Delivery of Public Services

James Daly Excerpts

Tuesday 28th June 2022 Commons Chamber

[Mr McFadden]

My hon. Friend is absolutely right. As she outlines, these backlogs have real and important human effects; they are not just numbers on a page.

[James Daly (Bury North) (Con)]

Will the right hon. Gentleman give way?

[Mr McFadden]

I will make some progress.

This is happening not just in the field of justice. Record numbers of patients are waiting for NHS treatment, and they are waiting longer than ever: the waiting list for NHS treatment is now 6.5 million, with more than 300,000 patients having been on the list for over a year.

Given that the system had to focus on dealing with covid, some might point to pandemic effects. There would be some justification for that argument if we had not gone into the pandemic with waiting lists that had already rocketed, but we went into the pandemic with waiting lists of 4.4 million patients, almost double the number on the lists when this Government came to power. Long waits and more people waiting are not just features of the pandemic. The number waiting more than 18 weeks is now 2.5 million, but even before the pandemic that number was nearly three quarters of a million. Some 840,000 patients were told in April that they will have to wait more than a month for a GP appointment—if they can even get through to the surgery in the first place. Millions of people are struggling to get any access to NHS dental treatment. Last year 2,000 dentists left the NHS, almost one in 10 across the whole country. There are 4,500 fewer GPs than in 2013, and Conservative manifesto promises to increase the number of GPs have been broken repeatedly. These delays are not the fault of NHS staff or the patients; they are the result of 12 long years of the Conservatives presiding over the system we have and it is time they took responsibility for the backlogs and the delays that have resulted from their long period in office.

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[Mr McFadden]

Well, the Government have chosen the route that we discussed in the Chamber last night. I do not want to repeat that, but other routes are available to them to reduce the bureaucracy experienced by our farmers and exporters.

The delays in asylum matter because they cost money. Seventy-five per cent of asylum claims are eventually endorsed, but, until they are decided, legitimate claimants cannot make a positive contribution to the country by taking up a job, and claimants who are denied cannot be removed from the country. It is neither in the interests of those who seek refuge nor in the national interest to have a system so beset by delays and backlogs. It is certainly not value for money for the taxpayer, either.

On passports and driving licences, people are being asked to wait up to 10 weeks for a passport—a standard that was itself breached more than 35,000 times in the first quarter of the year according to the Home Office. That is where backlogs beget backlogs. There are reports of travellers being asked to seek emergency travel documents because passports have not been issued, but now—this is the least surprising news ever—there is a queue for those documents, too.

Three quarters of a million drivers are waiting for their licences to be processed because of the backlog at the Driver and Vehicle Licensing Agency. A large proportion of those drivers have medical conditions and need specific permission to keep driving. That is where the backlog begets workforce issues, because, until those people get their new licences, they often cannot return to work. I appreciate that none of that may be as exciting as the latest wedge issue thought up in No. 10, but delivering on basic governance is the Government’s job, and it is time to do that job. The duty of service delivery does not go away. At the heart of this are two issues: getting the workforce right and making the most of new technology.

[James Daly]

The right hon. Gentleman touched on criminal justice earlier. Will he join me in asking Andy Burnham, the Mayor of Greater Manchester, to take responsibility for the appalling situation that the criminal justice system is in, in Greater Manchester? It is not protecting vulnerable people or investigating crime, as a result of which my local residents are suffering. Will he join me in asking Andy Burnham to take responsibility and do something about it, which is his job?

[Mr McFadden]

I detect a pattern with these interventions. They seem to be saying that the problem is everyone’s responsibility except the Government’s. There is no escaping 12 years in office.

There are two issues at the heart of this: workforce and technology. Staff shortages are common in many areas. The unemployment figures have fallen, but so too has the overall number of people in employment. More than half a million people have left the labour market since the pandemic. They are from all age groups, but the biggest group is the over-50s, and their biggest reasons for leaving the labour market are ongoing health issues and caring responsibilities.

This is where the delays and backlogs become a vicious circle. I have already mentioned that when people with medical conditions cannot get a new driving licence approved, it can prevent their return to work. The Access to Work programme is there to help people with disabilities into work, but people face delays of up to 12 weeks in their application being processed, and the waiting list for decisions has quadrupled over the past year. That holds people back from taking up jobs and makes the staff shortages worse.

The NHS employs some 1.2 million people, but it went into the pandemic with 100,000 unfilled vacancies. We have argued for a forward plan for NHS staffing, and for training so that the vacancies can be filled. That was supported by the cross-party Health and Social Care Committee, but fiercely resisted by the Government. I have to say to the Minister that looking the other way will not make the workforce issues go away. Why are the Government so resistant to the forward planning needed by the NHS?

The question is how we make the most of our potential workforce, and help those who could go back to work to do so. Many people in this country are suffering from long covid. There are people with mental health issues, and people for whom childcare costs are a barrier. We support an expansion in mental healthcare, so that we get support to those who need it within a month, and we support mental health hubs in our local communities. More breakfast clubs and after-school activities would not only be good for children but would help parents get back to work, too.

The point of all this is that we should use the talent and energy of everyone who can make a contribution, and address any barriers to work that they face, but that is not the Government’s response to the backlogs; they have proposed staffing cuts of 20%. How will that help anyone to get a passport, driving licence or health treatment quicker, or get their case to court sooner? Is it really the best that the Government can come up with? Is it even a real response, or just another initiative thrown up to provoke a debate that distracts attention from the real issues that people face?

The issue is not just about the workforce; it is also about using innovation and technology to make public services better for the public. Covid has been described as the great acceleration. It was a time when years of change were compressed into months—in education, in the way we work, in the way we shop and pay for things, in accessing healthcare and so on. The question is how we make the most of what we have learned, and of all the other rapid changes in daily life that are powered by technology, to reform our public services for the future. Our ambition should not be just to return to where we were in 2019; it should be to improve, so that we can have high-quality public services for all.

We already knew that the Conservatives were running a high-tax, low-growth economy—we have said that many times—but the backlogs that I have outlined in public services, in area after area, show that it is also a high-tax, low-delivery economy. We have the highest tax burden since the 1950s, but people cannot get a passport or an appointment with a dentist. That is simply not a good enough deal for the British public.

The Prime Minister says that he wants another two terms in office, but our public services cannot afford another two terms of backlogs and chaos. This Government are not really governing any more. They are simply campaigning.

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[Mr Clarke]

My right hon. Friend is right to say that with this budget for the NHS comes a responsibility for that organisation to be absolutely open and candid—in a way that, frankly, it has too often not been—about where its resources are deployed, and certainly to avoid funding a culture of managerialism at the expense of the patients. We have had recent success in securing some of the data that we have been looking for, but this is a subject where ongoing pressure from across the House for greater transparency is welcome. Certainly if there is any data that we hold that my right hon. Friend would like to see, I will do my best to facilitate that.

[James Daly]

I welcome the steps the Government are taking to address the challenges within the system. Does my right hon. Friend agree that it is a bit rich for Labour Members to be lecturing anybody on waiting times when waiting time targets in Wales have not been met for many years? As of May 2022, nearly 700,000 patients were waiting for care, which is a 50% increase since February 2020. That is a record to be ashamed of.

[Mr Clarke]

My hon. Friend makes an important point. The performance of the Welsh Government in this area is genuinely concerning, but this also demonstrates a point about fundamental fairness. This debate is sometimes mischaracterised as everything being this Government’s fault, but as we have heard from the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone), the performance of the Scottish healthcare system is blighted by many of the challenges that we are facing in England. Clearly there are also problems in Wales and significant problems in Northern Ireland. What matters is that we set out a clear plan to deal with them.

Our NHS elective delivery plan states that by next month no one will be waiting more than two years for elective care, except where patients choose to wait longer for some reason, and in a number of highly specialised areas.

We know that considerable progress has been made in achieving that target. The number who have waited two years or more in acute hospitals has fallen by 15,000 to 6,700, down from a peak of 22,500 in January. At the same time, the Government are on track to deliver our manifesto commitment for 50 million more primary care appointments by 2024. GP appointment numbers have already recovered to pre-pandemic levels, with 25.3 million taking place in April, of which 1.3 million were covid vaccinations.

The motion also mentions court dates, where we are also making good progress. We are providing almost half a billion pounds to address criminal court and tribunal backlogs.

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[Darren Jones]

My hon. Friend is right, and it is for the Government to do something about it. What is the point of having a Government or paying taxes if the Government stand by and say, “Oh well, this is just something that we cannot really affect”? Inequality is growing and it is now impossible for people to make themselves wealthy in our country without inheriting wealth. These issues are getting worse and worse, and the Conservative Government think it should just be left to the market and that the Government have no role to play.

In the backlog Britain that exists in reality today, whether that is passport services or elsewhere, Ministers sit by. They blame anyone else they can think of and threaten public services without taking any responsibility for their role as Ministers of the Crown. It is their job to fix these issues. Why are they not doing so? Until I see the Conservatives get a grip of the economy—[Interruption.] The Chief Secretary to the Treasury and the Minister for Security and Borders are chuntering, but they are welcome to intervene.

[James Daly]

Does the hon. Gentleman make the same points to the Welsh Government regarding their appalling NHS waiting times?

[Darren Jones]

I am a Member for Bristol, but I point out that the Conservative and Unionist party ought to take some responsibility from here about what is happening across the country and the Union. Once again, however, its Members deflect responsibility and distract the public from the real cause of our problems, which is 12 years of Conservative economic mismanagement.

The facts may be uncomfortable, and Ministers may chunter, but they come from the Office for Budget Responsibility and the national statistician. Ministers have no answer to that evidence of the Government’s economic mismanagement of the last 12 years—they merely deflect and blame others. Until I see a Government who are ready to get a grip of the economy, with a plan to make Britain stronger, more successful and more sustainable, with the energy to not just survive until the next vote of no confidence, but invest in and modernise our public services, I have little hope that we will move away from the Conservative legacy of the high-tax, low-growth backlog Britain that we live in today.

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[Alyn Smith (Stirling) (SNP)]

I congratulate the Labour party on bringing forward today’s debate, and acknowledge at the outset—I am seeking common ground with those on the Treasury Bench—that government is hard. Government means not being entirely in charge of events, and the Government must be responsible for things beyond their direct control. The SNP has been the Government of Scotland since 2007, and it has seldom been easy to achieve the results we wanted, but we see the verdict of the people of Scotland on the performance of the SNP Government: the 2019 Westminster election, the 2021 Holyrood election and the local election this year have been resounding SNP victories.

[James Daly]

The hon. Gentleman is making a very fair point, but is that the reason why A&E waiting times in Scotland are at a record high? In May over 10,000 people were waiting over two years for medical treatment; is that not a shameful record for the SNP Government?

[Alyn Smith]

I was hoping to find common ground, rather than hear endless whataboutery. We could all swap stats about the performance of our relative Governments, but I am here to critique the performance of this UK Government and try to find solutions. Have there been challenges? Of course there have. Are we all facing common challenges from the international global situation with covid? Of course we are. It is how we respond to those challenges, the decisions we make, and how we resource our public services that we can be judged by. The people of Scotland judged the SNP Government, and resoundingly backed us. Of course there are challenges, but I am proud to stand by the SNP’s record.

To govern is to choose, and it is the choices of this UK Government that we can critique today. I endorse the comments of my right hon. Friend the Member for Dundee East (Stewart Hosie) about the underlying causes of policy failure, the UK Government’s wrong decision in leaving the EU, and doing so in the way they did. That compounded a number of our difficulties, just as wrong management choices affected the delivery of public services. I will not belabour or repeat the points my right hon. Friend made, but the SNP remains very clear about our ambition for Scotland: we want an independent Scotland, back in the European family of nations. The people of Scotland will have a choice on that in October 2023. We will come back to that discussion at the proper time, I do not doubt, and I look forward to that.

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[James Daly (Bury North) (Con)]

It is an honour to follow the hon. Member for Stirling (Alyn Smith), who seemed to argue that incompetence is justified as long as a party gets the democratic mandate to continue to act in that manner. I welcome his straightforward comments accepting that the SNP Government, who have responsibility for the matters that we are discussing, have faced the same challenges, including those resulting from the pandemic, as the rest of the world, and, like others, found difficulties in overcoming them, hence some of the bad figures that I quoted. I thank him for his straightforward response.

In talking about the delivery of public services—the Labour party, who brought forward the motion, do so with such certainty of criticism and purpose—we must look back to Labour’s previous actions as well as at its current actions, because clearly it must be doing something right. I gave the example—it is worthy of repetition—that Labour politicians criticise Conservative politicians for challenges regarding waiting times, yet in Wales 700,000 people are waiting for planned care, which is a 50% increase on February 2020, and no Opposition Member makes any reference to it. If the Welsh Government have any idea of how to address that, I would welcome Members sharing the news with us. What is the idea? What will they do? There is nothing on that. [Interruption.] I will not give way.

So we go on and look back further. The criticism in respect of the NHS is that, in effect, money has been put in but wasted in various ways. I thought, “I must look back at when Labour ran our NHS. I’m sure that there is a real record of investment and getting a really good bang for the taxpayer’s buck.” Although I am the very proud MP for Bury North, I am from Huddersfield and my local hospital was under threat under the last Labour Government because of the decision to build Calderdale Royal Hospital.

[Margaret Greenwood (Wirral West) (Lab)]

The hon. Gentleman is talking about the Labour party’s delivery of the NHS. Is he not aware that public satisfaction with the NHS was the highest it has ever been when Labour left office?

[James Daly]

The hon. Lady talks about public opinion. Calderdale Royal Hospital was constructed with a £34 million private finance initiative deal that, at the last reckoning, cost the taxpayer £740 million. The last Labour Government wasted millions upon millions of pounds on the NHS that should have been invested in modernising and developing frontline services—it was absolutely criminal. We have made record investments throughout our time in government, as shown in the increased number of nurses and the increased services that my constituents are able to access, although there are challenges.

[Margaret Greenwood]

The hon. Gentleman is being generous with his time. Surely he must be aware that his Government’s Health and Care Act 2022, which was enacted just a month or so ago, opens up the NHS to private sector takeovers that will be deeply inefficient because money that should be spent on patient care will be taken out and given to shareholders.

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[James Daly]

Privatisation of NHS services began under Labour. There was more privatisation under Labour, so I thank the hon. Lady for giving me the opportunity to highlight Labour’s desire, when it was last in power, to privatise large parts of the NHS.

[Paul Bristow (Peterborough) (Con)]

Does my hon. Friend remember Labour’s famous slogan before every general election: “We have just 24 hours to save the NHS”? Well, it has been a very long 24 hours since 2010, has it not?

[James Daly]

I remember another slogan from when Labour left office: “there is no money.” I agree with my hon. Friend.

We talk about figures all too often in this House, and we can come up with any figure. It could be £1 billion, £2 billion, £500 billion or £500 million. That is not the delivery of public services; it is just us coming up with figures. The question is: what delivery model will get bang for our buck and deliver services so that people in Scotland do not wait so long in A&E and so waiting lists are not as long in Wales? The delivery model is the issue.

[Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)]

The hon. Gentleman keeps referring to the healthcare system in Scotland. When will the English Government implement free prescriptions and free annual eyecare for the people of England? When will they implement free social care for the elderly in England?

[James Daly]

There is record investment in the NHS in England, and it is for the decision makers, those who deliver frontline services and medical professionals to make those choices. The hon. Gentleman is saying that politicians, not medical professionals, should decide the right choices for patients. [Interruption.] It is strange that he is laughing, but he makes my point on the method of delivery.

I have a constituency example of what this Government have done to deliver public services. I have already spoken of the Mayor of Greater Manchester’s appalling supervision that led directly to my local police services, and the local police services of my hon. Friend the Member for Heywood and Middleton (Chris Clarkson), being put in special measures, and to the most vulnerable people in our communities being put at risk. My local council, a Labour council, was given £122 million to support people, businesses and frontline services during the pandemic. Under the £37 billion package that was before the House last week, 12,000 households in my constituency will get at least £600 to support them through this period, and most of them will get up to £1,200. When we talk about those figures and what the Government have done, we see that they are supporting the people in Bury to the tune of hundreds of millions of pounds. The problem is that the delivery model is Labour-controlled Bury Council, which is incompetent, I am afraid, and its record would suggest that. We therefore need a wider debate about how we link the money that the Budget and the Treasury gives to local and regional government and how that is spent in the most efficient way.

[Chris Clarkson (Heywood and Middleton) (Con)]

My hon. Friend is making an excellent speech. He rightly points out the grotesque incompetence of our Mayor. The second largest police force in England, Greater Manchester police, is failing; it is considered to be inadequate. I was wondering whether he could remind me who the Health Secretary was when people were drinking water out of flower vases at Mid Staffs and, apparently, satisfaction with the NHS was at its highest.

[James Daly]

The Mayor of Greater Manchester has been consistent in his past and present career regarding the delivery of public services. The important point is that we have to learn from the mistakes that my hon. Friend highlights and make sure that public services are delivered in a different way.

The Government have invested more than £400 billion during the pandemic. Not only have they given the metropolitan borough of Bury the £122 million that I mentioned, but both constituencies in Bury have got upwards of £200 million. There are three free schools and there have been two levelling-up fund bids, as well as all sorts of other things—including the purchase of Gigg Lane, Mr Deputy Speaker—directly to help and support the aim of us all to make sure that public services are delivered in the best possible way. However, we cannot have this debate simply about figures. We have to work out a way to ensure that managers in the NHS and civil servants in various councils throughout the country deliver on the manifesto and the mandate that is given by the Government through record levels of investment in schools, the NHS and all the other things that we are discussing.

The Government’s record is something to be proud of. We heard from the Opposition what their plan is: nothing. There is no plan. This is simply an opportunity to read out a load of manufactured points, rather than supporting the Government in their efforts to level up and make sure that public services are delivered in the interests of constituents throughout the country.