Income Tax (Charge)

Jeremy Corbyn Excerpts

Tuesday 5th November 2024 Commons Chamber

[Wes Streeting]

My hon. Friend is absolutely right about equity and fairness of access. The Government are determined to close the gap in healthy life expectancy and health inequalities that blight our nation. GPs and primary care are an important part of doing that. Unless we fix the front door to the NHS in primary care, we will not solve our NHS crisis. Unless we address the crisis in social care, we will not fix the NHS crisis. We will be able to do that only if we do so right across the country.

[Jeremy Corbyn (Islington North) (Ind)]

I fully understand the crisis that the Secretary of State inherited. He will be aware that most hospitals are running at a deficit, many have substantial debts and many are spending up to 15% of their income on servicing private finance initiatives. Is his Department prepared to make some kind of intervention to reduce that burden, perhaps by taking over the PFIs directly in order for our hospitals to be able to spend more on what they are there for, which is, of course, patient care?

[Wes Streeting]

I am grateful for that intervention. The right hon. Gentleman is absolutely right that we walked into a position of enormous deficits in the NHS, and an enormous black hole in the public finances was left by the last Government. That is why we have had to make some difficult choices. That is why we have to learn from the mistakes of the past and not repeat them in future. We are doing as much as we can as fast as we can. That is why it was important that the Chancellor made the bold choices she did in her Budget, so that, as well as plugging the black hole, we are fixing the foundations. Thanks to the fiscal rules adopted by the Chancellor, we will ensure that the Government do not repeat the waste, the profligacy and the irresponsible spending of our Conservative predecessors.

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[Jeremy Corbyn (Islington North) (Ind)]

I welcome this debate, which centres on health and inequality within our society. The hospitals are in a crisis situation, with huge demands on them, insufficient resources and underfunding, and of course huge debts from the past that are not being addressed. In an intervention on the Secretary of State earlier, I asked a question about the future of private finance initiative projects, which take up over 15% of most hospitals’ budgets. I think PFIs need to be taken over by the Treasury—as was envisaged in previous manifestos—as a way of releasing that cash directly into the national health service, which would help with waiting lists for operations and all the demands that are not being met.

My second point is that healthcare is not just about hospitals: it is also about social care and mental health. In the case of my own borough, Islington—a very typical inner-city borough in many ways—our social care costs are up by £20 million and going up all the time, because there are more and more people with demands. Families are moving away, more and more people are isolated, and demands are getting greater and greater. There has to be a change in the whole social care policy, and I hope the Government will bring forward serious proposals for a universal, wraparound national care service to take away the pain and stress that so many families face as a result of social care costs.

Likewise, the mental health crisis is real, it is serious and it is here, particularly among young people—sadly, often particularly among young males. I realise that it is early days for this Government, but I hope they will appreciate that not only do we need a much more effective and efficient mental health service, but we need to recognise that mental health stress comes from other stresses in society such as housing, jobs, families, environment and many other issues.

We cannot separate the question of healthcare and health needs from poverty in our society. Ending the two-child benefit cap would release some people, including children, from the desperate poverty they are in. Not taking away the winter fuel allowance from very poor pensioners would help a great deal. Likewise, the issues of housing stress, huge rent levels in the private rented sector and desperate levels of overcrowding for many people in communities such as mine have to be addressed. Under the proposals of the 1945 Labour Government, health and housing were linked together, and we need to look seriously at that.

My local authority, Islington, has lost £105 million in payments since 2010. That is typical for local government. We need the money put back in to deliver the services our people need.

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[Darren Jones]

The hon. Gentleman perhaps forgets that the vote is tomorrow. No doubt he will come to the House to vote to support the allocation of £22 billion of extra funding so that the national health service can cover the cost of the doctors and nurses who, under his Administration, were striking on the picket line while Ministers refused to talk to them. Under this Government, they are back on the wards and in the theatres delivering for the people of this country.

The Government recognise the need to reform the social care system, and we thank those who work in the system for the work they do to help those in need. That is why we agreed a £600 million funding increase for 2025-26, and we will return to this issue in the second phase of the spending review.

I politely say to Members that I understand the temptation to ask for more spending, as I often did in opposition, but Ministers have to explain how they will pay for it. If Opposition Members want more spending or, indeed, fewer tax rises, they will have the opportunity tomorrow to set out to the House what they would do differently. Would they increase income tax and national insurance on workers once again? Would they increase VAT on people who go to the shops? Would they increase corporation tax for businesses, which we have pledged not to do? Would they reject the investment in schools, hospitals, the police service and the future of our country? Given their behaviour under the last Administration, do they wish just to borrow money every single month to pay the bills, month after month, increasing the national debt and increasing the cost of the national debt, but not investing in the fabric of this country, as this Government will do?

[Jeremy Corbyn]

May I take the Minister back to the question of social care? I understand what he is saying and that proposals will be brought forward, but there are two things: immediately, there is a crisis in local government about simply paying for existing social care, and, for families all over the country, there is a crisis about how they will support people who are in care at the present time. Is there an aspiration to bring forward a much more comprehensive model that will provide hope for people who are often going deeply into debt, selling property and all kinds of things, just to support a loved one who is in desperate need of profound social care?

[Darren Jones]

I thank the right hon. Member for his question. This Government have aspirations to improve the social care system, and we will set out further detail on those plans in due course.

Lastly, although not related directly to the NHS or public services, I welcome the supportive comments from Members across the House about the mineworkers’ pension scheme and the Post Office Horizon compensation scheme. As you know, Madam Deputy Speaker, I worked on those issues for many years when in opposition. We failed to persuade the former Government to do the right thing, but the great thing about being in government is that we can just say it is so, and it has been so. That is the difference that a Labour Government can make.

The Labour party has a proud heritage of delivering public services to meet the needs of the nation: the national health service, social security, comprehensive schools, the Open University, academy schools. This new Labour Government will seize the generational need to reimagine public services once again. We have an ageing society, fewer working people paying tax, increasing demand, failing standards and increasing costs. After 14 years of a Conservative Government, that is the legacy they have left this country. We will not walk by on the other side and ignore those challenges. We will set out how we will reform our public services, building on this Budget of investment, choosing it over decline, focusing on outcomes, prevention, devolution and innovation in order to modernise our public services.

As I have set out today, the big opportunity—the opportunity to build the new foundations of the new public sector—is technology. The productivity of our public service is held back by IT systems often dating back to the 1950s and the 1970s: fax machines in the NHS, an inability to share information between public services, tens of thousands of public servants doing their best to administer casework using paper. That situation has not been affected in any positive way over the past 14 years.

This is not about machine-learning algorithms, but about old computers in cupboards with information that is in desperate need of being transferred to the cloud. It is about the un-newsworthy but vital work of integrated software across Departments, an area of spending I protected and encouraged in phase 1 of the spending review. It is about what might seem obvious to people at home who are now used to doing their banking on an app or their shopping online, who cannot get through to a GP surgery, a decision on their universal credit or an answer to their tax question without a lengthy and often unsuccessful attempt to speak to someone on the telephone.

Our new digital centre of Government will drive digital transformation across Government, because modernising public services is not just a great opportunity; it is a non-negotiable requirement for any modern party in a modern Government today. If we had followed the Conservatives’ path of further decline, we would have broken public services that cost more, while failing the public who rely on them and the public servants who work in them. By choosing to invest, this party—this Government—will deliver a modern state that meets the needs of the nation and delivers a bright future for us all. Reform and growth, investment over decline—those are the choices reflected in this Budget and that is the change this Labour Government will deliver.

Ordered, That the debate be now adjourned.—(Gerald Jones.)

Debate to be resumed tomorrow.

NHS

Jeremy Corbyn Excerpts

Thursday 23rd May 2024 Commons Chamber

[Victoria Atkins]

I am delighted to hear that, and also to say that on my travels last Thursday, I had the great pleasure of visiting Dorset and seeing for myself not just a wonderful community hospital in Shaftesbury, but the brand new A&E unit that is being built in Dorchester. It is thanks to the hard work of the local trust, but also to Government investment, that that important hospital—alongside those that my right hon. Friend has described—can ensure that people in Dorset receive the care that they need in a modern way. That is the modern national health service as we Conservatives see it.

[Jeremy Corbyn (Islington North) (Ind)]

Does it not concern the Secretary of State that we are spending a great deal of money because of the private sector, which is an undermining factor in the NHS? The NHS paid £11 million to the private health sector in 2022, and many hospitals are spending 15% of their budgets on private finance initiative contracts. Does she not think that we could save an awful lot of money by concentrating on expanding the NHS workforce? Their loyalty, dedication and efficiency are far better and far greater than the atomisation of our services into myriad private sector providers. It is cheaper and more efficient to provide the service publicly, thus providing a better service for everyone.

[Victoria Atkins]

Let the record reflect this rare moment of agreement between the right hon. Gentleman and me. The PFI contracts signed by the last Labour Government have been an unmitigated disaster for our hospitals, and for the integrated care boards and others who are trying to fund them. The Labour Government drafted the contracts so incompetently that we cannot leave them without a massive cost to the taxpayer. That is the real cost of Labour-run private finance initiatives.

However, I part company with the right hon. Gentleman on the role of the independent sector. We already rely on that sector to provide something to the tune of 10% of elective procedures. I want our residents treated as quickly and as well as possible, and to my mind the independent sector must play an important role in that. We Conservatives want to make it even easier for patients to choose where they receive their treatments, so that they receive them more quickly, as well as the quality of service that they want. I do not know whether he will be here after the election campaign, but we there is at least one area on which we have agreed, namely PFI.

Future of the NHS

Jeremy Corbyn Excerpts

Thursday 23rd February 2023 Commons Chamber

[Matt Hancock (West Suffolk) (Ind)]

I rise to set out in this debate on the future of the NHS, with the experience of three years as Health Secretary, how we can build on the promise of healthcare that is free at the point of delivery for every single person in the United Kingdom. This is a promise that I hold dear in my heart and that my party has supported with enthusiasm throughout the NHS’s over 70-year history. In fact, the NHS has been run by Conservative-led Administrations for the majority of its time.

It is a joy to follow the hon. Member for Jarrow (Kate Osborne). A few of her comments were not quite right, but I can tell from what she said that she, like me and like the vast majority in this House, supports the principle of an NHS that is free at the point of use. As a Conservative, there are many reasons why I believe in that so strongly. I will set aside and not make the straight- forward political argument that no party in this country would ever get elected to power without steadfast support for the NHS. As Nigel Lawson put it, the NHS is the closest thing we have to a national religion, and that captures it about as well as we can. Over 75% of the public believe that the NHS is crucial to British society.

However, there are substantive reasons, as well as those purely political ones. The first is the importance of the efficiency and effectiveness of the delivery of healthcare—the nuts and bolts of why it is good to have a free-at-the-point-of-use healthcare system. According to 2019 figures, just before the pandemic, the proportion of GDP that we spent on healthcare in this country was just over 10%. In the United States, it is over 16%. In Germany and France, it is higher too, yet life expectancy is higher in the United Kingdom, showing that we deliver more effective healthcare, and a lot of that is because it is a universal service delivered free at the point of use.

The second argument, which is quite an unusual one that is not often made but is important especially to those whose heart beats to the right, is a pro-enterprise, pro-business one. Enterprise is the source of prosperity for any nation; a quick look at the history books demonstrates that that is where our prosperity comes from. We can start a business in the UK and employ somebody in the private sector without having to pay for healthcare, whereas in many countries around the world, one of the first costs for a new or growing business is healthcare for its employees. That is not necessary here. There is a pro-trade, pro-business argument for having an NHS free at the point of use.

Thirdly, there is the moral argument for having a universal healthcare system. It is impossible for any of us to know when we will need healthcare—it is impossible to know when we might have a condition or an accident that means we need healthcare. The NHS means that we, metaphorically, sit by each other’s bedsides and support each other in our hour of greatest need. That is why the public’s connection to the NHS, and certainly my connection to the NHS, is not just a question of policy; it is a deeply emotional connection. We are in the NHS at some of the best times in our life, such as when children are born, and some of the worst times in our life too. That provision being there for us when it really counts means that there is a moral case for universal healthcare provision, free at the point of use, that I hold dear too.

[Jeremy Corbyn (Islington North) (Ind)]

I absolutely agree that there is a moral case for healthcare free at the point of need in our country—I absolutely support that. Does the right hon. Gentleman not think, though, that there is something immoral about the huge profits that are being made out of the NHS by private contractors that have been brought into it, when those profits that are paid to shareholders all over the world in the form of dividends would be better invested in the healthcare of people in this country?

[Matt Hancock]

I am very grateful to the right hon. Member for that intervention. I am not surprised that he agrees with what I said about the moral case for a universal healthcare system, nor that he makes the case against any use of profit in the NHS. I was going to come on to exactly that point, because it is bunkum to suggest that the NHS has ever in its history provided services without the use of private companies. That has happened throughout the long and proud history of the NHS, and it is absolutely vital to its functioning—always has been, always will be, under Governments of all stripes. I will come on to explain why.

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[Liz Twist]

That certainly concerns me and, yes, my hon. Friend is absolutely right to say that. Actually, I would say that in the north-east we have really good and positive acute services, which are the ones he is talking about, thanks to the hard work of so many people, but what we lack is the preventive work and the work to avoid people becoming ill in the first place. We have the lower life expectancy and the health inequalities that my hon. Friend the Member for Jarrow talked about, so it is important to our people that we do that.

I was interested to hear the comments of the right hon. Member for West Suffolk on health inequalities. He is right to identify them, but what the Government have done is reduce the amount available to public health to address those issues before they develop. It is great that we have good hospitals and good-quality services, although they are really under pressure, but unless we address those public health issues and fund public health services, we are not going to tackle some of those issues.

The other aspect of that is social care. Once again, the Government have failed to tackle social care, and we know that one of the key things in tackling social care is getting people discharged from hospital, and getting them and supporting them to be independent at home. However, we really need a plan and to think some more about this. It may be a different Department—[Interruption.] No, it is the same Department now—sorry; my mistake—but we need to tackle that issue if we are going to make real progress.

I want to talk a little about mental health services. Many Members will know that I chair the all-party parliamentary group on suicide and self-harm prevention. We see the impact of a whole range of different policies, and the inability to access services. Too many mental health patients are forced to seek mental health treatment through emergency or crisis services. One in 10 ends up in A&E. We need to ensure adequate access to mental health services for both children and adults facing mental health crises.

[Jeremy Corbyn]

My hon. Friend makes an important point about isolation and mental health, particularly for teenage boys who, sadly, have the highest suicide rates. There has to be a reach-out and an understanding that overcrowding, poverty, bad housing and many other things contribute to mental health stress. It is not just a medical condition.

[Liz Twist]

It is absolutely right that socioeconomic factors have an impact on the number of suicides and lead people to suicide ideation. It is clear that mental health services for young people are struggling. People can be identified as having mental health problems, referred to child and adolescent mental health services and still not get the support they need for years. It is a difficult situation and something needs to be done. Mental health is an integral part of our NHS and needs to be dealt with effectively.

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[Jeremy Corbyn (Islington North) (Ind)]

I thank the hon. Member for Jarrow (Kate Osborne) for initiating a debate that enables us to discuss the real philosophy behind the national health service.

When Aneurin Bevan piloted the original NHS legislation through the House, he was inspired by the way in which those in the community of Tredegar supported each other. In many ways, our NHS owes as much to the mining community in south Wales as it does to anyone else, in the sense that that was a community providing for each and every person, irrespective of their ability to pay but absolutely cognisant of their needs. That, surely, has to be the principle behind the national health service. There has been a little bit of rewriting of history today; just for the record, the Conservative party opposed the foundation of the NHS in 1947. It is on the record. It is in Hansard. No one can rewrite that.

We must also recognise that on his mission to establish the NHS, Nye Bevan was forced to make a number of compromises, the biggest of which was over the GP contract idea. The then BMA, which has thankfully mended its ways and is now very much part and parcel of the trade union movement within the NHS, opposed the NHS and threatened not to take part in it at all, hence the contractual arrangement that GPs have. In a sense, it is that contractual arrangement that is a fundamental problem within the NHS, and it affects not just GPs, but many others as well. There has been a discussion about dentistry today. Surely, many other countries do not have this problem; they see a doctor as an important part of the health service, as we all do, and therefore we should employ them on a salary to be a doctor within the NHS. There are a small number of places around the country that have salaried GPs. I had one such practice in my constituency and it worked absolutely fine, until this Government interfered and handed it over to an American healthcare company, which, fortunately, has now been sent on its way, and the practice is now out for tender once again.

The original provision of the NHS was total healthcare, including preventive healthcare, such as optical treatment and dentistry. That was taken out of the NHS only two years later, and the prescription charges came in at the same time. As many have said today, we need to look at dental costs. Even within the NHS, they are so huge for many of our constituents that they either suffer the pain or borrow huge amounts of money to get private dentistry just to be able to get through the pain barrier that comes from not being able to get treatment. That is not acceptable. It is actually very expensive not just for the individual, but for our health service as a whole. We need to think a bit more about revisiting the totality of our national health service.

The undermining of the NHS went on for quite a long time. It reached its zenith, if you like, with the Health and Social Care Act 2012, which was piloted through by the coalition Government. That built on previous internal market ideas and specifically encouraged the contracting out of services, which are making a great deal of money through pharmacies in hospitals, through private finance initiatives in hospital and through a whole lot of other things. Money is being taken out of healthcare and handed over as private profit, which is why I intervened on the former Health and Social Care Secretary on this issue.

If we run the health service on the basis of internal markets and profitability, a massive bureaucracy is required to manage that internal market. That means that we end up with many managers working out who will get a contract to do which bit, rather than making the objective the totality of the hospital, the care system, the care service and whatever else it happens to be. We should be looking to more public ownership and intervention in the NHS, not less, and we should not be handing services over to private contractors.

It is not sensible to have a private contractor—say, Virgin Health—running a pharmacy within a hospital. That pharmacy should be part and parcel of the service of the hospital, where all are working for the same employer.

[Ms Marie Rimmer (St Helens South and Whiston) (Lab)]

I agree entirely with the sentiments expressed by my right hon. Friend. However, does he accept that, when we do not have the supply of workers to meet the needs at the time, we should bring in more nurses and doctors from abroad? We should do that while we assess the numbers that we need to train. Once we have trained more people, we can stop bringing in the staff from abroad. The same applies to contractors and the private sector now. What is not known widely is that many GP practices are private companies—they are not part of the national health service. Where that is not happening, we should be recruiting more GPs.

[Jeremy Corbyn]

I agree that the issue of recruitment is crucial, which means that the issue of training is crucial. However, we have relied for a very long time, and we still do, on many medical professionals coming from other countries, making their homes here and making an incredible contribution to all of our lives. We should thank them, thank the Windrush generation and thank that generation of Irish nurses and others who came to this country to work in and run our NHS. My hon. Friend is right: when there is a shortage or a crisis, we need to reach out to somebody else—perhaps a private contractor—to help deal with it. I can see that happening in an emergency situation, but it has now become part and parcel of the NHS.

Most Members of this House grew up with the idea that the GP was the local person in a local practice. That GP might or might not have been in an NHS-owned building, but they were part of the NHS. We now have major American companies owning a large number of GP practices and providing that service. When I warned, during the 2019 election campaign, that the Government were in secret negotiations with the USA to allow American healthcare companies to enter our health market—as they deftly termed it—I was told that this was some kind of Russian plot that I was regurgitating. It was nothing of the kind. It was a dodgy deal done by this Government to bring in those private healthcare contractors who are making a great deal of money out of our NHS. What we need is public ownership of our NHS. I absolutely agree with the intervention of my hon. Friend the Member for St Helens South and Whiston (Ms Rimmer).

I think everybody would accept that the NHS performed brilliantly during covid. However, what the former Secretary of State did not say was that he managed to make a lot of monumentally ineffective contracts with Serco and others that made a huge amount of money out of track and trace—out of our NHS budget. Those places that used local public health services for track and trace had a much better outcome. We should recognise that the need to invest in local public health services for preventive measures such as track and trace, as well as for many other preventive health measures, is very important, because, as others I am sure will agree, that ends up reducing the overall costs.

A central part of my contribution today is about the care services in this country. Everybody knows that quite a large number of people in NHS beds cannot leave hospital because the care service is simply not sufficient and cannot accommodate them. That means that they are stuck in the worst possible situation. They are in a very expensive NHS hospital bed, where they do not want to be, and are in danger of picking up or passing on an infection while they are there. They want to be in a care facility, but there is not one available for them. That is a monumental waste of money and resources, and it is also very cruel on the individuals concerned. We have all met such patients in hospital.

There was a 15% reduction in care beds between 2012 and 2020. Now, 84% of our care services are owned and run by the private sector. There have been debates in this House for as long as I can remember about the inadequacy of social care, the need to invest more money in social care, and the need to provide for real social care.

Social care is a fear that stalks many families. It is the fear that an older relative—a parent, or whoever—will develop dementia or any other condition, and need social care as a result. The amount of money that they would have to pay into the private care system terrifies people. To avoid that cost, who pays? Usually it is women in families who give up jobs, careers, and their life to care for somebody. It is not that they do not love their relative—they do love them—but their whole lives are turned around by the needs of care. We must grasp this nettle.

If in 1948, with all the post-war problems of investment, public austerity and so on, we were bold enough to develop a national health service, surely to goodness by 2021 we can be bold enough to develop a national care service, which takes away the fear for so many people of the enormous costs of healthcare—healthcare that at the moment is largely provided by the private sector on low wages and in sometimes not very adequate conditions. I think we need to revisit that. An interesting report produced by Unison on social care makes five recommendations, and I will quote the first:

“Remove the profit motive from the care sector. This would involve transitioning to either a national care service or a mix of not-for-profit provider types. If coupled with sufficient Government funding that meets the true cost of care provisions (something which is currently not in place), it would offer a number of benefits including greater financial accountability, value for public money, and likely greater attention to achieving quality care rather than generating a return for investors.”

People are making a great deal of money out of those with social care needs. I think we need to turn that around and ensure it is a public investment.

Our NHS was founded and put forward by very brave people, and it is something we should value and preserve. I think of the people who campaigned for many years on the national health service, but it has problems within it. It has the care problem that I have mentioned, and the inadequacy of mental health provision has been mentioned by a number of colleagues. Some years ago we mounted a huge campaign in my constituency to prevent Whittington Hospital from closing its A&E department. We were successful. The local papers, the community—everybody—got behind the campaign, and the A&E department is open and treats more than 90,000 patients a year. At the end of the campaign we held a celebration rally, and the main organiser of the campaign, Shirley Franklin, said, “Would you all have been here if it had been a mental health unit to be closed, or would you have stayed away?” I think we all know the answer to that. Mental health is seen as something separate and different that we simply do not want to talk about. We must invest in it fully.

This debate is about investing and extending, and thanking those who have gone before us. Some weeks ago I learned with great sadness that the late Alice Mahon died on Christmas day. I will be attending her funeral the week after next. She was a fantastic worker in the NHS, an auxiliary nurse, and I remember her like it was yesterday, standing up in this Chamber and challenging Ministers, be they Tory or Labour: “What are you doing to defend the principle of an NHS that is free at the point of need?” We can learn from the inspiration of wonderful people like the late, great Alice Mahon.

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[John McDonnell]

That is an extremely valid point that must be addressed. When some of us were doing health economics in the 1980s and onwards, we were always told that the level of funding required just to maintain a standstill operation for the growing ageing population was at least 4%. What happened under Labour was a 6% annual rate of funding.

I will be honest with the hon. Gentleman: when I was on the Government Benches and Labour was in government, I was asking for more. Gordon Brown, to give him his due, had a sense of humour; I always used to produce an alternative Budget, so he described me as the shadow Chancellor even when I was not. I did that on the basis that I thought 4% was not enough and, while 6% was right, we needed to go further, because it was about not just the ageing population but the increased levels of morbidity we were experiencing. In addition, as the hon. Gentleman mentions, new treatments come on board and are more expensive.

Even though I was looking for increased investment, beyond what Labour was doing then, Labour was not just keeping pace with the 4%, but was going beyond it at 6%. To be frank, although the hon. Gentleman swore in the Chamber earlier, he should have heard some of the language I used in 2010, because I was quite angry as well. Those of us who were there will remember that in 2010, investment dropped to 1%. We were saying to George Osborne, who was the Chancellor at the time, “You are going to reap the whirlwind here for dropping the level down to 1%, because it means an erosion of the services that are provided.”

In addition, that investment did not recognise our ageing population or the other emerging issues with morbidity. I understand that the covid inquiry will include analysis of the resilience of the health service to cope with the covid pandemic. I believe that a number of those representatives are seeking to have George Osborne appear before that inquiry, because he bears responsibility for that under-investment.

Other hon. Friends have mentioned mental health, and I agree that it has been the Cinderella service. When I looked at mental health funding, I found that it has increased at a faster rate than overall NHS funding—at times nearly 3% as against 1%. However, that follows years of small increases or real-terms funding cuts, and the number of NHS mental health beds is down by 25% since 2010.

Curiously enough, I was on a bus in my constituency yesterday with a former mental health nurse, who described to me the implications of that and the consequences for the individuals concerned. Community mental health nurse numbers were also impacted upon. Some of us will have dealt with the results of that in our constituencies; in my constituency, I have to say, it has meant dealing with suicides as well.

[Jeremy Corbyn]

Is my right hon. Friend aware that the impact of an inadequacy in healthcare provision falls on A&E departments, which take in people who have mental health crises but are ill-equipped to cope with them; on neighbourhoods that cannot cope with people going through crises; or on the police, who have to intervene simply to look after someone for whom there ought to be mental health provision. We fail to invest in mental health provision at our peril.

[John McDonnell]

Anyone who has talked with them will have heard local police officers say that they have become social workers, mental health workers and so on. In many instances, they are doing the best job that they can, but they need expert support, including from health workers in the community.

I looked at the figures, and there are now 1.6 million people on the waiting list for specialist mental health services. One of my concerns, which was raised in a debate some months ago, is what is happening with CAMHS —child and adolescent mental health services. Delays in treatment have increased massively since 2019, and waiting lists are getting longer. I have looked at the stats: 77% of CCGs froze or cut their CAMHS budgets between 2013-14 and 2014-15, which was the crunch year; 55% of the local authorities in England that supplied data froze or increased their budgets below inflation; and 60% of local authorities in England have cut or frozen their CAMHS budgets since 2010-11. Again, that is staggering.

To come back to mental health nurses, in 2010, we had 40,297 of them; we are now down to just 38,987. That does not seem a significant drop, but it is still a drop. As a number of Members on both sides of the House have mentioned recently, we are going through a mental health crisis—one that affects young people and young men in particular, as my right hon. Friend the Member for Islington North has pointed out.

Let me come to the stats on social care. Age UK estimates that more than 1.5 million people aged 65 and over have some form of unmet or under-met need—[Interruption.] Excuse me—[Interruption.] Thanks a lot; I could do with something stronger.

Urgent and Emergency Care Recovery Plan

Jeremy Corbyn Excerpts

Monday 30th January 2023 Commons Chamber

[Steve Barclay]

Community hospitals are key to tackling the issue of delayed discharge. Community settings have been a bit of a Cinderella in the past. The data on community settings tends to be weaker than it is in other parts of the NHS. Alongside domiciliary care and making better use of residential care capacity, the third element for discharge is to look at how we use community step-down in a much more constructive way. One key issue there is to have wraparound services so that people do not simply get transferred to a community setting, but that it is a staging post before getting to the home, which is where most patients want to be.

[Jeremy Corbyn (Islington North) (Ind)]

The social care sector is dominated by dedicated staff who are paid low wages. High profits are made from it and there is an insufficiency of spaces. Will the money that the Secretary of State has announced go to local authorities? Can it be spent on public provision? Does he not think it is time to recognise that the internal market and privatisation have sucked money out of health and social care—money that could have been spent on patient care and caring for people in the community and in special facilities?

[Steve Barclay]

One area of the right hon. Gentleman’s question where I do agree with him is the importance of local authorities. One reason I am keen to see more clarity on data and transparency is that there can sometimes be a tendency for the local authorities to be blamed for discharge, when often it is factors within the NHS that contribute to some of those who are fit to leave hospital not doing so. On the money allocation, the £2.8 billion is targeted to local authorities—funding set out by the Chancellor—with £4.7 billion the following year. We are increasing the money for local authorities, but alongside that we are working with them to improve the data so that we can see where there are blockages due to local authorities. For example—Mr Speaker will be familiar with this—Blackpool often has visitors from out of the area, so the NHS there deals with a number of local authorities, not simply the nearest one. We are working intently on how we support local authorities as part of the wider discharge package.

Civil Proceedings

Jeremy Corbyn Excerpts

Tuesday 29th March 2022 Commons Chamber

[Maggie Throup]

It has been clear throughout the pandemic that people living in areas of deprivation and different ethnic minorities have been impacted more than others. We are committed to addressing that, which is why we will launch a health disparities White Paper shortly that will look at all the different issues.

[Jeremy Corbyn (Islington North) (Ind)]

Following on from the point that was just made by my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams), the Minister must be aware of the massive effect of the whole coronavirus process on mental health, particularly among young people—even among children in primary school. Are the Government committed to putting the necessary resources into the hardest-hit communities where the mental health crisis is at its worst?

[Maggie Throup]

The right hon. Gentleman makes a very good point. We know that the pandemic has had a mental health impact not just on children and young people, but on people of all ages. That is why it is important that we are now living with covid and getting our lives back to normal, which is one way of helping restore that normality that we are so desperate to get back to.

The Government helped businesses at a time when many faced disruption, including through the coronavirus job retention scheme. We have also supported the self-employment income support scheme, which paid out more than £28 billion to nearly 3 million self-employed people and was one of the most generous schemes for the self-employed in the world.

--- Later in debate ---

[Andrew Gwynne]

My hon. Friend hits on an important point for debate at some stage in the near future. There is a concern that the cohort that has been drawn up for access to antivirals is not as wide as it could be, and certainly not as wide as in other European countries. We must also think about how we provide the maximum level of confidence to those communities.

For me, an ideal package to protect the immunosuppressed and clinically vulnerable would be the availability of free lateral flow tests for people coming to visit those who are clinically vulnerable or immunosuppressed, a drug such as Evusheld that would give at least 70% confidence—similar to the efficacy of the vaccine—to those people who are not able to be protected by the vaccine, and then access to antivirals if they become symptomatic.

I have asked the Minister on a number of occasions when we can expect information on the eligibility for free testing and have not even received an approximate date for when it will be published. That is totally unacceptable. We urgently need that clarity, given that we are three days away.

I draw colleagues’ attention to the provisions in the motions relating to sick pay that are set to expire. Here in the United Kingdom, we have one of the worst levels of sick pay in the OECD. Statutory sick pay currently sits at just £96.35; that, I am afraid, is shameful. I could not live on that and feed my family, and I am not sure the Minister could either. The 2 million low-paid workers who earn less than the lower earnings limit of £120 receive nothing. That is before we consider self-employed people, who continue to remain ineligible for statutory sick pay. Self-employed people were badly let down over the course of the pandemic. A recent study by the Community trade union shows that a majority of self-employed people were rejected from vital covid isolation support payments. In suspending the temporary provision that allowed workers to receive statutory sick pay from the first day of their illness, the Government are stubbornly sticking to their regressive attitude to sick pay, which will continue to have a lasting negative impact on public health.

In recent remarks, the Prime Minister urged the public to exercise “restraint and responsibility” to avoid spreading the virus. This Government love to lecture us on personal responsibility while also pricing people out of making the right decisions. We should not be forcing people to choose between putting food on the table or infecting their colleagues. As well as being morally reprehensible, the sorry state of sick pay in this country will lead to more workers getting sick, leading to worse public health outcomes and, in the long term, costing the country far more in reduced productivity.

[Jeremy Corbyn]

I absolutely agree with my hon. Friend about rates of sick pay. Is he aware that the levels of poverty since the end of the pandemic are increasing, that access to food banks is in greater demand than ever before, and that statutory sick pay often leads people to take serious risks because they have no alternative but to go out and try to work, even though they may well be displaying symptoms, in order to feed themselves and their families? That is a disgraceful situation in this country, and it can be dealt with by having a proper system of decent statutory sick pay as every other European country does.

[Andrew Gwynne]

My right hon. Friend is absolutely right. Of course, for too many people in this country, that is the reality of their day-to-day to living—and we know that it is going to get worse. I should remind the Government that we are in the middle of a cost of living crisis, although I appreciate that they may not have realised that given the Chancellor’s spring statement last week and his inexplicable decision to clobber working people with the highest tax burden in 70 years. Inflation is at a 30-year high, energy prices are sky-rocketing, and we are facing the biggest drop in living standards since the 1950s. I really do fear that, as my right hon. Friend said, more and more people will be drawn into levels of poverty that we have not seen in this country for a very long time.

This is completely the wrong time for the Government to remove provisions that give people the financial support to self-isolate while also ending free tests. Surely the Minister cannot continue to defend this patently self-defeating policy. If people cannot afford to test and they cannot afford to self-isolate, what does the Minister think will happen? Do the Government think that covid will magically vanish? Of course it will not. Living with covid does not mean ignoring the fact that it exists. It does not mean turning back the clock to 2019 and forgetting that the pandemic ever happened. The pandemic happened, covid is here, and for too many people covid will still be an issue going forward.

In terms of living with covid, only Labour has set out a proper plan that would prepare us for new variants while securing our lives, livelihoods, and liberties. We would prioritise testing and make it fit for the future, fix sick pay, and learn the lessons of the pandemic. The Conservatives’ plan is to repeat the phrase “personal responsibility” over and over again, and hope that no one notices that there actually is no plan. We cannot simply turn back the clock and pretend that covid never happened.

--- Later in debate ---

[Imran Hussain (Bradford East) (Lab)]

I rise briefly to speak on these measures with regard to the coroners process and particularly the registration of deaths.

In my local authority of Bradford, some of the measures over the past two years have seen a significant reduction in the bureaucratic hurdles and red tape that people face in registering deaths. That includes a significant decrease in the delay between the death of an individual and their burial. Some may see that as trivial, but for those of the Muslim faith it is particularly important, as it is a key requirement for the recently deceased to be buried as soon as possible. I strongly believe that it would also be a good thing for those of all faiths as well as of no faith, because it enhances the dignity that is afforded to an individual after their passing; the deceased can be put to rest as soon as their relatives wish.

However, what the Government propose in this statutory instrument does not include the measures that we have seen over the past two years that have helped such a rapid turnaround. The SI does not include measures that allowed for deaths to be registered over the phone rather than solely in person, which is incredibly useful for the bereaved at a difficult time; measures that allowed the medical certificate of cause of death to be issued if the patient had been seen by a doctor within 28 days of their death rather than the previous 14 days; or measures that allowed certificates to be issued on the same or next working day, overnight, at weekends, or on bank holidays. Following their expiry last week, these measures are no longer in force. As a result, families will begin to see longer wait times and greater difficulties in their relatives being released from mortuaries, which will understandably cause great distress.

The measures that the Government are extending today are essentially intended to clear a backlog in the legal system, but we must remember the backlogs elsewhere in the public sector, such as in GP surgeries and hospitals more broadly. That is a particular concern to bodies in Bradford such as the clinical commissioning groups, Bradford Council, NHS organisations and other partners, which all feel that the changes of the last two years have worked well to make the system more efficient and sympathetic, at a time of immense distress for families. While I fully understand the need for protections to be put in place, I implore the Minister to work with Health Ministers—I am also happy to work with the Minister to discuss this further—to see what can be done to ensure that the deceased can be released quickly.

[Jeremy Corbyn]

I endorse what my hon. Friend says. Can he think of any reason why regulations cannot be introduced now to ensure that the speedy turnaround of death certificates that has been achieved, which has been of great comfort to the Muslim and Jewish communities in Britain, can be introduced urgently, so that this process can continue without causing stress to families who, by tradition, want if at all possible to undertake a burial within 24 hours of death?

[Imran Hussain]

My right hon. Friend makes an excellent point, which is the one I was coming to. I implore the Minister, because not only is this hugely important to our Muslim and Jewish communities; as I said earlier, dignity in death is important to those of all faiths and none. My right hon. Friend makes a valid point. This is an area where the Minister maybe has the power to work with us to bring something to the House that can secure cross-party support, in order to make a real difference and give people dignity in death. Again, I offer the Minister my support to work on this in all sincerity.

Vaccination: Condition of Deployment

Jeremy Corbyn Excerpts

Monday 31st January 2022 Commons Chamber

[Sajid Javid]

I thank my hon. Friend for her introductory remarks. As for her question about children and vaccines, she will know that when it comes to vaccination in general, we take advice from the expert committee of the Joint Committee on Vaccination and Immunisation, which, as she would rightly expect, keeps vaccination decisions under review at all times.

[Jeremy Corbyn (Islington North) (Ind)]

I hope that the Secretary of State can recognise the very important message given by the unions and the royal colleges only seven weeks ago about the short-sightedness of a compulsion policy, which would drive people—vital workers—out of the care sector and the NHS. I hope that we will never go down the road of compulsory vaccination. I support vaccination, but persuasion is much more powerful than compulsion. Persuasion, when people understand it, is a far more powerful message to get across.

Will the Secretary of State tell us what is the cost of each vaccine to each resident of this country, what is the cost of its manufacture, and whether he has any plans for the patent to be moved into public ownership so that the massive profiteering from these vaccinations can end and the public can get the benefit of it?

Public Health

Jeremy Corbyn Excerpts

Tuesday 14th December 2021 Commons Chamber

[Rachael Maskell (York Central) (Lab/Co-op)]

I rise to express my serious concerns about the principle of mandatory vaccination, not for any ideological reasons but because it will have the contrary effect to that intended and therefore is wrong.

My concerns are first and foremost for public safety and also patient safety. That is the analysis I bring; having worked in the NHS for 20 years as a clinician, that is drilled into us from day one. The Government’s lack of strategy in managing this pandemic is astounding and they must understand that we need to get ahead of the virus in order to lock it down, as opposed to locking people, and their futures, down. A lack of consistency also continually comes through their policies. They cannot have it both ways; there must be one approach that carries that thread of containing the virus. They cannot say to one venue that they are are going to lock it down but tell another venue it has all the freedoms it needs, because that simply does not work; in fact, it is dangerous, and therefore the Government need to get a grip.

The very people we revered—who just a year ago we were clapping and calling our heroes—are the very people who are now exhausted, traumatised and frightened, and the legislation before us will sack them. For two decades I was their colleague and I know the dedication, compassion and care they give to their patients; I was their trade union leader and I know their professionalism and the sacrifice they give for the people they care for. I will not undermine that trusted relationship, which is absolutely essential in delivering healthcare in our country, and I will not ride roughshod over Labour’s NHS constitution, which pledges to assist people to participate fully in their own healthcare decisions and to support them in decision making. I will not turn my back on working people, and I will never forget my roots and those I served alongside. While the Prime Minister partied, NHS workers put on layers of personal protective equipment and fought for lives. That is what those in the NHS do: you make sacrifices and while traumatised you just keep going.

[Jeremy Corbyn (Islington North) (Ind)]

My Friend’s excellent work as a trade union leader in the NHS is well understood. She is speaking on behalf of NHS workers; has she any idea how many will be affected by this totally wrong attempt to force vaccinations and passports on people?

[Rachael Maskell]

I am grateful to my hon. Friend for making that intervention and he makes a point I wanted to make myself. The Government’s estimate on that in their impact assessment is 123,000, and even in the best-case scenario 62,000 will lose their jobs, which the NHS simply cannot afford.

Health and Care Bill

Jeremy Corbyn Excerpts

Report stage
Tuesday 23rd November 2021 Commons Chamber

[Mr John Baron (Basildon and Billericay) (Con)]

Thank you for calling me, Mr Deputy Speaker, and I thank Mr Speaker for selecting my new clause 19. I also thank all those who have kindly supported it.

It remains an inconvenient truth that although our cancer survival rates are improving, we continue to lag behind international comparators. The primary reason for this is that the NHS does not diagnose cancers early enough. New clause 19 seeks to put that right by placing improved outcomes—that is, survival rates—at the heart of the NHS.

[Jeremy Corbyn (Islington North) (Ind)]

I strongly support the new clause. Does the hon. Gentleman also recognise that there can be delays in obtaining GP appointments in the first place, and someone who feels that they may be suffering from some form of cancer often loses several days—if not, on some sad occasions, weeks— before they get into the NHS system for treatment?

[Mr Baron]

I tend to agree, and that is in part what the new clause is intended to address.

I chaired the all-party parliamentary group on cancer for nine years. We were painfully aware that the Government had once estimated that if the country matched the best survival rates in Europe, 10,000 lives a year would be saved. In 2013, the OECD confirmed that that our survival rates ranked near the bottom when compared to those of other major economies. As we have improved our rates, so have other countries, and we are not closing the gap. A more fundamental change is required.

Back in 2009, when I first became its chairman, the APPG conducted a major inquiry which showed that the main reason our survival rates lagged behind others was not that the NHS was any worse than other healthcare systems at treating cancer once it was detected, but that it was not as good at catching cancers in the crucial early stages. In other words, late diagnosis lay behind our comparatively poor survival rates. The APPG had some success in getting the one-year survival rates—rates of survival one year after diagnosis—into the NHS DNA.

A key advantage of focusing on this kind of “outcome measure” is that it gives healthcare professionals much greater freedom and flexibility to design their own solutions, which could include running wider screening programmes and better awareness campaigns, and establishing greater diagnostic capabilities at primary care. A further advantage of focusing on outcome measures is that it will better align NHS priorities with patient needs. Survival rates are what really matter to patients. However, clinical commissioning groups are too often focused on “process targets”—the 62-day wait for treatment being an example—because they are often linked to funding. The one-year survival rate measure was not.

Research produced by the House of Commons Library found that nine such process targets were applicable to cancer alone, such as the 62-day wait. Process targets have a role to play in improving the NHS, but all too often they are a blunt tool offering information without context, and they can be exclusive, especially when funding flows are attached. Also, I consider it unacceptable that, in the case of certain cancers at least, patients should have to wait for 62 days—two months, in effect—for treatment. That is simply not right. Furthermore, process targets can easily become a political football between the two Front Benches, and only short-term points are scored. All sides are guilty of this, but it rarely helps patients.

In addition, process targets are not the best way of helping those with rarer cancers, with often fall between the cracks because data on those cancer types have not been routinely collected. That is a real problem. If we want to drive up survival rates, we cannot exclude rarer cancers, if only because they account for more than half all cancer cases.

Given the advantages of outcome measures such as one-year survival rates, I have tabled my simple amendment, new clause 19. Its aim is to ensure that NHS England puts outcome measures above process targets.

Coronavirus

Jeremy Corbyn Excerpts

Thursday 25th March 2021 Commons Chamber

[Jeremy Corbyn (Islington North) (Ind) [V]]

A year ago, the House gave the Government unprecedented powers to curtail and limit economic activity and our normal liberties, and placed huge responsibilities on our public services to deliver us from the dangers of the pandemic. A year later, we are not properly scrutinising this legislation. We are not apparently debating any amendments to it, and we have been given a take-it -or-leave-it approach by the Government, which is unacceptable in any democracy. Earlier this week, the renowned human rights group Liberty produced a very good document that suggested a better, alternative way of approaching this, and my great friend the Member for Brent Central (Dawn Butler) introduced it earlier this week as a Bill in this House.

I represent a densely populated inner-urban constituency. My local authority, Islington Council, my local hospital, the Whittington Hospital, and others have performed wonders during the past year in supporting people through this desperately difficult time. Volunteers, through mutual aid groups, have done fantastic work. They have organised and run food banks very efficiently, provided mental health support and supported our NHS workers. They are the very best of our society.

The effects of lockdown are not even across the whole country, however. If you live in a good-quality suburban house with a garden and plenty of space, working at home is difficult but it is not the end of the world. If you have space for your children to study, it is okay but not great, because they ought to be in school. We understand that. But if you are a family with three or four children living in one or two-bedroom flat with no balcony, no open space, insufficient computer access and insufficient income because of the coronavirus crisis, it is a very different story indeed. They are the children underachieving in school and the people going through a mental health crisis and, sadly, that has led to an increase in domestic violence. I have raised these matters before during debates and questions on this.

Overall, the Government’s record through the pandemic has been lamentable. They did not take seriously what the World Health Organisation was telling them in January last year, 15 months ago, and their levels of incompetence over the provision of PPE and their handing out of massive contracts to the private sector for the failed track and trace do not inspire confidence. We say well done to the scientists who have developed the vaccines and to those administering the vaccine programme as we speak, but why are the patents for these vaccines going to continue to be held by the private sector when the public have invested so much in them? Why are the poorest people in the poorest parts of the world not getting any access to these vaccines at all?

We should review this situation. It has brought out the best and worst of our society. Healthcare workers and others are now rewarded with a pay cut as a result of this. We need instead an approach that increases statutory sick pay and universal credit, guarantees decent housing and recognises the fact that those refugees and migrants without access to public funds also need to be protected. Our liberties are at stake under this Act. Why on earth could the Government not at least review section 21 on the powers of the police to prevent protest and demonstration? We need to live in a free society in which people can express their wishes. That surely is the very least we can expect from this Parliament and this Government. That is why I will not be supporting this legislation when we are invited to vote on it later today.

NHS Staff Pay

Jeremy Corbyn Excerpts

Monday 8th March 2021 Commons Chamber

[Helen Whately]

My hon. Friend is absolutely right. So many businesses have been so hard hit by the pandemic, and it is vital that we support not only the livelihoods of individuals who work in the businesses that have been hit, but those businesses themselves, because they are what will help us come through this and recover from the economic pain of the pandemic. He is right that the Government are having to balance these enormous demands on the public finances, and we also need to take steps ourselves to recover those finances so that we have a strong economy for the future.

[Jeremy Corbyn (Islington North) (Ind) [V]]

Does the Minister realise that there is a sense of the most enormous anger all across the country? Nurses have seen us through this crisis and have saved many lives, yet they are offered a pay cut as a result of it. Some are already having to resort to food banks to survive, and a third are thinking of leaving the profession unless they get a decent pay rise. Surely to goodness, if £37 billion can be found to pay Serco for a failed track and trace system, the money must be available to pay NHS staff properly. You cannot clap for them, and cut their pay at the same time. Surely we should just pay them properly, so that we can have a national health service that we can all be proud of and all rely on for all time in the future.

[Helen Whately]

Actually, talking of anger, it is probably not very helpful for many of those on the Opposition Benches to be fuelling a level of anger by calling a pay rise a pay cut. We are being absolutely clear that NHS staff are getting a pay rise. I also say to the right hon. Member that we need an NHS Test and Trace system to control the virus and we need NHS staff.