Health and Care Bill

Daisy Cooper Excerpts

Consideration of Lords amendments
Monday 25th April 2022 Commons Chamber

[Sir Iain Duncan Smith (Chingford and Woodford Green) (Con)]

I will speak briefly to Government amendment 48A, which is in lieu of amendment 48B. Essentially, it requires the health service to ensure that it does not use products made under forced or slave labour anywhere in the world. That is a big statement by the Health Department, and one that I think we all welcome—I have certainly campaigned on this issue for some time.

In the great sweep of this health legislation, on which there are agreements and disagreements across the board, that may not seem to be something that will directly affect our lives, but in truth it will resonate beyond our shores. It is already resonating among the Uyghur, who have found themselves under distinct pressure, with husbands often separated from wives and families broken apart for forced labour thousands of miles away from their homes. This measure will speak to them; it is, in a way, a sign that Governments in the free world are taking up this real cause and recognising that it is intolerable for us to turn a blind eye and buy equipment, clothing and so on simply because it is cheaper and helps our cost balance. I do not believe that it will in the end; the trade-off between cost and the human rights of those who have suffered so much under the heel of those totalitarian states is an abysmal one.

Child labour is used in rare-earth mines; when we use those rare-earth materials for the manufacture of our computers, we turn a blind eye to it. When slave labour is used in the Xinjiang region to produce the cotton and the cloth for our personal protective equipment, making it quicker and easier to get, we turn a blind eye to it. It is not just done there; it is done in many countries around the world because it is easier and cheaper, and we tolerate it. I therefore welcome that my right hon. Friend the Secretary of State and the Ministers have tabled the amendment. It will speak volumes to those who are oppressed. It will say to them, “The free world has not forgotten you.” I am certain that in due course the rest of this Government will do the same, and other Governments will then follow suit. I congratulate us for making the right decision.

[Daisy Cooper (St Albans) (LD)]

I will speak to the workforce amendment and the amendment on the social care cap.

The Lords have compromised on the workforce amendment—they have now asked for projections every three years instead of every two, and they no longer require independent verification of the projections—so it is deeply disappointing that the Government have not moved to meet them halfway, especially when outside the Government there is so much cross-party consensus that the amendment is badly needed. I know from my constituency of St Albans, as I am sure many Members know from theirs, that our NHS and care staff are burnt out. They are understaffed and overworked. Those people, who continue to turn up every single day, need to know that the cavalry is coming, and without this workforce amendment, they simply will not.

There have been worrying reports that NHS trusts have been silenced when they have tried to talk about the numbers of staff that they need to recruit, so will the Minister address this question in his response: if the Government will not produce workforce planning numbers, will they at least commit to not interfere with or silence any part of the NHS or care sector that decides that it wants to produce its own workforce projections? I look forward to hearing the Minister’s assurances on that point.

When it comes to the social care cap, Ministers have stated time and again that their changes would save the Treasury £900 million a year by 2027-28, but that saving comes at the expense of people with fewer assets and savings, including those who will have been paying five years of increased national insurance contributions, which were put in place partly to fund these care reforms. The Government continue to say that that improves on the current situation, but they conveniently ignore that it is much worse than their original proposal. The social care cap provision does nothing to generate more care; it does nothing to give protections to unpaid carers, who are often on lower incomes but save the Government millions of pounds; and it does nothing to help the social care workforce. I know from my constituency that hospitality, the NHS and social care are all fighting for the same people, and nothing in the Bill will help to improve that situation.

[Peter Aldous (Waveney) (Con)]

I am grateful to have a few minutes to say a few words on the cap on care costs and on workforce planning.

With regard to the care cap, it is important to congratulate the Government on tackling a problem—or attempting to defuse a ticking time bomb—that all their predecessors shied away from. However, there is concern that the proposals are a rushed tag-on to a Bill that was designed for a different purpose: the integration of health and social care and the setting up of integrated care systems. I accept that there is a clear correlation, but the legislation that addresses the problem of people being forced to sell their homes to pay for their care should have been considered and scrutinised separately and carefully, with the objective of putting in place a system that has political consensus and will stand the test of time. That is what the Dilnot proposals and the Care Act 2014 achieved, and they should be the foundation stone on which we build this new system.

My concerns are twofold. First, clause 140 is extremely unfair to those with limited assets and modest incomes. The changes may save the Government hundreds of millions of pounds, but they do so at the expense of those on low incomes and those who live in parts of the country where house values are lower, such as Lowestoft in my constituency. Secondly, there is a worry that working-age adults with disabilities will be unfairly penalised, hence the introduction by the other place of a provision to address it. I acknowledge the Government’s worries about the cost implication of that additional provision, but that iniquity needs to be addressed.

On workforce planning, there is a staffing crisis both in the NHS, where there are 110,000 full-time equivalent vacancies, and in social care, where there are another 100,000 vacancies, high staff turnover and very limited respite for unpaid and family carers. Those deficiencies cascade through the health and care system, creating bed-blocking in hospitals and impeding the efforts made to reduce waiting lists. There is an urgent need for strategic planning to address this crisis. There is concern that framework 15 is not working because of inadequacies in the collection of data, lack of assessment of workforce numbers, and unresponsiveness to societal shifts.

Since we last considered the issue last month, the other place has sought to address the Government’s concerns and, as we have heard, has made reasonable concessions. There is a crisis that must be addressed, and I hope that at this very late stage the Government will accept this reasonable amendment, so that we can get on with this much-needed work.