Budget Resolutions

Debate between Jane Ellison and Barbara Keeley

Thursday 9th March 2017 Commons Chamber

[The Financial Secretary to the Treasury (Jane Ellison)]

We certainly have covered a lot of ground in today’s debate; indeed, we have strayed internationally, as well as covering an awful lot of domestic policy. Before I address some of the key themes, I wish to stress again the central point made by my right hon. Friend the Secretary of State for Communities and Local Government when he opened the debate. Our ability to provide public services is entirely dependent on our ability to pay for them. Indeed, the right hon. Member for Leicester East (Keith Vaz) said in his speech that before we talk about spending, it is important to talk about how we would raise the money. That is the last thing we have heard from the Opposition today.

Key to this debate is the fact that if we do not live within our means, deal with the deficit and get debt falling, we simply will not be able to continue to fund the public services that we all care about on both sides of the House; of course, the generations to follow will then suffer. We have seen how debt has been left for others to deal with, which is why at the heart of the Budget and our economic policy is our continued resolve to restore the public finances to health, increase our economic resilience and secure our public services for the future. At the heart of our aims is the work to bring down the deficit. We have made great strides, and in doing so we have been able to bring what we spend and what we raise further into line. That is how we can afford public services.

We have already cut the deficit by almost two thirds, but the work is not done. We are also on course to get debt falling as a share of GDP by 2018-19. We are, though, the first to acknowledge that there is no quick fix, no silver bullet and, contrary to assertions by Opposition Members, no magic money tree. That is why we are sticking to the spending plans we have set out and why we are taking a systematic look at how we can become ever smarter in how we spend taxpayers’ money, including by conducting an efficiency review that aims to get more value for money and to save £3.5 billion. As my right hon. Friend the Secretary of State said earlier, we are looking forward to benefiting from the insight and expertise that Sir Michael Barber can bring to bear on the process.

We all have to acknowledge that this work is part of a longer-term challenge. There are many pressures on services in advanced economies around the world, and if we do not grapple with the issue of how we pay for things, we just cannot tackle them. We heard quite a lot from the shadow Minister, the hon. Member for Worsley and Eccles South (Barbara Keeley), about social care. We made a significant announcement in the Budget statement about a £2 billion injection of extra cash—[Interruption.] Opposition Members say from a sedentary position that it is not enough; I return to my previous point: we have heard so much from them about where they would spend more, but we have heard absolutely nothing about how they would pay for it. They have a few gimmicky ideas, to which I shall come—I am going to address one of them head on—but their answer really is the magic money tree. We have made new money available, and further details have been announced today about how it will be allocated. That is real money made available very quickly—£1 billion is being made available for the new financial year starting in just a few weeks—and it is really important that we do that.

Nevertheless, we acknowledge that there is a longer-term challenge. As I said, all advanced economies face pressures as populations become older and the rise in complex and chronic conditions continues. As well as offering some kind words about me relating to my previous role, the right hon. Member for Leicester East rightly drew our attention to the Government’s work on prevention. I shall not be drawn into talking about that too much—as a former public health Minister, I could talk on that for some time—but I remind him of the national diabetes prevention fund and the related work, and the £16 billion a year from the public health budget that we give to local government.[Official Report, 13 March 2017, Vol. 623, c. 1-2MC.] All Members have acknowledged what the sugar levy and other work are doing to turn the sugar tide.

I also draw the right hon. Gentleman’s attention to page 35 of the Budget book—our consultation on the damage that white cider can do. We are consulting on the alcohol by volume duty rates because we have heard from many charities, particularly those working with the homeless, about the impact of the abuse of white cider, in particular, on the health of homeless people and many young drinkers and the increase that it provokes in the frequency of visits to A&E.

[Barbara Keeley]

Surely the key point is that we are almost abandoning prevention. Some 1.2 million older people live every single day with unmet care needs. There is no prevention when a frail older person who needs care does not get it, and this money goes nowhere to helping with that.

[Jane Ellison]

I disagree with the hon. Lady about prevention. We can do a lot on prevention, particularly with older people. With this new money, we can have more care packages. For example, falls prevention, which is delivered in the community or at home, is one of the most valuable ways to keep people out of accident and emergency. But we are not in any way downplaying the challenges of dealing with these pressures. We are not burying our heads in the sand. It is a matter not just of common sense but of responsible government that we must face up to the question of how to secure our social care system for the long term. He is not in his place, but the right hon. Member for North Norfolk (Norman Lamb), my former colleague in the Department of Health, talked about that, and there are areas of great agreement across the House about some of those challenges. That is why we announced that we will publish a Green Paper by the end of the year in which we will set out our proposals to put spending on a sustainable footing.

The hon. Member for Worsley and Eccles South said from the Opposition Front Bench that this was about the long grass. I will not embarrass her by reading out the very long list of times that the last Labour Government attempted to grapple with this issue over 13 years.

[Barbara Keeley]

rose—

[Jane Ellison]

No, I am not going to take another intervention—I will take the same time that the hon. Lady took.

The list is very long. Labour said in its 1997 manifesto that it would tackle this issue; there was a royal commission in 1999, a Green Paper in 2005 and the Wanless review; it was said that the issue would be resolved by the 2007 comprehensive spending review, and there was another Green Paper in 2009—13 wasted years. I am afraid that Opposition Members provoked me to embarrass them. Their long grass was very long indeed.

We are injecting not just new money into social care but an extra £425 million into the NHS to help A&E departments triage patients more effectively and to support local NHS organisations as they reform and improve for the long term the way services are provided to patients. By putting more money into social care and those specific parts of the NHS—triage and capital for A&E—we are addressing some of the very issues that Simon Stevens has talked about recently as immediate challenges of dealing with pressures in the system.

My hon. Friend the Member for Harrow East (Bob Blackman) asked about STPs. The investment that we set out will make a real difference by supporting regions with the strongest plans that are ready now to deliver their long-term visions. We will revisit STPs in the autumn to see whether there are further areas with strong cases for investment, but the NHS obviously also has a part to play in looking at how it can, for example, dispose of unused land and reinvest that money. I give my hon. Friend that assurance.

Let me talk a little about education and skills. We have already taken action to fundamentally reform and improve school education, with the result—this is never acknowledged by the Opposition—that 1.8 million more children are in good and outstanding schools compared with 2010. The simple fact is that vastly more children are getting a good or outstanding education. In this Budget, we further galvanised our schools with £320 million of investment in new schools and £216 million for the maintenance of existing schools.

My right hon. Friend the Secretary of State for Communities and Local Government spoke compellingly about the sweeping reforms that we have introduced to put technical skills at the heart of our education system. I sense great cross-party consensus that that has been an undervalued part of our education system. That will give young adults a chance to develop new talents that will stand them and, of course, our country and economy in good stead as we work towards the high-skill, high-wage and hi-tech economy that will help us to be competitive in a global marketplace.

I have spoken about the importance of controlling our public finances, investing carefully in our public services and ensuring that our spending is sustainable. Alongside that, I want to make a few remarks about the importance of ensuring that our tax system is sustainable. We cannot talk about one side without talking about the other. The flipside of how we invest in public services is how we fund them. Let me address two issues.

First, a number of hon. Members have mentioned business rates. It is right that we update them to reflect today’s property values, but we recognise that this has meant a sudden jump for some. I thank my hon. Friend the Member for Richmond (Yorks) (Rishi Sunak) for his excellent speech. I am familiar with some of the pubs in his beautiful constituency. He mentioned the importance of supporting pubs. That was part of the £435 million package of support that the Chancellor outlined yesterday. He has been working on that with the Secretary of State for Communities and Local Government to help businesses manage the steepest increases following the business rates revaluation.

Secondly, there has been much discussion in this debate of the changes we have made to national insurance contributions, and I will respond directly to some of the points made. Let us be clear that the contributory benefits funded by national insurance contributions are very different from employment rights. Much of this debate and the public discourse has criss-crossed between those two important, but distinct, subjects. National insurance pays into a fund that pays out to the NHS and contributory benefits—principally the state pension, but also parental pay. We have announced that we are looking carefully at maternity and paternity rights.

Sugary Drinks Tax

Debate between Jane Ellison and Barbara Keeley

Monday 30th November 2015 Westminster Hall

[Jane Ellison]

That is not right. Again, I come back to the point stressed in the report by Public Health England—indeed, the Health Committee’s excellent report underlines it—that there is no silver bullet. It is really important that we address the fact that a number of wide-ranging issues need to be tackled and that several options are available to us in policy terms. PHE concluded that no single action on its own will be effective in reducing the nation’s sugar intakes. Its report shows evidence to suggest that higher prices in targeted high-sugar products, such as sugar-sweetened drinks, tend to reduce the purchases of such products in the short term.

Mention was made of the possibility of Cochrane reviews in coming years. An interesting article in the current issue of The Economist notes that the longer-term effect on public health is as yet unknown. Obviously that is because in most cases these measures have not been in place long enough, but it is an important concern—and the hon. Member for Swansea West (Geraint Davies) will have noted a degree of reticence on the part of those on his own Front Bench about the evidence, but anyway. We are, of course, well aware of what Public Health England said in its report about the evidence on higher prices. However, its report also argued strongly for implementing a broad, structured programme of parallel measures across all sectors, if we are likely to achieve meaningful reductions in sugar intakes across the population. As we have heard, it identified areas for action that include restrictions on marketing, advertising and price promotion, and work to reduce levels of sugar in food and drinks—I welcome the focus of a number of speeches on reformulation of product, as we think it has a significant role to play. Areas for action also included improving public food procurement and improving knowledge about diet and nutrition. We are considering all the evidence and working closely with Public Health England to develop our policies.

A number of Members have talked about education. This debate provides the opportunity for me to talk in more detail than I generally can in such debates about the Change4Life programme, in which we continue to invest significant sums. The Change4Life campaign has provided motivation and support for families to make small but significant improvements to their diets and activity levels. Last January, Change4Life’s Sugar Swaps campaign encouraged families to cut back on sugar through two TV advertisements focusing on sugary drinks and after-school snacks. That campaign also included radio, digital and outdoor advertising.

[Barbara Keeley]

I expressed concern about budget cuts for Public Health England. Will the Minister address that? I, too, admire the work it has done, but it is not helpful to cut the budget, is it?

Vaccine Damage Payments Act

Debate between Jane Ellison and Barbara Keeley

Tuesday 24th March 2015 Westminster Hall

[Jane Ellison]

My sense is that the scheme, which aims to provide proportionate help, has got the balance about right, but I have heard the concerns expressed today. It is worth noting that successive Governments have considered this matter and chosen not to alter the scheme. That consideration would have involved looking at it in some detail. Equally, I note gently that the shadow Minister, analysed the situation and asked many questions, but made no commitments, although she aspires to sit in my place in just a few weeks.

The House will note that many successive Governments of different parties have looked at the scheme and have, I think, drawn the same conclusion, which is that the balance is about right. That is not to say that the hon. Gentleman’s concerns are not listened to: far from it. I have listened to his concerns and will take those away and reflect on them.

There are no current plans to make any changes to the time limits. Again, the hon. Gentleman made his case about that, as did other hon. Members.

[Barbara Keeley]

I hear what the Minister is saying, but this may be the last chance to comment. I talked about a case where the payments are not in any way compensatory. Previous Governments lifted the level of payment substantially up to £120,000. Can she not give any hope to parents in their 60s who are struggling with care? Care is expensive, and increasingly so under her Government. What can she say to give some hope to parents in that situation, of whom, as we have heard, there are very many, including my constituents?

[Jane Ellison]

The challenge is that a number of aspects of the scheme, which has existed under successive Governments, make some individual cases particularly hard. The hon. Lady has touched on some reasons for that in her contribution.

The Government have no plans to change how the scheme is run, as one might expect in the last week before the House rises before the general election, and there are no plans to review it, as I have said. However, we are about to have a new Parliament. I am sure that the hon. Member for Dumfries and Galloway and other hon. Members may wish to return to this subject. The work of the all-party group will continue. The hon. Gentleman has indicated that he wants to raise the reform of the Act in the new Parliament. The shadow Minister has made some points, but no commitments. The hon. Member for Dumfries and Galloway may therefore wish to use the next few weeks lobbying within his own party, if he cannot speak in Parliament, making his case forcefully to his colleague.

I note the concerns expressed today. I am not in a position to say that the scheme will be reviewed. As is the way of these things, all these matters will now be for a new Government to consider. However, the hon. Member for Dumfries and Galloway put his points thoughtfully, as ever, and they have been thoughtfully taken on board and will be considered.

NHS (Government Spending)

Debate between Jane Ellison and Barbara Keeley

Wednesday 28th January 2015 Commons Chamber

[Jane Ellison]

I remind all Opposition Members of their predictions about employment at the beginning of this Parliament. If any of them wants to remind us of those, they can be my guest.

We recognise the significant and continuing pressure on services in the short term and the need to invest in new ways of providing care for the future.

This Government have put more performance data in the public domain and have put an unprecedented emphasis on transparency. Indeed, some of the statistics Members quote in these debates are in the public domain only because the Government have put such an emphasis on transparency. Transparency is one of the key drivers of safety in our system.

As public health Minister, I welcome the focus on prevention in the “Five Year Forward View”. I think this is common ground across the parties. Prevention has to be a key part of the NHS’s plans. When we keep people healthy and out of hospital, it is a win for them and a win for the NHS. Mention has been made of the national diabetes prevention programme. We will be the first country in the world to implement such a programme at scale to help prevent the onset of the disease and reduce demand on the NHS. Investing in the NHS with a focus on prevention is one of the keys to a sustainable footing for the NHS in the long term.

Thanks to the work of NHS staff and the funding protection provided by the Government, the NHS is treating more patients than ever. Again, that flies in the face of all the dire threats about its peril. There are 9,000 more doctors and 3,300 more nurses. The additional funding announced by the Chancellor in the autumn statement will enable the NHS to continue to meet the rapidly rising demand in the short term, while making investments in new services and facilities to transform care for patients and ensure that the NHS is sustainable in the long term.

[Barbara Keeley]

The Minister mentioned an increase in the number of nurses, but there is no increase in the number of district nurses, of whom we have lost thousands. Week in, week out, the Health Committee keeps being told how serious that is for all aspects of care in the community.

[Jane Ellison]

I am sure that, like me, the hon. Lady will welcome the 589 new nurses in her trust.

The more sensible Opposition Front Benchers have made it clear in interviews that the link between reform and investment is important. I want to pay tribute to the NHS, which is well on track to make up to £20 billion of efficiency savings to be reinvested in front-line care. For example, the NHS is securing savings of £2 billion a year as a result of the drive to tackle waste and improve procurement. Tough decisions were taken at the beginning of this Parliament to protect the NHS budget—against the advice of the Labour party—that have allowed us to strengthen family doctoring and reform out-of-hospital care. We all agree that integrating health and social care is important, and that is exactly why the Government have the £5 billion better care fund. It is an area on which—despite what Opposition Members say—there is significant consensus. They should support that fund instead of, as I recall, inviting us to put it on pause.

We have heard about how Labour plans to raise more money for the NHS, but in 2015-16 it would raise nothing. The Government are already consulting on a tobacco levy. The tax on family homes, by the Opposition’s own admission, would not start until 2016-17 and has already been spent three times—paying down the deficit, funding the NHS, getting rid of the 10p rate. As a London MP, I have to say that the chance of the homes tax surviving Labour’s London mayoral candidate race is minimal, given the ire raining down on it from Labour MPs in London. On top of that, Labour plans to spend an extra £5 billion, including more than £2 billion on committing equal resources to physical and mental health and more than £1 billion on GP access—it just does not stack up.

We came to government with a long-term economic plan to reduce the deficit and build a stronger economy, with a commitment to protect and safeguard the NHS. We have kept that important promise on the NHS and we kept our promise on the success of our economic plan. We recognise that the NHS still faces significant challenges, both short and long term, as the hon. Member for Leicester West (Liz Kendall) laid out—rising demand, an ageing population and growing expectations—but it is only through sticking to our long-term economic plan that we are able to put the investment in. We are making a down-payment of £2 billion on the NHS’s five-year forward view and we fully support the long-term vision for the NHS, by the NHS—by the most senior and experienced clinicians in our country. The Government have committed to put more resources in now and in the future to give all our constituents a better service, free at the point of use and fit for the future.

Question put.

Physical Inactivity (Public Health)

Debate between Jane Ellison and Barbara Keeley

Tuesday 18th November 2014 Westminster Hall

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

First, I thank the hon. Member for Blaenau Gwent (Nick Smith) for securing this debate on such an important topic. It is one of my personal passions, particularly while I have been in this job. It is evident from the contributions of so many colleagues, who made so many thoughtful points, that many share my passion for this area. I do not pretend to think that I can respond to every specific point that was raised, because it has been a varied and wide-ranging debate, which demonstrates Parliament’s appetite to get stuck into this topic. I will return to the powerful role that MPs have in increasing levels of physical activity if I have time towards the end of my remarks.

Society has changed a great deal, and that sits behind everything we have been debating this morning—why we have become more sedentary—and other Members have laid that out. I will not spend too much of my speech going over the evidence base, because it has been well covered by the hon. Gentleman and other Members, but the evidence base is well established for the problems that the level of physical inactivity in our nation is causing. I was pleased to hear Members talk about not only physical conditions, but mental health. I think dementia was also mentioned. There is an important evidence base for the fact that becoming more physically active can benefit people in a great many ways. One of my personal passions is how physical activity can impact on social isolation and exclusion; I will try and touch on that later. I will not reiterate what other Members have said on the statistics on how inactive we have become as a nation, because they are all on the record; I would prefer to use my time—I am conscious of leaving a little bit of time for the hon. Gentleman to wind up—by telling the House what the Government are doing.

I will say a few words about obesity. It is a slightly complex area, as I was saying to the hon. Gentleman just before we came into the Chamber. We are clear that all the expert evidence suggests that while physical activity brings the important health benefits that we have been discussing—such things as stronger muscles and bones and improved cardiovascular health and metabolic health, as well as some of the psychological well-being aspects—tackling obesity is fundamentally about eating and drinking less. That is what will lead to significant weight loss. That is not to belittle the role of physical activity, but to emphasise its importance. Physical activity cannot just be seen through the narrow prism of its role in weight loss, because it is bigger and more important than that and goes to the heart of so many well-being and other social issues. I am keen that it is not cast only in the light of weight loss. We need to understand its role in tackling obesity, not least in encouraging active lifestyles in children from the very start and not building up problems for future generations, but it is a little more complex than that.

[Barbara Keeley]

Will the Minister acknowledge that it is important for overweight people and large people to take exercise, because they will be healthier, whatever size they are, if they do that? There is a danger in focusing just on weight loss, instead of exercise. If people take exercise, it is likely to lead to a healthier lifestyle and a desire to lose weight.

[Jane Ellison]

Absolutely. I could not agree more with the hon. Lady. It is exactly why we should not just link obesity and physical activity together. It is better for everyone to move. I will come on to some of the conditions that are helped by that, but she is right that whatever someone’s age, weight or state of health, moving more is always a better option.

Members have touched on this, but it was an important moment when we saw prevention put right at the heart of the NHS with the publication of the “NHS Five Year Forward View”. Public Health England collaborated closely with the NHS on the prevention chapter of that forward view, which states:

“The future health of millions of children, the sustainability of the NHS, and the economic prosperity of Britain all now depend on a radical upgrade in prevention and public health.”

It cannot be said more profoundly than that that this issue is important. The attention given to that aspect of the forward view was heartening to me as the public health Minister, because I had not heard the prevention agenda put quite so much at the heart of the health debate in our country and related to the sustainability of our great public services to that extent.

Members have talked about shifting the narrative. With the best will in the world, Governments can only do so much. We have to shift the population’s thinking from where we are now to where we need to be. A couple of Members touched on the role of some of the major charities. I have been having conversations with some of the major health charities about how they can harness the reach and reputation they enjoy among our population. For example, Macmillan Cancer Support is famous for its wonderful cancer care, but it is a bit less famous for the excellent work it does with the Ramblers on the evidence base on walking as a key element of physical activity. I have been talking to Macmillan and others, including some of the big cancer charities, about what more they can do to get people to understand more widely the role of physical activity in preventing diseases, because those charities have enormous reach into the population.

I pay tribute to Breakthrough Breast Cancer on its message, “Raise your pulse, reduce your risk”, which is a campaign that tells women that 30 minutes of daily physical activity can reduce the risk of breast cancer by at least 20%. Arthritis Research UK launched a piece around understanding arthritis, which addresses exactly the point that the hon. Member for Worsley and Eccles South (Barbara Keeley) made in her intervention. It is tackling the misguided belief that someone should rest if they have joint pain and is trying to put some of its weight, resource and reputation behind simple messages on standing, walking and being more active, even for people with some of those physical challenges.

We have dwelled a lot on physical inactivity among the young, and I will come on to some of the things that the Government are doing to help that, but the most inactive generation is the oldest generation. Only one in 10 men and one in 20 women over 75 are active enough to stay healthy. I am lucky enough to have both my parents still with me—one is 80 and the other is just under 80—and very much active and healthy. My father is still cycling 50 miles a week at 78. I look at their lifestyles and I see how much can be gained from staying active as people grow old. It helps them to remain independent for longer and tackles some of the thorny issues of social isolation. Active older people are unlikely to be lonely. We must be passionate about the activity agenda for older people, as well as the sensible focus on getting the young into good habits.

On the role of Government, experience from across the globe shows that getting everybody active every day will work only if everyone is involved, including all levels of government, so I want to discuss what we have been doing recently, because the level of activity is good. At a national level and following up on the Olympic legacy—I chair a cross-ministerial group on the physical aspect of the legacy—we started “Moving More, Living More” as a cross-Government policy to get more people active. It stresses that physical activity is everyone’s business. If it just sits in a health silo, we will fail again. I have had conversations with Lord Coe, who recognises that we have been around this circuit before. Physical activity cannot just be a health measure; it must be embedded across all levels of Government and local government.

Following on from that, we have taken a much more granular approach and have provided a proper toolkit. Just last month, Public Health England published the “Everybody Active, Every Day” framework. It was going to be published early next year, but I urged it to bring that forward to this autumn, so that it was available to local authorities when planning their 2015-16 spend. We have provided £8.2 billion for public health over three years, and it is important that we also provide the best evidence base for how to spend that money for local populations.

I want to describe how the scheme was produced, because it has been a wide-ranging collaborative effort. I hope that MPs all received their toolkit. It might still be lurking in the inbox—we all receive a lot of e-mails—but please look for it, because it was designed to give MPs a role in promoting the agenda. The campaign was co-produced with more than 1,000 cross-sector organisations and individuals at national and local level. It was begun at a workshop in January this year. Since then, we have had nine expert round tables attended by more than 200 experts. Five regional forums have been attended by some 750 individuals, including people from local authorities. The “Moving More, Living More” policy and the recommendations of the all-party commission on physical activity—I see one of its members here—fed into the process. We held sector-specific presentations and workshops, bilateral meetings with Government and nine expert rapid topic overviews.

Good and promising practice has been collated, and we have also commissioned work on what constitutes such practice, with more than 960 submissions for assessment. I have also commissioned a review of return on investment data, which is critical for local government. A public consultation was held on the draft documents, with 183 submissions raising 550 specific issues. The output from the exercise, which was launched at the Oval last month, includes a toolkit, as mentioned, for elected representatives—I worked with Public Health England on the MP toolkit and we are looking at one for locally elected members as well—and free British Medical Journal-sponsored e-learning modules. Regarding the review of promising practice in communities, we have commissioned the Centre for Sport and Exercise Science and ukactive’s research institute to consider and rate submissions. We have also done some detailed topic overviews, in particular looking at some in-depth guidance for addressing complex issues around deprivation and health inequalities, which will respond to one of the points raised by the hon. Member for Blaenau Gwent.

I have attended a high-level round table with local government leaders, who I must say are a great deal more optimistic than the shadow Minister about their ability to deliver on this agenda. The meeting was cross-party and extremely positive, and I have seen many of the things that they have been doing. This is a collaborative effort right across local and national Government to take us to the next level in terms of an evidence-based approach to physical activity. Like the right hon. Member for Rother Valley (Kevin Barron), who spoke about public health sitting well with local government, I absolutely think that it has landed in the right place. I have seen some fantastic examples of real leadership, but we need to give local government the tools to do the job. We do not want people endlessly reiterating the evidence base and endlessly trying to work out what works and carrying out their own evaluations when that can be done at a national level through the resources of Public Health England.

The four areas within “Everybody Active, Every Day” are “Active society”, “Moving professionals”, which is about ensuring that our professionals are geared up to make every contact count, “Active environments”, and “Moving at scale”, which is about the big interventions—as opposed to small, excellent micro-interventions—that will really make a difference to the population. The framework contains a lot more detail, and I urge Members to have a look at it, because it is what we are now engaging with local government leaders on. I was asked about the data that local authorities have at their disposal and the Active People survey provides them with areas to target.

In addition to all that, my Department has given £11.4 million to the Change4Life sports club programme, through which 13,500 clubs have been established to help our children to be more active. Those clubs have deliberately been set up in areas of high childhood obesity and significant deprivation. We are also investing £180 million over three years into the primary PE and sport premium to improve health outcomes for primary-age children. We have provided £30.5 million to fund the School games organisers, who are responsible for delivering the games and co-ordinating Change4Life sports clubs. Much work is ongoing with the Department for Transport around cycling cities, and we have augmented its funding by putting money into five walking cities.

Sport England recently announced that it is also making more money available to help to get people more active. I echo everything that has been said today about women’s participation and removing barriers to entry. Some extremely good points were made. I welcome the fact that Sport England has recognised that and is looking to fund things that many of us would not traditionally recognise as sport and things beyond team sport. Like my hon. Friend the Member for Romsey and Southampton North (Caroline Nokes), I remember the Lycra shame of the 1980s and the “feel the burn” movement. We do not want people to go to something once and then give it up. We must remove the barriers to entry. I heard about wonderful local government initiatives, such as T-shirt swimming days for people who do not want to swim in just a swimsuit, and other clever things.

However, we need to get the message out there, which much of the debate concentrated on. I must be honest that I do not believe the chief medical officer’s guidelines are well understood. They are difficult for health professionals to understand and the same is certainly true for the public. I have commissioned a piece of work from Public Health England to develop a mantra for physical activity similar to “five-a-day”, which, if not universally observed, is widely known and understood.

I hope that I have provided a sense of how we are trying to follow up on the Olympic and Paralympic legacies. Lord Coe has been clear that that will be judged over decades not years, because although the shadow Minister suggested that it has developed over the past five years, the problem has developed over decades, but we are taking action. MPs have a valuable role to play. It is a huge job, but we are making great strides towards getting everybody active every day. I thank Members for their participation in the debate.

Oral Answers to Questions

Debate between Jane Ellison and Barbara Keeley

Tuesday 15th July 2014 Commons Chamber

[Jane Ellison]

I congratulate my hon. Friend on her great campaigning on this issue, and on the really good results that she has had. As she says, we have recently consulted on changing the regulations under the Medicines Act 1968 to allow schools to hold inhalers in the way that she has described. There was overwhelming support for such a change, and we will lay the necessary statutory instrument this week to enable the change to come into force on 1 October.

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

T6. On nurse-patient staffing ratios, it has been reported in the Health Service Journal that out of 139 trusts surveyed, 119 failed to fill their registered day nurse hours, 112 failed to fill their registered night nurse hours and 105 failed to fill their registered nurse hours across day and night. Is it not time for Ministers and NICE to state straightforwardly that a ratio of one nurse to eight patients or better is the only way for patient safety?

Tobacco Packaging

Debate between Jane Ellison and Barbara Keeley

Thursday 7th November 2013 Commons Chamber

[Jane Ellison]

The Government are following discussions in another place closely. Beyond that, I am not able to comment in this debate, but we are well aware of those discussions and Ministers are participating in them.

Australia introduced standardised packaging in December 2012, and New Zealand and the Republic of Ireland have committed to do that. In addition, other academic studies are emerging about the effects of that policy.

The UK has a long and respected tobacco control tradition internationally, although at times in this debate it has been possible to miss that point. Under successive Governments the UK’s record has been good, and we will continue to implement our existing plan to reduce smoking rates while keeping the policy of standardised packaging under active review. The tobacco control plan for England sets out national ambitions to reduce smoking prevalence among adults, young people and pregnant mothers. As the plan makes clear, to be effective, tobacco control needs comprehensive action on a range of fronts.

I will talk a little more about this in the context of devolved powers of public health to local government, but there is a slight danger that by focusing only on one aspect of tobacco control, we forget that there are other—and indeed more—things that we could do. Even if it was possible to say today that we would do this tomorrow, we would still be debating how we could effectively control tobacco and stop children taking up smoking. As various hon. Members have said, including the right hon. Member for Rother Valley (Mr Barron), this is an ongoing battle to protect children’s health.

[Barbara Keeley]

Is the Minister concerned about the fact that between April 2012 and March 2013, there was an 11% decline in the number of people setting a quit date? We are concerned about children, but if they are still watching their parents smoking, it is more likely that they will start. I hope that she is disturbed by the fact that the numbers setting out to quit are falling—it is the first fall since 2008-09. The Minister should address that point.

[Jane Ellison]

We are aware of that, but smoking in this country has dipped below 20% for the first time ever. I am aware of the hon. Lady’s concerns and I shall talk a bit about some of the public health campaigns and the new opportunities, not just for the Government but for local government and individual Members, on tobacco control policy.

As our plan makes clear, effective tobacco control needs comprehensive action on many fronts. The Government are taking action nationally. We are committed to completing the implementation of legislation to end the display of tobacco in shops. Since 2012, supermarkets can no longer openly display tobacco. In 2015 all shops will need to take tobacco off view. Tobacco can no longer be sold from vending machines, which has stopped many young people under 18 accessing smoking.

I do not want to downplay the importance of this policy—we are conscious that it could make an important contribution—but we can do many other things. The reasons why children, in particular, take up smoking are very complex, and are to do with family and social circumstances. One policy alone will not address that. Local authorities have a vital role to play, which is why we have given local government responsibility for public health backed by large ring-fenced budgets—more than £5.4 billion in the next two years. I encourage all hon. Members who have participated in today’s debate to ask tough questions of people locally. I hope that they are talking to their public health directors, health and wellbeing boards and clinical commissioning groups about where tobacco control sits in the armoury of local government. That is why this power has been devolved. The local insight and innovation made possible by that policy will help us to tackle tobacco use at a local level as well as through policies that the Government can put in place.

--- Later in debate ---

[Jane Ellison]

I will move on as I have tried to respond to the hon. Gentleman’s point.

Our local stop smoking services are among the best in the world. The fact is that smokers trying to quit do better if they use them. Research has found that

“English stop smoking services have had an increasing impact in helping smokers to stop in their first 10 years of operation”—

although I hear the challenge that has been made on the recent drop—

“and have successfully reached disadvantaged groups.”

The latter are obviously particularly important from a public health point of view.

This year, Public Health England has launched a new dedicated youth marketing programme. This marketing strategy aims at discouraging a range of risk behaviours, including tobacco use, among our young people. In this financial year, that is worth more than £1.5 million.

[Barbara Keeley]

The Minister does not seem to be saying what the Government will do about the decline in quitting—the fact that stop smoking services are not reaching people to the extent that they should be. Does that concern her, and is she going to do something about it?

[Jane Ellison]

That is something that I will look at carefully, but I point out to the hon. Lady that obviously this issue now falls under the remit of Public Health England. It will be on my agenda for the next meeting with the chief executive, and I will write to her after I have had that discussion, if that would be helpful.

Women (Government Policies)

Debate between Jane Ellison and Barbara Keeley

Wednesday 8th June 2011 Commons Chamber

[Barbara Keeley]

It hardly matters, I think. We are talking about three or four years of cuts and this year’s cuts will be followed by similar cuts next year and the year after. I am surprised that Government Members can look with such equanimity at something such as the 2,000 job cuts that are happening in Manchester.

The hon. Member for Devizes (Claire Perry) talked about protecting the NHS, but in reality hundreds of jobs are being lost in the NHS, as they are in local councils. Jobs are being lost through the abolition of our primary care trust in Salford and that change is also causing turmoil to local services and decision making. At Salford Royal hospital, 720 jobs are being cut, including those of 146 nurses. The Christie, our regional county hospital, is to reduce its staffing by 213—one in 10 of the current work force—including 40 nurse-grade jobs and 50 health care support or assistant jobs. I am sure that none of us would look with equanimity at that level of job loss.

[Jane Ellison (Battersea) (Con)]

Does the hon. Lady not accept that her own party did not campaign on the basis of ring-fencing or protecting the health budget? Does she not accept that it is highly likely that the situation would be far worse had her party been elected?

[Barbara Keeley]

No, I do not accept that. The turmoil that has been caused by the unnecessary top-down reorganisation, as well as the £3 billion cost of that reorganisation, is not helping.

Finally, and close to home in my constituency, Royal Bolton hospital is losing 60 posts, including 32 nurses, with 92 jobs going next year and 95 the year after. At Wrightington, Wigan and Leigh hospital, 533 jobs are going—a 13% reduction. These are the jobs and careers of my constituents, and women’s jobs are disproportionately affected because all those organisations employ significantly more women than men.

In recent months, there has been quite a focus on women’s jobs that are being lost, but the cuts also mean the loss of services that women use more than men. Women, as we know, are more likely to use libraries and health services and they need support from social care for family members and themselves as carers. Women will carry a disproportionate burden of the spending cuts that are affecting social care services as 58% of carers are women, and of those carers who combine caring with part-time work, 89% are women.

Next week is carers’ week, which has great support across the House, and the theme will be the true face of carers. Carers are being asked to talk about the reality of their lives as carers—how hard they can find it to be a carer and what could really make a difference to their lives. A report by the Care and Support Alliance in March showed that levels of unmet need were increasing even before the cuts to local council budgets. That is a great cause for concern. In the alliance’s survey of 1,000 people, nearly seven out of 10 respondents felt that they needed more support, more than two in 10 said that services had been cut back even though needs might have been increasing, and more than two in 10 said that the person cared for needed support but was not receiving any services.

That is not surprising, given that councils have been cutting their eligibility criteria for social care for some time, increasing charges for services and removing caps on charges. I am proud of the fact that, despite the swingeing 27% cuts to council budgets at Labour-run Salford city council, it has managed to retain eligibility criteria for social care at a level to help people with moderate needs as well as those with substantial or critical needs. Salford is now one of only 15% of councils that provide that level of care. That is in great contrast to councils such as coalition-run Birmingham city council, which recently tried to set its eligibility criteria to a new level of “personal critical”. More than 10,000 people would have seen their care packages downgraded and more than 4,000 people would have had no care services or support whatever.

My hon. Friend the Member for Birmingham, Erdington (Jack Dromey) reported the distress of constituents who came to him for assistance: people who were extremely vulnerable themselves or caring for someone who was elderly, ill or disabled. Women carers were disproportionately included. The Care and Support Alliance survey revealed that changes to services that happened even before the cuts had led to

“a negative impact to the person with care and support needs.”

The report quotes one female carer talking about the impact on her life. She said:

“I am unable to go out with my husband because one of us needs to remain at home with my mother. Unable to go out with my sister (also disabled) because if I go out she needs to stay home to support my husband in caring for our mother. Unable to visit friends, have a weekend away or take a holiday. Feel abandoned by the state—Carer’s Allowance withdrawn when I reached 60 last year, Carer’s grant reduced by Local Authority from £400 pa to £100 pa this year, top-up fees now payable for the 3 hour respite per week, no extra help available.”

Of course, such extra stresses also put further pressure on the health of many women who care. Another female carer is quoted in the Care and Support Alliance report as saying:

“I care for two and I am disabled myself. Although they have increased the care for my father, he still needs extra care from me. I get no help with my husband, who is also becoming more demanding and no help for myself. So my life gets harder and harder and my health is deteriorating as a consequence.”

Women who are carers are also worried about the Government’s plans to cut £1 billion from disability living allowance over five years by reducing the number of people who are eligible. Tightening the eligibility criteria for DLA will mean that many carers will not be eligible for carer’s allowance, which will be available only for those who look after someone who is in receipt of the middle or higher level of DLA. As three quarters of the recipients of carer’s allowance are women, that is yet another area in which women will bear the brunt of the cuts.

Carers UK has estimated that seven out of 10 women will be carers in their lifetime. We know that social care services for older people are underfunded and that the number of over-80s is increasing, so the pressure on family carers, who are mainly women, is bound to increase. Once again, women will be disproportionately affected.

Women are more reliant on the services that the public sector provides and therefore stand to lose more from cuts to services and from the loss of jobs that I have talked about. That affects my constituents and women who are carers. I have campaigned since I have been in the House to improve services and support for carers, six out 10 of whom are women. More could always be done, but Labour gave primary care trusts extra budgets to fund respite care, introduced the carers grant and provided £770 million in new funding for disabled children.