Health and Social Care

Jeremy Lefroy Excerpts

Monday 13th May 2013 Commons Chamber

[Mr Robin Walker (Worcester) (Con)]

It is a pleasure to speak in the debate on the Humble Address that was proposed so elegantly by my neighbour and hon. Friend the Member for Mid Worcestershire (Peter Luff), in whose speech I was named and suitably embarrassed. I was grateful for the kind tributes that were paid to my late father by my hon. Friend and the right hon. Member for Doncaster North (Edward Miliband), the Leader of the Opposition. I was keen to speak in today’s debate because what the Leader of the Opposition referred to as “that voice of moderation” and what my hon. Friend rightly identified as the middle way, the spirit of one nation conservatism, is not, as the right hon. Gentleman tried to suggest, unfashionable, but is at the heart of this Government’s programme and embedded in the Queen’s Speech.

“Efficiency with compassion” were the watchwords of my late father. He believed that a balance of the two was essential to meet the challenges of the hour and the needs of our country. I believe that the same is true today. Compassion has been shown by the coalition Government in introducing the Care Bill and by being the first to introduce legislation to cap social care costs. I spoke in the debate on last year’s Gracious Speech to express my disappointment that there was no such legislation and to support Opposition Members who were calling for it. It would be churlish of those who spoke out then not to recognise the enormous significance of the move in this Gracious Speech.

By setting a cap, albeit a higher one than many of us would have liked, the Bill will start the process of ensuring that nobody has to lose their home to pay for care. Setting a cap at any level should help the insurance industry to create products that protect thousands more people from that risk. The threshold, as the right hon. Member for Sutton and Cheam (Paul Burstow) pointed out, is key and will ensure that thousands more people are helped by the Government than would have been the case without the legislation.

This is not a theoretical far-off issue that we can put off tackling, but a real and painful issue that has affected our constituents for too many years. Hard-working people who have laboured and saved for years to afford the roof over their heads should not find that when they need care, their families are deprived of that asset. We all have constituents to whom that has happened. This is not, as some would like to pretend, a problem only for the rich. It affects everyone who owns a home and stands to lose it if the costs of their care are too great. Many of them are people who can afford to own a home only in retirement and many of them live in former council houses.

It was right of the Government to commission the Dilnot review and it is right to strike the balance that Dilnot acknowledged was needed between the cost of the policy to the public purse and the desperate need for a cap. Too many homes have been sold to pay for care. It is a tragedy that Governments of all colours have failed to act sooner to address the problem. It is greatly to the credit of the coalition that it is proposing the first part of a solution. I also draw the Minister’s attention to Macmillan’s ongoing campaign for further progress on free social care at the end of life, which was mentioned by my hon. Friend the Member for Truro and Falmouth (Sarah Newton).

Compassion is also being shown in the determination to improve the pensions of those who have spent years bringing up children, in the focus on preventing sexual violence across the world, and through tackling the impact of climate change, which will affect millions of the poorest people in the world. Compassion continues to be served by other ongoing policies of the coalition Government, such as the pupil premium, which directs funding to the most deprived pupils and helps schools to raise their attainment; the greater increase in the basic pension; and the increased investment in our NHS.

We have heard much from Labour Members about the pressures on our NHS and Ministers are right to have acknowledged the challenges faced in A and E and urgent care, but it is absurd for the Labour party to rail against pressures that have been building for years, including under its rule, and then to implement cash cuts in NHS spending in Wales, where that party runs the Government. The South Worcestershire clinical commissioning group will receive a £7 million increase in funding this year as a result of the coalition’s policy of increasing NHS spending. By coincidence, that is the amount by which the funding of Welsh health boards is being cut this year by the Labour Administration. On a recent visit to my local hospital, I saw some of the pressures on A and E, but I also saw how the coalition’s investment had enabled the retention of more nurses and how it will soon deliver a new clinical decisions unit that will help to alleviate some of the pressures.

We have heard much from the Labour party about the supposed privatisation of the NHS. I recently asked my local clinical commissioning group what amount of its budget goes to the private sector. Knowing that it has for some years, including under Labour, contracted certain operations, such as hip replacements, to private sector providers, I had presumed that the amount would be quite significant. I was surprised to find that the spending of the South Worcestershire clinical commissioning group in the private sector amounted to just 1.8% of its budget. That is less than its increase in spending this year. This Government are committed to efficiency and compassion in the NHS.

Compassion and efficiency are served by the emphasis on education in the Queen’s Speech. I would like to expand on that in more detail, but fear that I do not have time. We have heard excellent speeches from my hon. Friends the Members for Lancaster and Fleetwood (Eric Ollerenshaw) and for South West Devon (Mr Streeter) about the funding formula in health. I merely point out to the Government that addressing the funding formula in education is equally urgent.

[Jeremy Lefroy (Stafford) (Con)]

Will my hon. Friend acknowledge that that is an issue across many parts of England, including in my county of Staffordshire?

[Mr Walker]

I wholly agree with my hon. Friend. I will be in Staffordshire to meet the F40 group and its executive, who are campaigning for fairer funding and a more efficient system.

That brings me to the efficiency side of the equation. As a member of the Business, Innovation and Skills Committee, I would have liked to speak on the day of the debate that was themed on that portfolio. I regret that the Opposition chose to assign that theme to a Friday when I, like most other MPs, have many commitments in my constituency, including speaking to local businesses and schools.

There is a great deal in the Queen’s Speech to support business and increase efficiency in Government. The employment allowance is something that I have campaigned for and it will be extremely welcome to smaller businesses and entrepreneurs as it will reduce the cost of taking people on. I would like to have seen a Bill to reform business rates and will continue to push for further such reforms. The Bill to reduce regulation on business has been called for by almost every business organisation that I have met and will be universally welcomed, as long as it works.

The investments in infrastructure are sensible and necessary to support growth in our economy and to get Britain moving. Reducing the deficit is essential. For all the noises off that we have heard from the Opposition in this debate, they still have not got the point that the answer to a debt crisis cannot be to borrow more. When one invests, it is essential to invest well. The story of Worcester’s colleges is just one example. The previous Labour Government promised huge rebuilds costing tens of millions of pounds, but delivered nothing. This Government have delivered measured investments that have made a difference.

It would be remiss of me, having spoken in the Back-Bench debate on an EU referendum some years ago, not to mention the amendment that has been tabled by many Back-Bench Members, which I hope will be selected for debate by the Chair. I was proud to support a motion that called for a European referendum two years ago. I welcome the fact that our Prime Minister has set out clearly that he will fight for a referendum at the next election and that he is pressing for a renegotiation of our relationship with the EU in the meantime. He was right to wield his veto, he was right to press for a reduction in the European budget, which many thought was impossible, and he is right to say that the people of this country need to be given a real choice. Like my right hon. Friend the Member for Mid Sussex (Nicholas Soames), I have every confidence that he will continue to succeed on this issue.

I regret that some in the media have sought to build the amendment up as a criticism of the Prime Minister. It is for that reason that I did not sign it. However, I do regret that we could not include an EU referendum Bill in the Queen’s Speech, not because I believe it could have succeeded against the arithmetic of this House and its current composition, but because the debate would have shown how out of touch the main Opposition party is on this issue. I shall therefore support the amendment if the chance arises, and I welcome the fact that in my party at least, it will be a matter of conscience and a free vote. Although the current media frenzy is trying to paint a picture of division, I am pleased that my party is united in its determination to change our relationship with Europe for the better.

In conclusion, it is a challenge for all Governments to balance efficiency with compassion, but for all the strains of coalition—and there are many—the coalition Government continue to govern in the national interest. Perhaps that is why, despite being mid term and despite visits in the weeks before the recent local elections from the leaders of UKIP and the Green party and the Leader of the Opposition, the party that won the greatest share of the popular vote across Worcester was none of those but the true one-nation party—the Conservative party.

I particularly welcome the historic and long overdue decision announced in the Gracious Speech to place a cap on the cost of social care. I am honoured to have spoken in this debate and I look forward to supporting the Government as they continue to press for a fairer and more prosperous Britain.

--- Later in debate ---

[Jeremy Lefroy (Stafford) (Con)]

It is an honour to follow the hon. Member for Barnsley Central (Dan Jarvis), with whom I entirely agree about standardised packaging for cigarettes. I also agree with those who have spoken in favour of a minimum price for alcohol on public health grounds.

The Gracious Speech contains many important measures that are likely to assist the economy in my constituency—not least the employment allowance, the reduction of the burden of excessive regulation and measures to make it easier to protect intellectual property. Unemployment has fallen in my constituency since the election, but there is still a great deal to do. The number of apprenticeships has risen, so I welcome the Government’s plans to ensure that it becomes

“typical for those leaving school to start a traineeship or an apprenticeship, or to go to university.”

As previous speakers have said, the Government are taking important long-term decisions on the financing of pensions and certain parts of social care. Those decisions, including the change in the state pension age, the introduction of a flat-rate pension and the capping of care home costs, aim to give more certainty in an increasingly uncertain world, and I shall return to that.

I shall be opposing one measure, I am afraid—the plan for High Speed 2. It is my belief and that of my constituents that both the concept and the business case are deeply flawed. My constituents cannot understand why a route is announced 13 years before work starts without a proper plan to compensate immediately those whose property has been rendered unsellable. I have visited and heard from constituents who must, for pressing personal reasons, move house now, but who simply cannot. I urge the Government to put in place a full, fair and speedy system of compensation or purchase of property to enable those constituents to carry on with their lives.

I now wish to concentrate on health and social care. First, I ask the Government to provide time for a full debate on the Francis report into the Mid Staffs NHS Foundation Trust. Important lessons have already been learned. The appointment of a dedicated inspectorate of hospitals is a major step—unusually, I must disagree with the hon. Member for Walsall South (Valerie Vaz)— as is the introduction of more practical teaching into nursing training.

However, there is much more in the Francis report that needs to be debated. The vital and important work that Julie Bailey and Cure the NHS did to highlight problems in care deserves a thorough hearing. Earlier, we were all moved by the speech made by the right hon. Member for Cynon Valley (Ann Clwyd), who is looking into the matter and takes it so seriously. We also need to look at how mortality statistics are compiled and used, as they are becoming important and controversial.

Secondly, I spoke about the importance of trying to give some certainty on basic needs in an uncertain world. That applies to health as much as to pensions and social care. The provision of a national health service free at the point of need probably provides more peace of mind to the people of this country than any other single thing that a Government could do, apart from ensuring security, law and order.

Health care affects each of us and does so, in different ways, throughout our lives. It is a common bond between us and contributes to social cohesion. Yet its long-term financing is on difficult ground. The Government have rightly protected NHS spending at a time when other budgets have had to be cut, but with a growing and ageing population, it is likely that we will need a real-terms increase in spending in the coming years.

There is little room to cut costs from other Departments. We have to find another way to allow controlled, efficient and effective increases in health and social care spending, to deal with the challenges posed by an ageing population while not cutting other essential public services. I encourage the Government, over a period of years, to look at turning national insurance into a national health insurance that, as now, is based progressively on personal income, and which will provide the funding for health and, eventually, social care. That would enable us to have a sensible discussion on the national insurance rate required to fund health and social care properly, separate from the wider debate on tax rates and tax policy.

Thirdly, I wish to raise again the question of emergency and acute tariffs, on which my hon. Friend the Member for South West Devon (Mr Streeter) spoke so eloquently. The continuing squeeze on them, coupled with the fact that activity greater than 2009 levels is paid at only 30% of the full tariff, is leading inexorably to financial difficulties for acute hospitals, particularly district general hospitals such as mine at Stafford. However, it is not only the smallest that are affected. Major trusts also face deficits. Even if they are not, they will have to pick up the work load if acute services are removed from their smaller neighbours. That situation cannot continue. The drift towards centralising all emergency and acute services in the largest hospitals has to be stopped—even reversed. It will mean much closer working between hospitals, as hon. Members have said, and perhaps the end of many smaller trusts, though not smaller hospitals. It will also mean that royal colleges will have to get a grip and stop the fragmentation of health care into more and more specialties that cover less and less. We need, as the head of a medical school said to me recently, to rediscover the importance of high-quality generalists. A publicly funded national health service can only survive on that basis. That does not mean that specialisms have no place in the NHS—of course they do—but they must not drive out good general medicine.

Fourthly, the Government need urgently to look at health allocations across the country, as my hon. Friend the Member for Lancaster and Fleetwood (Eric Ollerenshaw) said. The welcome increase in public health funding where there are particular inequalities was meant to enable per head allocations to become fairer, but that has not happened. Currently, South Staffordshire receives at least £40 million per year below its recognised fair shares allocation, and that is making the work of local clinical commissioning groups even harder. The Government have committed themselves to addressing this, but it needs to be done this year or CCGs will find themselves in a very difficult position right from the outset.

Finally, it is vital that the Government listen to the public. On 20 April, it is estimated that 50,000 local people went on a local march and rally, which I had the honour of addressing, in support of Stafford hospital. They were speaking out against the idea that emergency, acute and maternity services could be removed, and were making the point that alternative services were too far away and, in any case, themselves under great pressure, and that the proposals did not take proper account of the increasing population and demography. All of that is common sense, and I hope that the administrators currently running Stafford and Cannock hospitals listen to that common sense, and that it is heard across the country.

Monitor has a chance, together with the trust development authority, to establish a sensible and long-lasting configuration for emergency and acute hospital services across the country that recognises the important role of our smaller, acute district general hospitals. That can be done and it must be done. The Government are tackling the long-term problems on pensions that we need to take on, and it is vital that we do the same for health and social care.