Social Security
Debate between Julian Lewis and Debbie Abrahams(2 months, 2 weeks ago)
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Debbie Abrahams (Oldham East and Saddleworth) (Lab)
I recognise the serious economic context of the debate today. The Institute for Fiscal Studies, for example, has estimated that 320,000 people are being pushed into poverty because of mortgage interest rate rises triggered by the disastrous autumn 2022 mini-Budget, and of course the then Prime Minister made many unfunded policies.
I recognise that the policy measures in the King’s Speech will go a long way to reduce household costs and increase incomes in the medium term, but those tackling the appalling poverty that we are seeing will not come in time for this winter. I am proud that Labour are continuing with the triple lock on pensions, something that will be worth an extra £460, but that will not happen until next spring. The setting up of a new energy production company, Great British Energy, alongside making homes more efficient, is a fantastic initiative that will contribute to our net zero targets and reduce energy bills for millions, but again that will not be in time to offset the 10% increase in energy bills this winter. I support our focus on growing our economy, but again that will not happen overnight.
The Joseph Rowntree Foundation estimated in its report earlier this year that there are 2 million pensioners living in poverty—about one in six of all pensioners. In areas such as my constituency, poverty rates are much higher. We have one in two children living in poverty. From the figures, we estimate that will be the same for pensioners. We know that four in 10 older people in Oldham East and Saddleworth have a disability, and almost half have a long-term health condition. We also know that, even before the escalation of energy costs, over one in six households were living in fuel poverty. Although pension credit provides extra financial support for the poorest pensioners, and opens up help such as housing benefit and council tax discounts for those who are eligible for it, only 5,500 of the 9,000 households in Oldham are eligible to claim it. Again, I welcome the automatic linking of pension credit to housing benefit to increase the uptake, but this again will not happen in time—in the next few months.
Debbie Abrahams
I am not going to give way. I thank the right hon. Member, but I cannot because I am under strict guidance from the Deputy Speaker.
One in three pensioners living in poverty are in the private rented sector, so what are we going to do about that? Even if everyone eligible for pension credit were claiming it, according to Age UK, there would still be another 2 million pensioners slightly less badly off who will not be eligible for pension credit and now the winter fuel payment. The cut-off threshold for pension credit is just under £12,000 a year for a single person. These are not wealthy pensioners. Poverty is poverty whoever experiences it, and we know that we have 8 million working people living in poverty, as well as 4.5 million disabled people, 4 million children and 2 million pensioners. As we did in previous Labour Administrations, I know we will tackle this, but again it will not happen overnight.
Could I point out what we know about the health effects of the cold? The Lancet published a very good paper reviewing data from the last 20 years, and it showed the extra deaths—the excess deaths—as a result of cold. I could mention dozens and dozens of cases from my constituents who have written to me and who, again, are just clinging on following the last 14 years. Is my right hon. Friend the Secretary of State able to say not just what other options she may have considered for offsetting the loss of the £300, but what alternative ways there are of raising the £1.4 billion we will get from means-testing the winter fuel payment? I know how complex and difficult our economic situation is, but, please, we must protect our most vulnerable citizens.
Mental Health Act 1983
Debate between Julian Lewis and Debbie Abrahams(5 years, 4 months ago)
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Dr Lewis
I am delighted to see the hon. Member for Bermondsey and Old Southwark indicating his agreement. It meant that they would not then suffer a much worse breakdown, which would have meant that they would have to be incarcerated, for want of a better word, for a much longer period.
Debbie Abrahams
To prevent people, including people living with dementia, from having to be admitted to hospital, there needs to be community support and after-care support once people are discharged, to ensure that they can be kept as healthy and independent as possible in the community for as long as possible.
Dr Lewis
The hon. Lady is absolutely right, as long as we recognise that what is needed is a range of facilities. Even the most ardent advocate of doing away with in-patient beds would, if pressed, admit that there will always be some people who at some point absolutely need to have some in-patient treatment.
If there are some people who need to go in for a considerable period of time, and hopefully there are a lot more people who do not need to be admitted to acute units at all, it follows almost logically that there will be some people who are on the borderline between the two, who can get by in society with a degree of self-awareness—either their own or that of their immediate family—and that when the warning signs appear, provided there is that network of specialist care with beds for very short-term stays, they can receive what I call a “top-up”, or, if we were talking about servicing a vehicle, something that will prevent a much greater collapse from happening later, with all the consequent horrors.
The question of what happens when people are admitted to acute units arose on a second occasion. I mentioned the first occasion, when I tried to introduce my private Member’s Bill in December 1997 and it was overshadowed by foxhunting. On a second occasion—on 9 December 2010, to be precise—I had secured an Adjournment debate on what happens about the information that is given to someone’s nearest and dearest when an adult is sectioned and goes into an acute unit. That occasion was on the day of the key debate about the trebling of student tuition fees, so once again we found mental health being somewhat upstaged by other matters that were of national importance. However, that is no reason not to persist or not to continue to try and emphasise to Ministers how these issues will never go away until they are finally tackled.
On that occasion in December 2010, I raised the case of the daughter of my constituents, Mr and Mrs Edgell. Sadly, their daughter—who was called Larissa but known as Lara—had taken her own life in 2006. For two years prior to that, the medical authorities had refused to share information about her with her parents; because she was an adult in her thirties, they refused to share vital information about her suicidal thoughts with her parents, on the grounds of patient confidentiality.
It subsequently turned out that there were very good guidelines that said that such information should be shared. So, I wrote to the then Minister with responsibility for care services, the hon. Member for Bury South (Mr Lewis), saying that there was clearly a breakdown in the system if adequate rules existed but were not being put into practice locally. The rather unsatisfactory answer that I received at the time was that the responsibility lay with the local medical authorities to ensure that the central guidelines were implemented.
As I say, that was at the end of 2010, so it was a long time ago. I wonder whether the Minister will be able to reassure me that there is now more central direction. In the case of Lara and her parents there was inadequate sharing of vital information, under the mistaken belief that patient confidentiality trumped the fact that an adult patient was incapable of making her own decisions. I would like to know whether that situation has been rectified, or whether we are still dependent on local medical institutions and authorities to apply a central guideline that ought to be better known.
This week, I received a letter from Lara’s mother, who asked me to attend this debate. I can do no better than to read from what she says, not so much about what happened to her daughter but about the continued interest that she has in the workings of the mental health services. She says that she would like to make her own recommendations; given what happened so tragically in her immediate family, we owe it to her to give serious consideration to those recommendations, which are as follows:
“1. The 1983 Act should be revised to prioritise the dignity of individuals who come to be in the Service’s orbit.
2. Such individuals should have their values and world views respected and have a significant say in the manner of their treatment.
3. They should have the option to refuse certain treatments.
4. Mental hospitals must be places where patients feel safe: there have been numerous allegations of staff members being abusive, provocative and/or intimidating.
5. Use of force should be absolutely minimised. This includes physical restraint, seclusion, or forced medication.
6. A reduction in ‘sectioning’.
7. A reduction in stigma”—
and finally:
“8. All aspects of the Mental Health Service should be more open, and subject to independent scrutiny from time to time.”
I will conclude by making one left-field observation relating to the armed forces. The Select Committee on Defence, which I have the honour of chairing, has been recommending for some time that we establish a centre of excellence for the mental injuries suffered by those who put their life on the line to defend this country, preferably alongside the national centre for physical rehabilitation at Stanford Hall. We have now raised this issue twice with the Secretary of State for Health and Social Care, who has given us a reasonably encouraging response. However, once again, we feel that he is coming up against resistance because of the philosophy that people must be treated locally when at all possible, not admitted as in-patients in centralised locations. That is causing a pushback against our idea.
Our idea is based on the fact that those who suffer injury in combat situations have experienced a peculiar and unique form of trauma, different from those that ordinary mental health professionals can be expected to understand. I am sure that my hon. and gallant Friend the Member for Plymouth, Moor View (Johnny Mercer) will want to expand on that topic, if he is lucky enough to catch the Chair’s eye. We believe that there is a case for a national centre of excellence, and that the welfare of members of our armed services who suffer mental injury should be no less important to us than the welfare of those who suffer other, physical forms of injury in the cause of defending our freedom.