School Funding

Debate between Julian Knight and Julie Cooper

Wednesday 25th January 2017 Commons Chamber

[Julie Cooper (Burnley) (Lab)]

As a former teacher, experienced school governor and parent, I fully understand the value of providing every child with an excellent education. Education changes lives, it empowers individuals, it increases social mobility, and it is the single biggest driver of economic success for a nation. It is right that we pursue high standards and seek to provide the very best education for all the children of this country.

This Government are going about things in the wrong way, however. The new national funding formula will see 98% of schools worse off and demonstrates more than anything else could that the Government are not serious about raising educational standards or about social mobility. My constituency of Burnley, which continues to have some of the highest levels of social deprivation and is in the top five most deprived areas in the whole of Lancashire, will lose £477 for every secondary pupil and £339 for every primary pupil. In the past, the Secretary of State has said that no school would lose more than 1.5% of funding per year under the new formula. How can she square that with projections that my schools will lose 8% on average by 2019?

Even before these cuts, we are already seeing increased class sizes, subjects being dropped from the curriculum, pupils with special educational needs and disabilities losing vital support, and teacher vacancies. I ask the Secretary of State how she believes cutting funding for schools in Burnley will help a whole generation of young people to succeed.

There is nothing fair about funding that is not sufficient. How can it be fair to take educational funding from schools that are already stretched to breaking point—schools that already go the extra mile to give every child the best possible start in life?

[Julian Knight (Solihull) (Con)]

The hon. Lady said that 98% of schools will lose, but I understand from the figures that I have that 70% of the hon. Lady’s schools will gain from this new funding formula. Would she like to comment on that?

[Julie Cooper]

I hope that the hon. Gentleman’s figures are correct, but I fear that they are not. My information suggests that they are not. The research that I have done shows that that is not the case.

My schools are already working flat out to ensure that children coping with social and economic deprivation can overcome disadvantage and fulfil their potential, yet those schools are having the rug pulled from under them. Robbing Peter to pay Paul—or robbing Peterborough to help Poole—is not going to help. In my constituency, there has been a concerted effort by the key stakeholders, the schools, the council and businesses to work together to grow the local economy. That has not been easy, but we are making good progress. We are focusing our energies on raising skill levels, confidence and aspiration among young people. Considerable effort has been expended on this, and these funding cuts feel like a kick in the teeth.

Education is the key not just to better life chances for individuals but to our economic success. Ensuring adequate funding is crucial so that every child, wherever they live and whatever their background, can fulfil their potential. As a nation, we know that every citizen matters in the widest possible sense, not least to our economy. Investing in education is an investment in the economy, and failing to do that is short-sighted in the extreme. A Government who talk of increased social mobility and growing a strong economy need to understand that investment in education is absolutely fundamental to those aims.

Pharmacies and Integrated Healthcare: England

Debate between Julian Knight and Julie Cooper

Wednesday 11th January 2017 Westminster Hall

[Julie Cooper]

I do not disagree with the hon. Gentleman’s point.

It is important that we recognise that community pharmacies provide their own premises and train their own staff. As a former business person, I totally get the point about value for money, but this is not just about money; it is about the efficient use of money. We all understand the pressures that our NHS face, and we have to look at that. There are a lot of myths floating around, so it is important that we clarify that.

There has been a lot of talk about the clusters. Again, because pharmacies are private businesses, they respond to demand in the community.

[Julian Knight (Solihull) (Con)]

The hon. Lady brings her expertise to the debate. Does she agree that we need more innovative approaches? The Grove surgery in Solihull has a symbiotic relationship with its local GP services, but in parts of the UK we seem to have run into the sand. We need greater public awareness and encouragement to take such innovative approaches forward.

[Julie Cooper]

I will come on to that very point in a moment.

To return to value for money, it is important that the Government take a responsible attitude and review funding for pharmacies, and I think that professional community pharmacists across the country accept that. Much has been made of the clusters. Pharmacies are independent businesses that arise and stay in business where there is demand. I do not know whether this is widely understood—hon. Members will have to forgive me if they already know this—but the global sum allocated to pharmacies is what pharmacies cost the Government. The Government know what community pharmacies are going to cost. If a new one opens, it does not cost the Government any more; it just means that the same amount of money is shared out more thinly. That is a bit of a red herring. We can be sure that if there is no demand for the services that a pharmacy provides, it will close.

Much has been made of the £25,000 payment, but that does not cover the cost of putting a van on the road and paying for a driver to deliver and administer a prescription delivery service. Those services are absolutely invaluable to communities with many elderly people. I had a conversation with practice managers and general practitioners in my constituency recently, and they were absolutely horrified because they use that service—there is a lot of repeat ordering—and if it were lost, they could not cope.

The Government are suggesting that in-surgery pharmacists are a substitute, but that is another red herring. I welcome the use of well-qualified pharmacists in GP surgeries, but that is a totally separate issue. It is like comparing hospital doctors with GPs. Community pharmacists are at the heart of the community and are accessible for many hours. The hon. Member for St Austell and Newquay (Steve Double) made the point very well earlier when he said that eight minutes is the average wait to see a qualified professional who can help with most things. We have got to embrace that and use what is already there.

I have had conversations with the National Pharmacy Association and the Royal Pharmaceutical Society, and just last night the chair of the English Pharmacy Board said, “We want to work with the Government. We want to sit down and look at how we can do more.” There is the idea that integration is a new thing waiting to happen, but we were proud as community pharmacists to be at the heart of the primary care team, working with GP surgeries, hospital discharge teams, community nurses and district nurses. They often came to us. GPs came and went—that is even more the case now, given the problems with retention in GP practices—so we provided the only continuity in healthcare for many chronically ill people. Particularly for the elderly, that was a vital part of the service, and we were really proud to provide it.

Many community pharmacies are proactive. When this business of moving towards a clinical approach was suggested, community pharmacies accepted it without it needing to be mandated. We invested in a purpose-built consulting room to provide a more clinical environment. That is the way forward, and most community pharmacies accept that.

What is the alternative to what the Government are proposing? For a start, we need a proper assessment of what the cuts will mean. There has been no impact assessment of which pharmacies will close. I agree with the hon. Member for Bury St Edmunds (Jo Churchill) that it will not be the multiples that will close; it will be the independent pharmacies that rely on the £25,000 to provide their core services. That is an absolute fact. Not a single pharmacy in my constituency qualifies for access payments, and only three in the entire city of London do. I can say with absolute confidence that in my constituency it will not be Boots that closes or cuts its hours; because of the volume of business, it has other ways of covering its overheads.

I ask the Government not to throw money willy-nilly at pharmacies, but to look at their value and assess the impact of the cuts. If they think that the best way forward is for some pharmacies to close, they must ensure that the right ones close. We must do what the professional organisations are asking for and come to the table. Pharmacies are begging to take on extended roles. There is so much good will there. The minor ailment scheme, which we were privileged to provide, is an important service. Busy families who have children with minor ailments do not have time to be at the GP surgery. GPs accept that, without that service, they could not manage. We all know that GPs work hard and are overstretched. This is not about criticising the work they do; it is about supporting them, saving the NHS money and taking off pressure.

I ask the Minister not to reconsider the funding, but to look at the way he works with pharmacies in the NHS. I ask him to look at their role, as many Conservative Members have said, and at how they can work with the Government to support other areas of the NHS, thereby saving money. Let us avoid a knee-jerk reaction with no proper assessment of the impact. Let us deliver a better integrated service. The way to do that is not to make blind cuts with no proper assessment.

Hospital Parking Charges (Exemption for Carers) Bill

Debate between Julian Knight and Julie Cooper

Friday 30th October 2015 Commons Chamber

[Julie Cooper]

I am grateful to my hon. Friend for making that important point.

We all need to understand that carer’s allowance is not dished out willy-nilly. To qualify, a person has to devote at least 35 hours a week to caring for a person with substantial care needs, and many carers provide far more hours than that. To fulfil their caring role, they often have no option but to work reduced hours, and some are forced to give up work altogether. They often face a steep drop in income if they have to leave work or reduce their hours in order to care, and there is sometimes a double loss of salary if they are caring for a partner who also has to give up work as a result of their illness or disability. Some 2.3 million people have given up work to care, and that loss of income is often coupled with a steep rise in expenditure as a result of the additional costs of caring and disability, including travel and parking costs as they support the person they care for to attend medical appointments or continue to provide care during stays in hospital.

One carer, Jackie, shared her story with me. She cares full time for her husband David, who has secondary progressive multiple sclerosis and hairy cell leukaemia. She said:

“As David’s wife and sole carer, I was at the hospital every day from 9.30 am until 7 pm. We live 22 miles from the hospital and rely on benefits as our sole income—so the expense of travelling to and from hospital every day and paying the parking charges was huge. We exhausted the little savings we had. Weekly parking tickets were available and cheaper than daily charges, but I never knew how long my husband would be in hospital for. The last thing I needed was to be worrying about car parking charges when I was anxious about whether my husband was going to make it or not. Carers are at such a disadvantage already, car parking charges are one extra penalty they do not need.”

For carers, fulfilling their caring role often involves parking at hospitals for hours on end day after day, week after week. Hospital parking charges place an unfair financial burden on those caring for disabled, seriously ill or older friends or family members. NHS hospital trusts and foundation trusts are responsible for setting their own charging policies and are not currently required under law to provide any exemptions. Some hospitals in England already provide free car parking, and others offer some concessions, although these are few and far between and invariably poorly advertised.

[Julian Knight (Solihull) (Con)]

I congratulate the hon. Lady on bringing forward this interesting Bill. She has just said that some hospitals in England do not charge for parking; surely that shows that there is discretion in the system.

[Julie Cooper]

The fact is that the current system is very hit and miss. Some hospitals provide small concessions, but that is not widespread.

There are no specific exemptions for carers, and hospital car parking charges are particularly onerous for carers who spend long hours on hospital visits on a regular basis. Research by Carers UK found that 48% of carers are struggling to make ends meet, and 45% said that financial worries were affecting their health. The average cost of parking in England is £39 per week, and in London that rises to £130. For those on low or no incomes—as is the case with many carers—charges at any level are a burden they could do without. Dozens of carers have shared their experiences with me over the past few months, and many have said that their entire carer’s allowance is taken up with the cost of hospital car parking and petrol. Many have been forced to get into debt to meet their day-to-day living costs.

I am grateful for the support of Members from across the House, and I know that the Minister shares many of my concerns. In response to some of the issues I have raised, he intends to publish revised guidelines to hospital trusts on parking charges that

“will explicitly include carers in the groups who are eligible for concessions.”

That is new and I welcome it, but it does not go far enough because most hospitals choose to ignore the guidelines. In the past 12 months, more than 100 hospital trusts have increased their car parking charges—recently, the Medway Maritime hospital increased its charges by a staggering 60%—and the trend is not to support the vulnerable. Indeed, Mid Yorkshire Hospitals NHS Trust has gone a step further and introduced charges for disabled parking. The direction of travel is wrong, and more action is needed if we are to effect real change.

It is also important to consider the emotional pressure facing carers, because when someone who has spent hours at the bedside of a person they care about comes out of a hospital, the last thing they want to do is join a queue to pay for parking. They should not need to worry whether the machine is working or whether they have the right change. They are often distressed, and invariably in a hurry. Often they are on their way to pick up clean clothes and supplies, and they are already planning their return journey, which in many cases is on the same day. Some hospitals require payment on entry, which brings its own pressures. Carers who are on limited budgets need to estimate how long each hospital visit will last, and they often have to leave the ward or treatment room to run out and replenish the ever-hungry parking metre.

In the last few months I have encountered many apparently rational arguments against my proposal, and I shall consider them each in turn. The British Parking Association argues that the removal of charges elsewhere has been unhelpful, and that abuses of that have led to a shortage of parking at medical sites. That is easy to deal with, because my proposal does not ask for free car parking for all, but focuses on a specific group of hospital users, each of whom would display a carer’s charge exemption badge in their car, ensuring that only those genuinely entitled would benefit.

Other critics have pointed out that in many areas carers are able to make use of hospital shuttle buses, which are often provided free of charge. They have said that travelling to hospital in a car is in itself a luxury, but they clearly do not understand the issues. Often, carers cannot access services for a variety of reasons, such as other commitments or dependants, which means that they need their own transport. Sometimes hospital transport requires multiple bus changes, and rural communities often have no bus service at all. Sometimes a patient’s condition means that any form of transport is unsuitable. I have spoken to people who are suffering from cancer and who rely on their carer for transport and for support through the regular chemotherapy and radiotherapy sessions. These patients often have impaired immunity, so exposing them to infection on public transport is surely not an option for them.

The main criticism of the proposals in the Bill relate to the perceived loss of income to the NHS. I would make the following points. It is estimated that the contribution made by carers saves the NHS more than £100 billion each year by virtue of the time they spend supporting people in hospital. Sick children, people suffering with mental illness or Alzheimer’s disease, or those with physical and mental disabilities have special needs. They need special care when they are at home and those special needs do not go away when they are admitted to hospital. In fact, they often need more help to cope in an unfamiliar environment.

If carers and parents did not visit and support each day, hospitals would not be able to cope. I spoke to one lady who gave up work three years ago to look after her husband who had developed Alzheimer’s. Her husband had a fall, broke his hip and was admitted to hospital. For three years she had been feeding, dressing and calming her husband, and she continues to perform this role in hospital. The nursing staff already have enough to do attending to the medical needs of all the patients on the ward. They simply do not have the time to provide such intensive caring. Similarly with stroke patients, I have met many carers who go the hospital each day and sit patiently feeding their loved one, leaving nurses free to perform their duties as qualified medical practitioners. Many families are struggling in poverty because their child has an ongoing medical condition. A parent or carer’s presence at the hospital often provides many hours of valuable support that would otherwise have to be provided by the nursing staff—at what cost?

During the preparation for the Bill, I have met parents who have more than one child with multiple health needs, both of whom are constantly in and out of hospital, necessitating multiple journeys to and from hospital. This means little, if any, time for the parents to go to work as they are performing a big support role on the ward, but suffering significant financial hardship. And we want to charge them to park! Torbay and South Devon NHS Foundation Trust proves the point. It has successfully implemented a free parking scheme for carers. It acknowledges that the financial impact has been minimal by comparison with the benefits received. For example, nurses at the hospital report that the scheme means they have more free time, as carers are able to spend longer visiting their loved ones. Carers who use the scheme say they feel valued, that the scheme saves them money and that it removes one of the many stresses in having to visit hospital.

In addition, there is evidence that patients make a faster recovery when they have the continuous support of a known and trusted carer, and are often discharged from hospital earlier, with obvious financial savings to the NHS. Hospital car park charges are a financial punishment for carers for looking after a friend or family member. Without carers, many people would never be able to access the healthcare they need to help them to manage their illness or disability. Carers have so much to cope with, why do we give them one more financial burden?

As a former member of Lancashire’s health and wellbeing board, I know that one of the ways that the Government seek to make savings in the NHS is by reducing the number of hospital stays. Where carers are willing and able to provide ongoing care at home, many patients can now be discharged at an earlier stage than in the past, thus freeing up much needed beds. They go on to return routinely as out-patients, with transportation invariably provided by their carer. The saving to the hospital in those instances is far more than is ever collected in car parking charges. Carers enable people to continue to live in their own home, saving the expense of care homes.

The Minister rightly recognises that if we want to keep people out of hospital we must improve out-of-hospital care. He has also acknowledged that

“Carers do a magnificent job”

and that

“they do not always get the thanks or support that they need.”

I am singling out carers for special attention because they are vulnerable and going through a difficult time, and because they matter and they need our support.

I ask hon. Members to support the Bill to provide free car parking at hospitals for qualifying carers and in the future to consider supporting eligible carers. It will not solve all their problems by any means, but it will help, and just as importantly, it will send a signal to carers around the country that we value their contribution. The Bill would support carers and send a message that Britain cares about carers. Carers are crucial to the future of Britain’s health and wellbeing. Surely the least we can do is allow them to park for free.