(5 years, 6 months ago)
Commons ChamberThat is an absolutely relevant point. Other colleagues have referred to the relative pension levels. Ministers often quote the percentage increases, but the average pension payable is £84 a week. That is a paltry sum. I also respectfully point out to the Minister that the Government have never been called upon to make a single payment into the scheme.
I refer to my declaration in the Register of Members’ Financial Interests: I am a deferred member of the mineworkers’ pension scheme. My hon. Friend mentions the fact that British Coal—the National Coal Board—never put a single penny in the scheme. Many people have called this the crime of the century. At the time of the discussions, the projections were that the agreement would raise £2 billion. The Government have taken £4 billion from the miners of this country without putting a single ha’penny back in. Is this not an absolute disgrace?
Absolutely. I could not put it any better myself. It is now time to review the surplus sharing arrangements and the level set in 1994 and consider whether the decisions taken then were taken with the best financial advice and in the best interests of miners.
To be fair, the Government have been consistent in their arguments against making changes to the scheme. These arguments are set out in various responses to parliamentary questions and were restated by the Chief Secretary to the Treasury in her response on 14 May to a cross-party letter co-ordinated by my hon. Friend the Member for Blaenau Gwent. I want to summarise the Government’s response because it is important to consider their arguments. The first is that the sharing arrangements work well for beneficiaries; the second that the sharing arrangements provide fair compensation for the Government; and the third that there can be no unilateral action and that changes can be made only with the agreement of the trustees. I want to take each point in turn.
First, does the surplus-sharing scheme work for beneficiaries? The Government’s position is that the scheme has worked well. In her letter of 14 May to my hon. Friend the Member for Blaenau Gwent, the Chief Secretary said:
“The sharing arrangements has meant beneficiaries enjoy bonus payments worth more than 33% of their index-linked benefits”.
As highlighted in a previous debate by my good and hon. Friend the Member for Barnsley East (Stephanie Peacock), the average payment from the scheme is just £84 a week, and it is a great deal less for widows, many of whom have outlived their husbands by many decades. Our industrial legacy means that many miners, like my father, never reach retirement age. Those who do are often in ill health, and will draw their pensions for fewer years than those who retire from other industries and sectors.
We often talk about deferred wages. When miners made those contributions, week after week and year after year, the expectation was that they and their families would have security in their retirement. After we delivered the Downing Street petition, w Sullivan, a campaigner and former miner, spoke of some widows receiving pensions of
“as little as £8.50 a week”.
Emlyn Davies, another campaigner, receives just £57 a week in return for 26 years’ work in the pit: a poverty pension for years of working in damp, dark, dangerous conditions, sacrificing health and wellbeing. Let me say to Conservative Members, and to people watching this debate, that to me it seems offensive to argue that the scheme is working well for beneficiaries when miners and their widows are receiving such a pittance as £8.50, £57, or even £84 a week.
(9 years, 3 months ago)
Commons ChamberI refer the House to my entry in the Register of Members’ Financial Interests and declare that I am proud to be a trade union member. I am a member of Unite and of the Trade Union Group. I am delighted to show solidarity with the more than 6 million people who are part of the UK’s largest voluntary organisation—the trade unions.
I do not share the analysis of the hon. Member for Bexhill and Battle (Huw Merriman) about the nature of the Bill, which attacks fundamental civil liberties and the democratic rights of trade union members. I believe that it is politically motivated. It will deepen the UK’s anti-trade union laws, which are the most restrictive in the western world. The changes will worsen industrial relations and push us further down the path to a more confrontational labour-relations policy. I abhor the thought that it could potentially criminalise firefighters, nurses, teachers and other workers who are simply trying to defend a fair and safer workplace.
The Government are demanding a democratic standard in relation to balloting not sought by any other organisation, or by many Members of the House. I was disappointed by the Secretary of State’s responses in the opening statements. If the Government want to enhance workplace democracy, I ask them to engage with trade unions on the introduction of e-balloting and secure workplace ballots, which would help to increase participation and turnout in trade union ballots.
Will my hon. Friend explain the benefits of e-balloting and workplace ballots?
There is a contradiction in the Government’s position. E-balloting is accepted for the first stages of the election for the Conservative party mayoral candidate—it is secure enough for that—and for secure workplace balloting on recognition agreements, which is enshrined in legislation, but e-balloting is not accepted in the Bill.
I will give way in a second.
However, I think what we have safely also found out today is that the hon. Member for Paisley and Renfrewshire North has much better powers of persuasion than the leader of his party. If only he were leader of his party the party might not be in the dire straits that it is in at the moment.
(10 years, 1 month ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
That is essential. Whether people are climate change sceptics or not, there is a general belief and understanding that we are getting more rain that we have ever had before. It is essential that we have a strategic plan not just for next year or the next five years, but for 10, 20 or 30 years into the future. We need joined-together thinking with all the services that will be required to ensure that we address the problem adequately.
One major issue is the role of fire and rescue services. In my community, I witnessed horrific levels of flooding that posed a danger to life, particularly to an elderly community that was stranded because of the floods and the water levels, and the fire and rescue service did a fantastic job on that occasion. My hon. Friend the Member for Easington (Grahame M. Morris) mentioned the work of fire and rescue services. Is it not strange that despite the fact that they get called out to such areas and face danger when they try to rescue people—such as the elderly people I have just mentioned—they have no statutory obligation to respond to flooding in England and Wales? Is it not even stranger that there is such a statutory obligation on fire and rescue services in Scotland and Northern Ireland? Is it not about time that that was the case in England and Wales? I cannot see why anyone would disagree with that. Fire and rescue services, carrying out the fantastic service that they do, should be under a statutory duty to respond to flooding.
As the hon. Member for East Londonderry (Mr Campbell) has just said, we must look back to see what happened not only in 2013-14, but 10 or 15 years ago, and learn lessons from it. The winter of 2013-14 was the wettest on record. The fire and rescue services have said that 7,800 homes and nearly 3,000 commercial properties were flooded, and 28 fire and rescue services supplied crews, high-volume pumps, flood rescue tactical advisers and pumping appliances. A large number of incidents were attended by the fire and rescue service, and across the UK over the entire three months nearly 7,000 incidents were recorded. The vast majority of those were in England, with more than a third in London, Surrey and Kent. Firefighters in Wales dealt with 457 incidents during the three months, the Scottish fire and rescue service dealt with 356 incidents and there were 27 incidents in Northern Ireland.
My hon. Friend is making a powerful speech. He has mentioned an important aspect of our preparedness and the lessons we should learn from the flooding to help us create more resilient plans. Does he agree that the Minister should have discussions with colleagues from other Departments, such as the Department for Communities and Local Government, about putting in place plans on a regional or area-by-area basis to facilitate such an intervention, where firefighters have been involved not just in rescues but in safeguarding critical infrastructure, leafleting, issuing warnings and so on?
I thank my hon. Friend for his intervention, and I will ask that question when I wind up my short contribution.
In 2013-14 most fire and rescue services recorded a large number of rescues—there were almost 2,000 rescues across the UK during those three months. Most of the rescues were in Surrey, Kent, Devon and Somerset, with Surrey alone recording more than 1,000 rescues during the three months. The figure is generally believed to be an underestimate. We must learn lessons from 2014 and beyond. It is time to acknowledge the main recommendations of the 2007 Pitt review, which the hon. Member for Winchester mentioned. The review, which was commissioned by the Labour party, had six key components: knowing where and when flooding will occur; reducing the risk of flooding and its impact; rescues; maintaining power and water supplies during an emergency; better advice and help to protect families and homes; and recovery. I do not understand—I hope the Minister will explain—why there should be a statutory duty in Northern Ireland and Scotland but not in Wales and England. Hopefully we can put that right.
The fire and rescue services have done a tremendous job, and they have been there when others are running away. I am talking about not only fires but flooding—I have seen that with my own eyes. As MPs, I am sure we all have experience of flooding monitors, who are unpaid volunteers from local communities who do their best. They check the flooding and alert other people. Those unpaid volunteers do a fantastic job. The Morpeth flood action group in my constituency does a great job, and not only in that type of work. It brought the funding and the partners together, and consequently we have what I would class as a success story.
The fire and rescue services do not just turn up and pump water; they rescue people and save lives, too. They were there in boats and other appliances to clear furniture and carry people on their shoulders. They did everything. They did a fantastic job. They also monitored for carbon monoxide and other gases once the water started to subside. I have emphasised the need for the Government to acknowledge that we must act now to ensure that the fire and rescue services have a statutory duty and the correct funding for flood training. They need the right appliances and funding for everything else that comes with a statutory duty. It is essential that those services are funded because, frankly, there has been a huge slash-and-burn exercise within local government that has had a huge impact on the fire and rescue services. Responding to flooding, which is an additional responsibility, is unfunded.
This debate is due, as we need to discuss how we can ensure that we do the best for the communities that we represent through flood defence schemes and ensuring that finances are available. We must also ensure that, when floods unfortunately occur, the fire and rescue services have a statutory duty and are in place to carry out the fantastic job they do anyway.
(10 years, 7 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is a pleasure to serve under your chairmanship, Mr Chope, and to have this opportunity to raise some important issues in relation to the Deregulation Bill. I am delighted that the Minister is here to respond.
I am speaking up for my constituents in Easington who are likely to be affected by the amendments that the Government made to the Deregulation Bill in Committee. I am also speaking up for Unite the union—of which I and many taxi drivers are members—and the GMB. I am also speaking on behalf of a number of stakeholders who feel disfranchised by the Government’s truncated consultation.
It might be useful if I mention the background and where we stand with consultation. Back in July 2011, the Government asked the Law Commission to consider wide-ranging reforms to taxi and vehicle licensing legislation. The Department for Transport asked the Law Commission to undertake a comprehensive review with the aim of modernising and simplifying that legislation. There is no doubt that taxi and vehicle licensing is a complex area, and many right hon. and hon. Members have concerns about the effect that the amendments are likely to have in their constituencies.
In May 2012, the Law Commission launched a wide-ranging consultation on the Government’s proposals. Indeed, the industry has many stakeholders who have been involved in that ongoing process over the past two years. In parallel with the Law Commission’s ongoing review, however, the Government launched another review with a truncated 10-day informal consultation on three specific new clauses that were added to the Deregulation Bill in Committee.
The long consultation process under the auspices of the Law Commission is still ongoing, but I understand that stakeholders and industry and union representatives were told on Friday 14 March 2014 that the new clauses would be added to the Deregulation Bill. That is unacceptable. Will the Minister give an explanation? I have sought advice from a number of stakeholders not just within my trade union but within the trade, and the only conclusion I can draw is that the Government have decided that there is insufficient time to allow due consideration of the Law Commission’s draft Bill before the general election in 2015.
I congratulate my hon. Friend on securing this important debate. Is he saying that the Government have pushed through three amendments to the Deregulation Bill while there is an ongoing consultation?
My hon. Friend is absolutely right. I hope that the Minister is able to clarify the Government’s thinking, because the shortened consultation was launched with barely a week’s notice before the amendments were considered by the Public Bill Committee. That must concern parliamentarians who are keen to ensure that there is full and proper consultation on controversial and contentious issues.
The Cabinet Office guidance on consultations states:
“Timeframes for consultation should be proportionate and realistic to allow stakeholders sufficient time to provide a considered response… For a new and contentious policy, 12 weeks or more”—
that is 12 weeks, not 12 days—
“may…be appropriate. When deciding on the timescale for a given consultation the capacity of the groups being consulted to respond should be taken into consideration.”
As has been demonstrated by the objections raised by all concerned parties outside Whitehall, the policy is clearly contentious and there are a number of different viewpoints. Indeed, I have had a couple of debates over the past few days, including one this morning on local radio, and there is a huge degree of contention on the pros and cons of the three new clauses. Nowhere in the guidance do I see a reflection of the current situation, in which such a disparate industry with such disparate views, and with many different stakeholders and interested parties, was given only 10 days’ notice of the proposals.
(10 years, 9 months ago)
Commons ChamberI want to humanise the debate somewhat. I spoke to a number of disabled people this morning and what they had to say was amazing. Over the past couple of years or so, my surgeries, like those of most Members present, have been visited by lots and lots of disabled people who want to discuss the benefits system. The reality is that many disabled people have given up. A lady said to me this morning, “Mr Lavery, do you understand what it’s like to be treated like an animal?” That rocked me. Why are disabled people being made to feel as if they are being herded into a corner and treated like animals?
That is how they feel. They do not even feel that they are counted as a statistic in life anymore, other than as being an embarrassment to society. They feel as if they are personal rejects—total outcasts from society—because they are disabled and unwell. We should not be making people feel like that in one of the richest countries in the world.
The attack on the disabled and the vulnerable is relentless. Disabled people, the sick, people who have been sick for many years and those who might have just become sick or disabled in the past few years need a voice. We should not forget that it is fantastic being able-bodied and well in health, but some of us are just around the corner from being poorly, disabled, sick, unwell or perhaps terminally ill. We should not forget that when we make decisions in this place to hammer the disabled and the vulnerable, because we could be next.
We should put ourselves in some of these people’s shoes: they become ill or have been ill; they attend test after test; and they attend the Atos centres, which are like the scene in “Little Britain” where “Computer says no.” There is no flexibility and they have to try to explain their problems to somebody who is not even medically qualified.
I apologise for interrupting a very passionate speech, but is my hon. Friend aware that the Department for Work and Pensions is facing a court case because of its failure to provide proper information and support to blind and partially sighted people whom they are supposed to be helping to get into employment?
I thank my hon. Friend for that intervention. I am very much aware of the fact that there are a number of cases proceeding through the courts, but as we have seen over the past couple of weeks the courts do not seem to be terribly in favour of the disabled or the disadvantaged.
I want us to put ourselves in the shoes of the people who face these tests. After they leave the test centre, they wait for weeks and weeks—in fact, they wait for months and months—for the envelope to drop through the door and tell them whether they have been accepted for benefits or not. Can Members imagine how these people, particularly those with mental health problems, feel every morning, waiting for that envelope?
People who are looking for employment and support allowance or jobseeker’s allowance are being sanctioned for different reasons. A constituent of mine was sanctioned by the DWP after he attended a hospital appointment because he has a severe heart condition. As a result of being sanctioned, he did not have any money to put food on the table for months. It has been suggested that people have been sanctioned when they are in a coma in a hospital bed in intensive care. Is that any way to treat ordinary human beings? The answer is, of course not.
Let us look at the other legislation that has been introduced. Just in the past few weeks, up to 50,000 people in this country had to pay the bedroom tax. A lady committed suicide because of the bedroom tax and then her family got a letter from this Government saying they were sorry, but she should not have had to pay because she was covered by the pre-1996 housing benefit regulations.
Universal credit is a failure. It has been rolled out in two or three places and is an absolute car crash, but it is not the DWP or Members of Parliament who are suffering; it is the disabled people who rely on these benefits who are anxious and suffering as a result of this Government’s absolute nonsense and chaotic organisation.
People who make ESA applications have to wait to learn whether they are in one group or the other. How many have appealed? I believe that 40% have appealed successfully, and others are waiting to appeal. The hon. Member for Argyll and Bute (Mr Reid) mentioned how long they are waiting. People’s conditions change before their appeal is heard. It is utter nonsense. The way in which we are treating these people is an absolute disgrace.
A lot of facts and figures have been mentioned today. The 11.3 million disabled people—8% of the population—are bearing 29% of the cuts. Those with the severest disabilities—2% of the population—are bearing 15% of them. It is an absolute outrage.
To sum this up, people are dying as a result of the Welfare Reform Act 2012. Disabled people are being evicted from their homes and people are being forced into the arms of unscrupulous lenders. Is this really the sort of country we want to leave to the next generation? This is IDS UK.
(10 years, 11 months ago)
Commons ChamberI totally agree with my hon. Friend. I have been through the Bill and I am puzzled by the fact that there is a threat—if we do not agree to something that is a lot less than what people deserve—the insurance companies will walk away. I always thought that if the Government pushed through a Bill that said 100%, it would be 100%. If that is what the Bill says, surely that is what it means and what the insurance companies will have to do. From what has been said throughout the stages of the Bill, it appears that the insurance companies are running this, not Parliament. That concerns me because there have been great discussions and great debates on all sides, but I am yet to hear any persuasive reason why the victims should not receive 100% of their compensation.
My hon. Friend is making a powerful argument. The very lifeblood of insurance companies is the assessment and measurement of risk, so would it not be reasonable to have expected them, from the start of the consultation in 2010, to set aside a contingency fund to meet the full liability of the victims’ claims?
(12 years ago)
Commons ChamberI rise to speak in favour of the motion tabled by my right hon. and hon. Friends on the Opposition Front Bench. The Deputy Speaker suggested that we might introduce a bit of Christmas cheer into the proceedings, and the hon. Member for Stevenage (Stephen McPartland) certainly painted a very rosy picture of investment in his constituency. I thought he made a very good speech, incidentally.
In case Ministers are making their Christmas lists, let me tell them that one of the first things that this Government did was cancel a new hospital that served part of my constituency in order to save £464 million. Restoring that funding might be a good use for some of the £3 billion underspend. It was not a private finance initiative scheme but a scheme that was approved by the Department of Health and the Treasury but stopped in the emergency Budget.
I want to concentrate on two specific issues that are directly linked to the motion and on the important question of trust in the Government’s pledge on the funding of our NHS. I believe that the Government are keeping the public in the dark about a range of issues relating to publicly funded contracts delivered by private sector organisations, including on cancer care.
On trust, none other than the Prime Minister broke yet another pre-election promise. Having said before the election that he would extend the Freedom of Information Act 2000 to all publicly funded organisations, he did not do so. As a result, the public cannot access information about private sector providers in the NHS. This does not apply just to the NHS. In his comments, the Prime Minister referred to other publicly funded organisations such as the Carbon Trust, the Energy Saving Trust, the Local Government Association, and traffic penalty tribunals. It is increasingly apparent that many of the large corporations that apparently enjoy cosy relations with this Tory-led Government are extremely anxious that the Prime Minister does not extend the Freedom of Information Act to them. Currently, it instead allows them to hide behind a cloak of commercial confidentiality as billions of pounds of taxpayers’ money are awarded to them in barely transparent contracts. The public are deliberately being kept in the dark, and I have no doubt that an expensive lobbying campaign is under way to ensure that the Prime Minister and the Tory party do not change their minds on this issue.
Meanwhile, private companies benefit by gaining intimate knowledge of public sector bodies through their own submissions of freedom of information requests. That information is then used to undercut or outbid the very same public sector bodies when contracts are tendered or put up for renewal. Members might ask what the relevance of this is in the NHS context, but as someone who worked in the NHS, who is passionate about it, and who has tremendous admiration for the people who deliver the service, I can say that it is a huge concern to me. The area that I worked in—the pathology service that carries out diagnostic tests—is under threat. This huge uncertainty continues, and we need to know precisely what the position is.
Virgin Care, Circle, Serco, Care UK and any other private sector companies awarded a public contract to provide hospital, community or even specialist diagnostic cancer services are not subject to the FOI Act. We have no idea how these companies went about winning those lucrative, taxpayer-funded contracts. Under current arrangements, the best that may be hoped for in terms of any rudimentary accountability is achieved through a Commons Select Committee inquiry of the type conducted by the Public Accounts Committee chaired by my right hon. Friend the Member for Barking (Margaret Hodge). However worthy this process, it is by its very nature very limited in scope, and such inquiries can only ever touch the tip of the iceberg.
This is a national scandal that has prompted me to table early-day motion 773, which has attracted quite a wide range of support, mostly from Labour Members. It calls for the FOI Act to be extended to private sector bidders for public service contracts, particularly in organisations such as the NHS.
My concern is that this has overtones of the Government’s response to Leveson, in so far as I do not believe that the Government want their corporate friends to be accountable to Parliament, even though our public services are being awarded to those companies in ever greater numbers. We should follow the public pound and ensure that we know who is getting it, and how and why they are spending it.
The Secretary of State has said that there will be no large expenditure projects that are not fully thought out and properly costed. That brings me to my second point. Responses to FOI requests from my hon. Friend the Member for Leicester West (Liz Kendall) have made it clear that the Secretary of State is presiding over cuts to essential cancer networks, yet we know that he is planning to spend £250 million of taxpayers’ money on two proton machines, even though, according to the Department of Health’s own report, there is little evidence that they provide any benefit. There are no clinical trial data and no randomised control trials, which are the gold standard by which the National Institute for Health and Clinical Excellence judges the effectiveness of clinical therapies. Indeed, the new chair designate of NICE appeared before the Health Select Committee earlier this week and said exactly that.
The economic justification for purchasing those two machines has been based on informal discussions with the manufacturers who make them. If the machines are to be viable for the two hospitals that are to have them, they will need to treat 1,350 patients a year at a cost of £40,000 per patient. However, according to the Department of Health’s own dataset, the highest number of patients ever treated with proton therapy in one year is 79.
I would like to draw the House’s attention to the situation in Germany, which has invested more than most in proton therapy. Today, two of the three proton machines in that country are being mothballed. In Kiel, €250 million was spent last year on a machine, but it is now being dismantled and put into storage because of a lack of demand.
Can my hon. Friend explain to the House what a proton machine actually is?
Probably not, in the very limited time available, but I can tell my hon. Friend that proton therapy is a form of advanced cancer treatment.
My argument is that the money the Department is proposing to spend on those incredibly expensive machines would be far better spent on advanced radiotherapy machines such as the stereotactic body radiation therapy machines that the hon. Member for Stevenage mentioned. There are other forms of therapy that are far more cost- effective. I might add that we in the northern region have no access to such therapies. Indeed, whole regions of the country do not.
The one remaining proton machine in Germany is at the university of Heidelberg, and it treats a maximum of 1,200 patients each year. The German Radio-oncology Society has said—[Interruption.] I hope that the Minister will listen to this. The society has said that
“for the vast majority of cancers there is no proof that proton therapy is more beneficial than other forms of innovative radiotherapy that are one hundred times less expensive”.
This proton debacle highlights the perversity with which the Government are running the NHS budget, and these questions lie at the very heart of whether we can trust Conservative promises on the NHS.
The Prime Minister tells the public that by April next year every cancer patient who needs innovative radiotherapy will get it, while at the same time the Secretary of State for Health starves dozens of hospitals and cancer networks of vital money needed to buy innovative radiotherapy equipment. We now know that money is being redirected into those two highly dubious projects. The Secretary of State needs to cancel those projects now and redirect the money into radiotherapy machines that will help tens of thousands of people in my constituency and across the country. This has the potential to be a monumental scandal and a waste of public money. I urge hon. Members who share my concern to sign early-day motion 773, to lobby the Health Secretary and ask him to reconsider his spending priorities in relation to cancer therapies, and to support the motion on the Order Paper.
(12 years, 1 month ago)
Commons ChamberThere are concerns across the piece. Whether air guns are covered depends on the definition of air gun, but I hope to come to that in a few moments if my hon. Friend bears with me.
Public safety must be the primary aim of gun control legislation, but it is clear that the police, in view of significant budget cuts, can no longer afford to subsidise the licensing system. We heard in the debate a few moments ago of hon. Members’ concerns about 20% cuts in police budgets in their areas.
I congratulate my hon. Friend on securing this debate, which is on an emotive point for him. Does he agree that all aspects of firearms control should be a major concern and top of the agenda for prospective police and crime commissioners?
My hon. Friend makes a good point. We are only a few weeks away from the elections for police and crime commissioners. I have discussed the issue with Ron Hogg, who is a PCC candidate in County Durham, and who has some expertise in the matter. It is important that this is a local priority, but I also suggest that we should have a national framework laying down guidelines—something stricter than guidelines, in fact—to be applied evenly. Part of the problem is that we have a patchwork of arrangements.
We cannot do firearms licensing on the cheap at the risk of compromising public safety. There is also a strong case for strengthening the link between the licensing authority and medical professionals when considering an application for or a renewal of a firearms certificate. We need early and proactive intervention when a firearms holder’s mental and physical health deteriorates.
(12 years, 8 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
The Budget is a great missed opportunity, not only for the north-east but for the whole country. It should have been a Budget for jobs and growth, but instead it was a Budget for tax cuts for the rich and the toffs.
Unemployment rates in the south-east of Northumberland—in my constituency—are alarming. According to the Library, statistics revealed last week showed that, on average, 22.2 people were applying for each jobseekers’ vacancy. Earlier this year, according to the Office for National Statistics, that figure was 55.5. Every time we mention the problems faced by unemployed people in our area, we are told that we should look at the positive signs, such as Nissan. Nissan has been and is tremendous, but it is a million miles away from where I live.
I am sorry to stop my hon. Friend in full flow, but it is important to place on the record that, although we welcome the additional jobs and the announcement about Nissan, it must be put in context. Does he agree that although 250 jobs are welcome, they do not go anywhere near even offsetting the private sector job losses in my constituency alone? Reckitt Benckiser has lost 500 jobs; Fortress Doors has lost 100; Carillion, Cumbrian Foods and, most recently—
(12 years, 9 months ago)
Commons ChamberMost of the health care professionals—indeed 90%; the ones who were not invited to the summit—oppose the changes in one form or other. Also, 80% of Lib Dem voters want the risk register published—an even bigger percentage than that of Labour voters.
Does my hon. Friend agree with the Secretary of State about the huge support for the Government from GPs over these reforms?
A number of Members on the Government Benches have referred, in Health questions and at other times, to the huge support among clinicians and GPs in their area, but Clare Gerada, the chair of the Royal College of General Practitioners, has said that just because GPs are compelled to man the lifeboats does not mean they agree with the sinking of the ship. That sums things up.
Hon. Members on the Government Benches should be particularly concerned by some recent polling figures. According to a poll by ICM, the over-65s—the category of people who are most likely to use the NHS and most likely to vote—want to drop the Bill by a margin of 56% to 29%, or two to one, which is the largest such margin. Sadly, not one Conservative Member, as far as I am aware, has had the courage to sign the early-day motion or to call publicly on the Health Secretary to publish the risk assessment. I know that, privately at least, some of the more thoughtful Conservative Members have been advising the Secretary of State to publish, but he seems to be flatly ignoring them. The risk register contains an objective list of the Department’s view of the risks, an estimation of the likelihood of each specific risk occurring and an estimation of its severity if it did occur. To be clear, what the Health Secretary is determined to conceal are the severe and likely risks of his own reckless attack on the NHS.
The Prime Minister must also be held to account for his broken promises on the NHS, for allowing his Health Secretary to put the NHS at risk and for standing by him while he tries to cover up the mess that is the Health and Social Care Bill. I remind the House that the coalition agreement that was signed by the Government parties stated:
“The Government believes that we need to throw open the doors of public bodies, to enable the public to hold politicians and public bodies to account.”
How does that statement square with this decision? Where is the accountability now? No one in the country voted for these health reforms, the Health and Social Care Bill has no mandate and we in the House will be asked to vote on reforms in the knowledge that the Department of Health and the Health Secretary are complicit in hiding the associated risks.
(12 years, 10 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is a pleasure to serve under your chairmanship for the first time, Mrs Riordan. I congratulate my hon. Friend the Member for Newcastle upon Tyne Central (Chi Onwurah) on securing this debate. The number of Opposition Members who are present today is a testament to the issue’s importance. I wish we had a little longer to speak, because I will have to truncate my remarks.
I served on the Committee that considered the Health and Social Care Bill, and I am a member of the Health Committee. As someone who has worked in the health service for more than a dozen years, I can say that the subject is very close to my heart. I am grateful to a number of organisations for their work, including the Association of North-East Councils, the National Education Association, the Campaign for Warm Homes, Durham county council, the North East Public Health Observatory and Health Works, which won a national award last week for its innovative and pioneering work in tackling health inequalities at the very heart of my constituency, and I thank that organisation for the information that it provided to Members for this debate.
The NHS reforms contained in the Health and Social Care Bill are only one aspect—a very important aspect—of how Government policies will increase health inequalities. We must make it clear that there is no consensus on this matter. There is clear blue water between the views of the Opposition, who think that resources should be applied to the areas of greatest need to address real and fundamental problems, and the attitude of Government Members. Across every Department, coalition policies will exacerbate socio-economic inequalities and, ultimately, health inequalities, as indicated by Professor Sir Michael Marmot in his report. I wanted to mention some figures in my region, but I do not have enough time.
Chronic obstructive pulmonary disease, or COPD, is particularly prevalent in the north-east. It is often associated with heavy industry, coal mining and the like. Last year, my own primary care trust received a national award for its innovative approach to tackling this public health issue within our community. COPD costs the NHS an estimated £491 million every year.
Mortality rates in the north-east are higher than in the rest of England, accounting for 6% of all deaths in England, and the inequality gap appears to be increasing, which is a real concern.
I want to focus on two significant issues in the limited time that I have: first, inequalities in access to health service, which is a key factor that influences health outcomes; and secondly, the broader problem of health inequalities produced by deep-seated differences of social class.
As we have heard, in 1979 the Government’s chief scientific adviser, Sir Douglas Black, produced a report on the extent of health inequalities in the UK, and he acknowledged that the NHS could do much more to address those inequalities, alongside other improvements across the Government. As I mentioned earlier, those improvements include ones to child benefit, maternity allowances and pre-school education, as well as an expansion in child care and better housing. All those changes would address health inequalities.
Those findings by Sir Douglas Black were subsequently reinforced by further research and reports by Professor Peter Townsend and Sir Derek Wanless and more recently by Professor Sir Michael Marmot, all of whom I have had the pleasure to meet in one forum or another before and after I was elected to serve in the House.
There is a stark danger—a clear and present danger—of a downturn in the progress that has been made in addressing health inequalities because of decisions being made by the Government, both in the Department of Health and elsewhere, and severe cuts to services for the most vulnerable. That makes it all the more important that the NHS focuses on tackling health inequalities. Let us make no mistake: under Labour, good progress was made to address health inequalities, but a great deal more needs to be done.
I have served on the Health and Social Care Bill Committee for a year now, as well as on the Select Committee on Health, and I would argue that that Bill changes the fundamental aspects of our NHS. The NHS has been fragmented, with privately led commissioning, the reintroduction of a postcode lottery, an unco-ordinated health system and greater competition. That fragmentation risks entrenching the inequality of access to health services and health outcomes. Fragmentation is the antithesis of a co-ordinated approach. We need more co-ordination, more integration and a more focused approach.
Stephen Thornton, chief executive of the Health Foundation, talked about health inequalities when he was one of the expert witnesses who gave evidence to the Health and Social Care Bill Committee. He said:
“a duty needs to be placed on the national commissioning board and the consortia”—
the commissioning groups—
“to embed shared decision making in all care and treatment”.––[Official Report, Health and Social Care Public Bill Committee, 8 February 2011; c. 19.]
Only by reinforcing the duty on the commissioners themselves to reduce health inequalities is there any chance of achieving that goal.
The cuts that are falling across every Department are clearly hitting the poorest hardest. The Association of North East Councils has shown that the north-east will be worst affected by those cuts between now and 2013. Child poverty is rising in my constituency. Currently, one child in three in my constituency is living in poverty, but in the Eden Hill ward in Peterlee 48% of children are in poverty, and in Deneside in Seaham, which is next to where I live, the figure is 40%. Those figures should concern not only the local MP but the national Government.
Recently, the TUC produced figures after the unemployment figures were released that show that, on average, 7.5 jobseekers are chasing every vacancy, but in the constituency of my hon. Friend the Member for Hartlepool (Mr Wright) the figure is as high as 24 jobseekers chasing every vacancy. Youth unemployment is rocketing, and the coalition Government seem to have no intention of reducing health inequalities.
I will make a very brief intervention. My hon. Friend has just mentioned statistics about child poverty, unemployment and jobseeker’s allowance applications, and earlier in the debate other colleagues talked about the inequalities in the north-east regarding the situation within the NHS. Those statistics and that situation are wholly unacceptable. The Prime Minister said before the election that he would attack the north-east first and then Northern Ireland second. That is happening. With the Welfare Reform Bill, there will be a continued attack on the north-east. Does my hon. Friend agree that that does not bode well for the future of the people in the north-east and that things can only get worse?
I am grateful to my hon. Friend for that intervention, and I agree with him. I was shocked to attend a meeting in my constituency last Friday about the contingency plans that are being put in place for emergency feeding centres after 2013. Those centres are the soup kitchens that we have not seen since the 1930s or the miners’ strike in 1984.
My final point is that the Labour Government produced the first ever targets to reduce health inequalities in the population, and the poorest were healthier when we left Government than they had been when we took office in 1997. My plea to the Minister is this: raise the standards and be a champion for public health and not an apologist.
(13 years ago)
Commons ChamberI rise to support the motion in the name of my hon. and right hon. Friends on the Front Bench. We are aware of the national figures, so in the limited time that I have I will concentrate on the picture as it affects Easington and the north-east region.
As Opposition Members are aware, the north-east has suffered more than perhaps any other region. Unemployment currently stands at 11.7%. In both the public and private sectors, unemployment is rising unabated as a direct consequence of the Government’s policies.
As we already know, the public sector is losing jobs more than 13 times faster than the private sector can create them. We were promised a private sector-led recovery. We were told that the public sector jobs that have been lost in the north-east—we have lost more than 32,000 so far—would be replaced by a growing private sector. That clearly has not happened over the past 12 months.
The latest job figures show that the north-east has lost a larger proportion of jobs than anywhere else in the country. We have 6,000 fewer jobs in the construction sector compared with the same period last year. Clearly, Government policy has had a direct impact on the private sector. Cutting infrastructure projects and the Building Schools for the Future programme has hit construction jobs. The figures produced by the northern TUC show that the public sector is losing 2,000 jobs a month.
As my hon. Friend the Member for Stockton North (Alex Cunningham) mentioned, the Conservative Government of the 1980s and early 1990s bear a heavy responsibility for the worklessness that exists in areas such as mine. When the traditional industries were still operating—in my case it was coal mining—the numbers of people who were employed were high and the numbers on benefit were relatively low. It was not until the pits closed that we saw significant increases in unemployment and incapacity claims. As hon. Members have already said, there is a human cost to unemployment. After closing the pits in Easington and in the north-east, the Conservatives left villages, towns and entire communities without work.
Does my hon. Friend agree that the unemployment statistics in Easington are very similar to those in Wansbeck? In my constituency, there is in excess of 30 people applying for each job vacancy and that is intolerable. The Prime Minister has kept one of his promises: before the election, he said that the north-east would be hit the first and hit the hardest.
Indeed. I share my hon. Friend’s concerns, and that has certainly been the case. We are facing a worsening of the north-south divide. It is also the case that the north-east has faced some of the worst increases in unemployment across the UK. The hon. Member for Salisbury (John Glen) said that there were 1,000 people out of work in his constituency. There is more than three times that number in my constituency. The number of 18 to 24-year-olds out of work in Easington has increased by 65%. For the over-50s, the figure is up 58%, which is just as concerning. The situation for those out of work in the north-east is much bleaker than in many other regions.
Unemployment and worklessness are not evenly spread across the country. Indeed, they are concentrated in particular pockets, largely the older industrial areas of the north-east, Merseyside, Scotland and Wales, and that makes unemployment far harder to deal with. I should like to commend the excellent work carried out by Professor Steve Fothergill and his colleagues at Sheffield Hallam university in identifying some possible solutions. I know that time is short, so I will bring my speech to a close.
There are real concerns about the Government’s intentions in relation to workfare. If jobs exist, why are they not being offered as real jobs with real wages? We need a plan from the Government for jobs and growth. Our Front-Bench team has a five-point plan to kick-start the economy, but the Government could go further. There are some helpful suggestions from the Institute for Public Policy Research for supporting employment, and I raised them with the Minister of State, Department for Work and Pensions, the hon. Member for Thornbury and Yate (Steve Webb), in a recent Adjournment debate. I would point out, however, that the Government’s promises on jobs and growth are as hollow as a chocolate Father Christmas.
(13 years, 7 months ago)
Commons ChamberI am grateful for that and I agree. It is fundamental to have a solid evidence base on which to plan health interventions.
As I mentioned, the Government propose in the Health and Social Care Bill to transfer health improvement functions from PCTs to local authorities, and to create a new body, Public Health England, to be rooted in the Department of Health. Public Health England is expected to take on full responsibility for overseeing the local delivery of public health services, as well as dealing with national issues such as flu pandemics and other population-wide health threats from next year. The majority of public health services will be commissioned by local authorities. However, the revolution under way in the NHS is just as important to the future of public health in England.
The Bill, which proposes the abolition of strategic health authorities and primary care trusts, raises more questions than it answers. The responsibilities currently held by PCTs could be moved to local authorities, to the Department of Health, to commissioning consortia or to the NHS commissioning board. How the important work of public health observatories will be safeguarded for the future is still unknown. The decision to divide public health responsibilities between the Department of Health and local authorities will fragment any cohesive approach to tackling health inequalities. Whether new commissioning consortia will carry out some functions is at this stage unknown.
There are further concerns about whether Public Health England should be outside the Department of Health to protect its independence. If it was placed within the NHS, perhaps as a special health authority, surely that would better meet the Government’s own aim, often stated, of liberating the NHS from political control.
The Minister will be aware of the response to the White Paper by the public health observatories in March 2011. That response calls for a sub-national level of organisation of Public Health England to be created, with sufficient critical mass to ensure that the outputs of Public Health England continue to be valuable locally as well as nationally. There are many examples where that is the case, not least in my own region, the north-east, where the public health observatory has done excellent work on addressing inequalities that affect people with mental health issues and inhibit their ability to access services. The lessons of that can be rolled out across the country.
The important work of the observatories over the past decade has been self-evident. On 24 June 2008 the health profiles for every local authority and region across England were published jointly by the Department of Health and the Association of Public Health Observatories, an organisation which, as I mentioned earlier, has lost all its funding. Using key health indicators, public health observatories were able to pinpoint national health statistics at a local level, providing valuable information to address health inequalities and improve health outcomes.
As the Minister at the time, my right hon. Friend the Member for Bristol South (Dawn Primarolo), now the Deputy Speaker, noted, the importance of those statistics was
“to target local health hotspots with effective measures to make a real difference.”
In my constituency, Healthworks, an excellent clinic established in Paradise lane in Easington and opened by Sir Derek Wanless, is a prime example of how that information collected by the observatories was used to great effect to target the areas in greatest need.
The Association of Public Health Observatories, with the Department of Health, also published a health inequalities intervention toolkit to enable every English local authority to model the effect of high-impact interventions on the life expectancy gap. As far back as 1977, the Department of Health’s chief scientific adviser, Sir Douglas Black, was asked to produce a report on the extent of health inequalities in the UK and how best to address them. The report proved conclusively that death rates for many diseases were higher among those in the lower social classes. It acknowledged that the NHS could do much more to address the situation. It called for increases in child benefit, improvements in maternity allowances, more pre-school education, an expansion of child care and better housing. A further report was subsequently produced by Professor Peter Townsend. Indeed, only last week I attended a seminar, in which the principal speaker was Sir Michael Marmot, on the impact of cold homes on health outcomes. The report indicated that the cost to the NHS of illness resulting from poorly insulated houses and cold homes is £2 million a year.
The Marmot review, published in 2010, stated clearly, as one of its nine objectives:
“Economic growth is not the most important measure of our country’s success. The fair distribution of health, well-being and sustainability are important social goals. Tackling social inequalities in health and tackling climate change must go together.”
I am grateful to my hon. Friend for mentioning that important and contemporary report. I completely agree with Sir Michael Marmot’s findings— and Marmite is also very good for public health. Building on the work of Professor Townsend and Sir Douglas Black, Sir Michael Marmot states as one of his recommendations:
“Action taken to reduce health inequalities will benefit society in many ways. It will have economic benefits in reducing losses from illness associated with health inequalities. These currently account for productivity losses, reduced tax revenue, higher welfare payments and increased treatment costs.”
I mentioned the economic benefits of insulating houses. It would be a real step forward if the Marmot report’s six principal recommendations were incorporated and linked to quality standards in the public health outcomes framework that the National Institute for Health and Clinical Excellence is working on.
(14 years, 1 month ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I have a whole series of examples of hospitals and services that are threatened with closure or reductions in services from right across the length and breadth of the country, which was highlighted in a recent report in The Sunday Telegraph. I have the whole list, so I agree with the valid point that my hon. Friend makes forcefully.
After only six months in power, the coalition is putting the proud record of the previous Labour Government on the NHS in jeopardy. On top of this, feedback from the front line shows that the Government are removing the safeguards and patient guarantees that drove down waiting times and assured the same quality of care irrespective of where a patient lived. This is not a Government protecting the NHS. It seems as if this is round 2 of what the Tories never managed to accomplish in the 1980s: to break up and privatise the service.
On 20 July, in evidence to the Health Committee, the Secretary of State said that he wanted to
“entrench the sense of greater ownership on the part of patients”—
that is ownership of the NHS. Is it not the case that the reforms will give ownership of the NHS to the private sector, and that only the NHS logo will be left behind?
My hon. Friend makes a valid point. The White Paper “Equity and Excellence: Liberating the NHS” certainly seems to be setting out in that direction.
Certain projects, and particularly one in my area, have suffered as a result of the departmental expenditure limits that I mentioned earlier, which will result in a decrease of 17.9% over the four-year life of the Parliament. A new hospital in the north-east of England at Wynyard was to have served the southern part of my constituency of Easington, as well as the constituents of Stockton North and Stockton South, and those in parts of Sedgefield and Hartlepool, but it was an early casualty of the cuts.
In the longer term, the coalition partners seem to want not a capital budget, but to pursue a roll-out of private finance initiative hospitals. They want to place every privately built hospital into competition in the private sector so that they can be commissioned by GPs controlling the entire health budget in the private sector. The direction of travel for the health policies of the present Government is clear, but it is my belief that the duty of the Government should be to protect essential public services such as the NHS from the distorting effects of the market.
We need to learn lessons from recent history. It is ironic that my party’s efforts in government to incorporate market conditions in health showed that that could drive costs up rather than bring about efficiencies. Such an example was recently cited in the media. The Coventry University hospital was built under a PFI scheme. As we all know, PFI allows private companies to build public sector infrastructure, but although it gives the benefit of delayed costs to the public purse, those companies are entitled to levy huge interest rates, fees and services charges in the longer term. Treasury figures show that when the contract for Coventry University hospital is paid off in 2041, the estimated cost to the taxpayer will be £3.3 billion. If the state had built the hospital, the cost would have been a fraction of that sum. Indeed, the hospital at Wynyard was costed at £464 million—that is an incredible difference. Market discipline and privatisation do not automatically produce value for the public purse.
The Minister is right, but I was making the point that important lessons from history need to be learned. We are reacting to evidence that PFI does not necessarily provide value for money. Each case has to be considered on its merits.
Given the real-terms cut to health spending, an agenda of wholesale management reorganisation and the effective privatisation of the NHS budget, the impact of the comprehensive spending review and the Department of Health White Paper will not only alter the principles on which the NHS was founded, but squeeze health provision, increase costs, allow hospitals to go bust if they are failed by the markets, and create a postcode lottery of health services. There is widespread opposition to elements in the White Paper among health care professionals, including from the British Medical Association, which is not noted as radical left-wing organisation. The BMA states that it has
“opposed the increased commercialisation and competition imposed on the NHS in recent years and there is little evidence of any benefits to patients. It brings with it additional costs as well as disincentives for collaboration and co-operation.”
Staff costs account for more than half of NHS expenditure. Future decisions on pay will have a great impact on the health budget. The Royal College of Nursing has already highlighted short-sighted cuts by NHS trusts to their work force and services. The RCN is aware that about 10,000 nursing posts have been earmarked for removal in anticipation of cuts to front-line services. What consideration has the Minister given to the pressure to increase staff pay in coming years? By 2013-14, GPs will have had their pay frozen for four years; consultants for three years; and NHS staff earning more than £21,000 for two years.
Is my hon. Friend aware that despite the two-year pay freeze on public sector pay for those earning above £21,000 a year, which was announced by the coalition in the emergency Budget, the King’s Fund notes that the NHS payroll bill is likely to increase by up to £900 million a year due to the increments that are built into most NHS contracts? Does he agree that that reinforces the inadequacy of the NHS settlement for patient care?
I do indeed. My hon. Friend makes an important point. Another is the impact on the NHS budget of the VAT increase that is to be implemented on 1 January 2011.
Kieran Walshe, professor of health policy and management at Manchester business school, has criticised the coalition Government’s approach of making change without evidence. The implementation of the massive reorganisation that is set out in the White Paper will need at least another £3 billion in addition to the sums already identified, such as for wage costs, inflation, and the increase in VAT. That is at least another £3 billion from the NHS coffers, and the plans were still being altered after the coalition agreement was published. The decision to abolish primary care trusts seems more like a last-minute whim of the Secretary of State than a well-thought, evidence-based approach to health service reorganisation.
Professor Walshe said:
“the transitional costs of large scale NHS reorganisations are huge…projected savings from abolishing or downsizing organisations are rarely realised.”
Those of us who have been involved with local government will appreciate how true that is. He continued:
“Closing down or merging organisations produces a round of expensive redundancies, early retirements, and redeployment, while new organisations find new premises and appoint lots of new staff.”
I echo the concerns of Mencap—I am grateful for its briefing—which states
“As the government have still been unclear about the transitional and ongoing costs for moving to the new commissioning arrangements, this settlement may not be sufficient to deliver against needs.”
In contrast, the Secretary of State still believes that he can save money by carrying out the biggest reorganisation in the history of the NHS. Indeed, on 2 November, he said:
“We are cutting management costs in the NHS by 45%. We will cut total administrative costs as well, and in total that will save £1.9 billion a year by 2015.”—[Official Report, 2 November 2010; Vol. 517, c. 759.]
Will the Minister tell us what account has been taken of the unknown costs of the reorganisation?
Professor Chris Ham is the chief executive of the King’s Fund—the Minister’s favourite organisation. He questions why the Government would
“embark upon such a fundamental reorganisation as the NHS faces up to the biggest financial challenge in its history.”
Is it not the case that Ministers should be honest with the public? The impact of the spending review will mean deep cuts to vital services in the NHS. When the Health Secretary delivered his White Paper to the House, he said:
“The dismantling of this bureaucracy will help the NHS realise up to £20 billion of efficiency savings by 2014, all of which will be reinvested in patient care.-—[Official Report, 12 July 2010; Vol. 513, c. 663.]
Coalition Minsters are trying to give the impression that health provision has somehow been protected by a real-terms increase in the health budget, but that myth is starting to unravel. The coalition Government have admitted that current levels of health care will not be maintained. They are undertaking a massive reorganisation and all the evidence suggests that the projected savings will not be realised.
Edward Macalister-Smith, the chief executive of NHS Buckinghamshire, said:
“the amount of money that is available from administrative savings, management savings and the financial back office, is a very small proportion. Most of the money is spent on clinical care. If you want to reduce your spending, make your spending more efficient, that is, I am afraid, where you have to concentrate.”
It is simply not possible to achieve the sort of savings that the Government have outlined. The settlement for the NHS will come no way near maintaining current health care levels. Some £1 billion is being taken to plug the hole in social care. Many more billions are being wasted on a wholesale reorganisation, and the coalition seems to have agreed to take a gamble with the £80 billion NHS commissioning budget.
According to research carried out by the King’s Fund, the VAT rise to 20% from January next year will cost the NHS an additional £250 million a year. Furthermore, additional pressures will be placed on the NHS, thanks to the massive cuts that are being levied on local government budgets. There are also serious concerns that cuts to local government will lead to a shortage of hospital beds as the elderly and vulnerable are left without local care, thus placing even greater pressures on the NHS. The 26% cut in central Government funding for local authorities will pile on the pressure for the NHS. Nigel Edwards, the head of the NHS Confederation, has warned that the pressure on beds could mean that hospitals will be unable to admit patients “who badly need care”.
It is wrong for Ministers to pretend that their reorganisation will improve service delivery or that it is possible to save £20 billion through efficiencies alone. They should be honest about what they are doing to our national health service. The Government are not keeping the promises that they made to patients and staff to protect NHS health care funding.