Carers

Huw Merriman Excerpts

Thursday 9th June 2016 Commons Chamber

[Huw Merriman (Bexhill and Battle) (Con)]

Thank you, Mr Deputy Speaker, for calling me to speak in this important debate. I thank my hon. Friend the Member for Eastleigh (Mims Davies) not only for securing the debate, but for bringing to the Chamber her powerful experiences and sharing them with us. I also want to thank the Minister for all that he does to ensure that carers are given the support they need and deserve.

I want to sign up to the suggestion made by my hon. Friend the Member for Chippenham (Michelle Donelan) that we should extend the pupil premium to all young carers. There are 160,000 young carers whose life chances are disadvantaged by the amazing duty that they perform. Extending the pupil premium to all those young people seems to me to be a very fair exchange for all that they do.

Looking at the other end of the age spectrum, 28% of my constituents in Bexhill and Battle are over 65. By comparison, the national average is 17%. Accordingly, I have a very high number of older carers in my constituency. That is what I want to focus my contribution on today. The 2011 census revealed that there are over 1.8 million carers aged 60 and over in England—almost 16% of the population in that age range. The number of carers aged 85 and over grew by 128% in the past decade, according to a report published last year by Carers UK and Age UK, and it is expected to double over the next 20 years, according to a Government report from 2014.

East Sussex has the highest proportion of over-85s in the UK. Again, that group will be highly pertinent to my constituency. Supporting this army of carers is absolutely essential if we are to ensure that our NHS continues to function. Given the Government’s welcome desire to support keeping people at home in their advancing years, rather than placing them in hospital, that support is even more important. I welcome the passing, by this Government when in coalition, of the Care Act 2014. The Act granted significant new rights to carers in England and placed duties on local authorities to ensure that support is delivered, advice is given and information is provided. It also placed a duty on NHS bodies to co-operate with local authorities in delivering Care Act functions, which, if the clinical commissioning groups in East Sussex can work as a whole, will lead to a “Better Together” integrated health system in East Sussex.

I am conscious that the delivery of those rights is contingent on local authorities having the necessary financial resources in place. I welcome the devolution of business rates to my county, but the yield in East Sussex is low and the demands from a population with above-average ageing is high. Our county will need more time to deliver and more investment in infrastructure to attract new businesses to the coast if this is going to provide for carers and other groups who need local authority finance and support.

I welcome the new 2% levy that local authorities can apply to council tax, provided that it is spent on adult social care. While I champion the rights of carers within the home, many carers are caring for loved ones who reside in care homes due to complex or advanced needs. It is absolutely essential that those carers have the comfort of knowing that their loved ones will be well cared for when they are not in the home to deliver it. I have championed the care home industry, which features heavily in my constituency. Funding them properly via the new 2% levy will, I hope, result in better Care Quality Commission ratings than those that have been awarded following recent investigations.

Across East Sussex, 60% of our care homes were found to be inadequate or needing improvement. It concerns me greatly that, because of these poor ratings, many of our carers may choose to soldier on at home when a care home would be the better choice for their loved ones. All the care homes that I have visited in my constituency have been fantastic. It is important that those that need to improve do so with the extra funding that the Government have procured.

In a rural constituency such as mine, social isolation can be a particular concern. This is exacerbated for older carers looking after loved ones. According to a report published in 2011, more than two thirds of older carers reported not getting breaks away from caring at all, with a further third getting a break only once every two or three months, or less. Let me therefore take this opportunity to thank all those constituents who do so much to give carers a break. While I am at it, let me name-check my mother and my two sisters, who regularly host teas at home attended by carers who do not get the chance to get out of the house and get looked after by someone else for a change. While it is right to look to the Government to be the ultimate support, very often it is the community and their acts of kindness, via visits, conversations, moral support and basic errands, who improve the welfare and wellbeing of our elderly carers. I salute all those who do it.

I am keen for the Government to look at the following suggestions that were made to me by the fantastic Care for the Carers team in East Sussex. First, we should help national partners reach more carers. Would it be possible to make it a duty for the NHS to identify carers, in the same way that the Care Act does for local authorities? Secondly, we should ensure that carers have good support. Would it be possible to ensure that local authorities do not charge carers for the support that they are entitled to? East Sussex is currently not charging carers, which I recognise and celebrate.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

I thank the hon. Gentleman for his point about the NHS having a duty to identify carers. I have tried three times to introduce that in a private Member’s Bill, so I am really pleased to find support for it among Conservative Members.

[Huw Merriman]

I am pleased, as a novice in the House, that there is agreement across the House on that cause.

Thirdly, there should be help for carers in complex situations—those caring for people with dementia or mental health problems. It seems to me to be an obvious ask to promote good practice recommendations to commissioners and health professionals and to promote it in national policy making.

Finally, I thank and express huge admiration for all those who care for others in my constituency and beyond. I know that they seek little praise, but it is right that we should praise them this afternoon.

Defending Public Services

Huw Merriman Excerpts

Monday 23rd May 2016 Commons Chamber

[Huw Merriman (Bexhill and Battle) (Con)]

It is a pleasure to follow the hon. Member for Sheffield Central (Paul Blomfield) in this debate on the Queen’s Speech. In the time afforded to me, I want to focus on the defence of three key public services—the NHS, schools and the BBC.

On the first, 28% of my constituents in Bexhill and Battle are over the age of 65, versus a national average of 17%. There are forecasts that the national average will reach 25% by 2050, which is a cause for great celebration. However, as a result of an ageing population, my constituency has the highest rate of dementia in mainland Britain. East Sussex has the highest percentage of over-90s in the UK, and is predicted to be able to make the same claim for the over-75s and the over-85s in the years to come. Accordingly, the state of the NHS is of particular importance to my constituents—not just those who rely on it in their older age, but those who need to access it across the age spectrum.

I have ruptured, and this week re-ruptured, my Achilles tendon, so I have been something of a drain on NHS resources. It has, however, given me the opportunity to witness, at first hand, the NHS and the first-class people who work in it. I want to say a huge thank you to every clinician and employee for what they do for my constituents. Their clinical expertise, dedication and care make me incredibly proud to be British and equally determined that we should listen to their ideas for and concerns about the NHS.

The decision by our junior doctors to call the first ever all-out strike was a deeply depressing outcome of the breakdown of the contract negotiation. On the day of the strike, I went to the picket line to meet the junior doctors who had looked after me following my first Achilles tendon rupture. I spent an hour listening to the concerns of those junior doctors. Some concerns were linked to their personal circumstances and their feeling that it was unfair, in their position, to have only the same rights as a fixed-term employee when it came to the unilateral imposition of contract terms. Other concerns were about their workplace and their ability to do their best in the face of increased demand from patients.

On that day, I was asked whether I would write to the leader of the BMA and the Secretary of State for Health and pass on those junior doctors’ desire for talks to resume and a negotiated settlement to be reached. I duly did so and was delighted when talks were subsequently held and a resolution was reached. I hope that the junior doctors will consider the settlement negotiated by the BMA a fair compromise that is worthy of acceptance, and I thank the Secretary of State for going the extra mile.

It is clear to me that, once the contract is finally negotiated, we should have a grown-up debate about the future of the NHS. Can we expect it to meet the needs of an ageing population, carry on purchasing ever more expensive drugs, deliver innovative treatment and cope with an increasingly obese population when we as a nation only put 8% of GDP towards health? In the French and German model, it is 11% of GDP. Inflationary patient demands on the NHS equate to a 4% increase per annum, yet the increase in spending, welcome as it is, is running at 2%. This Conservative Government have spent record amounts on the NHS, but does the current situation make it reasonable that those who fail to take individual responsibility, or who waste the time of our doctors or nurses or disrespect them, should pay towards their care or be denied it? I welcome the Government’s decisions to introduce a new Bill to tax sugar content and to strengthen existing rules to ensure that all health tourists from abroad pay for their treatment. However, we could also look closer to home in expecting patient responsibility in return for treatment.

I am intrigued by the requirement for the NHS to deliver £22 billion of savings at the same time as introducing a seven-day NHS. If we are to have a fully functioning NHS on a Sunday, it means absorbing all the costs of running and supporting such a service. I ask myself whether I want to have my physiotherapy on a Sunday, and the answer is that I do not.

[Dr Murrison]

I share my hon. Friend’s confusion, but in fairness, it is only right to point out that weekend working means meeting the four key clinical standards that Sir Bruce Keogh outlined. I fear that my hon. Friend will probably not be getting his physiotherapy at the weekend.

[Huw Merriman]

I thank my hon. Friend for that clarification—it turns out that I will be satisfied, then. However, the point is that when we talk about a truly seven-day NHS, we need to be absolutely clear what services there will be on a Sunday. Those who work in the profession want the flexibility and freedom to work hours that allow them to experience an enriched life and to raise a family. They want to succeed in the workplace and to make a contribution in their field. If they cannot, they will decide to work in another profession. I hope that that will be taken into account when changes are made to Sunday operating practices.

From discussing the pressures on the modern-day NHS with Government, clinicians and managers, it appears to me that there are many shared views on patient safety and individual patient responsibility. Like most of my constituents, I yearn for the day when politicians and clinicians join together and recommend the difficult decisions that both parties know are required. Our NHS would be stronger for it, and our patients would be better served.

I turn to our schools. I was particularly pleased by the introduction of the new White Paper on education. The day after it was announced that schools would be forced to become academies, I spoke in this place about the need to allow good and outstanding schools to make their own choice. I am delighted that the Government have made that alteration, although rightly not for schools for which local education authorities are not fit for purpose or those that are no longer of a viable size.

That is not to say that becoming an academy is not a good idea for a school that wants to. I have just spoken of junior doctors’ desire to take control of their career and their destiny, and it strikes me that we now have a generation of headteachers who are no longer willing to be told what to do by their LEA but want to make their own decisions about how to run their school and whether to expand. It comes down to choice, which drives up standards. I hope that my local schools will consider making their own determination on expansion.

[Tristram Hunt]

The “Educational Excellence Everywhere” White Paper, published in March, states that every school will become an academy. Is that choice?

[Huw Merriman]

The choice to become an academy will be there for every school that wants to take it. As has been made clear, if the LEA is no longer fit to deliver and is not functioning properly, a school will be required to do so. [Interruption.] I see that the hon. Gentleman is now having a separate conversation having asked me that question, but I have done my best.

Somewhat unusually, I have a high proportion of Church of England and Roman Catholic schools in my constituency. For academisation to work in my community, a local cluster of schools forming a multi-academy trust looks the most feasible idea. I welcome the Department for Education’s guidance to help the Church to become a part of that, and I look forward to working with my diocese to ensure that it is able and willing to do so. Without it, the advantages of academisation will be hard to deliver.

Overall, I am incredibly excited by the proposals contained in the White Paper, which will deliver fairer funding to a rural constituency such as mine, where our spend per pupil is almost half of that in parts of London. They will also give headteachers more freedom to train and recruit, which is a particular challenge in a rural constituency such as Bexhill and Battle.

In the past 12 months I have visited a school a week in my constituency and have been fortunate enough to spend time with my brilliant local heads and teachers. I welcome the Government’s ring-fencing of schools spending, but I am conscious that schools are addressing a funding gap following increased national insurance and pension contributions and the advent of the national living wage. The more power my local schools are granted to determine how to spend their budget, the better they will deliver education. I look forward to playing my part in helping the education Bill become law.

I confess that I am a happy and enormous supporter of the BBC. The programme for its future that the Government are seeking to deliver is intended to promote social mobility and empower people from all backgrounds to succeed to their true potential. Having failed my 12-plus exam and attended a secondary modern school, I found that much had passed me by in the years between 12 and 16. It was only when I went to a further education college for my A-levels and experienced independent thought and working that I discovered a love of learning. Having the BBC as an additional source of learning and inspiration was essential in getting me to university. This rarely comes up in debate, perhaps because many in positions of influence had the benefit of a more rounded education, but for those of us who have had to grab every opportunity to better ourselves, the BBC has been an essential rung on the ladder in the advancement of social mobility. Having got involved in discussions on the details, I am delighted that the Government’s charter renewal will preserve and improve the BBC, and I thank them for that.

The programme that the Government outlined in the Queen’s Speech is evidence that they will fight to defend public services, not just by preserving all that they do well, for instance through the BBC’s charter renewal, but by introducing reforms that enable more innovation and provide more power for decisions to be taken locally, such as through the education White Paper. I look forward to supporting the Government when difficult decisions on reform have to be made for the benefit of my constituents in Bexhill and Battle.

World Autism Awareness Week

Huw Merriman Excerpts

Thursday 28th April 2016 Commons Chamber

[Huw Merriman (Bexhill and Battle) (Con)]

Although I am aware that my right hon. Friend the Member for Chesham and Amersham (Mrs Gillan) is not in her place, I start by thanking her for her work in this area. I am aware from my constituents that she has bestowed so many rights on them through legislation and that she has started this whole chain. I pay tribute to her and give her my thanks on behalf of my constituents.

I was elected only 12 months ago. Before the election, I had no direct experience of autism. On being selected, a group of mothers who had autistic children or children with Asperger’s reached out to me and explained how difficult their lives were, what they needed and how hard it was to navigate through the system. I made a pledge to do all I could to help people with very special children.

On election, I was faced with one of my first cases. A mother told me how she had applied to the Driver and Vehicle Licensing Agency for a blue badge because her child, who was six, had such a difficult condition. Whenever he saw anybody in the street, he just collapsed on to the floor. As a result, she had to carry her child everywhere. She applied for a blue badge, but because the DVLA’s tick-box system did not register any physical disability her application was turned down. We had to fight on her behalf. We were fortunate to be able to go in at a higher level and get somebody to understand the complex needs of her child. That taught me that those with autism, who have such unique and differing needs, do not fit into the tick-box system. I ask the Minister whether he can find some way of ensuring that anybody who works in a tick-box employment system—or a Q and A system—has autism training. It is often impossible for the families of autistic children to navigate the system.

Since then, I have dealt with more cases, and I have been involved in some very special groups dealing with autism in my constituency of Bexhill and Battle. I have two points on which I wish to focus: education and the workplace.

I am fortunate that in Bexhill we have two very special schools that cater for those with autism, as well as those with other conditions. The first is Glyne Gap School, a day school which is rated “outstanding” in all areas. The Ofsted report in 2015 referred to

“the inspirational leadership of the headteacher and assistant headteachers”,

with the result that

“all staff have an uncompromising focus on the quality of learning for all pupils.”

Surely that must be the goal of every school that looks after children with autism.

The second school is St Mary’s, also in Bexhill, where young people do not just learn, but live. The school has had a difficult time owing to a crisis of confidence in the chief executive. I visited the school the day the chief executive left and I was amazed at how caring, supportive and dedicated those teachers were to children with incredibly difficult and challenging conditions. I take my hat off to all who work in that environment. The school still requires improvement, but I believe that better times are ahead.

Constituents have raised with me a number of points in respect of schools. I have two very good schools but, as I mentioned, autistic children have individual and different needs and often need a different school to cater for them, but my council, East Sussex County Council, tends to favour just one school. As a result, it is very difficult for parents to get their choice of school. I would like to see more freedom. I welcome the fact that we have trained 90,000 teachers in autism, but another comment that I have had is that a child was felt by their parents to have been isolated and restrained, rather than experiencing positive handling strategies, which Team Teach and other strategies provide. As has been mentioned, my constituents struggle because of the long time it takes to get a diagnosis.

I have only 30 seconds left, but I want to mention employment. Tomorrow I have a jobs and apprenticeships fair, and I am delighted that St Mary’s in Bexhill will be bringing its young people down so that we can try and get them apprenticeships. I am fortunate to have in my constituency an organisation called Little Gate Farm, which helps people find employment opportunities. It tries to bridge the gap between school and employment in rural communities. I salute what that organisation does, and I salute what everybody does in my constituency for those very special and gifted people.

Mental Health Taskforce Report

Huw Merriman Excerpts

Wednesday 13th April 2016 Westminster Hall

[Huw Merriman (Bexhill and Battle) (Con)]

It is a pleasure to speak under your chairmanship, Mr Wilson. I congratulate my hon. Friend the Member for Halesowen and Rowley Regis (James Morris) on securing the debate. It was a pleasure to listen to the right hon. Member for North Norfolk (Norman Lamb) and the Minister speaking at the launch of the mental health taskforce report last month.

Since I was elected, constituents’ concerns about mental health provision have caused me to immerse myself in the issue and further my education on this most harrowing of subjects. I want to focus on concerns about early-stage treatment for young people. At Prime Minister’s questions recently, I mentioned visiting three families in one day in my constituency, each of whom had a child who they felt had not been given the early-stage intervention that they expected by child and adolescent mental health services. I asked the Prime Minister for more focus on early-stage treatment, so that young people do not find their condition becoming more acute. I work closely with my local CAMHS team, and I have the highest regard for the many excellent specialists who do their best. However, it is of concern to me that constituents face lengthy waiting times and that some have been moved from pillar to post when receiving treatment.

Building up trust is a key ingredient in successful diagnosis and treatment. I hear stories about young people finding the courage and trust to open up about their condition only to find that there is a new practitioner at the subsequent session, and it disappoints me to find that the young person has then regressed because of the change in personnel. I would like a commitment to treatment being given on a fixed one-to-one basis. If we can do that for maternity provision, surely we can do it for mental health treatment.

At the mental health taskforce launch, I was buoyed by the commitment by the Minister and the chief executive of NHS England to implement the excellent report. I pay tribute to the chief executive of Mind, Paul Farmer, and his team for the review. An aspect of it that cheered me was the commitment to funds to ensure that our non-mental health NHS hospitals have adequate mental health expertise on site to deal with those who are hospitalised as a result of mental health issues or who have such a condition in addition to a physical illness. What drove my concern about that was the experience of a family in my constituency following a suicide attempt. The NHS staff did not have the ability to deal with the mental health condition and my constituent, a young man, was forced to wait until CAMHS staff could make their way over from another town miles away. I understand the need for specialist treatment, but it strikes me that there is a need for a culture change across the NHS, and that all staff should be trained to understand mental health and provide a basic level of treatment in the area. Specialisation in health is important, but if the NHS becomes overly specialised it can lead to a lack of general involvement in care for patients in such areas.

I welcome the news that the Government will fund 24/7 mental health provision in our hospitals, but I was somewhat alarmed at the suggestion by my local trust that the funding may not stretch far enough. I also want to ensure that that specific coverage will not mean that other NHS staff with the necessary levels of technical understanding and empathy feel that they are not empowered to help the many patients in hospital who need help with their mental health care in addition to their physical wellbeing.

Getting early-stage intervention right is a key part of getting proper diagnosis for people with a mental health condition and lessening the chances of acute difficulties. It is the most important investment not only for people’s welfare and wellbeing but to enable young people to fulfil their hopes and dreams in their careers and make something for themselves and their country. We should not misdiagnose young people who are suffering growing pains, and who need families’ and friends’ coaching and guidance to overcome the problems of adolescence. However, I have met too many young children who face a difficult future because their mental health condition was not treated at an early stage. I applaud the report and the Government’s response. They are leading the charge to ensure that we can support all who are affected by this terrible condition. I look forward to a better mental health service in the years to come.

Community Pharmacies

Huw Merriman Excerpts

Tuesday 23rd February 2016 Westminster Hall

[Huw Merriman (Bexhill and Battle) (Con)]

It is a pleasure to serve under your chairmanship, Mr Streeter. I congratulate my hon. Friend the Member for St Ives (Derek Thomas) on introducing this important debate.

Some 28% of my constituents, across our 200 square miles of East Sussex, are over the age of 65. Losing our pharmacies would affect all my constituents, but I am particularly concerned about the impact on the elderly and vulnerable. I spoke today with a pharmacist in the village of Ticehurst in my constituency, who told me about his concerns. First, he is concerned that the Government might cut 6% from his dispensing fees. Secondly, he is concerned that they might withdraw the £2,500 that all pharmacists are paid annually. Thirdly, he is concerned that the Government might impose a clawback, meaning that if a budget is overspent, pharmacists might be required to reimburse their fees. Fourthly, he is concerned that the pharmacy will have to cover the welcome introduction of the national living wage and the cost of new pension arrangements.

I understand that it is essential for the NHS to make savings—£22 billion over this term—and it therefore seems reasonable to expect the £2.8 billion pharmacy budget to contribute to that. The Government rightly point out that many of our pharmacies are situated in walking distance clusters, but I am concerned that the proposed funding changes, if not sensibly targeted, could affect not just pharmacies in clusters but the rural pharmacy that is miles from another one and more than just a dispensing chemist. Because a pharmacist knows his or her customers, he or she is able to advise them on solutions more cost-effectively than if they were to utilise the wider NHS, including GPs and A&E.

[Mr Steve Baker (Wycombe) (Con)]

In an unscientific Twitter survey, which I kicked off at the beginning of the debate, 62% of respondents say they would prefer to see a community pharmacist first. Does my hon. Friend agree that the Government should be clear when making their funding allocation about the extent to which people would prefer to make use of community pharmacists before they see GPs?

[Huw Merriman]

Much as I prefer to disagree with everything that is said on Twitter, I could not disagree with that particular scientific survey.

[Julian Sturdy (York Outer) (Con)]

My hon. Friend is making a powerful argument about rural pharmacies. A pharmacist in my constituency contacted me. He said that, if the proposed cuts go through, he will have to cut staff and the apprentices he is training, as well as reduce opening hours and stop the free services, such as the deliveries to housebound patients. The cuts would not just stop the important services that my constituents and many others get from rural pharmacies; it would also deeply impact on skills, and on skills going back into the services that we have to protect.

[Huw Merriman]

I very much agree with my hon. Friend’s point, and I can give another two reasons why pharmacists are so important. Like the post offices, our pharmacists also act as the eyes and ears for the welfare of certain vulnerable constituents. As a staple part of our village and town centres, pharmacies provide the footfall that allows our pubs, restaurants and shops to survive in an increasingly difficult environment.

I am not a deficit denier, and it would be hypocritical to be elected on the platform of balancing the Government books by 2020 and then to refuse to countenance savings in this area. It strikes me, however, that a better focus for efficiency is not the fees for dispensing, but the volume of drugs wasted by over-dispensing. For example, some drugs may be dispensed for a period of three months, only for the individual to change a course of treatment or stop treatment altogether. As soon as those drugs leave the pharmacy, they have to be used or destroyed. I wonder exactly how much money could be saved by dispensing for shorter periods of time.

Additionally, I find it extraordinary that pharmacists deliver NHS prescriptions free of charge to all who want that service. I understand why those who cannot collect their prescriptions should get them delivered, but to provide free delivery, effectively on the NHS, appears to be an area that is ripe for efficiency savings. I welcome the Government’s proposal for a pharmacy access scheme. That would provide more NHS funds to certain pharmacies based on factors such as location and the health needs of the population. To that end, I ask the Government to distinguish and make a special case for rural pharmacies and to focus their efficiencies on those pharmacies that are within closer proximity to each other. If difficult choices are to be made, let us ensure that our constituents can still access a pharmacy within their locality.

Care Homes: England

Huw Merriman Excerpts

Wednesday 13th January 2016 Westminster Hall

[Huw Merriman (Bexhill and Battle) (Con)]

It is a pleasure to serve under your chairmanship, Mrs Main. I thank the hon. Member for Hove (Peter Kyle), one of my constituency neighbours, for securing the debate and permitting me to consider the role that care homes play in my constituency.

Some 27,000 of my constituents are aged over 65 years. The hon. Gentleman mentioned the ResPublica article, which states that by 2050 the proportion of people in the UK aged 65-plus will have risen to 25%. In my constituency it is already at 28%, against a national and regional average of 17%. Indeed, Bexhill and Battle has the fifth highest proportion of people over 65 years old in the UK.

As a result, many of my constituents live or work in care homes. Before and since my election, I have visited many of those care homes and been hugely impressed by the levels of care and devotion afforded to that most special group of constituents. It is therefore right today to celebrate the role that care homes play in our country and to say thank you.

There is an unfortunate perception of care homes, which regular visitors such as myself try hard to dispel. Although many people feel negatively towards hospitals, they are considered to be places where improvements in outcomes are possible. The same is not often said of care homes. The perception is of a place that people move to when their lives have deteriorated and will continue to deteriorate. That perception means that the public rarely hear about the improvements in outcomes that care homes deliver, the innovative treatment that residents are afforded and the compassionate care that owners and their staff deliver to residents. I hope that we can use this debate to celebrate what care homes do for our constituents.

However, it is right to highlight some key challenges for care home providers, and I shall list two that require the support of the House and the Government. The first, which the hon. Gentleman mentioned, is local authority funding. The gap between local authority care home fees and the cost of care home places in real terms continues to grow. That has represented a drop of almost 5% for council-funded residents over the past five years. That situation could be exacerbated by the welcome announcement of the Government’s new living wage, which will give care home staff a wage of £9 an hour by 2020. I was glad to hear the hon. Gentleman celebrate that pay rise for hard-working care home staff, who, as he mentioned, have been underpaid for many years.

Many of my local care home providers have approached me with concerns that they may have to cease operating if margins continue to be squeezed. On their behalf I have lobbied Ministers to highlight the funding gap, and I am pleased that the Government have now given local authorities the right to add a 2% council tax surcharge for adult social care. In East Sussex, local authorities and the NHS are delivering our “Better Together” integrated healthcare programme. Although I continue to lobby for lower taxes for my constituents, I hope that they will embrace that new tax levy as a means to support the funding of care for our elderly community. I therefore hope that the gap will be plugged, at least in part. It will be interesting to hear the responses of my right hon. Friend the Minister to the other questions that the hon. Gentleman asked.

I would like to touch on staff recruitment. In the care home sector, the staff turnover rate is 32%, which is incredibly high. It is clear that the sector has issues in recruiting and retaining staff. Reliance on staff recruitment from abroad is very strong. I am delighted that the Government have added care home nurses to the shortage occupation list, albeit temporarily. Those who criticise net increases in immigration to the UK need to understand that our population is getting older and needs more care, which means more carers. I welcome the desire of the care home industry to win more contracts from our clinical commissioning funders, because I hope that that will make jobs in care homes more fulfilling, skilled and desirable. I also hope that it will allow us to rely less on staff coming from abroad—from countries that are underdeveloped and whose own residents may need care and assistance even more than people in this country do.

I will conclude, to allow other hon. Members to speak. I welcome the debate, and I celebrate the role that care homes play in this country. I have visited care homes where dementia sufferers are taken on incredible journeys back to their childhoods, where schoolchildren are invited in to go through their exercise books with residents, where residents play games and sing and where there is a great celebration of the rich lives that they have experienced and will continue to experience. I look forward to visiting more care homes and championing their owners, staff and residents in the years to come.

Junior Doctors Contract

Huw Merriman Excerpts

Monday 30th November 2015 Commons Chamber

[Mr Hunt]

I do think that that is the primary concern of the vast majority of junior doctors, which is why I think it was wrong for the BMA to refuse even to sit down and discuss with the Government how we were going to implement a manifesto commitment. I now hope we can get past that, so I will not say any more other than that I think it is now possible to get a better agreement for the NHS, and I hope we will now be able to do that.

[Huw Merriman (Bexhill and Battle) (Con)]

Having been fortunate enough to hear both from junior doctors in my constituency and from the Secretary of State, it is clear to me that both parties are talking the same language but that the communication has not quite filtered through via the BMA. Once this matter is, I hope, resolved, will the Secretary of State think of ways in which dialogue can be improved directly between the Department of Health and junior doctors?

[Mr Hunt]

My hon. Friend is absolutely right: we have had some very unfortunate megaphone diplomacy over recent months, but I hope we can now put that behind us and that lessons will be learned. As he rightly says, we have never wanted to do anything other than what I think is good for doctors, as well as what is good for patients, and that is what the proposals were about.

Oral Answers to Questions

Huw Merriman Excerpts

Tuesday 7th July 2015 Commons Chamber

[Jane Ellison]

We take the issue of childhood health extremely seriously. We want every child to have the best start in life. That is why, for example, we are bringing record numbers of health visitors into the health service and why health is now part of the troubled families programme. In my area of responsibility, public health, it is why we have taken measures on matters such as smoking that particularly affect children in deprived communities.

[Huw Merriman (Bexhill and Battle) (Con)]

On adolescent mental care, capacity in my constituency can require lengthy in-patient care to be undertaken from Roehampton in south London. A constituent of mine makes regular visits to her young daughter making work impractical, but is unable to qualify for travel assistance as she is deemed physically able to work and does not qualify for benefits. As transport reimbursement is normally available only to those eligible for out-of-work benefits, will my right hon. Friend consider recommending widening the parameters to include those who have to travel outside their area?

[Alistair Burt]

I will look at the issue my hon. Friend raises. Clearly, in the first place, we want to make sure that more beds are available more locally, so that the issue does not arise. Greater concentration is being given not only to that, but to the level of care that can be provided before in-patient treatment is considered. I will take the point he makes about benefits and raise it with the relevant Department.