Income tax (charge) Debate
Full Debate: Read Full DebateJim McMahon
Main Page: Jim McMahon (Labour (Co-op) - Oldham West, Chadderton and Royton)Department Debates - View all Jim McMahon's debates with the Department of Health and Social Care
(4 years, 9 months ago)
Commons ChamberAs ever, the hon. Lady makes a sensitive and sensible point. She is right that clarity in definitions and the language that is used is important. I do not want to pre-empt what my right hon. Friend may say in the House in a little while, but I think that she will see in the coming hours and days a greater degree of clarity for people and more information and guidance on that matter.
I thank the Minister for giving way. Clearly, we are very early into this, and we do not quite know what the business continuity impact will be or the financial impact on business. Do the Government have a framework by which they will operate and have discussions? For instance, when Virgin Atlantic comes forward and says that it needs financial support, what will be the framework of that support and what might the Government want in return for that investment?
The hon. Gentleman makes a good point, which, almost to a degree, goes back to the point made by the hon. Member for Sheffield, Heeley (Louise Haigh) about giving people greater clarity and understanding of how things will work and in what way. Because the matters are fast evolving, as he says, they continue to be under review, but we will ensure that we work with industry—including both the example that he gives and others—to give the support that people need and that is most appropriate. Again, I hesitate to say this, but I caution slightly, as I did at the beginning, and say that if he waits until the Secretary of State’s statement, which I think is at half-past five, he may well get more details on that.
Coronavirus is the biggest challenge facing the NHS today. With clean hands and calm heads, we can help tackle it together, but, equally, we will not allow it to divert us from the long-term improvements that patients and staff rightly want to see. As the founders of the NHS knew better than anyone, we can fight the war while also planning for the peace.
Let me now turn to the measures in the Budget that will secure those long-term improvements. Last week, my right hon. Friend the Chancellor committed £6 billion of extra spending to support the NHS over the lifetime of this Parliament. That comes on top of our record long-term NHS funding settlement—£33.9 billion more over five years—which we have now enshrined in law. Most of the extra £6 billion will go towards delivering our flagship manifesto commitments. They include starting work on 40 new hospitals, 50,000 more nurses, and 50 million more appointments in primary care—more buildings, more people and more services. Let me take each in turn.
My hon. Friend makes very well the point that I was making. It is evident that if that particular GP does not have the virus, it would be better for us all if they know that sooner rather than later, so they can get back in and treat patients. It is also worth restating at this point that people who have suspected symptoms should not be turning up at their GP practice because that is one of the ways, unfortunately, that we will spread the virus.
The case that has been outlined is very important, but we also need to remember that social careworkers, who will be visiting all the people in their care in their homes, are also placing their patients at high risk, but at the moment there are no plans I have heard about to test those social careworkers. I should say, by the way, that many of them are paid just over the minimum wage, and there is a real question here. We say that we value the NHS and that we value these community workers, but I am not sure a lot of them feel that way at the moment.
I will be dealing with the concerns about the social care sector in a little while, but the points my hon. Friend makes are absolutely valid and they certainly require a Government response.
We should think about protecting NHS staff not just in terms of the doctors, nurses and other frontline staff, but in terms of the cleaners, porters and all the other essential staff who are needed to keep a hospital running and who also play a vital part in infection control. We often hear about the importance of data, and it seems to me that this is a particularly clear example of where data have a huge role to play. If the data are not collected on a regular and consistent basis, surely we will not be in the best position to take the right action.
Yesterday, it was announced that UK medical schools have been urged to fast-track final year students to help fight coronavirus. Can we have an explanation of how this will work, and how will we ensure that graduates still face rigorous testing to make sure they provide the best quality care for patients? There is certainly a role for them to play, but trusts need clarity about its limits so that they can plan ahead. Are staff on maternity and paternity leave being encouraged to return to work early, and would they be able to do so without losing any untaken leave?
My hon. Friend is right: a whole raft of issues will have an effect over the coming months, and although housing revenue accounts are separate to main council budgets, we still need to have that balance. Over the past decade, as a consequence of welfare reform, we have seen how councils and housing associations have adopted policies to deal with that loss of income from a number of changes to the welfare and benefits system, and we must keep that dialogue open over the next few months. We certainly could not expect full collection rates at this time, and we must work with people to understand the limitations of that. We will talk to the Government regarding any legislation that comes forward in due course.
I thank my hon. Friend for giving way; he is being extremely generous. Does he share my concern that, beyond rent, many households are just a payday away from poverty, so people will be sent into debt that they may never get out of in their adult lives? Surely, the Government need to do far more to help households that are really on the edge.
That is a very fair point. We are only beginning to understand just how precarious a lot of people’s household incomes are in this economy. It is going to take concerted Government effort to support people, but it is also going to take everyone in the private sector who has a debt with an individual holding off enforcing that debt while this crisis comes through. Again, that is something we need to work on. I am afraid I will not be able to take any more interventions.
Social care has been mentioned a couple of times already. Unfortunately, once again, we have a Budget in which social care is not addressed. Local authorities have had £8 billion cut from their adult social care budgets over the past decade, leaving people struggling without any care at all. Our social care system is already at breaking point, and it is likely that the spread of coronavirus will test it even further. Without proper measures to protect people in care homes and those who receive care in their own home, there could be tragic consequences. It is crucial that social care receives the same attention from the Department as the NHS. We expect to see a plan to advise people in social care along the lines we have discussed.
As my hon. Friend the Member for Cardiff South and Penarth (Stephen Doughty) mentioned, those in the social care sector have raised particular concerns about the availability of personal protective equipment. That equipment, which is crucial to protect staff and patients, is just as necessary in social care settings as in the NHS. I have heard from local care companies about difficulties sourcing hand sanitiser, to name but one example. As equipment runs low, how will care staff, including those who are self-employed, have the equipment they need to continue to keep patients safe?
However, the biggest concern for the social care sector is whether it will have the staff it needs to deal with this crisis. As we know, there are already 122,000 vacancies across the sector, leaving staff feeling under immense pressure. We know they already feel pressure, due to staff shortages, to come into work when they feel unwell, but in this case it is vital that they stay at home if they feel unwell. How will the Government ensure that there are enough staff to care for patients when we have far more people in the care sector who are unwell and self-isolating?
A quarter of social care staff and almost half of all home carers are on zero-hours contracts. For some care staff, there is no guarantee that they will be entitled to sick pay, despite today’s announcement. That is particularly true of those who work for multiple agencies or work irregular hours. It is vital that those staff, as a key part of the workforce, feel fully supported if they become unwell. We need a guarantee that all social care staff will receive statutory sick pay. All workers need reassurance from the Government that they will receive sick pay if they are unable to work.
Over the past few days, a number of nursing homes and care homes have made the difficult decision to close their doors to visitors. They made that decision themselves, in the absence of clear guidance. Families are now unable to see their loved ones, and they will want reassurance from the Government that that is the safest call. Will there be guidance on that issue for the care sector?
Inevitably, social care providers will face difficult choices over the next few months. Many will face higher costs. Last year, more than half of social care providers handed contracts back to local authorities because of financial pressures. That causes immense pressure on councils and, of course, worries for the families of people receiving care. It seems inevitable that we will face that situation again soon. Will local authorities and care providers get the financial support they need if cost pressures become too much to deliver safe care? At this difficult time, we must ensure that care services continue to provide the vital support that people need.
What about those who provide care for a loved one outside the system? Inevitably, there will be people who are not able to provide care for a period. The state has no official role to play in that situation, but those people will still need help and support. How will that be addressed?
In conclusion, providing well-resourced and well-funded public services is vital to tackle the spread of this disease, but of course that is not the whole picture. Every member of society will have to play their part. We will all have to recognise that the impact could be felt for many years to come, but we should take heart from the fact that we have a truly national health service and the capacity to rise to whatever challenges we face, so we are better positioned than many to take on this challenge. That will only be true, however, if we can be confident that the services people will rely on in the coming months are robust enough to deal with the storms ahead.
A decade of underfunding has not left us in as strong a position as we would like, but it seems that in the hour of need that may change. We will support the Government in any attempt to boost funding across the board, but we will not be afraid to point out when we believe measures are not enough. Beyond funding, we want messages from the Government about the action they are taking to be clear, consistent and quick. We all have a responsibility in this place to get that message across. Her Majesty’s official Opposition stand ready to give that message as well.