May Adjournment

Jeremy Lefroy Excerpts

Thursday 3rd May 2018 Commons Chamber

[Sir Edward Leigh]

It is a question of quality. Is it really necessary to have 30,000 people employed by the NHS, who have never been doctors or nurses and who have never met a single patient, earning over £100,000 a year? We of course need a level of good-quality management, but we must trust the people on the frontline. Whenever we talk to doctors and nurses they say, “Trust us. We are professionals.” They are the people that members of the public want to see. They are the ones with the vocation and the professionalism to look after us.

The hon. Lady makes a fair point and, like all arguments, we could take it to extremes, but in my view there are two models for the NHS. There is the traditional model that I grew up with in the 1950s and 1960s, and there is a newer model with evermore systems, targets, internal markets and the rest. My personal view—this may surprise the hon. Lady—is that the old-fashioned model probably worked better, because it put more competence and more control in the hands of nurses, doctors and consultants.

I am now going to say something that will probably be even more unpopular. I wonder why our Government are not prepared to bite the bullet and consider alternative funding for the NHS. With an ageing population, we must encourage people to put more of their own resources into their health. How are we going to do that? We could do it through general taxation and increase overall spending, but I have argued against that, or we could do what previous Conservative Governments have done. The Major Government and the Thatcher Government—I do not think the Major Government were particularly right wing—gave tax relief for people of pensionable age towards private health insurance. That is anathema to the Labour party, but it would actually put more resources into health. Most people of retirement age simply cannot afford private health insurance, because they pay for it from their taxed income. However, if we gave tax relief for private health insurance, as previous Conservative Governments have done, we would not be saying that we are against the NHS or devaluing it; we would be trying to encourage the people who are going to use healthcare more often to put more of their own resources into healthcare.

I am worried that if this massive real-terms increase in healthcare spending happens, we will be approaching the levels of health spending per head that we see in Germany or France. The fact is—let us be honest about this—that if we are going to be ill, we would much rather be ill in Germany or France. I know that the NHS is a kind of religion for many people, but the health services under the social insurance systems of France and Germany do work better. They cost more, but the people feel that they have real control over their healthcare. They pay large amounts of tax, but they feel that they have some kind of ownership of their healthcare—some kind of right. When something goes wrong, they are not just enmeshed in a vast bureaucratic machine; they believe that they have some right to treatment through social insurance. Indeed, in Germany, they do get that.

[Jeremy Lefroy (Stafford) (Con)]

My hon. Friend is making an interesting argument, and if I manage to catch Mr Deputy Speaker’s eye, I will talk about that myself. I want to bring to my hon. Friend’s attention a constituent of mine who had a baby in Germany, as a member of the armed forces, and then had one in the UK. She said that the experience in the UK was so much better than that in Germany that she would not recommend that anyone have a baby in Germany rather than the UK.

[Sir Edward Leigh]

I stand corrected, but I think it is a generally accepted fact. We all know from our friends and relations, and from public debate, that the health system in Germany is superb. I am sure there are glitches and areas where we might outperform it, but generally the system there works well.

The Government have to be honest in addressing how we will meet the needs of an ever-ageing population and the desire of that ageing population for ever-new levels of treatment. We have to devise new systems to encourage people to put more of their own resources into healthcare, as I do not believe we can do that out of general taxation.

Before I sit down, I promised to make a point about DFID. Nobody values the work of DFID more than I do. DFID is doing tremendous work throughout the world, but its budget—I say this as a former Chairman of the Public Accounts Committee—is under strain, not from underfunding but from an arbitrary link in legislation to a particular proportion of national wealth. The link simply does not work, and it creates all sorts of stresses and strains.

I am not suggesting to the hon. Member for Bristol West (Thangam Debbonaire) that we cut overseas aid spending; what I am suggesting is that we get rid of this arbitrary link in legislation and have the best, the most high quality, the most free from corruption and the best-targeted overseas aid budget in the world, which I am sure is our aim and what we are achieving in large areas. Imposing such an arbitrary device on spending, which must result in a splurge of spending towards the back end of the year, cannot be right.

--- Later in debate ---

[Jeremy Lefroy (Stafford) (Con)]

I am most grateful to follow the speech of my distinguished colleague, my hon. Friend the Member for Gainsborough (Sir Edward Leigh). I very much agree with him on a lot of areas, but I shall start with a point where I might pose a little challenge. I believe we wish, as a country, to be strong on defence. I absolutely agree with him on that and think that what my right hon. Friend the Member for Sevenoaks (Sir Michael Fallon) has said about a minimum of 2.5%—and possibly even more—is right. I am very proud that Stafford is host to three signals regiments and the tactical supply wing of the Royal Air Force. If we are to be a global Britain, punching above our weight by maintaining a proper diplomatic representation around the world, which is vital as we leave the European Union, and at the same time we are to ensure that our citizens have high-quality public services, be they in respect of law and order, health or social care, we cannot be an absolute low tax economy. The two things do not add up. If we look at the percentage of GDP that we spend on our public services and compare that with what happens in France, which has a similar global profile to the UK, we see that our figure is much, much less.

At this point I wish to raise the issue of our health service. I declare an interest, in that I am married to a doctor, and I am the father of a doctor and the brother of a doctor.

[Dr Julian Lewis (New Forest East) (Con)]

So where did it go wrong?

[Jeremy Lefroy]

My right hon. Friend may very well ask!

If we look at the World Health Organisation’s report on people’s perceptions of access to good quality healthcare in 2013, under a Conservative-led coalition Government, I am glad to say, we find that 82% of France’s population and 85% of Germany’s felt they had access to good quality healthcare, whereas in the UK the figure was 96%. For all its faults, and there are many, as I know personally from my constituency experience, our system is held in high regard and it provides almost everybody—96% is not 100%—with access to high-quality healthcare.

[Bob Stewart]

In my constituency, when an ambulance goes by with its alarms going off, this usually signals a heart attack or a stroke and someone being rushed to a really good hospital. The NHS is the place you want to go if you have a heart attack—private healthcare does not even start to deal with strokes and heart attacks. We are really well served by the people who do this.

[Jeremy Lefroy]

My hon. and gallant Friend is right about that. As far as I know, we will not find an accident and emergency department that is privately run in the UK. If there is such a department, we are probably talking about only one or two. It is not possible to do that because of the cost of running A&E departments. Parliamentary colleagues in France will talk about healthcare deserts in parts of rural France, where people cannot get access to the highest quality of healthcare that they want. I am not trying to play us off against France or Germany here; I am just trying to state a few facts, as we tend to run ourselves down sometimes.

I wanted to start by discussing the health service because it is now five years since the Francis report on the Mid Staffordshire NHS Foundation Trust, which is in my constituency and that of my hon. Friend the Member for Cannock Chase (Amanda Milling). That was a very difficult time for us all in Stafford. I am still very proud of the Stafford people and the Cannock people, who put so much into the work to preserve health services in Stafford and Cannock during that time. I am also proud of the work that has been done since then, and of the people who stood up and pointed out the real problems that were going on at the time, which needed to be corrected. If we consider what has happened since then, we see that patient safety has become an absolute priority for the NHS and for this Government, and I pay tribute to my right hon. Friend for taking that on. If we look at the recommendations in the Francis report, we can see that most of them are now in place. When I talk to colleagues from around the country, they say, “You know, that Francis report made a huge difference for my local hospital”. It made a difference not just for Stafford or Cannock, but for hospitals throughout the country, where patient safety has gone to the top of the agenda.

I pay tribute to the staff of the County Hospital, as Stafford hospital is now known, for what they have done over the past five years. In the past couple of weeks, more than 96% of patients in our A&E have been seen within four hours. That is well above the national target. I am most grateful to the staff for achieving that. Other things must still be done—there are more services that I want to see back in the hospital, or brought to it and the Stafford area for the first time—but I put on record my thanks to everybody who has made that happen over the past five years.

To return to the general point about the health service, it is quite true that they have a different system in Germany and France, and there are merits in that. It is a different system that requires co-payments: people have health insurance, whether it is largely state-funded, as in France, or done through private or co-operative health insurance systems, as in Germany. People still pay often several hundred euros a year on average to access healthcare when they need it. It is a serious issue and a political debate that we need to have. I am not necessarily saying that my hon. Friend the Member for Gainsborough’s points should be disregarded—not at all; they should be considered very seriously—but we have to look into what is sustainable.

[Nick Smith]

I agree with the hon. Gentleman that the 96% support for the NHS throughout the country is fantastic, but does he agree that the future challenges for the NHS are the modern killers that are out there now, such as obesity and related diabetes, and the conditions related to old age, such as dementia? The NHS now has to bend itself to deal with these new conditions.

[Jeremy Lefroy]

The hon. Gentleman is absolutely right, although I should say that that 96% referred to access to high-quality healthcare, rather than support for the NHS. I thought I should make that distinction. It may well be that the NHS has 96% support, but I was talking about access to high-quality healthcare.

The hon. Gentleman is absolutely right that diabetes, cancer and other conditions are clearly the issues. The health service has to adapt; I absolutely agree with my hon. Friend the Member for Gainsborough that it can be far too monolithic. Often, we see really good, inspired leadership that makes a real difference in some places—perhaps it even comes from those paid £100,000 a year—but in other places we see some very uninspiring leadership. It is often very much about who is taking on the challenges at the local level and what their motivations are. We clearly have a great deal more to do on that.

Time is short, so I shall move on from the NHS after one final point. I fully agree with the cross-party report published last week by my hon. Friend the Member for Grantham and Stamford (Nick Boles) and other colleagues from the Labour party and the Liberal Democrats. It contains 10 points on how to have a sustainable health system. I have been talking about most of those 10 points in this place for the past five or six years, so I would agree with them, wouldn’t I? Still, there is an awful lot in there for the Government to look at and perhaps take on. I return to the initial point: if we want high-quality services and a strong defence, along with funding for other issues of great importance to our constituents, we will have to pay a little more. The question is whether we pay that through a national health insurance system—a progressive system—through direct taxation or through contributions. Those questions have to be asked. I am in favour of a fully funded system, which may mean that we have to do it through the proposed national health insurance system.

The second thing I wish to talk about is General Electric, which is the largest private sector employer in my constituency. At the end of last year, it announced several hundred job losses, and the consultation on that is currently ongoing. It is a very serious situation. I praise General Electric and its predecessor, Alstom, for their investment in Stafford. They have built two new, modern, state-of-the-art factories, which will provide security for many people in my constituency.

For those facing the prospect of redundancy, it is vital both for them and their families, and indeed for the country, that we see how we can ensure that their skills—often very high skills—are best employed elsewhere. In that context, I want to raise again the matter of the Swansea Bay tidal lagoon, which I and other colleagues have been pushing for. If we are to have a power manufacturing sector in this country, we must be at the forefront of modern technologies, and that is one of them. I urge the Government to come forward with a positive decision on that as soon as possible.

My third point is a local matter. I am very glad to see two of my Staffordshire colleagues—my hon. Friends the Members for Burton (Andrew Griffiths) and for Cannock Chase—on the Front Bench at the moment. I know that they will probably agree with me on most, if not all, of these issues. We have already heard about potholes. Being a rural county, we have the same problems in Staffordshire. Potholes are not just an inconvenience; they are a menace. When cyclists go into potholes that are filled with water, they can suffer very serious injuries, as some of my constituents have. Cars suffers great damage, which brings loss either to the county if there is a claim or to the individual whose car has been damaged. We need to see more money put into that area, both at a local and a national level. After the winter that we have just had, it is a priority. I would like to see the Secretary of State for Transport coming forward with some supplementary funding for potholes for local authorities as soon as possible, because, as we already know, a stitch in time saves nine.

Bus services in rural areas are suffering. My hon. Friend the Member for Gainsborough did not mention this issue, but he has probably been affected by it as well. Clearly, we do not want buses running around empty and wasting a lot of money, but there must be ways of ensuring that our villages and small towns, which are becoming ever less connected with the major centres of population, see a reversal in the situation. We need innovative thinking. Perhaps we should go back to a situation in which councils, as in Nottingham, which runs a very fine public transport service, say, “We will have to step in and fill the gap to ensure that our communities are connected.”

Finally as far as local councils are concerned, I wish to raise the issue of breaks for carers. Carers across the country, and certainly in Staffordshire, perform an absolutely magnificent job. We need to ensure that they can have the breaks that they need, especially those who cannot afford them. They need to be able to get away from time to time. I welcome the fact that Staffordshire has supported such breaks and continues to do so, but the funding is too little. We need to see greater funding in this area and more innovative solutions to ensure that money is wisely spent and available to as many of our carers as need help.

Clearly, on the national scene, the debate is dominated by our leaving the European Union. I will not go into the principles on either side, but I will make points on four areas. Frictionless trade for the manufacturing industry in Stafford and the west midlands is essential. I was recently at the Honda factory in Swindon, and heard very clearly how important it is for us to have seamless trade, in and out, for components. The factory operates, as does almost all manufacturing industry in the automotive sector and others, a just-in-time policy. Such firms cannot have delays at borders.

Another critical area is data, as the Exiting the European Union Committee heard when we took evidence in the City of London. With the EU’s understandable fixation on data protection—we are, of course, putting that into our own law—the City is very concerned that we ensure that data issues are sorted out well in advance of our finally leaving at the end of 2020. It is vital that this is done, because data is at the core of not just financial services but every business.

Financial services companies have a concern about contracts that go beyond the end date of our membership of the European Union. That is a serious issue, because if we do not have the rules on contracts in place, there is a risk that contracts will not be able to be fulfilled and that people will not be paid such things as life assurance or pensions.

[Sir Edward Leigh]

My hon. Friend and I fought the last general election on a Conservative manifesto that stated in clear terms that we should leave the customs union. I hope that he shares my view that it is absolutely essential that we fully support the Government’s desire to leave the customs union, and that we have the right and the ability to make free trade deals with other countries.

[Jeremy Lefroy]

I absolutely agree that we need to be able to make free trade deals with other countries. The corollary to that is that we cannot be in the customs union, as my hon. Friend said. At the same time it is vital, as the Prime Minster has made clear, that we have frictionless trade and that our industries—not only manufacturing, but agriculture and many other industries—across the country can continue to operate without the hindrance and costs that might be caused by certain arrangements. I have every confidence that the Prime Minister and the Government will come up with the correct decision and conclusion, which may not be one that my hon. Friend and I are currently thinking of.

[Ian Mearns]

The manufacturing industry in the north-east of England relies heavily on frictionless trade, because so many components for Nissan vehicles, for example, come in or go out to other plants partly assembled. There are 7,000 or so people working at Nissan, but 35,000 people in the supply chain. Without frictionless trade, many of those jobs will be in real jeopardy.

[Jeremy Lefroy]

The hon. Gentleman makes my point exactly. My first job after university was working in the motor industry in Bridgend for Ford, which the hon. Member for Bridgend (Mrs Moon) mentioned earlier today in the House. The hon. Gentleman is absolutely right. It is vital that the interests of those workers and millions of other workers across the country in similar positions are taken into account.

My final point is about access to the high-quality staff that this country needs at all levels. It is quite right that we will be taking back control, but taking back control does not necessarily mean having a highly restrictive immigration policy. It means having an immigration policy that is suitable for the needs of our country, but one over which we have control. Mr Deputy Speaker, thank you very much for your forbearance.