Health and Social Care

John Glen Excerpts

Monday 13th May 2013 Commons Chamber

[Andy Burnham]

As ever, my hon. Friend says it more eloquently than I can. The Government are playing politics rather than addressing the national interest. People will see that, but at least the Government have revealed their hand. We will work hard over the next two years to show who is really to blame and expose this Government’s failures on social care, the NHS and public health. Let me take each in turn.

At face value, the social care measures that the coalition is proposing sound like progress towards a fairer and simpler system. Indeed, the Care Bill builds on many of the recommendations of the Law Commission’s review of adult social care legislation, which was initiated by the last Government and included in the White Paper I published before the last election. National standards for eligibility could help to bring consistency to the care system, and stronger legal rights for carers are long overdue, as is improved access to information and advice. However, the question in the minds of many today, particularly councillors watching this debate, will be: how on earth will we be expected to pay for all that? That is when we realise again that there is a huge gap between the rhetoric we hear from the Dispatch Box and the reality on the ground across England. More than £1.3 billion has been cut from local council budgets for older people’s social care since this Government came to power.

Just last week, the Association of Directors of Adult Social Services said that Government cuts to care and councils would mean a further raid of £800 million from care budgets in the next year. The Care and Support Alliance has said that the system is in deep crisis and that without

“appropriate funding for the social care system…the aspirations set out in the Care Bill will not be reached.”

The Care Bill does nothing for people who face a desperate daily struggle to get the support they need right now, with many paying spiralling charges for their care. That is the effect of this Government’s drive to cut councils to the bone. They are foisting huge care charges on the most vulnerable people in our society. These are the coalition’s dementia taxes.

[John Glen (Salisbury) (Con)]

Does the right hon. Gentleman not understand that the people of this country would have more confidence in what he says at the Dispatch Box had he not said in the last general election campaign that it would be irresponsible to safeguard the NHS budget, which is what this Government undertook to do?

[Andy Burnham]

I will come directly to that quotation in a moment, because the hon. Gentleman will remember that at the last election he stood on a manifesto promising real-terms increases for the NHS. I hope that when he speaks later—or if he wants to get up right now—he will tell me whether they have been delivered.

[John Glen]

I am grateful for the opportunity to acknowledge the great difference between England and Wales, where Labour is in power and where we are seeing real cuts in NHS spending.

[Andy Burnham]

Government Members are just embarrassing themselves. When they cannot answer a question, they try to raise another one or go on about Europe. It is just not good enough. The answer is—though the hon. Gentleman cannot admit it—that Andrew Dilnot said this Government had cut the NHS. It is there in black and white. That is what they have done, and they stood on a manifesto promising the opposite. I secured a budget to protect the NHS at the last election. I said that I could not give real-terms increases because that would be irresponsible; and as it turns out, nor can the hon. Gentleman. His party was writing cheques that it simply could not cash, and that is a fact.

The Care Bill does nothing for those hit by the coalition’s dementia taxes right now. Since this Government came to power, the average care user has paid £655 a year more for home care than when they came into office. Overall, that is around £6,800 a year. Dial-a-ride transport services have doubled in price over the same period, from an average of £1.92 to £4.12. Meals on wheels now cost an extra £235 a year, while people in Conservative areas pay more for each service on average than friends and family in Labour-controlled areas—on average, £15 a week or £780 a year more for home care. That is the record of this Government.

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[Mrs Madeleine Moon (Bridgend) (Lab)]

There are approximately 6 million carers in the UK, 2.2 million of whom provide more than 20 hours of care a week. Between them, they provide more than £119 billion- worth of care each year. They are listening to this evening’s debate. They want to know whether what is in the Queen’s Speech are empty words and further promises, or whether their lives will improve and changes will be made.

A lot of people have spoken of the work undertaken by my right hon. Friend the Member for Cynon Valley (Ann Clwyd) in the complaints review. I have sent copies of the letters I wrote when I made a complaint about the absolutely appalling treatment of my mother in an English hospital over a number of visits. I worked hard to make the complaint stick and ensure that my voice as her carer was heard, but even I, as a Member of Parliament, was worn down in the end.

I have sat in this debate and listened to Government Members criticise the Welsh health service. I have a very sick husband. He uses the Welsh health service, and I am grateful for the quality of care that he receives from it every day of the week. I know that my GP service is excellent and I know that if I need care from my local hospital for him, it is there, so I want to hear no more nonsense about the Welsh health service.

[John Glen]

Will the hon. Lady give way?

[Mrs Moon]

No, I will not; I am in the midst of my speech.

In Bridgend, there are 18,000 people providing care for relatives or friends. Some 5,500 of them provide unpaid care for more than 50 hours a week—care that is compassionate and dedicated; care of a quality that we would love to hear is being provided in our hospitals. I asked a group of carers recently what it meant to be a carer. One of them said, “It’s like trying to live two people’s lives and cramming them into one person’s life.” The other said, “You’re an expert in bodily fluids. Urine, faeces, blood and vomit are the daily recipe.” Is it any wonder that the Royal College of General Practitioners recommended last week that all carers should be screened for depression? It recognises that carers are particularly susceptible to depression and that there is a need for greater support.

Carers UK has reported that almost a third of those caring for 35 hours a week or more receive no practical support, while 84% of carers surveyed said that caring had a negative impact on health. That is up from 74% in 2011-12, so the problem is getting worse. Four in 10 —42%—of those caring for someone discharged from hospital in the last year felt that the person they were caring for was not ready to come out of hospital and that they did not have the right support at home. I worked in discharge care in a number of hospitals in Wales. Safe discharge was a major platform on which we worked. The things that are a problem remain the same. There is a lack of specialist equipment readily available for carers to assist with discharge—I am talking about beds that prevent bed sores, hoists, commodes, adapted bathrooms, swallowing assessments, speech and language therapy, occupational therapists and physios. It is not just nursing we need to focus on; it is all those important services.

We also need to look at the availability of treatment and medication that make a difference to people’s lives. I want to talk briefly about a condition that really shocks me and the carers of those who have it: aHUS, or atypical hemolytic uremic syndrome. I am the co-chair of the all-party kidney group. A few weeks ago I chaired a meeting of people with aHUS. There is a drug available for the condition that is called—excuse me, Madam Deputy Speaker, but it is a dreadful drug to pronounce—eculizumab. It sounds like some sort of African tribe, but that is what it is called. Taking eculizumab can virtually cure someone with aHUS. They get their life back. We are talking about a very small number of people who have the condition—less than 170. The typical form is triggered by a bacterial infection such as E. coli; the atypical form is genetic. We heard tragic evidence from families in which perhaps three or four generations of children and adults carried the genetic trigger. More importantly, the only treatment other than taking eculizumab is to have dialysis on a virtually daily basis. We heard from carers who have to place the extremely painful and long needles needed for dialysis into their children’s arms. Those children cannot have a kidney transplant because the transplant would almost certainly have the same condition. Even if they had a transplant, they would continue to need dialysis.

I am appalled to learn that the Government have agreed that those who are taking the drug on a trial basis may continue to take it, while those who have already been diagnosed but refused access to the drug on a trial basis will not be allowed access to it. Newly diagnosed patients will, however, have access to it. That is nonsense. We could save a large amount of money, and we could save those patients the trauma of daily dialysis. The drug was recommended for use by the Advisory Group for National Specialised Services and it has now been submitted to the National Institute for Health and Clinical Excellence for further appraisal. Sufferers of the condition might therefore have to wait until 2014 to get access to it, which is totally unacceptable.

Madam Deputy Speaker, I am sorry that I shall not be able to stay for the winding-up speeches, but I hope that the Minister will consider whether it might be possible for access to this drug to be extended to all sufferers of aHUS, so that they and their carers can once more have a decent quality of life, and so that the NHS can save money.

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[John Glen (Salisbury) (Con)]

I welcome the Queen’s Speech, particularly where it promotes the interests of people in our society who work hard, want to get on and recognise that in the long term their well-being is likely to be sustained when they rely more on themselves than on the state.

I want to focus most of my remarks on the Care Bill and on the absence of the plain packaging legislation. Before I do so, I make the observation that the integrity of the Government and their ultimate success will be reliant not so much on what they say on Europe, but on what they deliver on welfare reform and the state of the economy. Thankfully, there was no significant new legislation on welfare reform in the Queen’s Speech, because it is now about the delivery of what we have already brought before Parliament. I am delighted that the Government are listening carefully and working deliberately and carefully through the process of pilots before bringing in fully the welfare reform.

One aspect of that reform, referred to in the Queen’s Speech, is access to benefits for immigrants. It is right that the Government are considering limiting access to housing benefit and health care for people who have not earned the right to it. It is not enough to keep ignoring that uncomfortable truth because we are frightened of being too right wing, too nasty or too unpleasant. The routine experience of people up and down this country is that on the front line, at the point of delivery and at the point of receiving public services, they are too often displaced by people who, apparently, should not have the right to access those services. I am pleased that the Government will address that in legislation.

On the health aspects that are the focus of today’s debate, it is right that the Government have finally introduced the Care Bill, as every constituency MP has been concerned about this issue for many years. In some of our earlier exchanges today, we have, as usual, debated who cut what when. I know that before 2010—or before 2007—there were prolonged periods when this country had significant surpluses of moneys and, despite considerable evidence indicating that reform of the care system was required, nothing was done. I am therefore pleased that the coalition Government have found a way forward.

Some specific details on how the arrangements will work—the interaction with the local authorities, and the timing and practicalities of the cap roll-out—need to be delivered. That requires a spirit of collaboration and constructive engagement, and an examination of the complexity of multiple agencies of government working together to deliver care in circumstances that cannot always be defined by legislation. Too often in these debates we use examples from our constituency case load, which are often emotive and provoke an emotional response, but our responsibility as Members of Parliament is surely to absorb and take on those challenging individual cases, and to work through the different processes of government to see that better outcomes accrue and occur. We must also reflect honestly on the systems that led to those failures, and distinguish between the systems that may have failed and cases where—sadly, unfortunately—human error and individual failures led to dissatisfied constituents.

We must be honest about issues with the NHS, because we need behavioural change and a different appetite among the electorate for public health measures. We also need to take a constructive view about what is affordable with pensions. Therefore, I welcome the single-tier pension, which simplifies a lot of the complexity that has developed in our system.

I am deeply disappointed that the Government have failed to include legislation on plain packaging of cigarettes explicitly in the Queen’s Speech. I completely agree with the speech made by the hon. Member for Barnsley Central (Dan Jarvis). When we have 10 million smokers, when two thirds of those who start smoking do so before the age of 18 and when 200,000 young people start to smoke every year, it is not enough to rely on arguments about the complexity of illegal trafficking.

[Mark Lazarowicz (Edinburgh North and Leith) (Lab/Co-op)]

The hon. Gentleman is making an important and valid point and we have heard a number of his colleagues making similar points; I suggest that they table an amendment on the issue. If they do so, they might find that a lot of Labour Members support them, and who knows what might happen?

[John Glen]

I am grateful to the hon. Gentleman for that intervention, but I think we have had quite enough amendments this week.

Nevertheless, the point remains that we cannot rely on a debate about the issues of the illegal production of illicit cigarettes or in the packaging industry; those issues need to be tackled head-on. The core point is this: why does the tobacco industry spend so much money on elaborate packaging? It does so because such packaging works and because it encourages young people to take up the habit of smoking.

In this Chamber, the hon. Member for Shipley (Philip Davies) would usually sit next to me. Fortunately he is not here today, because if he were I am sure he would have intervened. He would have said it should be about freedom to choose. I am sorry, but I do not believe that 16-year-olds faced with massive peer pressure in certain communities genuinely have freedom to choose. It is not enough to say that the Government gain lots of tax revenues. For those individuals and their families, the health implications of smoking are dire. The situation is disappointing and I hope that a private Member’s Bill or another mechanism will be found to address the issue before the end of this Parliament.

[James Duddridge]

I am persuaded to a degree by my hon. Friend’s argument, and if plain packaging were the solution to eliminate the problem, I would be inclined to vote for it. However, I cannot help but think that there will be something else around the corner, such as a ban on smoking in films or a ban on role models being seen to smoke, and ultimately an absolute ban on smoking. That might well be the right answer, but I am not quite sure where the debate is going.

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[John Glen]

The reality is that smoking is almost unique in its proven health implications: the fact that it is so addictive and the fact that, particularly for young people, the implications for their future health are dire. We cannot just use the “freedom” arguments or ask “Where will the debate go?” to hide from that reality. We have a responsibility to do something about it.

I want to use my remaining speaking time to focus on the issue of rhetoric versus reality and the gap between the two, because I recognise that the election results a couple of weeks ago threw up big issues for my party about how we handle that. That takes me back to what I said at the outset. Most people want a Government who are concerned about the economic well-being of this country, about generating growth, about delivering fairly provided quality public services that not only look after the most vulnerable properly but give incentives to those people who can create wealth and jobs to do so, and about allowing the economy to prosper.

I think it would be wrong to get into a trade-off of rhetoric on the Europe issue, because all the proposed solutions are a long way off. The reality for this Government is that it will be a slow, hard and difficult process, but it is one that is well set out in this Queen’s Speech, with practical, sensible measures that are likely to win support over the course of the remainder of this Parliament.