emails in the past two or three years. Some of the cases are quite horrific. A council that has to cut its budget on social care does so by going out to the private sector, or agencies, and substituting their services for the service that the council used to provide through directly employed staff. The way in which those services are delivered—often the simple failure of people to turn up and provide the care when it is promised—causes real and increasing problems that I am certainly seeing as a constituency MP.
This is not surprising. The Chair of the Health Committee referred to the fact that we have had a 7% cut in real terms in spending on social care since 2010. Local authorities’ grants from central Government have been reduced by 37%. Councils have tried to prioritise social care—the evidence for that is absolutely clear—but they have not been able to protect it completely from the cuts. That is the reality. On top of that, not only has the money been going down but the number of elderly people requiring care is going up. We heard evidence that although the Care Act was great legislation in principle, all was not delivered in practice. The extra measures are welcome in trying to reward staff properly for the excellent work that many of them do in social care, but the increase in the minimum wage places additional costs on the system.
Amyas Morse, who wrote a very good article and made a good speech the other day about the relationship between health and social care, said that for a long time local authorities had been very successful in doing more for less, but have now got to the point of doing less for less, which is impacting on the people who received the services.
We should not blame local councils for failing to provide a certain standard of service. Simon Stevens told the Communities and Local Government Committee that even if every council did as well as the best, there would still be problems in the system. I challenged the Under-Secretary of State for Health, the hon. Member for Warrington South (David Mowat), to say whether there was a crisis in social care. He did not want to use the word “crisis”, but he did say that the system was “under stress”. Although we cannot agree about the word “crisis”, I think we can at least agree that the stress is obvious for all to see. An estimated 1.2 million people do not receive the care they need. That figure is 40% higher than it was in 2010.
We took evidence from people who were not getting the same amount of care as they had received in the past and others whose needs were increasing but whose care was not. We talked to care providers who were handing contracts back or pulling out of the service altogether, and to local authorities that are sacking care providers because the contracts were not being delivered properly. We also heard that people who pay for their care in care homes are subsidising local authorities because they cannot afford to keep increasing their fees. There is a cross-subsidy in the system, which does not seem fair to many people. At the same time, the turnover rate for care staff is 27%, so they do not have long-term experience and are not being trained regularly over time to deliver care. Those are all problems that we learned about from the compelling evidence that our inquiry received. The Committee will reflect on its conclusion, and I am sure that eventually we will, as always, come to an unanimous view in our report.
In the short term, of course the Government have done things, including the introduction of the council tax precept. I welcome the fact that, by and large, local authorities have taken that up, because the situation is so serious. There are problems, of course, with the fact that the council tax precept raises much more money for some local authorities than for others, and the better care fund, which is meant to stabilise the situation and help authorities that raise less, is back-end loaded. The new homes bonus cut and the additional grant are welcome for social care, but that causes real problems for some small district councils that are not social care providers and suddenly find that their budget position is fundamentally altered.
In his article, Amyas Morse described how the Government simply were not thinking through what would happen in the long term. They moved money—it is often a lack of money—around between social care and health without giving any real thought to the end result. Government officials, and sometimes Ministers, took decisions without any real understanding of what happened to the money at the end of the line, when local authorities faced with very difficult choices had to make decisions about the cuts that were being passed on to them. Those are just some of the issues on which we will reflect in our report.
Clearly, the link between health and social care is very important. We ought to join them up better and it will be interesting to see what comes out of the Manchester example, given that both services have been devolved. There is a clear link between the two, and not just with regard to delayed discharging; there is now virtually no money in the system for preventive social care. The only social care funding available is that for people with the highest need. If people do not get it in the early stages, that means that they are more likely to end up in hospital and cost the whole system much more. That is another thing that we learned.
I was pleased to sign, along with the Chairs of the Health Committee and of the Public Accounts Committee, the letter to the Prime Minister saying that we need longer-term arrangements. It is right, however, that the Government should respond to the here and now, because that is important. To put it bluntly, if we do not deal with the here and now, some people will not be around to see the long-term arrangements being put in place.
When the Communities and Local Government Committee went to Germany, we learned that it solved this problem 20 years ago. Those involved sat down on a cross-party basis and agreed a long-term solution. It might not be the right solution for this country—it is based on social insurance, because that is what the German health system, as well as its pensions system, is based on—but that is what they decided to do. It is interesting that it has stood the test of time for 20 years. They have recently decided, with cross-party agreement, to increase social insurance and there has been virtually no public opposition, because the system is seen to be reasonable and fair. The German system is not purely funded by the taxpayer—there are private contributions as well—but it is an example. For heaven’s sake, let us sit down on a cross-party basis, as the Chair of the Health Committee has said, and work out a solution that stands the test of time, whichever Government comes to power in the future.
Dr Murrison
There is much in the hon. Gentleman’s speech with which I agree. Does he agree that the fundamental issue is that countries such as Germany, France and Holland, to which people here would reasonably compare this country, spend a great deal more money through either the Bismarckian system that he describes or others—this country’s system is based on Beveridge—and that somehow or another we are going to have to close that gap, as it is highly likely that the difference in mortality, morbidity and outcomes generally in this country compared with those aforementioned countries is causally related to the amount of money that we put into healthcare?
Mr Betts
We heard quite a lot of evidence that, as a percentage of our national income, we do not spend as much as several others on health and social care combined. The Communities and Local Government Committee will reflect on that. Of course, it is not simply a question of asking for more public funding; I would not come to that conclusion, although I might personally believe it. There is, however, an issue with where we get the private funding from, because nobody has argued to us so far that the whole of social care can be publicly funded. There will be private contributions, so how do we raise that private money? Should it come from individuals who simply need care at that point in time, or should we ask people to pay more into an insurance system? How do we put in more money from the public sector? Indeed, can we rely on local authority funding alone, particularly if it comes largely from business rates, which will not grow at the same rate as the number of people who want social care?
