Digital Exclusion

Debate between Justin Madders and Jamie Stone

Wednesday 28th February 2024 Westminster Hall

[Justin Madders (Ellesmere Port and Neston) (Lab)]

I beg to move,

That this House has considered digital exclusion.

Prynhawn da, Mrs Harris; it is a pleasure to see you in the Chair this afternoon. It is abundantly clear that we are living in an increasingly digital world where technology has become essential to the way we socialise, work, shop, learn, manage finances and gain access to vital services. Digital skills, connectivity and equipment are all now essential to enabling an individual to fully participate in modern society. For the majority of the population, that has made life easier.

Tasks that would have required someone to leave the comfort of their own house in the past are now performed at the tap of a screen or the click of a button. Information that might once have required significant research can be recovered instantaneously. For the most part, those trends do not pose problems for people, but for the minority who might lack the digital skills or confidence to gain access to those services, it can make the world more and more inaccessible.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

Many of my constituents cannot work the system. They do not know how to or they give up, which means they miss out on vital NHS appointments and so on. Does the hon. Member agree with me that a back-up, offline system with a real voice at the end of a line would be a good idea?

[Justin Madders]

I agree. I will say no more about that because of the number of people who want to speak.

NHS Pay

Debate between Justin Madders and Jamie Stone

Wednesday 24th March 2021 Westminster Hall

[Justin Madders (Ellesmere Port and Neston) (Lab)]

It is a pleasure to see you in the Chair, Mr Hosie. I thank my hon. Friend the Member for Liverpool, Wavertree (Paula Barker) for securing this important and heavily subscribed debate today. She gave an excellent, impassioned introduction. She summed the issue up very well when she said that NHS staff are being asked to do more for less. That really does sum up the Government’s approach to a lot of things: more for less.

I thank all other hon. Members for their contributions today. There are too many to mention individually, but I will pick out one or two during my speech. I particularly thank my hon. Friends the Members for Luton South (Rachel Hopkins) and for Birkenhead (Mick Whitley) for co-sponsoring the debate.

Every Member spoke with great passion, sincerity and knowledge about why the Government’s approach to the NHS pay deal is flawed. It is disrespectful and ultimately self-defeating. Members who spoke showed clear support for and appreciation of the NHS workforce. Every single Member had that in common. They also have in common that they are all from Opposition parties. Not one Back-Bench Tory MP has come today to defend their party’s policy—not one. Worse still, not one has come to defend the NHS workforce. That says it all, doesn’t it?

I am sure we all agree, certainly among Opposition Members, that our amazing NHS staff have been the ones who have kept this country going during the pandemic, who have kept us safe and who have looked after our loved ones. They have been on the frontline looking after not just the 450,000-plus people who have been hospitalised with coronavirus, but everyone else who has needed medical attention, while at the same time putting their own lives on the line. Our NHS staff are feeling the strain. Do not forget that we entered the pandemic with a record 100,000 vacancies in the NHS, and with a health workforce smaller than many other countries, meaning that our NHS staff have worked longer and harder than others during the covid crisis.

For many people, the added pressure has had a profound impact on their psychological wellbeing. Almost half of NHS staff in England have reported feeling unwell from work-related stress—the highest rate recorded in the past five years—and NHS staff took 3.5 million sick days off between March and October last year due to mental health issues. The latest figures from the NHS staff survey, published this month, show that 300,000 staff have worked unpaid hours, and that almost 13,000 more staff reported working unpaid overtime compared with 2019, suggesting that over 1 million hours of unpaid overtime have been worked during this pandemic. It is little wonder that NHS staff are exhausted and that they are leaving.

My hon. Friend the Member for Liverpool, Wavertree made a strong case that pay increases can have a positive effect on retention levels, which is something that urgently needs addressing. The Minister will know all about the shocking number of healthcare staff who have left their NHS roles for better pay conditions and work-life balance in recent years, because she has seen the data—it is the Government’s own data that say this. She will be well aware that over the last year, 31,000 nurses and health visitors left the NHS—an increase of 50% since 2010-11.

[Jamie Stone]

Will the hon. Gentleman give way?

[Justin Madders]

I am sorry, but I will not have time to take any interventions.

The Minister will know that since 2010-11, there has been a 181% increase in nurses and health visitors resigning due to their work-life balance, and an 82% increase in the number leaving for health reasons. She will be aware that there has been a 57% increase in resignations since that time because people found a better reward package elsewhere.

Years of pay freezes, record vacancies and relentless pressure have had a devastating effect on our NHS workforce. Not surprisingly, as a last resort, hard-pressed staff are voting with their feet. That should ring alarm bells loud and clear that Ministers are not getting things right, that they need to change course and that they need to start listening to the NHS workforce. It is simply unacceptable that instead of giving our NHS staff the pay rise that they were promised, the Government are recommending that they should receive just 1% this year, an amount that the Government are fully aware is actually a real-terms pay cut. NHS staff are not being properly rewarded, as the Secretary of State said they would be. That is not what is set out in the legislation passed by this House, which the Government voted for in the NHS long-term plan.

As the Minister knows, the plan set out a 2.1% pay increase for all NHS staff. The head of NHS England, Sir Simon Stevens, has confirmed that the NHS did indeed budget for that 2.1% pay rise, so the Government have broken their promise. The Office for Budget Responsibility forecasts that inflation will rise by 1.5% this year, so instead of a pay rise that was budgeted for and indeed voted for, NHS staff will see a real-term pay cut of hundreds of pounds. Experienced nurses will see a paltry £3.50 per week extra in their pay packet, which is just 50p a day. My hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) told of a healthcare worker who will get 9p an hour extra.

Counting for inflation since the Conservative party took power in 2010, some NHS workers have seen their pay slashed by thousands of pounds a year. The starting salary for nurses, physiotherapists, radiographers and numerous other NHS roles has seen a real-terms pay cut of £841 per year, and average salaries have reduced in real terms by around £2,379. That is not being properly rewarded; it is not being rewarded at all. It is not good enough for those who have performed heroically over the last year to be rewarded in this way. For many, a real-terms pay cut will be the last straw. My hon. Friend the Member for Sheffield, Hallam (Olivia Blake) made the point that we are in an international market for healthcare staff and cannot afford to be complacent in such matters.

It could not be clearer that we need investment in our workforce. Waiting lists have spiralled out of control, and we will need the staff more than ever. The Government urgently need to reconsider their approach; otherwise, the exodus that we are seeing at the moment will become a flood. Hon. Members, the public, UNISON, other unions, the NHS Confederation and other bodies are all urging the Government to reconsider their 1% pay rise proposal, so what is stopping them? It cannot be a lack of money, because, as we have heard, £37 billion can be found for Test and Trace, millions can be spent on unusable PPE, and we have had £2.6 million for the Prime Minister’s new media centre. It is a political choice, and it is a choice that cannot be defended. Indeed, as we see today, it seems that no Conservative Back Benchers want to defend it.

I am sure that the Minister is well aware of the anger the proposals have generated, but let me read out a few quotes from bodies representing the workforce so that she can see the strength of feeling. The British Medical Association said it is a

“total dereliction of the Government’s moral duty”

and a kick in the teeth. The Royal College of Nursing said:

“This is pitiful and bitterly disappointing”

and “dangerously out of touch”. Unison said it is the “worst kind of insult” and “some kind of joke.” The TUC said it is

“a hammer blow to staff morale”

and Unite described it as “unyielding contempt”. So I do not think there is any mistaking how NHS workers feel.

That mood is matched by the public, who overwhelmingly oppose the Government’s position. A poll showed that 83% of the public and 78% of Conservative voters think the Government should increase their pay offer. For a Government who routinely pit people against one another when it comes to pay, that must surely tell them they are on the wrong side of the argument. If it does not, they must surely know they should think again when the former Health Secretary, the right hon. Member for South West Surrey (Jeremy Hunt), calls their offer a “miscalculation”. As understatements go, that is right up there. We do not know whether that view is widespread on the Tory Benches, because no Conservative Member is here to tell us what their view is. I am not surprised that the Prime Minister wants to avoid putting the proposals to a vote, because how could any Conservative Member look their constituents who work for the NHS in the eye if they vote for that? I do not know.

It should not have come to this. The Government really need to think again. The whole country is watching and waiting for them to do the right thing. It is not enough to say, “Wait for the pay review body” without giving a guarantee that, should the pay review body recommend a real-terms pay rise, that will be honoured by the Government. If the Minister confirms at least that today, that would be a start.

After the last year, we should not have to fight a battle to ask the Government to consider more than a 1% pay rise. It says everything about how little value those efforts over the last year have been appreciated. Our NHS staff deserve more than that. They deserve an agreed fair and sustainable pay settlement. Ministers should admit their mistakes and undertake to agree a multi-year pay deal with NHS staff. In starting talks, they should take the pay cut off the table and not set a ceiling. Time and again, the Prime Minister said that the NHS would not pay the price for the pandemic. The Chancellor promised that the NHS would get whatever it needed. It is time to put those words into action. It is time to ditch the empty promises and gestures. It is time to do the right thing.

We stayed at home to protect the NHS. We clapped for our carers during the pandemic, and we on the Opposition side meant it. As my hon. Friend the Member for Liverpool, Wavertree said, claps and smiles do not pay the bills. That is why the Opposition will not rest until our brave NHS staff get fair pay and the long-term settlement that they truly and honestly deserve.

Health and Social Care Workers: Recognition and Reward

Debate between Justin Madders and Jamie Stone

Thursday 25th June 2020 Commons Chamber

[Justin Madders (Ellesmere Port and Neston) (Lab)]

I congratulate my hon. Friend the Member for Newcastle upon Tyne North (Catherine McKinnell), the Chair of the Petitions Committee, on introducing the debate and brilliantly articulating the many issues relating to the recognition and reward of health and social care workers. I thank all those who have signed the four petitions, which have so far amassed some 290,000 signatures between them. By doing so, they have brought this very important debate to Parliament today.

This debate comes at a particularly poignant time, when health and social care workers have been at the heart of the fight against coronavirus, working day and night to protect the NHS and save lives. They, and all the key workers who keep this country going, are the very best of us. I want to take this opportunity to once again pay tribute to the hundreds of NHS and social care staff who have lost their lives to the virus. I hope that when this is over, we can find an appropriate way to remember the frontline staff who gave their lives in the line of duty.

This was a heavily subscribed debate, and it was clear from every Member who spoke that the gratitude the whole country feels for our health and social care workers is replicated in this place. We had some superb speeches from Opposition Members, with good representation from Wales. My hon. Friend the Member for Merthyr Tydfil and Rhymney (Gerald Jones) spoke with typical eloquence and highlighted the wise decision of the Welsh Government to recognise the contribution of care workers. I hope that the Minister will be able to respond positively to my hon. Friend’s request, or at the very least confirm that she is making strong representations to the Treasury about the tax treatment of that payment. We heard a similar point from my hon. Friend the Member for Pontypridd (Alex Davies-Jones), who also reminded us of NHS Direct, which was a great innovation from the last Labour Government.

My hon. Friend the Member for Bethnal Green and Bow (Rushanara Ali) rightly said that staff need to be rewarded with more than just applause, and she drew attention through her strong speech to the sorry record we have seen over the last 10 years on the NHS. My hon. Friend the Member for Coventry South (Zarah Sultana) spoke with great passion and listed a whole series of ways in which the health workforce is hit with extra burdens in the course of their duties.

My hon. Friend the Member for Erith and Thamesmead (Abena Oppong-Asare) drew attention to the scandal of nurses being forced to use food banks. That should shame us all. We also heard from my hon. Friend the Member for Hackney South and Shoreditch (Meg Hillier), who made the powerful point that medals do not put food on the table. She brilliantly highlighted how insecure work is a blight on the NHS and a systemic problem that needs addressing once and for all.

As we heard, even before the pandemic our frontline health and social care staff were working in overstretched and under-resourced settings. We must acknowledge that many of our frontline careworkers have been in extremely stressful and sometimes traumatic situations as a result of covid-19—situations that those of us who have not been on the frontline cannot even begin to imagine. Working in these uncertain times, dealing with a new and emerging disease, often without adequate protection, while coping with losing patients and worrying about getting ill themselves or taking the virus home to their loved ones are all contributing factors to staff burn-out and poor mental health. It is vital that we keep them all safe in the event of a second wave.

Yesterday, following the Prime Minister’s announcement of the relaxation of the 2-metre rule and sweeping changes to the lockdown in England, health leaders called for a rapid and forward-looking assessment of how prepared the UK is for a new outbreak of the virus. Those health leaders from the Royal Colleges of Surgeons, of Nursing, of Physicians and of GPs say:

“the available evidence indicates that local flare-ups are increasingly likely and a second wave a real risk.”

They also point out:

“Many elements of the infrastructure needed to contain the virus are beginning to be put in place, but substantial challenges remain”,

and they call on the Government to focus on

“areas of weakness where action is needed urgently to prevent further loss of life”.

We cannot have any failures in preparation this time.

We may no longer be gathering outside our homes on a Thursday night to clap for our carers, but our admiration remains. It has been incredible to see the effort from staff in the last three months—staff who, too often, get very little in return. We hope that they are recognised for their true worth now.

[Jamie Stone]

Will the hon. Member give way?

[Justin Madders]

I am sorry, I will not have time to give way.

Many of our NHS and care staff are exhausted and fearing burn-out. They need our support now, which means safe staffing ratios, adequate PPE and decent fair pay, because for them the hard work is not over—it is only just beginning. They will continue to give their all as they begin to tackle the backlog in non-covid care. The millions of routine operations, screening tests, treatments and therapies that were suspended or cancelled during the pandemic will now have to restart. Those challenges cannot be met without the staff.

As we know, there are well over 100,000 vacancies in the social care sector, and systemic insecure work and low pay are not the answer to resolving that issue. We know that prior to the covid-19 outbreak there were also 106,000 vacancies across the NHS, including 44,000 nurse vacancies. Those vacancies matter. They mean that NHS services were already under extreme pressure due to the ongoing staff shortages, before being further stretched by more shortages due to sickness or caring responsibilities during the pandemic. That, in turn, has put all healthcare staff under intolerable and unsustainable levels of pressure.

On top of those staff shortages, healthcare staff have had to work in unfamiliar circumstances or in clinical areas outside their usual practice, and of course they have had to work in very difficult circumstances. A survey by the Royal College of Nursing found that half of nursing staff felt under pressure to work without the levels of protective equipment set out in official guidance, and a survey by the British Medical Association of 7,000 doctors found that 45% were experiencing stress, exhaustion and burn-out. We need to listen to what the staff are telling us.

Just last week, we learned that student nurses who joined the frontline six months ago as part of the coronavirus effort are seeing their paid placement schemes terminated early, leaving them with no income and no guarantee that they will not face extra costs for completing their studies. That is no way to treat student nursing staff who have put their studies on hold to join the fight against coronavirus, and who are at the start of what we hope will be a long career in the NHS. They deserve better.

The Government still have not quite resolved the issue of the immigration health surcharge, where NHS and social care staff coming from abroad and working on our frontline are required to pay a surcharge of hundreds and sometimes thousands of pounds just to use the NHS themselves. It was welcome that, after considerable pressure, the Government announced last month that the surcharge would be abolished, but, as we have heard, there are still reports of people being charged. I would like an update from the Minister about what is happening in respect of that.

In conclusion, no one hearing this debate would be in any doubt that our health and social care workers are appreciated, admired and respected, but warm words are not enough. A clap on Thursday night is not enough. It is time for action, and for the Government to finally recognise the monumental contribution that health and social care workers make. No more poverty pay. No more “work until you drop”. No more sending people into work inadequately protected from exposure to a deadly virus. That cannot happen again.

The Government were too slow to recognise the need for PPE, too slow to protect the social care sector, and now they are too slow to properly reward our brave health and social care workers, who have literally put their lives on the line for us all. It is time we put that right.

Disability Assessment Services

Debate between Justin Madders and Jamie Stone

Wednesday 13th March 2019 Westminster Hall

[Justin Madders (Ellesmere Port and Neston) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Christopher. I congratulate the hon. Member for Chichester (Gillian Keegan) on securing the debate. Like many other Members, I am sure, I felt compelled to speak because of the number of constituents who have come to me with harrowing stories of their experiences, and with a clear message that improvements to disability assessment services are very much needed.

In my constituency, we have seen a variety of issues recently, including cases of incorrect information being recorded; there have been statements saying that physical assessments were carried out when they were not, and that a constituent could go out alone when the assessor was actually told in the interview that they could not. In one case, the information was so incorrect that it was assumed that the assessment report had been mixed up with that for another case. My constituent Amy was recorded as walking despite being wheelchair-bound, which must surely have been apparent at the assessment. When a complaint was raised, the DWP noted that that could be a “misleading statement”, but worryingly, Capita, which has consistently failed to meet its target for an acceptable standard of assessment, responded that there was no evidence that the statement made by the assessor had been misreported. I find that unbelievable.

Last-minute cancellations are a problem. We have heard from constituents whose assessments were cancelled on the day that they were due to take place. Even worse, in some cases, the constituents were actually at the assessment centre when their appointment was cancelled. Yet perversely, if a constituent is unable to attend their assessment, they are penalised. When one of my constituents rang up two days before her assessment to give notice that she would not be well enough to attend, she was told that it was too late for the assessment to be rescheduled, and that she would be recorded as a no-show. Those are double standards of the highest order.

Constituents who have attended assessments have raised with me the concern that their assessor carried out the assessment very quickly, and did not listen to their answers. Others were concerned that the assessment was not carried out safely. For example, a constituent with a slipped disk was asked to complete the physical part of the assessment without anything to support her, despite informing the assessor that she would need to hold on to something. Why are my constituents being put at risk in that way?

Another major concern is the refusal to conduct home assessments, despite medical evidence that they are necessary. That is a concern shared by organisations such as Macmillan Cancer Support, which has found that home visits can often be difficult to obtain, and that the option of a home visit is not widely communicated.

[Jamie Stone]

The hon. Gentleman makes an excellent point about home visits. Does he agree that the problem is compounded by the fact that some people have to travel very large distances for those assessments? That is an issue facing some of my constituents. It would be so much easier if they could be done at home.

[Justin Madders]

Absolutely. The hon. Gentleman’s constituency must be rather more rural than mine, but for anyone who has a disability, travelling distances of any order is challenge. Home assessments need to be much more widely promoted.