The National Health Service

Faisal Rashid Excerpts

Wednesday 23rd October 2019 Commons Chamber

[Chris Stephens]

I do not want Brexit to happen at all because of my real fear that health services in this country could very well find their way into a trade deal with the Donald Trumps of the world. [Interruption.] The hon. Member for Ayr, Carrick and Cumnock (Bill Grant) might mumble “Nonsense”, but many of us have a real fear that that is the case, so we have an opportunity in supporting the Opposition amendment.

I wish now to touch on the Pension Schemes Bill and to follow on from some of the comments by the hon. Member for Merthyr Tydfil and Rhymney. First, let me welcome the measure on collective defined contribution pensions that will be in the Bill. Such a measure, which we have discussed in the Work and Pensions Committee, is long overdue. It is another example of trade union pressure and trade union lobbying. We should congratulate the University and College Union and the Communication Workers Union, which have campaigned long and hard to ensure that collective defined contribution pensions become a reality.

I also welcome the fact that we are going to see the Pensions Regulator get increased powers. The Pensions Regulator was asleep while Carillion was paying out more in dividends to its shareholders than it was putting into its pension scheme. Clear evidence of that came out in the Carillion inquiry, so I welcome that change, just as I welcome the move towards pensions dashboards, which increases transparency.

I come back to the point made by the hon. Member for Merthyr Tydfil and Rhymney—the scandalous injustice that is not being dealt with. We are talking about women born in the 1950s growing up and discovering that they could not get access to a cheque book unless they got the permission of their father or their husband—[Interruption.] I am not joking. It was in 1980 that the law was changed; I would have thought that someone sitting on the Minister’s Bench would know that it was the Thatcher Government who actually stopped that. It was also the case that women could not obtain credit without permission from male relatives. They went through that during their lives and they are then told at some point that they cannot retire when they thought that they were going to retire. Many women tell me that they did not receive correspondence or a letter from the Department for Work and Pensions saying that their retirement age had changed. In fact, I suggest that, in my experience, we would be more likely to find someone who has the six numbers than a woman who has received a letter telling them that their pension age has changed.

[Faisal Rashid (Warrington South) (Lab)]

Does the hon. Gentleman agree that these women born in the 1950s are against not equality in the retirement age, but the way the matter has been handled by this Government?

[Chris Stephens]

Well, it has been handled by various Governments quite disgracefully, but Parliament has an opportunity now to address that injustice and it really needs to do so—it has to do so—because we are now faced with the sad situation where women seeking this justice are dying and that number is increasing every year.

There is another reason why we need to address the issue. We keep getting told that a general election is coming. Every Member of this House should realise that the average number of 1950s-born women in each constituency is 5,000. That is not counting their relatives and friends. They have the power, if this Government do not do something about this injustice, to vote for other candidates and other political parties that will.

Social Care Funding

Faisal Rashid Excerpts

Tuesday 1st October 2019 Westminster Hall

[Faisal Rashid (Warrington South) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Charles. Making sure that the sick and elderly are treated with care is the measure of any civilised society. I believe that we should not be judged by our personal wealth, but by our compassion for those in most need. Clearly, however, that ethos is not shared by our Government.

As we speak, 1.4 million older people are going without the care they need, which is totally unacceptable. We are faced with the huge challenge of meeting the increasingly complex care needs of an ageing population, yet as those needs have increased and intensified, state funding for those services has nosedived. Council budgets have been reduced by an average of nearly 50% since the Tories came to power. Those cuts have taken a staggering £7.7 billion out of social care funding since 2010.

In my constituency, Warrington Borough Council has had £137 million cut from its budget with another at least £22 million of savings to find by 2020. As a former new town, we are seeing a significant increase in our vulnerable older population—those who were drawn to Warrington for work and a better life in the 1970s and 1980s. Nationally, there are 8,000 fewer care home beds than in 2015, despite the kind of rising demand seen in my constituency. Reports indicate that, last year, almost 90 people a day died while waiting for care to be arranged for them at home. That is absolutely shameful. How can the Minister justify those figures?

The crisis in social care is felt by not just those in need of care, but their families and friends who must step in where the state has failed and where money is short. More than 5 million unpaid carers look after loved ones. Skills for Care has found an 8% vacancy rate in the social care sector, which is equal to 110,000 empty roles at any one time. Many who work in the social care sector are overworked and underpaid. Unison has documented at length the injustices faced by those who do such vital work: sleep-ins, impossible rotas, zero-hours contracts and unpaid travel time, to name just a few.

Make no mistake: this policy area is crippled by Government inaction and market failure, causing immense hardship and misery for those who need care and for those who provide it. It is high time our political leaders showed the courage necessary to rise to the challenge and fix this mess, ensured the safety and security of older generations and treated care workers with the respect they deserve. I am proud that my party has recently announced bold, radical plans to do just that.

Labour will introduce personal care free at the point of use in England funded through general taxation. Providing free personal care to older people will ensure that they will be able to live in their own homes for longer, providing them with dignity and the support to lead independent lives for as long as possible. I have seen at first hand from my mum, who passed away last year, how that is absolutely crucial.

[Sir Charles Walker (in the Chair)]

Speeches are now limited to three minutes.

Children and Mental Health Services

Faisal Rashid Excerpts

Tuesday 16th July 2019 Westminster Hall

[Faisal Rashid (Warrington South) (Lab)]

I thank the hon. Member for Burton (Andrew Griffiths) for obtaining this important debate. I imagine that not a single Member of the House would diminish the importance or severity of this issue. We all want every child to get the best possible start in life, but that is an empty commitment if we do not make sure that the right level of support and help is available for children who suffer from mental health conditions, just as we would for children with physical injuries. We would never allow a child with a broken leg to suffer alone, without professional treatment. Nor should we fail to provide a child suffering from depression or anxiety with the support they urgently need. In the past, the issue has not been given the priority it clearly deserves, so I am glad that finally a consensus is starting to build around the importance of improving mental health services for children and young people.

Despite the acknowledgement of how much needs to be done, the Government have failed to act decisively on the issue. Identifying a problem is all well and good. What we need is real leadership, concrete solutions and properly funded services. At present they are failing on all three fronts. Not enough has been done to address the inadequacy of funding for services or to reduce the number of children who do not have access to mental health support at all.

The Government’s children’s services early intervention grant has been reduced by almost £600 million since 2013. It is projected to decrease by another £100 million by 2020. Children’s services now face a funding gap of £3 billion by 2025. That underfunding is taking place in the context of a rising demand for children’s mental health services. Underfunding leads to a vicious cycle, as the support necessary for good mental health—provided through services such as housing, education and family support—is gradually cut away. When those resources are unavailable, early intervention becomes impossible and mental health problems are left to fester and deteriorate, until finally they require urgent medical intervention. Children are not suffering from more mental health problems at random: the conditions for mental ill health are being created by austerity.

That is why I support the recommendations of the Local Government Association’s “Councils Can” paper, which calls for the empowerment of local government to lead communities and improve young people’s mental health and wellbeing. The point about signposting pathways and helping charities is important. Properly funded housing, education and family support services need to be given priority to ensure the wellbeing of children and young people. Councils are uniquely placed to do that. That is why they need to be properly funded and at the heart of our efforts to address the issue.

Inequality is also a huge issue in the delivery of mental health services for children and young people. Research this year from the mental health charity Mind found that vulnerable people in some regions struggle with little more than half the NHS funding of those in the best-resourced areas. For example, in Surrey Heartlands health and care partnership, the average annual spend on mental health services per head of population is just under £125, but in South Yorkshire and Bassetlaw sustainability and transformation partnership the figure is over £220. The Government need to act as soon as possible. The crisis is absolutely huge.

NHS Reorganisation

Faisal Rashid Excerpts

Wednesday 12th December 2018 Westminster Hall

[Faisal Rashid (Warrington South) (Lab)]

I beg to move,

That this House has considered NHS reorganisation.

It is an honour to serve under your chairmanship, Mr Gapes. It is my pleasure to open this debate on our NHS as we near the end of the year marking its 70th birthday. In debating its reorganisation, we should not lose sight of what a great credit the NHS and its staff are to our country. Its foundation represents arguably the greatest achievement of this House. It is for precisely that reason that its reorganisation matters so greatly.

Let me set the context. Eight years of cuts and the biggest financial squeeze in its history have pushed the NHS to the brink. On all key performance measures, it is struggling to keep up with demand—A&E performance hit a record low this year, more than 4 million people are stuck on a waiting list, and cancer targets are repeatedly missed. In a speech last year, the chief executive of NHS England warned:

“On the current funding outlook, the NHS waiting list will rise to 5 million people by 2021. That is an extra 1 million people on the waiting list. One in 10 of us waiting for an operation. The highest number ever.”

As the NHS is pressurised to do more with less, it is imperative that Parliament properly scrutinises the ongoing process of its reorganisation. We should not allow the Government’s shambolic handling of the Brexit negotiations to distract us from reforms that are critical to the livelihoods of millions in this country.

I acknowledge that this subject is wide-ranging and complex, so I intend to focus on a few key issues: clinical commissioning groups; sustainability and transformation plans and partnerships; integrated care partnerships; health and social care integration; and healthcare infrastructure.

Let me start with the Health and Social Care Act 2012 and CCGs. Six years on from the coalition Government’s top-down reorganisation of the NHS, it is clear that that initiative has been as much of a disaster as Labour warned it would be. My hon. Friend the Member for Ellesmere Port and Neston (Justin Madders) rightly described those reforms as having put in place

“a siloed, market-based approach that created statutory barriers to integration.”—[Official Report, 6 September 2018; Vol. 646, c. 176WH.]

The 2012 Act removed regional health planning by abolishing strategic health authorities and creating a complex and fragmented system of clinical commissioning groups. Strategic health authorities helped co-ordinate the provision of healthcare across an area. Subsequent NHS reorganisations have often felt like partial attempts to reverse the damage done by the 2012 Act. It is therefore unsurprising that little effort has been made to keep the public informed of those changes.

[Mr Jim Cunningham (Coventry South) (Lab)]

I congratulate my hon. Friend on securing the debate. He touches on the reorganisation way back in 2012. Clinical commissioning groups were created, but they are not accountable to the public—we have problems trying to find out what their budgets are and so forth. We have the same problem with NHS England, which is another very difficult organisation to deal with. As a result of all this reorganisation, we have organisations that are not really accountable to the public, and the public do not get their voices heard.

My hon. Friend touched on staff salaries. If we worked it out, we would probably find that they have had an 8% real-terms cut in wages over the past seven or eight years, on top of which they have to pay car parking charges for the privilege of serving the public. Does he agree that that cannot be right?

[Mike Gapes (in the Chair)]

Order. Can I just request that interventions are not long speeches?

[Faisal Rashid]

I thank my hon. Friend for his intervention. I totally agree with him, and I will come to that point later.

The Health Secretary has not even put out a press release about his most recent set of NHS reforms. I wonder when that will happen. Despite not being locally accountable, CCGs hold more public money than local authorities. That lack of accountability is particularly concerning given the large sums CCGs handle and the potential for vested interests to benefit in ways that do not best serve local populations. For example, although GPs acting as both commissioners and providers of care are allowed to sit on local NHS boards, elected and accountable local officials are not. It is alarming that current arrangements allow for such potentially significant conflicts of interest while resisting local democratic oversight.

I turn to sustainability and transformation partnerships. Since the 2012 Act, we have seen the launch of 44 STPs, covering all aspects of NHS spending in England. That process has been characterised by Government secrecy, with little or no engagement with staff, patients, unions or the public before the publication of plans. Despite being asked by the Government to deliver changes to local health services, STPs were given no statutory status, and their meetings are held in private. In the majority of cases, councils have not been included at all, and a number have passed motions or issued statements condemning the process. Under this Government, changes have been initiated with no proper consultation or engagement locally with the public, patients or staff. Without accountability to local democracy, we cannot ensure that health and care systems are relevant to the people and places they are intended to serve.

STPs’ lack of accountability is even more significant given their role in administering spending reductions. Analysis by the Nuffield Trust found that some STPs are targeting up to 30% reductions in areas of hospital activity, including out-patient care, A&E attendances and emergency in-patient care, over the next four years. Those reductions are being planned in the face of steady growth in all areas of hospital activity. Too often, such initiatives encourage short-term savings, to the long-term detriment and overall cost of the NHS.

We should not forget that hard-working frontline staff bear the brunt of these pressures. It is sadly unsurprising that hospitals report growing shortages of doctors, nurses, midwives and therapists, while these bureaucratic bodies flourish.

--- Later in debate ---

[Mike Gapes (in the Chair)]

Order. I remind hon. Members that they should not make lengthy speeches in interventions. I would be grateful if all Members bear that in mind in future. I will not be very kind if I get the sense that we are getting three or four speeches from one Member.

[Faisal Rashid]

Thank you, Mr Gapes. I thank my hon. Friend for his intervention. I agree with him to some extent, but I think his microphone was not working, and it was very difficult to hear what he was saying. That needs to be looked at.

The Warrington and Cheshire STP is completely unworkable. It has the second largest footprint of the 44 STPs, covering 2.5 million people, 12 CCGs and 20 NHS provider organisations. There are so many bodies involved that the STP has been almost impossible to co-ordinate. It required £755 million in capital funding to be deliverable. Against a backdrop of cuts to NHS capital budgets it is unsurprising that the STP has made little progress.

Integrated care providers represent the latest iteration of the changes. Although ICPs could drastically change health and social care provision if adopted, their implementation is taking place without a vote or a debate. The details setting out what an ICP will do were published during the summer recess, with very little publicity. An ICP can be awarded a contract to deliver a general practice for up to 10 years. Significantly, these contracts can also be awarded to private companies. One of the criteria used to assess bids will be

“whether they are able to deliver value for money,”

moving away from an emphasis on quality and choice. Does the Minister believe that these changes should be made without parliamentary consent?

Mr Gapes, forgive me for using these confusing and seemingly never-ending abbreviations. The communication of the changes has been another major flaw in the process. Indeed, I echo the criticisms in the seventh report of the Health and Social Care Committee, published earlier this year, which noted:

“Understanding of these changes has been hampered by poor communication and a confusing acronym spaghetti of changing titles and terminology, poorly understood even by those working within the system. This has fuelled a climate of suspicion about the underlying purpose of the proposals and missed opportunities to build goodwill for the co-design of local systems that work more effectively in the best interests of those who depend on services.”

This unnecessary use of abbreviations and complex terminology has shut out the public and excluded them from the debate over the future of the NHS. The Government have a clear a responsibility to make the debate around NHS reorganisation far more accountable and accessible to the public.

Moving on to health and social care integration, there is broad consensus that if the NHS is to maintain levels of service provision while making the efficiency gains demanded of it, the integration of services across health and social care is vital. Demands on the NHS are becoming increasingly complex, and long-term integrated care has the potential to transform the lives of millions of patients, as well as improving the patient experience. It has huge potential to save money by cutting down on costly emergency hospital admissions and delayed discharges. However, a recent report on health and social care funding by the Institute of Fiscal Studies revealed:

“Social care is facing high growth in demand pressures, which are projected to rise by around £18 billion by 2033-34, at an annual rate of 3.9%.”

This is not something that can be done on the cheap.

For patients, the lack of integration of health and social care can be a maddening experience. I am sure many Members have heard complaints from constituents about having to constantly repeat their story to any number of different health and social care professionals. In my constituency, a community-led healthcare non-governmental organisation passed on the following patient comment, which sums up the problem well:

“When I get on a plane, there is a lounge, passport control, security, air traffic controllers—lots of separate organisations. But what I experience is a trip from A to B. In health and social care what most people experience is A to Z, B to Z etc. having to repeat their stories each time.”

This confusion is the outcome to be expected from the unnecessary complexity and fragmentation that has characterised NHS reorganisation for several years. The fear is that the next NHS reorganisation will not take into account or optimise the 80% of individuals’ wellbeing impacted by the wider determinants of health—housing, employment and connectedness to the local community.

In my constituency, Warrington Together offers a potential way forward as a locally appropriate, collaborative model of care. Its rationale is a return to the principles of the NHS when it was established in 1948: a single taxpayer-funded organisation working to a single integrated plan; promoting healthy lifestyles; utilising doctors and hospitals, as well as community care, social care and mental healthcare; and striving to keep an entire population well in the most efficient way possible, with enhanced stewardship by those who are locally democratically elected.

Warrington Together offers the opportunity to stimulate a social movement to ensure that changes to healthcare are more accountable to the local population. It has established a third sector health and social care alliance, which is an umbrella group made up of 12 local voluntary health and care providers, who can act with one voice and be contracted as a single entity. That will enable a broad range of providers to come together, offering such diverse care as housing and home repairs, mental health support, and links to local leisure and cultural opportunities. While that is not without its challenges, it represents something we should try to achieve on a national scale: involving local stakeholders to provide integrated health and social care services.

My last topic is healthcare infrastructure. NHS reorganisations need to be informed by infrastructure needs. Buildings need to be more efficient and cost-effective. It is estimated that one third of GP surgeries are conversions of former Victorian terraces, 1960s bungalows or former offices. They are often unfit for purpose and cause significant waste. Innovative and modern infrastructure helps to reduce energy and utilities costs to our NHS, while also protecting our environment. The less money we spend on the maintenance of outdated NHS infrastructure, the more money we can spend on long-term care.

I have a number of questions for the Minister to answer. How can he justify the creation of ICPs without a parliamentary vote or debate? Does he acknowledge that ICPs are moving away from an emphasis on quality and choice by allowing bids to be assessed based on whether they are able to deliver value for money? How can he explain the Government’s decision to keep accountable, elected local officials out of the NHS’s decision-making process? Without accountability to local democracy, how can he ensure that health and social care systems are relevant to the people and places they are intended to serve? Will he now acknowledge that the Health and Social Care Act 2012 has been a disaster for the NHS, creating a fragmented and overcomplicated system that fails to meet patients’ needs?

The 2012 reforms have been likened by one commentator to

“a football team reorganised in such a way that the defenders, midfielders and forwards have to contract formally with one another for a certain number of tackles, saves, passes and goals, according to a general plan laid out by the manager, even though all the money comes from the same source: the club, and ultimately the fans. To make things more complicated, on match days, fans are encouraged to swap their tickets for another game, at another stadium, with other teams.”

Is that not an effective summary of these reforms? Finally, does the Minister agree that the unnecessary use of abbreviations and complex terminology has functioned to shut out the public and exclude them from the debate over the future of the NHS?

--- Later in debate ---

[Faisal Rashid]

First, I thank all the Members who took part in this very important debate: my hon. Friends the Members for Coventry South (Mr Cunningham), for Mitcham and Morden (Siobhain McDonagh), and for Ellesmere Port and Neston (Justin Madders); and the hon. Member for Strangford (Jim Shannon). I also thank the Minister for giving some reassurances and the answers to some of my questions.

I will make a couple of points. I have heard time after time that there are more doctors and 11,000 more nurses than there were in 2010. Clearly, the demand has been even greater, which is why there are still shortages. We really need to invest in more doctors and more nurses, to cope with the demand for them, which is quite significantly higher than the numbers from 2010 to 2018 that the Minister cited. The numbers do not really make sense. The Minister also mentioned value for money. He said that there was no privatisation as such, but he is not ruling it out. At the same time, if value for money is the criterion, one will definitely think that privatisation will happen.

In conclusion, the NHS is a very precious institution for all of us; the Minister agreed with me about that. I urge him to look very carefully at reorganisation and to get everybody involved. Let us work together to make it happen for the people of this country in the long term.

Question put and agreed to.

Resolved,

That this House has considered NHS reorganisation.

Budget Resolutions

Faisal Rashid Excerpts

Tuesday 30th October 2018 Commons Chamber

[Julie Cooper (Burnley) (Lab)]

I note the Prime Minister’s recent announcement that austerity is over, although the message does not seem to have reached the Chancellor. There was nothing in yesterday’s Budget to end austerity and there is no doubt that austerity is alive and kicking viciously in my constituency. As with so many things, the Prime Minister seems to think that just by saying something she can make it happen. Her first announcement as Prime Minister was that she was going to help those just about managing. Well, the just about managing are still waiting, and the just about managing in Burnley are managing just a bit less well than they were two years ago.

When we confront the Conservative party with the dire consequences that its budget cuts have wrought on our constituents—from the rise in NHS waiting lists to the lack of care available to the elderly and disabled and headteachers struggling to manage underfunded schools—we are told that record amounts are being spent. It does not take an economist to see that the Chancellor cannot, on the one hand, take credit for reducing the deficit and, on the other, brag about increased spending, without having a better record on growth than this Government’s miserable effort.

Yesterday’s Budget failed to address the crisis in the NHS and social care—one mention of carers, but not a single penny of support; not even a mention of the WASPI women or women’s refuges; no attempt to right the wrongs of universal credit; no extra funding for the police and fire services; no attempt to provide additional funding for nursery schools, in spite of the Education Secretary’s recent warm words. The extra spending on repairing potholes is welcome, but I find it shocking that the Chancellor provided more for potholes than he did for schools, even though every school in Burnley and Padiham is facing damaging cuts.

The Government like to mislead with figures. There is a pattern of swingeing cuts, followed by the reinstatement of modest amounts amid a fanfare of celebration. However, the recent revelation from the Office for National Statistics about the Department for Education’s dubious figures really was something else. Most ridiculously, spending on private schools was counted as Government spending on education. Next, I would not be surprised to see the use of luxury spas included in public health spending.

For me, the most damning statistic to emerge over the summer was the one on life expectancy, which has fallen in parts of my constituency for the first time in over 30 years. That is a true reflection of the Government’s record in office and the price my constituents are paying for austerity. Members will not be surprised to learn that the last time there was a fall in life expectancy was the 1980s, during the tenure of another Tory Government committed to policies that resulted in the decimation of our public services. Members may recall that we were told at the time, “There is no alternative.” Well, there is an alternative: it is a Labour Government.

The Government consistently remind us of the need to be fair to taxpayers. Let us consider that with regard to taxpayers in my constituency. Consider the low-paid essential worker who earns £12,500 per annum. Every extra pound they earn is taxed at a marginal rate of 32%. Compare that with the tax paid by the multimillionaire who, barely lifting a finger, reaps the benefits of stock market wheeling and dealing, and pays capital gains tax at a mere 20%. There is nothing fair about that.

Let us consider fairness for council tax payers. The owner of a band A property in my constituency, worth as little as £50,000, has to pay a council tax bill of £1,220, while the owner of a band G property in Westminster worth £2 million gets a council tax bill £36 lower. There is nothing fair about that.

[Faisal Rashid (Warrington South) (Lab)]

Does my hon. Friend agree that eight years of austerity have failed completely and that only a Labour Government will provide the investment our country desperately needs?

[Julie Cooper]

My hon. Friend makes a good point; I agree with him absolutely.

Some 36% of the children in my constituency are growing up in poverty, and the changes to universal credit will make that much worse. Can it be fair to punish children whose only crime is to have two siblings? Five and a half thousand children growing up in Burnley and Padiham will be affected by those draconian measures. There is nothing fair about that either.

The people in my constituency know who is responsible for the growing queue at the food bank; they know who to blame when they cannot get a GP appointment; they know who to hold to account when the old and disabled are left to struggle on without adequate social care; and, perhaps most importantly, they will not forget that it was this Conservative Government who, most shamefully of all, forced record numbers of our children to grow up in poverty, short of food, warmth and hope. They will not forget.

[Victoria Prentis (Banbury) (Con)]

It is always a pleasure to follow the hon. Member for Burnley (Julie Cooper), but I disagree with her. This is a great Budget.

I am glad that the Chancellor has set aside substantial amounts to prepare for all eventualities as we approach Brexit. The Banbury constituency’s vote in the referendum was the closest in the country; by 500 people, we voted to leave. Now, I hear a great deal of unity locally over the need to get on with getting a deal. The uncertainty of Brexit is challenging for my constituents. With a good deal done, I really look forward to a pro-growth spending review early next year.

Locally, we can see that the economy is going well. There are great employment figures, but we need to focus on wage growth, which leads to more disposable income. I, for one, was pleased to hear the figures the Chancellor gave yesterday.

In my area, we are obsessed by healthcare. Everybody in this Chamber will have heard me talk, probably several times, about the Horton General Hospital, which we have been fighting to save for the past 40 years. The problem over the years has in fact been not financial, but structural. Small is beautiful and local, and we must not give in to the overweening ambition of Oxford to suck in more cases or more births. The German model of maternity offers choice but retains smaller obstetric units and, most importantly, excellent outcomes for mothers and babies. We have had a historical failure to recruit both midwives and obstetricians. Locally, we have had real progress with the clinical commissioning group since the fabulous new interim chief executive took over. The Horton has a very bright future.

I welcome the extra funding in the Budget—an average in real growth terms of 3.4% a year—but we need to ensure that it translates into extra people doing the right thing in the right place. Nobody is pretending that every sort of complicated surgery can be done everywhere, but A&E, paediatrics and simply having a baby with the benefit of an epidural should be provided locally. I know that the new Secretary of State for Health and Social Care agrees with this broad premise and I look forward to talking about my local situation with him.

In north Oxfordshire, we are proud of building three new houses a day. We are keen to welcome people to Banbury to fill our jobs and we are building them houses to live in. I am often asked how we are managing to make this progress: we have done so by having a consistent and strong local message and strong leadership. Cherwell District Council’s policy of putting housing generally on brownfield sites near towns, rather than piecemeal in villages, has seen new communities flourish. I also welcome the housing measures we heard about yesterday.

It would be wrong of me not to mention the public service I have worked in throughout my adult life. The Justice Committee, on which I am very proud to sit, recently heard that spending on justice will have fallen by 40% between 2010-11 and 2019-20. The Department does not have a protected budget. I was very pleased to hear what the Chancellor had to say yesterday and, more importantly, what I read in the Red Book afterwards, about the justice spend, and I welcome the £30 million to improve security and decency across the prison estate.

[Faisal Rashid]

Today I received a letter from the Cheshire police and crime commissioner co-signed by the acting chief constable informing me of £60 million in cuts since 2010 and a further £12 million in cuts over the next two years. There are severe pressures on policing in Cheshire. Does the hon. Lady agree that the Government have failed to provide adequate funding for policing?

Phenylketonuria: Treatment and Support

Faisal Rashid Excerpts

Tuesday 26th June 2018 Westminster Hall

[Faisal Rashid (Warrington South) (Lab)]

I commend the fantastic work of my hon. Friend the Member for Blaydon (Liz Twist) and the National Society for Phenylketonuria, who have worked incredibly hard to raise awareness of PKU in Parliament in the past few months.

Until I met with representatives from the NSPKU a few months ago, I knew very little about PKU, like many other hon. Members. Since, I have learned a huge amount about it, and it has become clear that this devastating disease requires action. It affects one in 10,000 people across the UK. Although it is rare, an estimated 3,000 individuals in England alone live with it and could benefit from increased awareness and improved treatment of it.

As we have heard, the only treatment of PKU available on the NHS is a severely restrictive diet. Patient voices from the NSPKU illustrate how much of a daily struggle that diet is. It often leads to eating disorders and unhealthy relationships with food. It forces patients into social exclusion and is a great burden on their carers, who often also report psychological distress and strained family relationships. Studies show that half of parents will stop work or reduce their hours to accommodate the extra work needed to take care of a child with PKU.

I am grateful to my constituents, who shared with me the story of life with their five-year-old daughter who has PKU. Their openness helped me to understand what that life is like, and the difficulties their daughter faces daily, especially when she is unable to eat the same meals as other children at school.

The fragmented nature of NHS services provided to PKU patients often leads to confusion and mistakes in the chain. The inconsistent quality of those services has made the system needlessly complex and has added to the patients’ burden. There have been multiple reports of clinical commissioning groups restricting funding for PKU dietary products. The variable quality of even the most basic treatment is simply not good enough.

Beyond dietary treatments, a drug called Kuvan has been developed, as has been mentioned. It can treat up to 25% of PKU patients and allow them to eat substantially more natural proteins, which fundamentally improves their quality of life. Despite having been licensed in the USA since 2007 and the EU since 2008, and being used in almost every EU country as a routine treatment for PKU, it is unavailable for the vast majority of patients in the UK.

Of course, Kuvan comes with a price tag, but as we approach the 70th birthday of our treasured NHS, we must allow it to uphold its fundamental principle of providing healthcare on the basis of need.

Oral Answers to Questions

Faisal Rashid Excerpts

Tuesday 8th May 2018 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

I am very grateful to my hon. Friend for raising this matter, and I very much welcome the contribution made by the charity to support teenagers in his constituency with psychological therapies and to help to address their mental health conditions. I join him in extending my congratulations to the mayor for choosing this very important cause and for endeavouring to raise so much money for it.

[Faisal Rashid (Warrington South) (Lab)]

T3. Chapelford medical centre in my constituency has been operating out of a portakabin on waste land for many years, due to excessive delays and the failings of various NHS bodies involved in this project. What action will Ministers take to resolve these shocking delays, and will they meet me to give assurances to my constituents?

[The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)]

I will be very happy to meet the hon. Gentleman to look at his local issue.

Social Care

Faisal Rashid Excerpts

Wednesday 25th April 2018 Commons Chamber

[Anna Turley (Redcar) (Lab/Co-op)]

There are few career commitments more commendable than dedicating time to the care of others, especially our elderly and vulnerable relatives. I am disappointed that the Care Minister is no longer in her place. I was shocked by some of her comments. She accused my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) of not mentioning or thanking social care workers. I listened very carefully to my hon. Friend’s speech, and it was imbued throughout with a passionate defence of the people who work in the care sector—their terms, their conditions, their pay and their commitment. I would like the message to go back to the Minister that I thought what she said was very unfair. All of us on both sides of the House know that people in our social care workforce deserve a huge amount of respect and gratitude for the hard work and long hours they put in to deliver the best care to our elderly parents and grandparents.

There is no doubt that social care has been in crisis for a number of years. Time and again, commitments have been reneged on and the issue has been kicked into the long grass. Government cuts have put pressure on the ability of local councils to deliver key services. Redcar and Cleveland has lost £90 million since 2010 and has had to cut £5 million from social care over the past three years. There is no way that that will not have an impact.

[Faisal Rashid (Warrington South) (Lab)]

Warrington Borough Council faces funding pressures of more than £3.3 million to meet its adult social care needs in 2018-19. Does my hon. Friend agree that it is up to the Government to support councils in their efforts to provide quality social care to their communities, not to pass the buck—

[Mr Deputy Speaker (Sir Lindsay Hoyle)]

Order.

[Faisal Rashid]

On to council taxpayers in my constituency or any other?

[Mr Deputy Speaker]

Order. I need to correct that. When I say “order”, it means you should stop. I am not trying to cause any problems. We must have short interventions. If not, I will have to put a time limit on speeches. Intervene, by all means, but interventions must be short.

--- Later in debate ---

[Faisal Rashid (Warrington South) (Lab)]

It is great to follow the hon. Member for Redditch (Rachel Maclean), although I do not believe in most of the things she said. I am grateful to the Leader of the Opposition for once again giving Members the opportunity to raise the important issue of social care funding on the Floor of the House. I thank my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) for leading this important debate.

Time and again, we hear from care providers, service users and charities that the social care system is at tipping point, that it is in crisis, that urgent Government action is needed, and that without that help the entire system will collapse, yet the Government continue to bury their head in the sand on this issue. It is clear that the social care system is still in crisis and the Government are still failing to act. The right hon. Member for Ashford (Damian Green) said that we should make this non-political. Well, the Conservative record on social care is utterly appalling. It is a record of savage cuts, U-turns and passing the buck that cannot be ignored. Since 2010, we have witnessed a fall in the quality of care, as well as cuts to the number of services that are offered and the number of people they are offered to. The Conservatives are spending less money on social care now than Labour was when we left office in 2010, despite demand having increased significantly. As it stands, only 2% of social care services are rated as “outstanding”, and according to the CQC, 41% of services that have been rated as “requiring improvement” in the past have failed to improve or have even deteriorated.

Even worse, though, is the Conservatives’ record on action on these issues. There has been a policy vacuum from the Government since the U-turn on the disastrous dementia tax, and they have since missed the opportunities to address the crisis. They failed at the autumn Budget, and they failed again with the one-off £150 million local government financial settlement, which fell well short of what is needed to rescue the sector. They have abandoned plans for a cap on care costs and a plan to introduce an asset floor of £118,000. These are cold, hard facts that cannot be ignored any longer. The social care system is at tipping point. This is about ensuring that the most vulnerable adults in our society receive the care they need, when they need it.

Since 2010, councils have shouldered the largest burden of spending cuts. Years of underfunding mean that our councils can no longer put enough money into care to meet the needs of an ageing population. As a result, cuts to adult social care during that time have now reached over £6 billion, and now less than one in 12 director of adult social care is fully confident that their local authority will be able to meet its statutory duties in 2017-18. As I said in an intervention, Warrington Borough Council is facing funding pressures of over £3 million in meeting adult social care needs in 2018-19.

Social care infrastructure is at the heart of our society. Many of us here today will rely on the social care system for ourselves or for our loved ones at some point in our lives. Indeed, some of us here today, and many of the constituents we represent, will already have experience with this broken system, and it will be clear to every single one of them that social care is in crisis. The situation is simply not sustainable. This is one of the most pressing issues of our time, and it cannot continue to be ignored. The Government must get to grips with this crisis now, before it is too late.

Privatisation of NHS Services

Faisal Rashid Excerpts

Monday 23rd April 2018 Westminster Hall

[Faisal Rashid (Warrington South) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Graham. I congratulate my hon. Friend the Member for Hartlepool (Mike Hill) on bringing the petition forward for debate.

I thank the 237,462 individuals who signed the petition and gave us the opportunity to raise the issue of NHS privatisation, which is important for many of my constituents. I know that the same is true for all Members present. The petition was signed by 442 of my constituents, and I was proud to join 200 of them outside Warrington Hospital in February to protest against NHS privatisation. The level of public concern about this issue shows just how important the NHS is to our country and its citizens.

The NHS is our most sacred and treasured institution. It was founded 70 years ago on the fundamental principle that everyone is entitled to free healthcare, and it does not discriminate on the basis of wealth, gender or race —it does so only on the basis of need. Every day, thousands of lives are saved by NHS staff at NHS hospitals, and we are extremely grateful for their extraordinarily hard work. The Government have a duty to protect the NHS and its staff, and to ensure that they can continue to provide world-class healthcare to the British public, free at the point of use.

We all use the NHS, and we all have a vested interest in ensuring that it is run effectively and efficiently, but let us be clear: privatisation and outsourcing do not do that.

Privatisation forces NHS hospitals to outsource vital services to private companies, which are often more interested in making a profit than helping sick people. That is a fundamental conflict of interest. The NHS has a duty to its patients, whereas private companies have a duty to their shareholders, but shareholders care about profits, and often the only way to make a profit is by cutting corners. That compromises the quality of care.

The Government claim that private sector outsourcing is good for the NHS and that it allows patients access to treatments based on the best quality of care and value for money.

[Paula Sherriff]

My experience is that we used to offer one-stop surgery shops, so that when patients came in they could have minor surgery on the same day. We were stopped from doing that. Patients had to come in on two occasions, and we were told explicitly by the management of Virgin Care that it was because it generated two tariffs, and made more profit. I should be interested to hear the view of those who defend the privatisation of healthcare about that.

[Faisal Rashid]

That supports my point, and is a great example.

The Government view of outsourcing does not reflect the reality of privatisation. Did patients receive the best quality of care from the private firm Circle when it took over management of Hinchingbrooke Hospital in 2012, making it the first privately run NHS hospital, only to withdraw from its contract two years later after it was placed in special measures by the Care Quality Commission because it had found serious failings in its emergency and medical care services? What about the 2013 Public Accounts Committee report on Serco’s running of GP out-of-hours care in Cornwall, which accused the private company of bullying employees, providing a short-staffed and substandard service, and manipulating data to hide the truth? Were patients receiving the best quality of care then? What about the imposition of financial penalties on the same company by NHS commissioners in Suffolk in 2014, after it missed key targets in its community health services contract? In 2012 Harmoni, a private provider of NHS out-of-hours GP services, having put in place an aggressive cost-cutting agenda, faced allegations from senior doctors that its service in London was so short-staffed that its patients were unsafe. I could recount many more examples of failed healthcare privatisation, but we do not have time.

The Government also claim that outsourcing allows the NHS to save money, but that is not necessarily true. The process by which private companies bid for contracts allows them effectively to cherry-pick the most profitable forms of treatment—usually low-risk elective surgeries. That allows the private sector to benefit from the predictable, and usually low, cost. That is far from providing the best quality of care for patients.

Why, then, do the Government insist on continued NHS privatisation? Since 2010, under successive Conservative-led Governments, the private sector’s involvement in NHS services has more than doubled. Evidence shows that that has seldom made the situation any better for staff or patients. The NHS is in crisis. Chronic underfunding compounded by a growing and ageing population has put an unbearable strain on the NHS and resulted last year in yet another winter crisis. My local NHS Trust, the Warrington and Halton Hospitals Trust, is on track for a forecast financial deficit of £16.8 million, and in December 2017 only 73.8% of A&E patients were seen within four hours, which is well below the target. Yet the Government’s only answer to the crisis is more privatisation.

Let me review the facts. Privatisation is bad for quality, budgets and the NHS. More privatisation is not going to help the NHS. The only way to help it is to give it the funding that it needs and that it has been telling us it needs. If we truly love the NHS, we will stop privatisation.

Social Care

Faisal Rashid Excerpts

Wednesday 25th October 2017 Commons Chamber

[Faisal Rashid (Warrington South) (Lab)]

Under the Conservative Government, social care is in crisis. That is clear to almost everyone in this House, and to the 1.2 million people across the country whose complex needs are not being met. In fact, it would appear that the only people it is not clear to are those in the Conservative Government. Anyone following either of the Secretaries of State responsible for social care over the conference period would have struggled to find any reference to the crisis, or indeed to social care. I am therefore pleased that the Opposition have used this day to bring this incredibly important issue to the Floor of the House, because we are faced with a complete Government policy vacuum.

Social care provisions have been neglected and gutted by central Government. By March 2018, £6.3 billion will have been cut from the adult social care budget during eight years of Conservative-led Government. Over the same period, the number of people with some form of unmet need will have increased by 48%. That is no coincidence. The Conservative Government’s failure to tackle the social care crisis is having a hugely damaging impact on elderly and disabled people in our society, pushing them into increasingly vulnerable and precarious positions where they are not receiving adequate or appropriate care.

Government cuts to local authority budgets mean that councils are simply no longer able to provide the necessary level of care. In the first five months of the fiscal year, 48% of authorities have reported home care providers handing back contracts, and Warrington Borough Council is no exception. Indeed, two providers have already handed back significant contracts this year, so the council is short of approximately 500 hours of home care on any given day, resulting in delayed transfers of care. Members will be aware that the Government’s response to the delays has been to punish local authorities fiscally for not meeting unrealistic targets by withholding funding and threatening extortionate fines. If the Government are not prepared to invest in essential care for the health and wellbeing of the elderly and disabled in society, what are they prepared to invest in? During the 2017 general election campaign, the Prime Minister infamously U-turned on her flagship social care policy. Five months later, she has still to provide us with any alternative, while other members of her Cabinet have yet to rule out the discredited dementia tax policy.