Oral Answers to Questions

Heidi Alexander Excerpts

Monday 12th May 2014 Commons Chamber

[Paul Burstow]

I hope the hon. Lady will forgive me, but I will make some progress, just as the hon. Gentleman did earlier.

Amendment 11B concerns the Human Rights Act, and I thank Ministers for keeping an open mind and for listening seriously to the concerns raised by Lord Low and others, and to me and other hon. Members who were concerned that an opportunity was being missed to close a gap. Legislation under the previous Government partially but not completely closed the gap, as a result of which those cared for in their own homes did not have the benefit of Human Rights Act protection. The amendment, which was agreed without a vote in the other place, gives that protection. It is the end of a story of seven years of dealing with a gap in the law that was opened by a court judgment. I am grateful that, notwithstanding the difficulties of our bicameral parliamentary process, it has worked at its best on this occasion, because it has meant that concerns raised through the Joint Committee that I chaired, through the Joint Human Rights Committee’s report and by Members in the other place, have now been comprehensively addressed.

Having said that, will the Minister confirm that a person who avails themselves of provisions in the Bill that allow them, as a self-funder, to ask their local authority to arrange their care at the point at which they start to benefit from the means-testing arrangements, and therefore have some support from the local authority, will then be covered by the Human Rights Act?

I would also like to thank the Minister for listening carefully to what has been said at each stage in the passage of the Bill, in both Houses, in respect of the trust special administration regime. It is important to emphasise that the approach set out by the previous Labour Government recognised that trust special administration was a last resort. Earl Howe has emphasised that in the other place. He was very clear that there are powers available to the Trust Development Authority and to Monitor to intervene as necessary in order to avoid trust special administration ever being triggered in the first place. I commend to Members the passage in House of Lords Hansard in which he sets out clearly all the steps that would need to be taken:

“Trust special administrators would be appointed—and I make this point emphatically—only when all other suitable processes to develop sustainable, good healthcare have been exhausted.”—[Official Report, House of Lords, 7 May 2014; Vol. 753, c. 1496.]

It is worth picking up on the point made by the hon. Member for Copeland. Having been given the opportunity to chair a committee looking at the guidance, I think that some of the points he made in his amendments today are exactly the sort that ought to be given proper consideration in the guidance. I hope that he, other Front Benchers, and indeed other hon. Members who have experience of the only two trust special administration processes that have taken place to date, will offer the committee their views and insights so that we can ensure that the advice we give the Government on guidance is as good and as clear as possible.

As was made very clear in the other place, we are not talking about a power that will effectively enable a wholesale reorganisation of the health economy. The Bill is very clear that this is about those matters that might require necessary and consequential changes. The amendments that were agreed in the other place, without a vote, make it clear that the essential services of trusts that find themselves drawn into a trust special administration process will be a proper consideration in the decision-making process.

It is curious that the Labour party now seems to want us to look at access in a different way from the way in which the trust special administration process that it put in place provided for. In other words, why was there no test on access with regard to the trust that was in special administration under its arrangements? Why did that not matter then but does matter now?

I think that the Government have listened very closely to what has been said and changed the Bill in a way that reflects the concerns that I described on Report. We will have the chance to comment further on the guidance—I hope that the hon. Member for Lewisham East (Heidi Alexander) and others will offer input into that—which will give us another opportunity to ensure that it is as tight and effective as possible on those very rare occasions when it is used.

I hope that consideration of the Bill will be concluded today and that it will make the difference to well-being, as a central principle, and to parity between those who receive care and those who give it. That is what the Bill does, and they are great things, and it is about time that they were on the statute book.

[Heidi Alexander (Lewisham East) (Lab)]

My hon. Friend the Member for Copeland (Mr Reed) has already set out the case for the Opposition’s amendment in lieu of their lordships’ amendments regarding the TSA regime, and I wholeheartedly agree with all that he said.

I would like to focus my remarks on why I believe that their lordships’ amendments do not undo the damage that lies at the heart of clause 119. While some people—I would probably include the right hon. Member for Sutton and Cheam (Paul Burstow) in this—seem to think that their lordships’ amendments are something of a cause for celebration, in my view the changes fall far short of what is really needed, which is the complete deletion of clause 119. Even with these latest amendments, clause 119 removes the legal protection for hospitals that face the axe because they happen to be located next to a failing trust that has been placed into administration. We know that this legal protection was vital in the case of Lewisham. The Government, having been told by the courts that they broke the law, are now simply changing the law so that in future they can close much-needed services in successful hospitals to deal with financial problems in others.

It has been suggested that the Lords amendments to clause 119 arose from discussions sparked off during debate on Report in this place. Yet the new clause we discussed then, which was tabled by, but then not supported by, the right hon. Member for Sutton and Cheam was very different from what is before us today. Of course, we all remember what happened last time: the Lib Dems were simply bought off with the offer of chairing a committee. It is therefore worth comparing what we discussed on Report and what we are debating now. If I recall correctly, the new clause that the right hon. Gentleman had in his name a month or so ago proposed that the commissioners of services in hospitals that fall outside a trust in administration should have, in effect, a power of veto over recommendations put forward by an administrator.

[Paul Burstow]

No, it did not. It provided for parity of esteem between commissioners of affected trusts compared with the commissioner of the service that was failing.

[Heidi Alexander]

I am grateful for the right hon. Gentleman’s intervention. I pressed him on this very point on 11 March, when I asked whether his new clause

“would provide a direct veto to commissioners of services at a hospital located outside the trust to which an administrator has been appointed.”

He responded:

“That is the intention, so the new clause has been drafted to have that effect.”—[Official Report, 11 March 2014; Vol. 577, c. 244.]

The new clause proposed in March—we had a full debate and discussion about it—suggested that if the commissioners were content with the proposals put forward by a TSA, full public and patient consultation would kick in, whereas if the commissioners were not content, they would call a halt to the process. As I said, I pressed the right hon. Gentleman on that, and he was clear in the remarks that he made at the time.

That is not what we are debating now. The amendment that was passed in the other place last week gives statutory consultation rights to commissioners of services in hospitals that fall outside the trust to which an administrator has been appointed. It suggests that changes to essential services that are proposed by the administrator but delivered outside the failing trust should not be caused harm, while seemingly leaving the definitions of “harm” and “essential services” to NHS England. The amended clause states that, should there be a difference of opinion between commissioners, NHS England will act as some sort of referee and have the final say.

I contend that what we have before us today is very, very different from what was mooted in this place on Report. The changes to the Bill that the Government have introduced in the Lords are minor at best, and confusing and irrelevant at worst.

[Paul Burstow]

indicated dissent.

[Heidi Alexander]

The right hon. Gentleman is shaking his head, and I can see that he disagrees with me about this, so let us look at the committee which has been set up and which he is chairing. Is it actually going to make any difference? My fear is that it is just camouflage for the fundamental damage that will be caused by clause 119. The committee will supposedly look at the rules that govern the use of the trust special administration regime. The most important rules that govern the use of the TSA regime are being set today, in this House and by this Bill.

[Paul Burstow]

I am grateful to the hon. Lady for giving way; she is being very gracious. The reason the Lords amendment is important is that it makes it clear that essential services in other trusts are now relevant to the guidance at which my committee will be looking.

[Heidi Alexander]

One person’s definition of “essential” might not be the same as that of another person.

The Lords amendment tinkers at the edges of clause 119. Although it offers some marginal improvement on the Government’s original clause, it does not go far enough. I would vote for deletion again if I could, but parliamentary procedure does not afford me that opportunity. There is no doubt in my mind that this clause, even with the latest amendment, will allow more fast-track hospital closures in future. It removes the protection that existed in law, which allowed Lewisham council and the Save Lewisham Hospital campaign to take a case against the Government and win.

The latest amendment may guarantee another layer of consultation, but it contains no overall guarantee that services will not be closed at successful hospitals to balance the books elsewhere. Is the Minister or the right hon. Member for Sutton and Cheam able to say unequivocally that had this amended clause been on the statute book at the time of the TSA regime in south London, the future of Lewisham’s A and E and maternity service would have been secure? They cannot, because it is not the case.

In conclusion, I do not accept that their lordships’ amendment provides the protection that some believe it provides. The amended clause still extends and augments powers for TSAs and NHS bureaucrats. Even with the increased checks and balances contained within their lordships’ amendments, the TSA process is still a chaotic and rushed mechanism for closing hospital services. It plunges local health economies into desperate uncertainty and takes power away from the public and clinicians.

I do not believe this is the way to make the sorts of changes our health service requires to meet the challenges of the 21st century. I have maintained that position throughout the passage of the Bill and I make no apology for sticking to my convictions to the end. The public do not want more fast-tracked hospital closures, but this Bill legislates for them.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

Before I turn to the amendments, I want to put on record my thanks to hon. Members for their contributions to today’s debate. I also want to express my thanks once again for all the contributions made by hon. and right hon. Members throughout the passage of the Care Bill and, indeed, for the contributions made by noble Members of the other place.

The hon. Member for Lewisham East (Heidi Alexander) made a characteristically robust contribution in standing up for her local health care services. I also pay tribute once again to the contribution made by my right hon. Friend the Member for Sutton and Cheam (Paul Burstow), not only today, but at the Bill’s inception, during its scrutiny by the Joint Committee and throughout its passage through this House and the other place. He has done a tremendous amount of work to ensure that the Bill is much better than it used to be. He deserves considerable praise for what he has done and the help he has given the Government in securing a Bill that is not just fit for purpose, but which will make significant changes and improvements to our health care system.

It is worth bearing in mind that the Bill represents the most significant reform of care and support in more than 60 years, putting people and their carers in control of their care and support for the first time. The Bill will also put a limit on the amount that anyone will have to pay towards the costs of their care. It is a very big step forward and one that was long overdue. The Bill also delivers key elements of this Government’s response to the terrible events that took place in Mid Staffordshire and the recommendations of the Francis report by increasing transparency and openness and helping to drive up the quality of care across our NHS and social care system. I am pleased that the Government were able to table amendments that have been accepted in the other place, and I hope that those amendments will enjoy support in this House today.

Before I turn to the substantive amendments tabled by the hon. Member for Copeland (Mr Reed), I want briefly to address the points made about human rights legislation and the issue of direct payments. It is important to highlight that like clause 48 of the Bill, as originally drafted, and section 145 of the Health and Social Care Act 2008, which was the preceding provision, Lords amendment 11B relates to providers of social care registered with the Care Quality Commission, covering personal care provided at home and in residential care settings. The amendment covers physical assistance—for example, prompting someone to take their medication, dress, eat, drink and perform activities of daily living—but not non-personal care. To answer the question asked by my right hon. Friend the Member for Sutton and Cheam, I am happy to confirm that when self-funders start to receive support from the local authority, they will indeed be covered by the Human Rights Act 1998.

To turn to the amendments tabled by the hon. Member for Copeland, it is worth highlighting to the House that, contrary to what he asserted, the TSA regime—let us remember that the regime was laid down by the previous Labour Government—has been substantively improved by the amendments made to the Bill. In particular, clause 118, which has been debated as clause 119 at various points, will extend the requirements on the trust special administrator to consult not just the public, staff of the failing trust and its commissioners, but other provider trusts, their staff and their commissioners, local authorities and local healthwatch organisations. There is therefore a comprehensive duty of consultation and engagement in the TSA regime, and that will be further strengthened by the amendments we are now discussing.

Amendment (a) to Lords amendment 40B and amendment (c) to Lords 40C amount to wrecking amendments and, as I shall outline, amendment (b) to Lords amendment 40B is unnecessary and unworkable. Amendment (a) to Lords amendment 40B and amendment (c) to Lords 40C would mean that the recommendations of a trust special administrator could not restrict access to any services of another affected trust. Like previous ones, they are in effect wrecking amendments that would make it impossible for the administrator to do their job.

Both Houses recognise that the NHS is a network and that no hospital is an island, and have already agreed that clause 118 must allow the administrator to take a holistic view of the local health and care economy to find the very best solution for a failing trust. That is of course in the best interests of local patients. As my right hon. Friend the Member for Sutton and Cheam outlined in Committee, it is right that a trust and its patients in particular are not thrown to the wolves when the quality of care is unsustainable or letting patients down, but that a holistic and broader view of the local health care economy can be taken. That was the previous Government’s intention in setting up the TSA regime, and it is our intention now. The previous Government were not the first Government who did not necessarily make their legislation accord perfectly with the intentions they outlined in impact assessments for the TSA regime. That is why we are now in the position of having to correct and improve the regime through the Bill.

The amendments tabled by the hon. Member for Copeland would undo the effects in relation to the trust special administrator’s regard to the wider health economy, and they would reverse the effect of clause 118, such that the administration regime would not be able to create a complete and workable solution to intractable problems or failures of patient care in the NHS. I am sure hon. Members will agree that that would be entirely undesirable, and that it would not be in the best interests of NHS patients, who must be protected where a hospital cannot deliver safe or sustainable care.

Amendment (b) to Lords amendment 40B would give the trust special administrator significantly less time to finalise his or her draft recommendations about the future of a failing trust by requiring the publication of all correspondence between the administrator and commissioners at least 10 working days before publication of the draft report. Hon. Members will be aware that we have extended the time for the trust special administrator to draw up the report from 45 to 65 days and for the consultation from 30 to 40 days, because those processes need to be done properly.

I remind hon. Members that transparency is already built into such processes at every stage. The administrator is required to publish the draft report submitted to Monitor and is expected to include in it the commissioners’ statement in agreement or disagreement to the report. Following consultation, the administrator’s final report is submitted to Monitor for a decision. That report, which Monitor must publish and lay before Parliament, again needs to present to the regulator the views of all affected commissioners. The administrator is required to attach to the final report a summary of all responses to its draft report that were received during the statutory consultation. That would include the views of all affected commissioners as respondents and explain what consideration was given to those responses. There is full transparency at every stage of the process. Quite apart from being wrecking amendments, the Labour amendments are therefore completely unnecessary.

Armed Forces Restructuring

Heidi Alexander Excerpts

Thursday 23rd January 2014 Commons Chamber

[Mr Hammond]

First, my hon. Friend continually asserts, and I continually rebut, the idea that we are trying to replace 20,000 regular soldiers with 30,000 reservists— that is not what we are doing. We are restructuring the regular force; the regular force will be smaller. We will use civilians in a different way from how we have used them in the past. We will use contractors more effectively, learning the lessons, particularly from the US experience of using contractors to support combat operations. We will also use reservists, but it is simply wrong for him to suggest that this is a straightforward swap of 20,000 regulars replaced by 30,000 reservists. That is not how it works.

My hon. Friend knows very well the answer to the second part of his question: there is not the budgetary capacity to maintain the Regular Army at 102,000 while building the reserve to 30,000 by 2018. That simply cannot be done without imposing new and unwanted cuts elsewhere.

[Heidi Alexander (Lewisham East) (Lab)]

I listened carefully to what the Secretary of State had to say about individuals being made redundant just before their immediate pension point. What he failed to say, of course, was that for some long-serving officers this loss can amount to tens of thousands of pounds in forgone pension payments. Does he really believe that that scale of loss is consistent with the spirit of the military covenant?

[Mr Hammond]

Let me just be clear about what we are talking about, as although the hon. Lady may understand this, perhaps not all hon. Members do. When people reach their immediate pension point they can leave the Army, notwithstanding the fact that they may be only in their 40s, and take an immediate pension. When somebody is close to, but has not reached, their immediate pension point when they leave the Army through a redundancy, they receive an enhanced lump sum redundancy package to reflect that fact and they still, of course, retain their pension rights when they reach their pensionable age of 60 or 65, depending on what pension scheme they are in. We have looked at the alternatives and concluded that all of them would deliver at least as much unfairness to other groups, and that this is the fairest and most appropriate way to proceed.

Oral Answers to Questions

Heidi Alexander Excerpts

Monday 25th February 2013 Commons Chamber

[The Minister for the Armed Forces (Mr Andrew Robathan)]

We are committed to reducing—and, indeed, are reducing— the star count in the Ministry of Defence by 25%, which means those with the rank of brigadier and above. It is true that the number of colonels is higher than in 1990, but it has fallen by 80 since 1 April 2010, and some of the jobs that those officers do are specific to NATO or to defence engagements. For instance, some are defence attachés. We need all those jobs, and that is why we employ those people. However, my hon. Friend has raised a very good point.

[Heidi Alexander (Lewisham East) (Lab)]

T9. The Minister for defence personnel will know that for the past two months I have been trying to secure a meeting with him to discuss the financial losses faced by Army officers who are being made redundant shortly before their immediate pension point. To date, he has not agreed to such a meeting. Will he do so today? If not, can he tell me how members of our armed forces should raise their concerns with this Government about broken promises on their conditions of service?

[Mr Francois]

I recently wrote back to the hon. Lady on this precise subject. I hope she has received the letter—she is nodding, and says that she has. I have also written to Ms Jayne Bullock, who wrote to me originally, and to a number of other servicemen’s wives who have campaigned on the matter. I remind the hon. Lady and others who support the so-called taper model, which a number of people have argued for, that we used that model for redundancies up to 2005-06, when the previous Government abandoned it.

Armed Forces Redundancies

Heidi Alexander Excerpts

Tuesday 22nd January 2013 Commons Chamber

[Mr Francois]

That was, in a sense, several questions in one. With regard to recruitment offices, the armed forces, like many other organisations, have had to be aware of the way in which the world has changed. Many people who apply to join the armed forces now do so initially online, rather than walking into a recruiting office in the traditional way. Nevertheless, a number of people still use recruiting offices, so we have rearranged the profile of our offices around the country to try to adjust to life in the 21st century. My hon. Friend also asked about people in the regular armed forces who might be made redundant. Of course, one opportunity would be for them to rejoin as a member of the reserve forces, and we would encourage them to do that wherever possible.

[Heidi Alexander (Lewisham East) (Lab)]

On 31 December, I wrote to the Minister on behalf of a cross-party group of Members to request a meeting with him about the significant financial losses faced by Army officers who are made redundant shortly before their immediate pension point. Given the responsibility shouldered by those officers during their careers, will the Minister now agree to have that meeting?

Defence Personnel

Heidi Alexander Excerpts

Thursday 6th December 2012 Commons Chamber

[Heidi Alexander (Lewisham East) (Lab)]

I feel quite inadequate to follow the speech of the hon. Member for Beckenham (Bob Stewart). He and I are both Members of Parliament representing south-east London constituencies. It would probably be fair to say that we have very different political views, but after listening to the speech that he has just made, some of those political views become somewhat irrelevant, given what he said about his own experience in the armed forces, and what he and many others who serve in the Army, the RAF and the Navy see with their own eyes. I feel very honoured and privileged to have listened to the speech that he gave.

I shall make a brief contribution today. We have heard other speakers talk about important global issues relating to our defence forces, ranging from the withdrawal of troops from Afghanistan and their safety during that process to important aspects of the role of our defence forces in light of Britain’s emerging position in the world. I want to raise a specific issue about officers who are currently serving in our armed forces.

One of my constituents, Jayne Bullock, came to visit me a couple of months ago because her brother, who is a serving officer in the Army, had been issued with a redundancy notice earlier this year. He was given his redundancy date, which was only days before his immediate pension point. I understand that he will no longer be eligible to receive his pension immediately upon his redundancy, and that this represents a significant financial loss to him and his family. I understand that of the redundancy notices that were issued this summer, that situation affects about 70 or 80 serving officers.

We heard from the hon. Member for Beckenham the vital job that such officers do in our armed forces. The responsibility that goes with being an officer in our Army cannot be underestimated. They have to deal with situations such as that which the hon. Gentleman described. It is only right that those officers are given the pension that they are due. I believe that the compensation that has been arranged for them in some form of lump sum falls far short of what they would have received, had they got their pension at their immediate pension point.

Will the Minister, in his concluding remarks, explain to hon. Members what he plans to do about this problem in the future? Although it affects a certain number of people who received their redundancy notices this summer, the problem will continue as there will be further tranches of redundancies. Would it be possible not to make redundant those people who are less then 12 months away from their immediate pension point?

We are all here today speaking highly of our armed forces, but we need more than warm words. We need to put our money where our mouth is. Will the Minister look into the issues raised by the Pension Justice for Troops campaign that Jayne Bullock has established, and look at what else might be possible in respect of providing those individuals with appropriate compensation? I hope that if not today, then at some point in the future, he will be able to offer those service personnel some good news.

Oral Answers to Questions

Heidi Alexander Excerpts

Monday 11th June 2012 Commons Chamber

[Nick Harvey]

The hon. Gentleman has answered his own question. If one has had to balance the budget having inherited a £38 billion black hole, inevitably certain capabilities would have had to be deleted. I remind him that the previous Government were using alternative methods of providing maritime surveillance. They considered that such methods would be adequate for a two-year period, and we have concluded that they provide sufficient cover for a further period.

[Heidi Alexander (Lewisham East) (Lab)]

7. What recent assessment he has made of the armed forces contribution to implementation of security plans for the London 2012 Olympics; and if he will make a statement.

[The Secretary of State for Defence (Mr Philip Hammond)]

The armed forces recently conducted an extensive exercise to test their operational readiness to provide safety and security, in support of the police, during the Olympic and Paralympic games. The exercise achieved its objectives and I am confident that we are well placed to deliver this important role.

I am grateful to the hon. Lady for the constructive way in which she engaged with the Army on the air defence missile site at Blackheath in her constituency for the exercise, and to her constituents, the overwhelming majority of whom were supportive of it.

[Heidi Alexander]

The Secretary of State mentioned the proposal to site surface-to-air missiles on Blackheath as part of the Olympic security plan. It is my understanding that a final ministerial decision has yet to be taken. When will that decision be made, and will the Department be in direct contact with residents who live in close proximity to the proposed site to inform them of it?

[Mr Hammond]

The hon. Lady is right. We have received the military advice on the outcome of the exercise and Ministers will now consider it and make a final decision on the deployment of ground-based air defence systems. As you would expect, Mr Speaker, when a decision is taken, an announcement will be made first to the House, but I will ensure that the Army engages with residents who live in close proximity to the site to ensure that they are aware of all the ramifications of any decision to go ahead and deploy.