Oral Answers to Questions

Heidi Alexander Excerpts

Tuesday 15th January 2013 Commons Chamber

[Dr Poulter]

I thank my hon. Friend for that question and he is right to highlight the fact that any decisions about service reconfigurations must be clinically led, as was outlined in the Government’s tests for any service reconfiguration.

[Heidi Alexander (Lewisham East) (Lab)]

T8. Last week, the Secretary of State refused my request to meet a small group of local GPs, hospital doctors and residents who are opposed to the closure of accident and emergency and maternity at Lewisham hospital, yet in his former role he seemed very happy to trade hundreds of texts with Rupert Murdoch’s lobbyists about the purchase of BSkyB by News Corp. Why is it one rule for Rupert Murdoch’s lobbyists and another for doctors in Lewisham?

[Mr Hunt]

I think that the hon. Lady might perhaps read Lord Leveson’s conclusions before she starts hurling about allegations, many of which came from her side of the House, that were later shown to be totally false. With respect to the decision on Lewisham hospital, I thought that we had a very useful meeting last night with the south London MPs who are directly affected. She understands that the process put into law by her party and her Government means that I cannot reopen the entire consultation and start seeing some groups without seeing all groups that are affected. That is why I am limiting the discussions I have with colleagues, but I think that that is the right thing to do.

South London Healthcare NHS Trust

Heidi Alexander Excerpts

Tuesday 8th January 2013 Commons Chamber

[Mr Hunt]

My hon. Friend makes a very important point. One of the most important things that I have to consider in the next 20 days is what he describes as the knock-on impact of all the proposed changes. I have a duty to find a solution that is financially and clinically sustainable for the South London Healthcare NHS Trust area. However, I need to consider the knock-on effects everywhere else, including in Lewisham and my hon. Friend’s constituency.

As well as legal advice, I will be seeking clinical advice and want to make sure that my officials agree with the financial considerations made in the report. I will consider all that advice in enormous detail before I come to any decisions.

[Heidi Alexander (Lewisham East) (Lab)]

I am grateful to the Secretary of State for agreeing to meet Members with Lewisham constituencies about this matter. Representatives of the Save Lewisham Hospital campaign, which is made up of local GPs, local hospital doctors and the public, are also very keen to meet the Secretary of State to put our case directly to him about why it is important to retain a full, admitting A and E and full maternity service at Lewisham. Will he agree to meet them?

[Mr Hunt]

I want to meet colleagues from the House but, as I am sure the hon. Lady will understand, I want to be careful not to restart the whole consultation process that has been happening in what I believe is a very thorough way in the past few months. However, one of the things that I will be considering very carefully—and I will listen to any points that the hon. Lady makes when I meet her—is whether the consultation has been done properly, as it needs to be done and as was intended by the legislation. I will not accept any changes unless I am satisfied on that point.

NHS Funding

Heidi Alexander Excerpts

Wednesday 12th December 2012 Commons Chamber

[Heidi Alexander (Lewisham East) (Lab)]

Will the Secretary of State give way?

[Mr Hunt]

I am going to make a little progress, if I may.

The right hon. Member for Leigh rather helpfully spelled out the difference between his position and our position when he admitted in the New Statesman that we are spending more than he wanted to spend on the NHS. He said of the NHS budget:

“They’re not ring-fencing it. They’re increasing it.”

In respect of NHS spending, he said:

“Cameron’s been saying it every week in the Commons: ‘Oh, the shadow health secretary wants to spend less on health than us’…it is true, but that’s my point.”

It was a good point, because we are spending more and he would have spent less. So why on earth call an Alice in Wonderland Opposition day debate condemning levels of spending in the NHS when he has so clearly put it on the record that he wanted that spending to be less?

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[Mr Hunt]

The simple truth that Labour Front Benchers cannot understand is that spending is related to budgets, and they wanted the budgets to be lower than they currently are.

[Heidi Alexander]

The Secretary of State seems to be very keen to ask questions of our Front Benchers. Why will he not answer the question put to him by my hon. Friend the Member for West Ham (Lyn Brown)? How many nurses have lost their jobs on his watch? I do not want to be told about the nurses-to-beds ratio—answer the question.

[Mr Hunt]

It is because we have protected the NHS budget that the number of clinical staff in the NHS has gone up and not down. [Interruption.] Okay, let me explain this, because there is a very important point here. Unlike Labour Front Benchers, I do not want to micro-manage every hospital in the country and tell them exactly how many doctors and how many nurses they should have. I want them to put money on the front line, and the result is that the number of clinical staff—doctors, nurses, midwives and health visitors—has gone up and not down.

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[Heidi Alexander (Lewisham East) (Lab)]

It is a pleasure to follow the measured and thoughtful speech that the hon. Member for Stevenage (Stephen McPartland) has just given. May I also put on the record my tribute to my right hon. Friend the Member for Cynon Valley (Ann Clwyd) and the vital work she is doing, at what must be an incredibly difficult time for her, on putting the importance of care and compassion back at the heart of our NHS?

I wish to focus on the current threats to NHS services in south-east London. My right hon. Friend the Member for Lewisham, Deptford (Dame Joan Ruddock) has already spoken about the threats to Lewisham hospital and the plans on the table, and I am going to treat the House to my own concerns about that matter. We are rightly debating national expenditure levels on the NHS today, but the harsh reality in Lewisham is that my constituents are confronted with the fact that their local accident and emergency and maternity departments may have to close in order to deal with financial pressures elsewhere in the NHS.

The Government can claim all they like that they are investing in the health service, but it does not feel that way in Lewisham. Last Friday, along with local doctors, my right hon. Friend the Member for Lewisham, Deptford and my hon. Friend the Member for Lewisham West and Penge (Jim Dowd), I presented a petition against the closure of Lewisham’s A and E and maternity departments to No. 10 Downing street. As has been said already, in five weeks the petition has been signed by more than 32,000 people. The proposed changes at Lewisham hospital are not only unwanted, but arguably unsafe and unjustified.

Lewisham is a busy hospital. More than 120,000 people visit the A and E each year and last year more than 4,000 babies were born there. Lewisham is a place where average life expectancies for both men and women are below national averages. Sadly, it is a place where sometimes, admittedly infrequently, a stab victim will walk into the A and E from the streets and a place where many teenage girls will give birth to their babies.

The A and E and maternity departments at Lewisham hospital are a matter of life and death for many of my constituents. I am therefore not surprised that more than 32,000 people signed the petition to keep a full A and E and full maternity service there; I am also not surprised that more than 100 local GPs, including the chair of the new clinical commissioning group and the head of every single clinical group at the hospital, have written to the Prime Minister to express their concern about the proposals.

The question for the Minister today is: will the Government listen? Will the special administrator to the South London Healthcare NHS Trust, a man appointed to sort out financial problems in neighbouring hospitals, think again about his plans for Lewisham when he draws up his final recommendations to the Secretary of State for Health?

I do not think that anyone can be under any illusion about the degree of local opposition to closing the A and E and maternity departments at Lewisham. I recognise that trying to balance the books at the South London Healthcare NHS Trust is a hard job, but asking a hospital that is not even part of the trust to pay such a heavy price seems patently unfair.

The plans for Lewisham are based on inaccurate data and flawed assumptions. The size and nature of the caseload at Lewisham’s A and E have been misunderstood. The estimated additional journey times to neighbouring hospitals have been woefully underestimated, yet the speed with which it will be possible to reduce the need for hospital care seems to be hopelessly optimistic and based more on wishful thinking than on hard fact.

Those are not the only problems with the proposals. I also cannot see how the current plans make financial sense. In the past week, we have had—even though the Government dispute this—independent verification that there has been a real terms reduction in spending on the NHS in the past few years. Surely it then becomes all the more important that every pound spent is spent wisely and well. How can it be wise to sell off more than half the Lewisham site for £17 million only to have to reinvest £55 million in reconfiguring the remaining buildings on that site to do different types of work? Why sell off the existing buildings, only to shell out money at other hospitals to increase capacity to enable other parts of the NHS to do the work that Lewisham is already doing very well?

The 4,000 babies who are born to Lewisham mothers every year will have to be born somewhere. Where? There is no free capacity in the system at the moment, so that will require investment. Where are the people who use Lewisham’s A and E going to go? We have all seen the reports of more and more ambulances queuing outside hospitals, with patients waiting to be taken into A and E but being kept in the ambulance because of a lack of space.

It is asserted that in Lewisham, if the proposal to close the A and E went ahead, only one in four people would have to go to other A and Es, while the other 77% would still be treated in the urgent care centre that would remain. That figure is fanciful. The emergency doctors at the hospital say to me, based on their analysis of patient numbers and the nature of the work that they do, that just 30% of people could still be treated at the urgent care centre.

I accept that the NHS cannot be preserved in aspic and I understand that it must change to meet the demands and challenges of the 21st century. However, those changes must be driven by patients’ health needs, not an accountant’s bottom line. That is not what is happening.

[Nick de Bois (Enfield North) (Con)]

The hon. Lady may be aware that we have had a long fight against the downgrading of my hospital, Chase Farm. Many people think that that fight is over, but I do not. With the new demographic figures and population increases in London, it is important that we continue to press authorities and Ministers to take these things into account, even at this late stage, because where people go is even more of a priority than she assessed it was before the figures came out.

[Heidi Alexander]

The hon. Gentleman is completely right. Lewisham’s population is growing, and has increased by 10% in the past 10 years. All the indicators suggest that London’s population will continue to grow. It is a diverse population with varied health needs, so it is imperative that people in our capital city can access high-quality services close to home.

In conclusion, before the election, the Prime Minister told us that he would cut the deficit and not the NHS. In 2007, he promised a bare-knuckle fight over the future of services at Lewisham hospital. How times have changed. He has broken his promises on NHS spending and he has broken his promises about Lewisham hospital. If anyone needs proof that the Government cannot to be trusted with the NHS, they need look no further.

Oral Answers to Questions

Heidi Alexander Excerpts

Tuesday 27th November 2012 Commons Chamber

[Mr Jeremy Hunt]

I congratulate my hon. Friend on his campaigning and hard work on this issue, which represents an interesting way forward for community hospitals. I wish him every success and I know that hon. Members in all parts of the House will watch carefully what happens in Cannock.

[Heidi Alexander (Lewisham East) (Lab)]

T5. I would like to press the Health Secretary further on the unsustainable providers regime, which has been enacted in the South London Healthcare NHS Trust. Given that the statutory guidance for that regime explicitly states that it is not to be used as a back-door route to service reconfiguration, why are Lewisham A and E and maternity services earmarked for closure? If that is not a service reconfiguration, can he tell me what is?

[Mr Hunt]

What this issue is addressing—it was legislation introduced by the hon. Lady’s Government in 2006—is a clearly unsustainable situation with South London Healthcare. The proposals have to look at making sure that there is sustainability throughout an entire local health economy. I have not made any decisions at all. I will wait for the proposals to come to me at the end of the year, and I will then make my decision in January.

Social Care (Local Sufficiency) and Identification of Carers Bill

Heidi Alexander Excerpts

Friday 7th September 2012 Commons Chamber

[Mr Nuttall]

We are less than halfway through the time allocated for the debate, which did not begin until after 9.45 am. I do not think that there is much danger of our not being able to hear the views of Front Benchers. I entirely agree with the hon. Gentleman that there are plenty of things that we want to hear from those on the Opposition Front Bench. I am particularly interested to know why, if this measure is so important, the Labour party did not present it in the form of a Government Bill during the 13 years in which it had the opportunity to do so.

[Heidi Alexander (Lewisham East) (Lab)]

If the hon. Gentleman thinks that it is so important to hear from Front Benchers, does he also think that it is important to hear from those of us who want to make the case for carers in our constituencies, and who have expressed to you, Madam Deputy Speaker, our desire to speak in the debate? I wonder whether he will be allowing those of us on this side of the Chamber to make our contribution.

[Mr Nuttall]

Absolutely. I completely agree. We want to hear from as many Members as possible, including the hon. Lady.

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[Norman Lamb]

I am grateful for that intervention. I do not have a specific figure but I am sure that the position varies around the country, with some universities being exemplars of good practice and others not. We must do everything we can. This debate is about whether to impose a specific legal duty or to use other, softer means, but I think we are agreed on the ambition that we must ensure that students with caring responsibilities get access to help and support through the institution where they are learning. We are completely agreed on that.

NIACE has produced the “Really Useful Book of Learning and Earning for Young Adult Carers”—RUBLE—that they can use to plan their time and plan ahead both in respect of their caring responsibilities and in pursuing education and employment opportunities. It also provides information about budgeting and money management. Young adult carers often manage finances on behalf of the whole family, which can be an incredibly onerous responsibility.

The national institute has also produced a resource pack for further education colleges about ways in which they can support young adult carers to engage effectively in learning. That has positive outcomes for young adult carers because it enables colleges and other support services to work together to ensure that the individual carer’s needs are met and that they do not fall through the gap in services at important times, such as the move from school to college, because those transitions are often the most difficult. The national institute is building on that work with the Carers Trust and Barnardo’s, especially so that its excellent resources are disseminated more widely.

One young adult carer who has used RUBLE said:

“The RUBLE has helped me to feel positive about myself. Last year I was really depressed. The RUBLE has reminded me that caring for my mum is really important. It’s also helped me to realise I have lots of positive attributes. I feel good about myself, what I do and my future. The RUBLE has improved my relationship with my mum and helped me to ask for help. Now I know what I’m doing and have plans for the future.”

Those are powerful words.

Some colleges, of course, are already supportive of young adult carers. For example, Loughborough has a transition mentor who engages with young adult carers, their families and staff to provide support that is tailored to individuals’ needs. Such support includes flexible timetabling and allowing the carers to keep their mobile phones switched on during classes so that they can keep in touch with what is happening at home. Although legislating to place a requirement on further and higher education establishments is seductive in many ways, it might override such emerging welcome, impressive and flexible arrangements.

[Heidi Alexander]

Far from undermining what universities and colleges are doing, would not legislating underpin their excellent work?

[Norman Lamb]

The hon. Lady makes a clever intervention. We need to have that debate, because we agree about the ambition of achieving much better support for young people with caring responsibilities who are in education.

The proposals set out by the hon. Member for Worsley and Eccles South include ensuring that there are “sufficient” local care services, and she spoke about that specific point. I assure the House that the Government are committed to supporting that outcome. We want care users and carers to have a real choice of a range of high-quality services—whether state funded or paid for by individuals—and to have the information that they need to make an informed choice that is right for them. The “Caring for our future” White Paper is clear that enabling people to choose from various care and support providers that offer different ways of meeting people’s needs and goals will drive up the quality of care and support, including support for carers. Under the provisions of the draft Care and Support Bill, we propose to place a duty on local authorities to promote diversity and quality in local care and support services, to facilitate choice, and to meet the care and support needs of all local people and their carers.

Enabling carers to have a life outside caring, and helping those with caring responsibilities to fulfil their employment potential, are among the key priorities outlined in our cross-Government strategy “Recognised, valued and supported: next steps for the Carers Strategy”. In designing local care provision and drawing up joint strategic needs assessments, local authorities should recognise the importance of identifying carers’ needs, including their need to work. Local authorities’ assessments and reviews should take account of a carer’s wishes to remain in or return to work, as well as whether a carer’s involvement in employment is at risk because of their caring role. It is extraordinary that carers are rarely asked about their wishes with regard to employment. By simplifying the law, we will ensure that this existing requirement is given far greater emphasis.

The White Paper also set out a commitment to offer support to every local authority in England to fulfil this duty and, in particular, to develop or improve its market position statements. Effective market position statements make public key market intelligence, including the data from the joint strategic needs assessment and data from local consumer surveys and specific groups. They will send a clear signal to the market about the current and future level and nature of local demand for care and support services. The hon. Member for Worsley and Eccles South specifically highlighted the importance of how we develop the local market. For the first time, organisations large and small, be they private companies or charities, will have a clear picture of the demand for care and support and be able to innovate and invest in their services and staff accordingly.

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[Heidi Alexander (Lewisham East) (Lab)]

I am grateful to the hon. Member for Shipley (Philip Davies) for keeping his remarks brief and giving me the opportunity to contribute to the debate. I was determined to remain in the Chamber until the bitter end, and I think it will be bitter because the Government are clearly determined to kill off a Bill that could make a significant difference to the lives of carers, particularly young carers. It would also make a difference to the way in which local authorities understand the nature of the social care problem—the social care crisis—with which they are having to deal.

I congratulate my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) on promoting this Bill. She is a long-standing and effective campaigner on these issues, and I was delighted when she asked me to co-sponsor the Bill, which I believed would give hon. Members the opportunity to talk about the social care crisis, and take steps to improve the lives of carers.

Let us be under no illusion: there is a crisis in social care. I say that for two main reasons. The first is a personal reason linked to my family’s experiences, and the second is that when I was a local authority councillor I saw the huge pressures that council budgets were under from increasing demand for social care, particularly for elderly people and adults living with disabilities.

My experience of the crisis in care relates to my nan, who sadly passed away last year. She was a working-class woman who had worked hard all her life and had to sell her home to fund care at the end of her life. She was from suffering from Alzheimer’s and was frail in her later years, and all her life savings were effectively used up to pay for her care. She had to sell her house, and when she passed away her estate was the £23,000 that people are allowed to keep after they have paid the costs of their care. It upset me to think that my nan, who had worked hard all her life, had to use her life savings in such a way and was not able to pass them on to her family. I do not begrudge the use of that money for the excellent care she received, but it is an issue faced by families across the country.

I mentioned my experience of local government, where I saw the huge pressure put on local authority budgets by the rising demand—it rose virtually every day. The Local Government Association recently produced research showing that councils currently spend about 40% of their budgets on social care, but that is expected to increase in the next seven to eight years. In 2019-20, 60% of councils’ money will be spent on social care— £2 in every £3 they spend. The problem is therefore huge. Any steps that the House can take to encourage local authorities better to understand services, demand and how best to meet needs in the local area are incredibly important.

As has already been said in the debate, when people reach a crisis point in their lives—perhaps they are caring for a loved one—they often turn to their local town hall for help and advice. If they have moderate means, they could face the problem of funding their own care. There is a woeful lack of information and advice for self-funders—people who pay for their own care package. That is the current situation. People do not understand what costs they must cover. They do not know whether they will have to pay for the next three or five years.

What happens when the money runs out? That was my family’s experience, and it happens in 25% of care self-funding cases. The cost to local authorities of people falling back on to the state is about £1 billion every year, but that is anticipated to rise. Local authorities, in planning how they will deal with such enormous costs, need to understand the demand and need, and the services that are provided, in their local area. In that way, they will not only be able to plan better, but to give appropriate and quality advice to individual carers and their families who come to them for support.

There is a current demand, but another question is whether the Government will proceed with the funding for the Dilnot proposals—we still do not know. Press reports in the summer suggested that they would like to proceed with Dilnot, but where will the money come from? Dilnot is not the whole answer. It covers social care costs, but it does not cover “hotel” costs—accommodation costs that can be significant for individuals who enter residential care.

All politicians need to level with the public about the scale of the challenge and what people are likely to have to pay for in their later life. If people know that they must sell their home to pay for their care or a proportion of it, they can start to plan, but there is currently complete uncertainty. Dilnot is heralded as the fantastic answer to the social care crisis: it might be part of the answer, but it is not all of it.

Local authorities need to be able to provide that high-quality advice to people who come to them for help and support. I recently met Partnership UK, which is one of the few companies in this country to provide an insurance product for elderly people and those moving into later life and who want to insure themselves against the costs of their care. Partnership UK informs me that in 2009-10, 53,000 people who were going into care homes were self-funders. Of those, only 14,000 had received financial advice and only 7,000 had received financial advice from a properly qualified person. That situation cannot be allowed to continue. Local authorities have a role in signposting people to relevant places and organisations where they can get independent, high-quality advice.

I have spoken about why the Bill is important in improving local authorities’ understanding of the social care needs and demands of their local population. Before I finish, I will say something briefly on the importance of the Bill for the early identification of young carers.

During the summer recess, I was fortunate to visit Carers Lewisham, which does fantastic work with a range of carers in Lewisham, south-east London. It works with about 500 young carers who are referred to it by schools in Lewisham. When I met young people at Carers Lewisham, what struck me was the enormous support they give each other. There is not just support from the adults to help understand the system; there is also support on a human level, reassuring each other that they are not the only individuals facing the very difficult challenge of caring for their loved ones.

In Lewisham, this works quite well. Schools refer young people to Carers Lewisham and they receive good, high-quality support. However, it is not like that everywhere and the issue is too important for it to be a postcode lottery dependent on whether there is a great head teacher in the school, or a great local organisation or great ways of local working. It would be hugely positive if we could underpin the excellent work that is happening at the moment through this Bill. It would not undermine the excellent work that is currently done, as the Minister suggested it would. It would make a positive contribution to the lives of young carers.

The duties in the Bill that would require parts of the NHS to identify carers are also critical. Carers in Lewisham told me that they face a constant battle to get the support they need from various different parts of the public sector—the council or different parts of the NHS. They spoke about the lack of join-up between hospitals, GPs and councils. If we have the duty to identify carers, hopefully that will foster better working between those different parts of the public sector. A survey conducted during carers week found that two in five carers put off having medical treatment because of the pressures of caring for loved ones. Paying attention to the health of carers, as well as the individuals they care for, is important, and the Bill would do a lot to improve that.

This is an excellent Bill. Sadly, it is obvious that the Government are determined to defeat it. It would have made a small difference to part of the big jigsaw that needs to be solved in the social care crisis. It would have provided immediate, effective steps in getting support in place for carers. Sadly, it is obvious, from the position that the Government have set out, that these provisions will not go through immediately. I hope the Minister lives up to his word and works with my hon. Friend the Member for Worsley and Eccles South to find other ways for the provisions to find their way on to the statute book.

Adult Social Care

Heidi Alexander Excerpts

Monday 16th July 2012 Commons Chamber

[Paul Burstow]

My hon. Friend is absolutely right to highlight that issue, which the Low Pay Commission has commented on over a number of years, including before this Government came into office. In our White Paper, we make it very clear that local authorities, as the commissioners of such services, must be mindful of their responsibilities in ensuring that the resources they provide to providers are sufficient to allow them to fulfil their legal obligations.

[Heidi Alexander (Lewisham East) (Lab)]

The Minister talks about the financial pressures faced by local authorities in providing care to elderly and disabled residents, but is he aware that the cost to local authorities of self-funders who have to fall back on the state is in the region of £1 billion a year? Does he agree that that is a very unpredictable thing for local authorities to deal with? What proposals does he have to help local authorities in that regard?

[Paul Burstow]

I am grateful to the hon. Lady for her question, because it allows me to talk about some of the points I think will directly address it. Reform of our care and support system is about more than just who pays for care; it is also about some other very important issues. A central proposition in the White Paper we published last week concerns the move from a service focused on managing crisis, and often not doing so very well, to one focused on supporting people’s well-being by concentrating on early intervention and prevention. That is why, alongside the White Paper, we published a draft Bill that will underpin the reforms we intend to make, consolidating, simplifying and modernising the legislation. The Bill sets out for the first time in statute some very clear governing principles about how decisions are made in social care, focusing on people’s well-being and living by the idea set out by our first White Paper in government of “No decision about me, without me”.

The Bill sets out a number of important changes that go to the heart of people being able to plan, prepare and have proper choice about the care available to them. First, it makes it a requirement for local authorities to ensure that there is a universal offer of information and advice so that people can plan and prepare. Secondly, it requires for the first time local authorities to focus on prevention. Thirdly, it requires a sufficiency of quality care so that choice is available to people locally. Fourthly, it requires integration and co-operation not just between the NHS and social care but between those agencies and housing.

The Bill will not only do that; it will simplify the point of entry into the state system. It will ensure consistent national eligibility and, for the first time in Government legislation, will ensure that there are rights for carers not just to an assessment of their needs but to support for those needs. It will also deal with the often mentioned issue of protection from disruption when people move from one part of the country to another or when a child moves from children’s services to adult services. It will guarantee continuity of services, which is not currently provided for.

Personal budgets, which were started by the Opposition but have not stuck well because of the legal framework, will for the first time be given a clear legal basis. I am delighted to say that whereas when this Government came to office in 2010 we inherited 168,000 people receiving personal budgets, by March of this year 432,000 people were benefiting from them. There will also be clear legal duties on the NHS, police and councils to safeguard people.

At the heart of our White Paper reforms is the notion that we need less variability on quality, to ensure that providers are responsible for driving up quality and accountable for doing just that, and to have more and open information about the quality of provision. That is why our provider quality profiles will provide that information in a way that will allow people to compare and rate providers for the first time and why we are putting an extra £32.5 million in to support those services.

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[Sarah Newton (Truro and Falmouth) (Con)]

I am delighted to follow the hon. Member for Scunthorpe (Nic Dakin), as I completely agree that this issue is about leadership. Some of my hon. Friends alluded to a better-tempered debate, such as the Back-Bench business debate, to which all parties made thoughtful contributions, based on a great deal of expertise from different walks of life—whether from people in the medical profession, those who had spent their life in social services or those who had a personal point of view from being a carer. We heard some heartfelt contributions in that debate, so I think we are united in the desire to do something about this issue.

What I have found deeply disappointing about today is the fact that this debate was called in the first place. There was significant and genuine desire by this coalition Government to solve once and for all this problem that everyone agrees needs to be solved. Everyone agrees that it needs cross-party support—for reasons that are obvious to anyone sitting in the Gallery or watching this evening’s debate and to all the various voluntary organisations that have been very substantially misquoted or very selectively quoted this evening. There is a unity of purpose, but it is not being served by the Opposition who are tabling Opposition day debates, falsely dividing the House.

If the Opposition were to put their efforts into working closely with the two parties that form this coalition to come to a sensible solution, I believe that measures would be in the White Paper, but we are still seeing sledging and negative comments from Opposition Front-Bench Members as we have seen all day. It is deeply disappointing that the Opposition are so thoroughly letting down the people whom they claim they represent. I do not believe it is too late, and I really urge them to get back to the table and to be more positive about the steps that the Government are taking—[Interruption.] Here we go again; I cannot even finish a sentence without Opposition Members chuntering.

The fact is that I worked very closely with a number of Opposition colleagues. Various Members have talked about the very good work we did in the inquiry led by the all-party group on local government that looked at this issue. There was an all-party agreed proposal that identified many measures—which the Government have picked up in the draft White Paper—that we can achieve together. The effort should be focused on what we agree on, so that we can offer the reassurance that is needed by the desperately worried people all around the country that have been quietly identified this evening. People are worried not only about the social care system now, but the social care system in the future. We should be reassuring these people and giving them hope that this House has the necessary combined will and determination. I do not think any of us want to face the electorate at the next general election saying that this problem has not been solved.

As to the timetable, yes, I would love to be able to stand here today and congratulate the Government on finding every penny to fund a long-term solution. If we can get the cross-party talks into gear in September, we should be able to put in place the mechanism that, as confirmed by the Secretary of State, could be built into a Bill and put before Parliament. When all parties have agreed on how this is to be funded—as many people have rightly said, it will cost billions of pounds every year and we are in a very difficult financial situation, so all parties must agree on how those billions can be found—there is every possibility that such a Bill will get through Parliament and, when next year’s comprehensive spending review is developed, the money will be found.

Yes, it is frustrating if we have to wait another year or 18 months. Before I entered the House, I spent the best part of my adult life working for Age Concern England and for the International Longevity Centre in the UK, coming up with solutions that previous Governments certainly kicked into the long grass, so this is our best hope in a generation.

[Heidi Alexander]

I respect the hon. Lady’s work on this issue, but does she recognise that there is almost universal agreement outside the House that the big disappointment is that there were no proposals last week on how, in the longer term, we provide the funds that we all want for care for the elderly and those with disabilities?

[Sarah Newton]

I accept that there is genuine disappointment, but people equally understand that all parties in the House must be committed on where the billions of pounds each year will come from, so that the proposals are sustainable for the long term, and so that people can save and invest without fear of the rug being pulled from beneath them.

The proposals are a sticking plaster—there is no doubt about that—but if only people could hear the facts, they would appreciate that more money is being put into the system while the problem is being resolved for the long term. It is not true that all councils are cutting back. Cornwall council has not cut its adult social care. It is working in extremely innovative ways with the NHS and the voluntary sector to ensure that services are improved. I do not accept the shroud waving from Opposition Members, who say that every part of the country is in crisis.

Care and Support

Heidi Alexander Excerpts

Wednesday 11th July 2012 Commons Chamber

[Mr Lansley]

I will not attempt—not least because of time—to give an analysis of the difficulties that have been experienced in Scotland. From my point of view, I had understood that what we have set out to do in the White Paper is very much to ensure continuity of care, so that when people move—certainly in England, for which I am responsible—local authorities have a duty to ensure continuity of support. If we can make it so that this happens across the United Kingdom, I am absolutely open to having the discussions necessary to do so.

[Heidi Alexander (Lewisham East) (Lab)]

The Health Secretary has spoken about the catastrophic costs that face some older adults suffering from dementia. My nan was one of those people. She had to sell her home and spent more than £100,000 on her care costs. Under the loan scheme proposed by the Government today, would somebody like my nan not just end up paying more for the costs of their care? Can the Health Secretary also clarify whether the interest payments would eat into the small amount of money that people like my nan can pass on to their families?

Mental Health

Heidi Alexander Excerpts

Thursday 14th June 2012 Commons Chamber

[Heidi Alexander (Lewisham East) (Lab)]

I want to keep my remarks quite brief, because I know that many other hon. Members are keen to speak. Let me start by apologising to the hon. Member for Loughborough (Nicky Morgan) for not being in the Chamber for the start of the debate. I heard some of her thoughtful and comprehensive remarks on the television before I got in here, and I congratulate her on securing this debate. May I also say how powerful and honest the speeches that we heard from the hon. Member for Broxbourne (Mr Walker) and my hon. Friend the Member for North Durham (Mr Jones) were? I echo what the Minister said earlier, which is that this place is often at its best when people speak from their personal experience, rather than quoting statistics from briefings that we have been sent or things that we have read in the newspaper. It reassures everyone outside this place that we are also human beings, as well as Members of Parliament.

I have little expertise in this matter. Having said that, I have a close family member who has suffered obsessive compulsive disorder and psychosis in the past, and I have two very close friends who also suffer from OCD. I know how difficult it can be for them to overcome some of the challenges they face, so I think it is important that we have this debate today. I want to focus on the huge challenge of providing high-quality mental health services in what are difficult economic times. Given the tone of the debate, I do not want to turn this into a piece of political knockabout, but I do want to speak about the reality of the situation in my constituency, where a number of mental health facilities either are threatened with closure or have already been scaled back.

The shadow Secretary of State for Health spoke earlier about how the mental health system is somewhat separate from the rest of the NHS. However, the mental health system is also facing considerable budgetary pressures—just as the rest of the NHS is—which is having an impact on some of the people we represent. During the parliamentary recess I visited a continuing care home for elderly mental health patients which is wholly funded by the NHS. The patients there are elderly people, often in their 60s, 70s or 80s, who have been sectioned and who have significant mental health needs, in terms of both medical and care support. The centre, in Granville Park in Lewisham, is threatened with closure. The service is excellent and the care provided is exemplary, and the families of the people who live there are incredibly concerned by the proposal to shut the unit down. South London and Maudsley NHS Trust is consulting on the closure. It claims that it has too many beds of that kind and says that it wants to scale back provision in Lewisham.

My constituents know that many more elderly people have significant mental health needs so it is hard for them to understand why a mental health centre should be closed. I have to say that the way in which the consultation has been conducted is far from perfect. Parts of it just do not make sense. I have raised my concerns with the PCT and the South London and Maudsley NHS Foundation Trust.

Also threatened with closure are therapeutic care services for adults who have much lower mental health needs. A fantastic centre, known as the network arts centre in Lee, has been threatened with closure. I hope that the South London and Maudsley NHS Foundation Trust will find a way to maintain the provision by setting it up as some form of social enterprise. This is a place where adults with mental health needs—perhaps not as significant as others’, as I said—can come together and enjoy arts-based therapy in a setting that helps them to take the next step towards their recovery. I am hopeful of finding a way through that situation, but when services like this are threatened with closure, it is a matter of huge concern to the people who use them.

I said that I would focus my remarks on the challenge of providing high-quality mental health services in difficult economic times, and the budgetary pressures faced by public services is one of them. Another is the greater uncertainty that individuals themselves face, which some hon. Members have touched on. A few weeks ago, I visited Mencap in Lewisham and met a group of people who were primarily carers for people with mental health difficulties. The questions they wanted to ask me were about the work capability assessment for the employment and support allowance; they wanted to ask me about the process their loved ones would have to go through in transferring from disability living allowance to personal independence payments; they wanted to ask me about the changes to local council provision of day centres. What struck me was the great deal of uncertainty in the lives of people living with mental health problems and the people who are caring for them.

We heard from the shadow Secretary of State about the importance of getting advice and support to people in difficult times, and he mentioned the miners in Easington. That brings it home that we all—the Government and councils—need to recognise the importance of getting that local advice and support to people when they face this uncertainty, which only adds to people’s stress and problems.

The mental health charity Mind sent me some details about its information line. It told me that in the last 12 months, it had received 40,000 inquiries, but that unfortunately, because of the pressure it is currently under, two out of five of those calls went unanswered. Since the start of recession, Mind has seen a 100% increase in the number of calls relating to personal finances and employment. We need to understand the worries of people out there, and find a way to do more to recognise the importance of the local services that provide support and assistance.

I said that I would be brief as others wished to speak. I think we have had a thoroughly excellent debate and I congratulate those who made it happen. I look forward to hearing the remaining contributions.

Oral Answers to Questions

Heidi Alexander Excerpts

Tuesday 12th June 2012 Commons Chamber

[The Minister of State, Department of Health (Mr Simon Burns)]

The Department is currently reviewing updated lists of properties for proposed transfer. Thereafter, the boards of the sending and receiving organisations will endorse the transfers and give their final approval in the next few weeks to allow the legal transfer process and human resources consultations to commence. The legal transfer of assets to either NHS providers or NHS Property Services Ltd will take place on 31 March 2013.

[Heidi Alexander (Lewisham East) (Lab)]

T7. We have learned today that public satisfaction with the NHS has fallen dramatically. We also know that satisfaction with GP services has fallen for the second consecutive year, and that satisfaction with accident and emergency services is going down by 7% each year. The Prime Minister promised that the NHS would be his priority. Is it not about time that this Government lived up to that promise?

[Mr Lansley]

We have learned no such thing. Indeed, we published on the Department’s website today a survey that asked people who had been looked after by the NHS how well they thought their care had been provided to them. It showed that 92% of the patients said their care had been good, very good or excellent. In my view, that survey of 70,000 patients who had received care from the NHS completely trumps a survey that asked 1,000 people what they might have thought about the NHS in relation to the media activity that took place last year.

Breast Implants

Heidi Alexander Excerpts

Wednesday 11th January 2012 Commons Chamber

[Mr Lansley]

I have no evidence of such behaviour on the part of other companies. My hon. Friend is right: PIP is only one of a number of suppliers, and in this country probably only one in seven breast implants were PIP implants. Other countries have looked at this, and across Europe the regulatory process should ensure the scrutiny of these implants, including proper testing. The European review must look at whether that surveillance, including unannounced inspections and appropriate testing, gives us the assurance we are looking for.

[Heidi Alexander (Lewisham East) (Lab)]

Yesterday, I was contacted by a constituent who had PIP implants inserted by the Harley Medical Group in 2006. She said:

“There is so much conflicting information at the moment, I feel as though I’m being pushed from pillar to post. To add absolute insult to injury nobody is keen on helping us, they are saying the NHS should help…or they say they will perform the procedures on us for an extra fee.”

Can the Secretary of State tell me precisely what further representations he will be making to private providers to ensure that all women get access to the advice and treatment they need?

[Mr Lansley]

We have been very clear about the advice we have given to women, and I hope that, through the NHS, any woman in those circumstances would go and see their general practitioner, who will have full access, from the chief medical officer, to the expert advice we have disseminated. I know that the Harley Medical Group has not shared with others the view that it can match the NHS’s standard of care; but given that, the professions are suggesting to surgeons that they should honour requests for replacement surgery free of surgical charge. I hope that gives a basis on which more of the private providers will now meet their full obligation of a duty of care.