Budget Resolutions

Debate between Kate Green and Andrew Gwynne

Tuesday 2nd November 2021 Commons Chamber

[Kate Green]

The hon. Member may not remember the Dilnot plan, which had cross-party support until Conservative Members torpedoed it. He may not have read the five principles that Labour has set out to underpin our approach to social care, including preventive investment to keep people at home and living independently for as long as possible, as we all want to. We have a plan that would invest in the workforce. It is not enough just to wish for better social care; the people have to be there to deliver it. That is Labour’s plan, and if the hon. Member would like more details, I am very happy to send them to him.

Despite 1.6 million people waiting for treatment, there was no guarantee in last week’s Budget that mental health will receive its fair share of NHS funding. Health stakeholders were most critical of the lack of a workforce strategy or a multi-year funding settlement to support it. We cannot deliver world-class healthcare if we do not invest in recruitment, retention and staff development. It is no wonder that the NHS is struggling when the number of adult health and care students declined by 15% in the three years before the pandemic.

The pandemic also shone a light on the problems that our schools, colleges and early years providers were already facing. No doubt it exacerbated them, but it did not create them. Last week, the Chancellor set out a £3 billion investment in skills, and the Secretary of State claimed that it was the biggest in a decade—but it comes after a decade of cuts to post-16 provision. The Learning and Work Institute calculates that funding over the spending review period will still amount to only 60% of the 2010 figure.

It is astonishing that at a time when our economy has to adapt to the challenges that the Secretary of State referred to—globalisation, digitisation and climate change in the post-Brexit environment—investment in skills remains so lacking. Four in 10 young people are leaving education without the level of qualification they need, the number of apprenticeships has fallen by more than 40%, and 9 million adults lack basic skills in literacy or numeracy. No wonder the Chancellor can promise only a paltry 1.5% increase in growth in the final three years of the forecast period.

At the same time that it is talking up the importance of vocational education, the Department for Education is scrapping most BTECs—well-recognised and respected qualifications that give opportunities to hundreds of thousands of young people.

[Andrew Gwynne]

I am grateful to my hon. Friend for raising the importance of BTECs, because for many young people and indeed many adults, BTECs are the route through the education system. As somebody who has a BTEC national certificate in business and finance and a higher national diploma in business and finance, I know that—it was my route through the education system. Let us make sure that we keep it open for future generations, too.

[Kate Green]

My hon. Friend is absolutely right. Again and again, I have met people who have described their learning journey from BTECs to university and an excellent career. Of course we want T-levels to succeed, but there is no reason to remove other qualifications that provide a different route that is more appropriate for some young people. Under Labour, every young person will receive education that is appropriate to them, whether that is an apprenticeship, technical education or university, and will leave it ready for work and life.

Women and the Economy

Debate between Kate Green and Andrew Gwynne

Wednesday 9th December 2015 Commons Chamber

[Kate Green]

I must correct the hon. Gentleman: it was a Labour Government who left that measure on the statute book. It took Conservative-led Governments another five and a half years to put that into action. Even now, what is being put into action is insufficient. It does not, for example, provide for a full breakdown of grades and job roles, so there is more to do. Of course it is a welcome measure, and we are proud to have brought it forward, but I hope the Government will not rest on their laurels and will be prepared to go further.

[Andrew Gwynne (Denton and Reddish) (Lab)]

My hon. Friend is absolutely right to raise the issue of the impact on women of the Government’s policies. She will be aware that there have been huge reductions in public services, and that women constitute 75% of the local government workforce, 77% of the NHS workforce and 80% of the workforce in social care. Does she agree that these reductions are having a huge impact on the employment prospects of women in the public services?

[Kate Green]

My hon. Friend is right about that. Of course the public services, too, traditionally have had a better record in many respects on promotion for women and other groups with protected characteristics, such as black and minority ethnic workers. There is certainly a concern that cuts to public sector spending will have an impact on women’s employment, and on their employment prospects, and that those cuts are part of the reason why unemployment has remained higher among women than men.

As I say, many of the Chancellor’s policies that are harmful to the interests of women are still, sadly, in place: the freeze and cuts to child benefit, universal credit, local housing allowance and tax credits; the cuts to the family element of tax credits; the changes to disregards, tapers and thresholds; the disincentive for second earners, often women, in universal credit; the benefit cap; the two-child policy in child tax credits; increased parent conditionality; and an alarming rise in lone parent sanctions. Even the free childcare offer is shrouded in complexity and uncertainty, is delayed and is apparently more limited in scope than had previously been planned for.

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[Kate Green]

Certainly, I am unable to describe the policies of the Government as pro-female, or indeed feminist. Perhaps the Minister will seek to defend the Prime Minister’s record.

Those women who saw their pension age increase as a result of the Pensions Act 2011, particularly those born between April 1951 and April 1953, have been hit especially hard. Not only do they have to wait longer for their pension, but unlike a man of exactly the same age, they are not eligible for a single-tier pension.

[Andrew Gwynne]

My hon. Friend will know the work that my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) and I have done in raising this issue. On Saturday, I was at Denton Morrison’s with the Women Against State Pension Inequality—WASPI—campaign group. It made that point to many of my constituents who were completely unaware of the changes and the acceleration in the state pension age, so those women who were expecting to get their state pension will be sorely disappointed. They said that the Government’s communications on this have been absolutely abysmal.

[Kate Green]

My hon. Friend is right. I, too, have met the WASPI women. Just the other day, my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) held a Westminster Hall debate on this very subject in which she pointed out the lack of notice to these women. That point was also made by my hon. Friend the Member for Leeds West (Rachel Reeves) and others when the legislation was passed by this House in 2011.

Scotland Bill

Debate between Kate Green and Andrew Gwynne

Tuesday 30th June 2015 Commons Chamber

[Kate Green]

I will speak particularly to amendments 113, 9, 114 and 10, and much of what I will say will echo what the hon. Member for Livingston (Hannah Bardell) said about the devolution of employment programmes.

It is clear that there are different labour markets not just between England, Scotland and Wales but within those nations. That is why I echo the point that my hon. Friend the Member for Denton and Reddish (Andrew Gwynne) made about the opportunity that our amendments and the SNP amendments offer not just for devolution to Scotland but for double devolution of labour market programmes within Scotland.

[Andrew Gwynne]

As a Greater Manchester MP like myself, my hon. Friend will know that as part of the cities and devolution package, Greater Manchester will be invited to bid for the next phase of the Work programme. Does that not suggest that, as my hon. Friend the Member for Edinburgh South (Ian Murray) said,double devolution is needed in Scotland so that communities can develop work programmes that are specific to them rather than centralised in Holyrood?

[Kate Green]

I agree. The intention stated in the Labour manifesto was to devolve labour market programmes to what we described as a combined authority footprint. That would enable recognition of the fact that local labour markets differ and recognition of the different industrial history and characteristics of people in particular parts of the country. Importantly, it would allow close alignment with the skills and industrial opportunities in particular communities. We want to see that opportunity for the devolution of labour market programmes to a sensible, localised level; I doubt whether it would be the whole of Scotland, because labour markets differ significantly within Scotland. There are considerable differences between the highlands and the central belt conurbations, for example.

Parliamentary Under-Secretary of State for Welfare Reform (Disabled People)

Debate between Kate Green and Andrew Gwynne

Tuesday 28th October 2014 Commons Chamber

[Andrew Gwynne (Denton and Reddish) (Lab)]

My hon. Friend is absolutely right to condemn unreservedly the reprehensible comments that were made by Lord Freud at the Conservative party conference, but should we not also condemn his actions? It must never be forgotten that Lord Freud is the chief champion of the bedroom tax, which has condemned two thirds of disabled people to live in poverty.

[Kate Green]

My hon. Friend is absolutely right that this debate is about the Minister’s bedroom tax, which disproportionately affects disabled people and their families, with two thirds of those who are hit being disabled people, their families and their carers. It is about the chaos of the personal independence payment, which is leaving thousands of people without essential support. It is about Ministers’ handling of the work capability assessment and the abject failure of their policies to support many disabled people into work, and it is about the collapse in social care and the services that support people to live the lives that they want. My hon. Friend is right that what this afternoon’s debate is truly about is putting the policies that Lord Freud and his colleagues have been pursuing under the microscope, and understanding what has gone wrong.

Museum of Science and Industry

Debate between Kate Green and Andrew Gwynne

Wednesday 26th June 2013 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to see you in the Chair, Mr Brady. I accept your strictures imposed earlier—you are certainly independent—but you are also a Greater Manchester MP, and it is always pleasing to see one of those reach the heights of chairing Westminster Hall debates.

I congratulate my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams) on securing this important debate. I first visited the then Greater Manchester Museum of Science and Industry in 1983, shortly after it moved to the historic Liverpool Road station site, in Castlefield. The museum visit was with 3rd Denton (Wilton street) cubs, and I remember being mesmerised as a 9-year-old boy by the big engines, the turbines, the wheels, the pistons, the smell of the smoke and the steam. It was really alluring and gave me a lasting interest in science, technology and innovation.

Over the years, the museum has grown, first encompassing the neighbouring Manchester Air and Space Museum and then gradually filling the whole of the Liverpool Road station site. For those who do not know, the Liverpool Road station is the terminus of the Liverpool and Manchester railway, which opened in 1830, and the museum buildings are therefore those of the world’s first passenger railway station, here in Manchester—or rather there in Manchester, since we are in London, England’s second city.

Other Manchester firsts housed in the museum include, as my hon. Friend said, Baby, the first programmable computer, which is so large it would probably fill this Chamber, but is about as powerful as a pocket calculator. Nevertheless, it is a Manchester first. There are also Rolls-Royce cars. Of course, it was in Manchester that Mr Rolls met Mr Royce and founded the company that continues to produce those cars. The huge emphasis on science is fitting, in the city where the atom was first split. The museum commemorates king cotton: Manchester is of course Cottonopolis, because cotton was the industry that the city’s wealth was built on. However, it also recognises the downside to rapid, uncontrollable growth—particularly the cholera epidemics of the 19th century, with the campaign for clean water and proper sanitation. There is even an opportunity—I do not know whether you have done this, Mr Brady—to walk through a reconstruction of a Victorian sewer, with the smells included.

The Museum of Science and Industry, better known as MOSI to its regulars over the years, is a much loved local museum, and I have fond childhood memories of it. One of the best Christmas presents that I ever had was when I was 12. My grandad’s friend was a friend of the museum, and he bought me membership, so I, too, became a friend of the museum. Back then, people had to pay to get into museums, but a perk with the friend membership badge was to get in free, so I spent many a good time there. More recently, I have enjoyed taking my children there. I think that such experiences are the reason that Mancunians would consider it a tragedy for the museum to close; that is why we breathed a collective sigh of relief when Ministers assured us, last week, that that would not happen.

Not only is MOSI hugely popular with visitors in the north-west and across the north of England; it is also an iconic national museum. We should not be tempted to call it a regional museum, because it is not. It is a national museum based in the regions, and we should emphasise that. It has uniquely interesting sections about the history of the industrial revolution and has helped to garner the inventiveness of our science base in the north-west. That scientific base is not just a thing of the past. As my hon. Friend mentioned, graphene is a modern Manchester invention and an example of the important role that science has always had, and will continue to have, in the economy of Greater Manchester and the north-west of England.

It is therefore a matter of some concern that in the past few months sources inside the museum’s parent company, the Science Museum Group, have claimed that the future of MOSI is under threat because of funding problems. As a result of the previous Labour Government’s move to give free access to important national collections, visitor numbers at MOSI have shot up. Last year, the museum welcomed more than 800,000 visitors, and it is rightly regarded as a major national centre for industrial heritage and innovation.

It is beyond argument that MOSI is a vital part of Manchester and that it provides cultural, educational and economic benefit throughout the region. It is an invaluable part of the local and regional economy, attracting tourists and prestige, and, as we heard from my hon. Friend, it supports many jobs. Surely, there is a wider principle that the benefits of tax revenue gathered nationally should be spread, so that everyone across the country can benefit from them.

Everyone pays taxes, so surely there is a case for the benefits of tax revenue to be spread as far as possible around the country. That has been demonstrated by the BBC, with the excellent move of a large part of its operation from London to Salford, spreading more of its economic impact outside the M25. Surely, our national museums should operate on the same principle. Everyone should have access to our national collections—a point firmly made by my hon. Friend the Member for York Central (Hugh Bayley).

[Kate Green]

My apologies, Mr Brady; I would not for one moment impugn your independence, but it is a great pleasure for us all to see you in the Chair this morning.

Will my hon. Friend join me in paying tribute to the Imperial War Museum, which of course has located the Imperial War Museum North in my constituency? It is a national museum in the regions, and it is very well visited and much loved.

[Andrew Gwynne]

My hon. Friend is absolutely right. The Imperial War Museum North is another national museum based in the regions that is bringing into Trafford wharfside, and into an iconic building at that, visitors who probably would never have seen those collections in the Imperial War Museum in London. We enjoyed a visit a couple of years ago to see the “Horrible Histories” exhibition, which my kids found absolutely fascinating. We should continue to trumpet the benefits of having national museums and collections in the regions, so that we all may benefit from learning from our past and looking towards our future.

The speculation about MOSI’s future was met by uproar from residents across Greater Manchester and the north of England. As we can see from the number of colleagues here today, the speculation has been met by real concern from most Greater Manchester politicians. The suggestion that MOSI would be affected by the Science Museum Group’s problems led me to write to the Secretary of State for Culture, Media and Sport. In my letter, I outlined that the acclaimed opening ceremony of the 2012 Olympics included a stunning segment on Britain’s development into the global industrial power that it is today. Danny Boyle is rightly lauded for portraying the history of Britain not just as a succession of monarchs, but as a land built by proud working men and women.

Life during the industrial revolution may not have been pleasant for some—indeed, it almost certainly was not—but surely it is just plain wrong to allow access to that history to be lost. I pay tribute to all those involved in MOSI’s development from the early days in 1969, when the then North Western Museum of Science and Industry opened in a temporary venue on Grosvenor street. It was later linked to the university of Manchester institute of science and technology, and then through the superb vision and drive of the former Greater Manchester council, which was instrumental in moving the museum and developing it on its current site, the museum turned into what it is today. The museum, along with the transformation of the county’s once polluted river valleys, is probably the former Greater Manchester council’s best lasting legacy. I thank the many volunteers and friends of the museum who have worked hard to keep things ticking over in the good years and the bad.

People in Manchester and across the north-west, and indeed across the country, are incredibly proud of our free museums, so it is of some small comfort to hear the DCMS announcement on the funding settlement for 2015-16, as no museums should close. Clearly, like MOSI, we await confirmation of the actual details of the funding package, and until those details are received, we cannot be certain of the structural deficit that MOSI will face or of which options will have to be considered. Opposition Members certainly hope that the Government’s culture funding cuts will not result in the closure or downgrading of this outstanding Manchester institution or of parts of it.

There are a number of concerns about the Science Museum Group and MOSI that I would like the Minister to address. Whatever financial problems are facing the Science Museum Group, particularly the London Science Museum, most of my colleagues here today would agree that they should not affect MOSI.

Of course there remains the question of what to do with the structural deficit. The Science Museum Group is currently £2 million in the red, which is projected to go up to £4 million, and potentially even to £6 million, depending on the CSR announcement today. Recent figures show that between 2010-11 and 2014-15 Government funding for the Science Museum Group, including MOSI, has been cut by 25% in real terms. So far, the Science Museum Group has undertaken a number of cost-cutting initiatives, including redundancies across the entire organisation, to try to make the necessary savings. Although it now seems that there will be only a 5% cut to the Science Museum Group’s budget, not the 10% cut that was envisaged, it will still have a significant impact on the budgets and savings that will have to be found.

Enterprise and Regulatory Reform Bill

Debate between Kate Green and Andrew Gwynne

Tuesday 16th October 2012 Commons Chamber

[Kate Green]

The hon. Gentleman is right to say that we need leadership in all walks of society—of course we do. We need to see it in our businesses, schools, public services and communities. I am sure he is not saying that there is no need whatever for the state to sign up, positively and proactively, to endorse and create an institutional mechanism and infrastructure to help achieve that. But if that is what he is saying, he is very much at odds with best international practice and the relevant directives of the United Nations and the European Union. As I have said, in a country where there is still gross inequality, it would take a great leap of faith to say that we can afford to dismantle the equalities infrastructure; surely what we should be doing is building it up.

[Andrew Gwynne]

My hon. Friend is right to say that the great advances that have undoubtedly been made in race equality, disability rights and so on do not mean that there is not unfinished work to be completed. There is an awful lot of progress still to be made and that is a case for a stronger commission, not the rolling back of provisions.

[Kate Green]

My hon. Friend is right. It is regrettable that we are having a debate about watering down the commission’s remit. There is no evidence of public support for that and there is not even much evidence of business support for it. Opposition Members believe that it sends the wrong the signal at a time when we still need to make so much progress.

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[Kate Green]

I accept what the hon. Gentleman says. The problem, however, is that we did not get any evidence from micro-businesses, although perhaps for the best of reasons. I accept it may be difficult for those businesses to find the time and resources to make submissions to formal Government processes, but equally, no evidence has been presented that many micro-businesses have a problem and have used the statutory questionnaire procedure. The legislation comes from speculation rather than information and evidence, and that is much to be regretted.

[Andrew Gwynne]

I agree with my hon. Friend. Does her case not underline the real point that these regulations—and the legislation—is working, and that the framework in place means that the statutory questionnaire procedure has not been used in the numbers suggested and is not the burden that it is made out to be by the Government?

[Kate Green]

That is absolutely right. It is also important to recognise that in an employer-employee relationship, there is an imbalance of power, even in many of the smallest businesses. One thing that the statutory questionnaire procedure helps to do is redress that power imbalance—that has been specifically noted in European directives as one of the purposes of such procedures. It is a regret that Ministers have decided that that protection for employees should be removed.

The statutory questionnaire procedure promotes efficiency in the workplace—cases can be abandoned or issues clarified early—but the fact that the judiciary has come out in the Government’s consultation largely in favour of it suggests that it also leads to efficiencies in the courtroom and the tribunal, because the issues will have been well analysed and distilled. Given the many pressures being brought to bear on employment tribunals, I would have thought that the Government would want to give serious consideration to the cost-effectiveness of the statutory questionnaire procedure in respect of tribunals.

These highly regrettable measures have been thrown into the legislation at the eleventh hour. It appears that they are more a sop to the prejudices of a small number of business organisations rather than a recognition of any business hostility to legislative provisions that have existed for many years.

Finally, I should mention what is happening to the general landscape of places where people can go for redress and advice. My hon. Friends have mentioned the ending of the commission’s grants programme to the voluntary sector; changes to its helpline provision; and the ending of its ability to offer conciliation services in non-employment matters. As the Minister well knows, that is happening against a backdrop of swingeing cuts to legal aid funding and to local authority funding for advice organisations. Those who have suffered discrimination or injustice now have real difficulty even to get to the means of presenting and taking their case. I would understand it if the Minister argued that that is not exactly the EHRC’s core function if it were not for the fact that all other provision of such advice and information is being dismantled. It is extremely difficulty for the Minister to argue that there is no need for the EHRC to provide such a service when the same service is being removed from every possible place where people in need might look for it.

The Opposition are distressed and saddened by the proposals in the Government’s new clauses and amendments. We are concerned that they speak either to Government Members’ intrinsic hostility to the concept of equalities and the landscape to protect them, or to a casual dismantling of provisions that work extremely well. We are concerned that the signal sent to wider society is a negative one—the suggestion is either that equality is a job done, which it plainly is not, or that it is no longer important, even though there is agreement across the House that it is very important.

I hope the Minister takes the opportunity to think again this afternoon about some of the Government’s proposals, but I can absolutely assure her that if that does not happen, the subject will be a matter of live debate in the House of Lords. Their lordships take a great interest in equality and social justice and will be very concerned about provisions that appear to weaken the institutional infrastructure to protect and promote equality. I look forward to many more robust arguments. I hope that, in the end, the provisions will be seen as damaging and that they will be withdrawn, so that we will be able to move forward as an exemplar country in our commitment to equality and our determination to make continuing progress.

Finance (No. 3) Bill

Debate between Kate Green and Andrew Gwynne

Wednesday 4th May 2011 Commons Chamber

[Kate Green]

Not slightly—straying from the ambit of clause 35.

My hon. Friend’s point is correct: fundamentally, the clause removes a universal approach, an approach that keeps everyone in the context of the child care market and the wider social community. That is a really important point.

It is also important to recognise that we are talking about developing children’s long-term economic potential. I do not like to think of our children as future economic actors—I like to think of them enjoying and making the most of their childhood now—but they are the next generation of providers and sustainers of our economy and community care for us in our old age. Removing this financial support from some families and not placing it in the child care market means that some children will be more likely to lose the advantages that good-quality, professional, formal child care can bring.

[Andrew Gwynne]

My hon. Friend is adding great expertise to the debate with her background in this area of policy. Although clause 35 was a mechanism that was suggested by the previous Labour Government, is not the difference between our approach and that of the Government that we would have invested the money raised back into child care provision?

[The First Deputy Chairman]

Order. I am not going to allow any further discussion as to what the money could have been spent on. This debate is simply about clause 35. I know that the hon. Lady has expertise in this matter, so I ask her to restrict herself to clause 35, which relates to higher earners’ child care.

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[Kate Green]

We are aware of the difficulty in planning the paying for child care. Parents are often required to pay a lump sum at the beginning of term or for a group of sessions. They are often required to pay for sessions that they subsequently cannot use for various reasons, but there is no money-back guarantee. Parents will often pay for sessions for more than one child, but there is no financial advantage to them; there is regrettably no bulk discount when buying child care.

Removing money from parents that they could have used to meet some of the burden and the lumpiness in the structure of the way that child care charges are often levied will be a real financial burden on family budgets. Some families will take on debt to meet those commitments, because parents will always try to put their children’s best interests first. If they are happy with their current child care setting, they will do all that they can to keep their child in that stable child care place.

Even if parents are worried that they might be unable to afford that place because of the loss of the tax advantage but can see a time coming when they could resume paying for that place, they will none the less not want to give up that child care place. If they think that they can afford the place again in six or 12 months’ time because their economic prospects might improve, they will stagger on through those six or 12 months, desperate to keep their child in that child care place for two reasons. First, they know that child care places are like gold dust and that, if they give one up, they might not get one back again very easily. That is certainly the case in some parts of the country. Secondly, they know that it will be good for the child. If a child is thriving, doing well and prospering in a settled, high-quality child care place, a parent will make all sorts of sacrifices elsewhere to sustain that child in that place.

[Andrew Gwynne]

My hon. Friend has hit the nail on the head. Is not the underlying impact of clause 35 that the Government know that, although the allowance will be taken away from higher-rate taxpayers, many of those parents will still fund those places and make sacrifices elsewhere in their family budgets?

[Kate Green]

That is right. There is plenty of evidence that parents, especially women, will always make financial sacrifices for their children’s well-being. We should be concerned by the fact that families will have to stagger under considerable financial pressure for the best of reasons—to keep their children in good-quality child care places. They know that that will help their children’s well-being, because they will be happy and enjoy their child care setting and the friendships and relationships that they make there. Let us not underestimate the importance of social interaction in child development, and good-quality child care can offer that.

Parents will do everything they possibly can in the interests of their child’s well-being and happiness. They will do everything to hold on to a good-quality child care place, even if they find themselves under financial pressure, possibly for a prolonged period. That has a knock-on effect elsewhere in the family budget, which might lead to the problems of debt, financial difficulty and stress that my hon. Friends have mentioned.

Financial stress among parents tends to feed back into children’s well-being, and children become aware of it in the household. They are aware of tensions and anxieties in their parents’ attitudes and behaviour. We have to understand how central good-quality, sustainable and stable child care is to children’s much wider well-being. That is why it is of concern that funding for that child care provision is being eaten away at by the provisions of clause 35.

There are opportunities to compensate for what is happening within the market. I particularly highlight the need to ensure that we maintain a supply of well-qualified child care workers, because pressures elsewhere in the public finances may mean that we see fewer good-quality child care workers coming through from training. Indeed, the loss of education maintenance allowance may have an impact on that. There are real concerns among parents about the nibbling away at the different pillars of the child care market.

When we ask parents what they worry about in balancing the family budget, they repeatedly highlight the high cost of good-quality child care. They do not want to buy poor-quality child care if it is at all possible to avoid it, because they are mindful of the value of getting their child into a high-quality, professionally run child care setting with excellent developmental and social activity, which the children can enjoy and in which they can flourish. Parents know that quality costs, and they do not want to compromise or cut corners when it comes to their children’s well-being, so they want to spend all they can on quality care.