Terminally Ill Adults (End of Life) Bill (Money)
Daisy Cooper Excerpts(1 day, 20 hours ago)
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Antonia Bance
No, I will not.
In the case of this Bill, we not only do not know how much it will cost or how it will be paid for, but we do not even know what the money will be spent on. Let us think of the questions that we do not know the answers to. What will be the cost of NHS doctors attending the final appointment and waiting while their patient dies? What will be the cost of a second doctor to sign off? What drugs will be used, and how much will they cost? Will assisted dying happen in hospitals, in hospices or in new, purpose-built facilities? How many will there be, and where?
Antonia Bance
No.
How much will those facilities cost? There are even bigger questions, too. Will this be an NHS service, or will we be contracting private providers? If it is an NHS service, which of my constituents will have to wait longer for an operation or a GP appointment because this Parliament will today authorise massive, unspecified spending in our cash-strapped NHS?
Antonia Bance
I will not—I have only a little time.
It is not just the health system that will take on new costs. Our civil courts are groaning under the strain of years of Tory underfunding, although my right hon. Friend the Justice Secretary is doing a brilliant job of putting our court system back to rights. However, this Bill will impose new unfunded and unknown costs on our courts. It blithely assumes that judges and courts will be available, yet the waiting time for a family court case at the moment is 10 months. That just will not work for the Bill. How much will the extra spending on courts cost?
Antonia Bance
I will not.
Those are all reasonable questions, and this House deserves to have many more answers than it has so far been able to get. According to the Hansard Society,
“To table a money motion, the Government must therefore assess how much money will be required and have some idea about where the funding will come from, although it is not required to set this out in the motion itself.”
That information is not in the motion, so will Ministers make that assessment available and set out where the funding will come from? I am glad to hear we have a timetable for the impact assessment, but it would be good also to see the delegated powers memorandum, given the scale of powers delegated to Ministers in the Bill.
Alongside others, the Minister is a member of the Public Bill Committee, and I thank him and all members of the Committee for their work on behalf of this House, scrutinising and seeking wisdom. I particularly thank the Minister for upholding the neutrality of this Government and our party towards the Bill in his acts on the Committee and in this House.
Those of us with concerns will not push this resolution to a vote today. I know that colleagues are desperate for there to be procedural game playing, but there is no such thing; there are in principle concerns and questions about practicalities. I do hope for some answers to my questions.
Liz Saville Roberts (Dwyfor Meirionnydd) (PC)
Can we just state what is really quite obvious? This House has voted for further debate in order to make workable and legally watertight legislation, and with that debate will come a full understanding of the resources needed for both England and Wales. Of course, in Wales, health is devolved and justice is reserved, and we need to understand the implications for that.
What has been a bit of an eye-opener for me, as a member of the Bill Committee—it is, of course, a larger Bill Committee for a private Member’s Bill than ever before—is the sense of the way in which this place operates. We have been given the role of producing workable legislation as best we can, on the advice of witnesses—there is a part of me that would like the Committee to receive more witnesses, but I am very aware that we have to move ahead with what we have been charged with doing: namely, producing that workable legislation—but we will not arrive today, next week or after we have heard from our witnesses at a complete, perfect, already-made understanding of what we need to do to make correct and workable legislation. For those things to be in place today, the House would need estimates and information that the Bill Committee has been charged with providing, which it will not be able to provide until we have heard the advice from the witnesses we are calling forward to give us a sense of what the resource needs and associated costs will be.
It will then be the duty of us all on Report and on Third Reading to ensure that the money and resources are sufficient for the legislation to be workable. With that in mind, I support this motion.
Daisy Cooper
Members in this House who have spoken against the money resolution say they are doing so because they have so many unanswered questions about the costs. Does the right hon. Lady agree that if Members vote against the resolution, they will never get those answers? That is precisely why the Bill should move forwards.
Liz Saville Roberts
Let us imagine what the public would make of our role in this place if this legislation were to fall at this point.
New Hospital Programme Review
Daisy Cooper Excerpts(3 days, 20 hours ago)
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Wes Streeting
I am grateful to my hon. Friend for his representation and for his outstanding work for the people of Leeds since his election. I can reassure his constituents that this is a credible and funded timetable that we can stick to—and I am determined to ensure that we do. As for promises made by the Conservatives, we saw the crocodile tears from the Leader of the Opposition this weekend. She says that she will admit that the Conservatives got things wrong, but she never, ever gives a specific example. In fact, we have heard more about steak sandwiches than humble pie since the election.
Daisy Cooper (St Albans) (LD)
The previous Conservative Government promises the people of west Hertfordshire that we would have a new hospital, and they even claimed that it was fully funded, so our sense of betrayal is incredibly acute. Today, the Labour Government have announced that the rebuild start for Watford general hospital has been pushed back by seven to nine years, without Ministers having even visited the hospital, even though it is shovel-ready. We have the land, we have the planning permission and we have done the enabling work, so can the Secretary of State say why 23 hospitals are ahead of Watford general, and what money will be made available for repair bills, which will inevitably pile up, possibly for the best part of a decade, while our hospital is left to crumble?
Wes Streeting
I can well understand the hon. Member’s anger on behalf of her St Albans constituents, who are invested in this project, as are the constituents of my hon. Friends the Members for Watford (Matt Turmaine) and for Hemel Hempstead (David Taylor). She will be able to see in the report, which we are placing online and in the Library, the methodology that we followed to assess prioritisation and ordering of schemes, which was about affordability, deliverability and the other factors that she would expect us to take into account. That is how we reached today’s decision. I can reassure her and her constituents that pre-construction work will begin from 2028 to 2030, with construction beginning in 2031 to 2033. Those of her constituents who are angry about the delays do not need to be told where the blame lies. That is why they returned a Liberal Democrat MP instead of a Conservative.
Access to Primary Healthcare
Daisy Cooper Excerpts(3 months, 1 week ago)
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Daisy Cooper (St Albans) (LD)
The Minister may be aware that I lobbied Health and Treasury Ministers in the previous Government for the best part of a year and a half to review outdated Treasury rules that prevent GP practices that want to move from staying within a city centre—the outdated rules force them to move to ring-road locations, away from the populations they serve. Will the Minister look at this issue with fresh eyes, with her new glasses, and work with Treasury colleagues to review these outdated rules?
Karin Smyth
I thank the hon. Lady for her assiduous work in opposition. Looking at the capital estate is one of my favourite new responsibilities, and our commitment to a neighbourhood service means that we need to bring services together. We need to look at this across the piece, to make sure that primary care is provided where it is needed. We often hear about hard-to-reach groups, but I do not think they are that hard to reach. Frankly, services are sometimes located in the wrong area. One of our key commitments is to shift services into communities, and the neighbourhood service programme is part of that.
Just three in 10 NHS dentists are accepting new adult patients, and geographical inequalities are vast. More than 1,200 pharmacies have shut their doors for good since 2017. Again, the record speaks for itself: public satisfaction with general practice has fallen from 80% in 2009 to just 35% last year. If there is any reason why the Conservative Benches are empty, it is because dissatisfaction with access to primary care is so stark, as we learned in July’s general election.
It is absolutely clear that primary care is broken, but NHS staff working in primary care did not break it; the last Government did. They cut funding for the community pharmacy contract, they failed to incentivise enough dentists to perform NHS work, and they pursued a disastrous top-down reorganisation of the NHS, with which we are still living.
The last Government might have broken the NHS, but it is not beaten. NHS staff remain as passionate, dedicated and skilful as ever, and this Government will work in lockstep with them, their counterparts in social care and local partners across the country to fix the NHS.
NHS: Independent Investigation
Daisy Cooper Excerpts(4 months, 1 week ago)
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Daisy Cooper (St Albans) (LD)
Much of the content of Lord Darzi’s report has been known for some years. None the less, today’s report is a scathing summary of the complete devastation that the Conservatives have wrought on our health services and on the health of our communities. We Liberal Democrats have long argued that we need to shift healthcare from hospitals to high streets, and from treatment to prevention, because doing so improves health outcomes and saves taxpayers’ money. It is a win-win.
But the report is long on diagnosis and short on prescription, so may I invite Ministers to read our fully costed manifesto to fix public health and primary care by recruiting 8,000 GPs, ending dental deserts, boosting public health grants by £1 million, implementing our five-year plan to boost cancer survival rates, and putting a mental health expert in every school?
Does the Secretary of State accept that there is an elephant in the room: social care? Will he meet me to discuss the Liberal Democrat plans for social care, starting with free personal care? This bold idea would prevent many people from going into hospital in the first place, as well as enabling them to be discharged from hospital faster. Does he accept that it is a truth universally acknowledged that we cannot fix the NHS if we do not fix social care too?
As for the dire state of our hospitals and primary care estate, well, the Conservatives have left it to fester like a wound. Will the Secretary of State give the green light to hospitals that are ready to rebuild, such as mine in west Hertfordshire? Will Ministers look to reform outdated Treasury rules that are preventing our integrated care boards and hospital trusts from spending and investing their funds in the GP practices and hospitals that we need? This Government say that they want growth. Well, health and wealth are two sides of the same coin, which is something the Conservatives do not understand. If Labour wants economic growth, fixing our health and social care must be its top priority. And it must be a priority without delay.
Wes Streeting
How refreshing to have constructive opposition in the Chamber. It was clear throughout the election campaign that my party and the Liberal Democrats have much in common, both in the commitments we made, which in some cases were identical, and in our shared areas of emphasis: the link between health and wealth, the importance of prevention and the importance of social care.
As the Prime Minister reiterated again this morning, we are absolutely determined to address both the short-term crisis and the long-term needs of the century in our social care system. We want to work on a cross-party basis wherever possible, so I would be delighted to meet the Liberal Democrat spokesperson.
Healthcare Provision: East of England
Daisy Cooper Excerpts(4 months, 2 weeks ago)
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Daisy Cooper (St Albans) (LD)
It is a pleasure to serve under your chairmanship, Sir Christopher. I congratulate the hon. Member for Norwich South (Clive Lewis) on securing this important debate.
The NHS used to be the envy of the world, but it is now in crisis, and services in the east of England are no exception. We have heard many examples in the debate of where our health and care services are in crisis. There is no doubt that the new Government inherit a litany of broken promises from the previous Conservative Government; that is why we Liberal Democrats have put health and social care front and centre of our campaigning in recent months and years. It is why, on the first day after the general election, we called for an emergency Budget to give the NHS and care services the money they so desperately need, and it is why we continue to urge the Government to act with real ambition and urgency on these issues.
In a debate on healthcare in the east of England, it is hardly surprising that dentistry comes out as the No. 1 issue. Dentistry is in an appalling state across the country, and particularly in the east of England, but arguably it is one of the easiest areas to fix. Under the previous Conservative Government we ended up in an absurd position where we had children having their teeth removed and people desperate for appointments, yet we had a £400 million underspend in one financial year. We also have thousands of dentists in this country who are willing to deliver NHS work, but who cannot because the contract is so convoluted.
I ask the Minister to outline the Government’s timeline for negotiations with dentists on fixing the broken dental contract. I also have a specific request from my hon. Friend the Member for North Norfolk (Steff Aquarone), who could not be here: he asks whether it could be made faster for people who want to operate NHS services to register to do so, because there are currently delays in the system.
A number of colleagues have spoken about the challenges with ambulance waiting times. The hon. Member for Norwich South and I have spoken in debates on this before and he will know, as I do, that the East of England ambulance service has had a very troubled history. To give credit where credit is due, there have been welcome improvements in the last 18 months, but there is no doubt that there are still huge delays in ambulance response times, which are very concerning to our constituents. Would the Minister support a Bill that I tabled in the previous Parliament to introduce localised reporting on ambulance response times, so we can see response times on a postcode basis?
Thirdly, I am surprised there has not been more talk about hospitals today. We know there is a legacy from the last Government of crumbling hospitals right across our region—the hospital in King’s Lynn is one of the worst such examples in the country and is being held up by stilts. In my area in west Hertfordshire, we have West Hertfordshire teaching hospitals NHS trust and Watford general hospital is in dire need of a new hospital. It is one of the hospitals in the country that is ready to go—it has the land, it has permission, it has the plans and it just needs the green light from the Government. I urge Labour Ministers to recognise that delaying those plans does not come without a cost, because the repair bill is getting bigger and bigger.
Finally, does the Minister recognise that we need an ambitious plan of recruiting 8,000 GPs? The last Government promised 6,000 and failed to deliver them. Does she agree that we should align the primary care estates strategy with the shift to community care? Does she also agree that the Labour Government will, as part of its consultation on the national planning policy framework, make sure that infrastructure comes first, so that places such as Wixams are no longer let down by the planning system we had under the Conservatives, where people got housing without infrastructure, GPs or dentists?
Oral Answers to Questions
Daisy Cooper Excerpts(6 months ago)
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Daisy Cooper (St Albans) (LD)
I welcome the Secretary of State and his Ministers to their roles, but let me gently warn him that if he intends to run a contest on which Member can harangue him the most on crumbling hospitals, our 72 Liberal Democrat MPs say, “Challenge accepted.”
Under the Conservatives, the new hospital programme ground to a halt. We know the terrible stories of nurses running bucket rotas and all the rest. We have the worst of all worlds at the moment: trusts such as mine in west Hertfordshire are champing at the bit to get going but cannot, and are being held back. Other trusts have capital funds that they want to spend but are not allowed to because of outdated rules, and there are industry concerns that the one, top-down, centralised approach of the Conservatives could decimate competition in that industry, when we need a thriving industry to rebuild our hospitals and primary care. What is the Secretary of State’s response to that approach?
Wes Streeting
I welcome the hon. Lady back to her place. We worked constructively on the Opposition Benches together and, regardless of the size of the Government’s majority, we intend to work constructively with her on this side of the election, too. By extension, I congratulate her colleagues on their election. I have discovered that I have 72 new pen pals, all sitting there on the Liberal Democrat Benches, and they have been writing to me about a whole manner of projects. My colleagues and I will get back to them.
The hon. Lady is right that this is not just about the new hospitals programme, important though that is; the condition of the whole NHS estate is poor. In fact, backlog maintenance, the direct cost of bringing the estate into compliance with mandatory fire safety requirements and statutory safety legislation, currently stands at £11.6 billion. That is the legacy of the last Conservative Government.
Daisy Cooper (St Albans) (LD)
The Liberal Democrats spoke about care a great deal during the general election campaign. At the heart of our plans was our pledge to introduce free personal care. Will Ministers please confirm whether they intend to open cross-party talks and, if so, whether free personal care will be on the table as one potential option?