Child and Adolescent Mental Health Services

Debate between Lord Beamish and Grahame Morris

Tuesday 3rd March 2015 Commons Chamber

[Grahame M. Morris]

I cannot disagree with that. I come from the perspective that we need to plan interventions on the basis of evidence, but how can we do that without current and relevant data on child and adolescent mental health? We certainly need that data. On the structure of the contracts, I am a firm believer in integration. There may well be issues with block contracts. The Health Committee received evidence from the south-west indicating that there are vast areas of the country where there is very little access to certain types of in-patient mental health provision, which is clearly unacceptable. One might have thought that a large block contract would make that less likely, but apparently that is not so. However, I am not an expert in commissioning; I am simply trying to identify the policy areas.

Having spent a number of years in local government, I have no doubt that local authorities wish to tackle some of the barriers that young people face in accessing mental health services. It is a complicated area, and we need to enable local areas—the hon. and learned Member for North East Hertfordshire (Sir Oliver Heald) just referred to larger block contracts—to commission better services, and perhaps that is better done on a more local level.

[Mr Kevan Jones (North Durham) (Lab)]

Does my hon. Friend realise that one of the problems with block contracts is that, because of their size, they freeze out small voluntary organisations that could deliver services on a local basis?

[Grahame M. Morris]

That is true. Some of the organisations that submitted evidence to the Health Committee and subsequently provided briefings made that point.

Another issue of concern is the complex commissioning landscape for CAMHS, which can result in poorly co-ordinated services and a lack of clarity about roles and responsibilities, leading to gaps in provision and poor transitions from child to adolescent and from adolescent to adult. The service is certainly underfunded. We often talk in this place about parity of esteem. As other Members have reported, CAMHS nationally is receiving about £1.8 billion of the £14 billion that is spent on mental health. Local authority-provided services, which are often having to bridge the gap, are facing huge financial challenges. My local authority, which I share with my hon. Friend the Member for North Durham (Mr Jones), has had to cope with cuts of £250 million over the lifetime of this Parliament. That is forcing councils to make extremely difficult decisions about which services are funded.

I fully understand the point made by the hon. Member for Brigg and Goole, but I also fully understand the difficult decisions faced particularly by authorities in the north that seem to be suffering disproportionate cuts. Councils are embracing their new public health responsibilities—

Health and Care Services

Debate between Lord Beamish and Grahame Morris

Wednesday 3rd July 2013 Commons Chamber

[Grahame M. Morris]

That is an excellent point. I am sure that Members across the Chamber will have experience of that. On Friday gone, we had a crisis meeting of the county MPs and senior politicians in my local authority area of County Durham to determine how to cope with a further tranche of cuts. The situation is becoming serious. It is said that the allocations have been ring-fenced, but the local authorities’ discretionary spend is all being absorbed into social care and expenditure for children and the elderly, and there is very little room for manoeuvre.

[Mr Kevan Jones (North Durham) (Lab)]

Will my hon. Friend give way?

[Grahame M. Morris]

I will give way to my hon. Friend.

[Grahame M. Morris]

Okay—

[Mr Jones]

Will my hon. Friend give way?

[Grahame M. Morris]

Am I allowed to give way to my hon. Friend, Madam Deputy Speaker?

[Grahame M. Morris]

With all due respect, Madam Deputy Speaker, I know that my hon. Friend was at the same meeting as me on Friday, and he will probably have a relevant point to make about that, so if you do not mind, I will give way to him.

[Mr Jones]

With respect to the Deputy Speaker, the point I wanted to make was that at the meeting last Friday we were told that Durham county council has to take £210 million out of its budget. Does my hon. Friend think that areas such as ours, which has a growing elderly population, will face more pressure than some others?

[Grahame M. Morris]

Absolutely. The pressures are becoming intolerable. Some of our great northern cities, such as Liverpool and Middlesbrough, seem to be shouldering a disproportionate share of the cuts, and it is a difficult task to try to balance the budgets and deliver the services that people require. There has been a discussion about whether the councils are in a position even to deliver their statutory requirements.

As the right hon. Member for Charnwood said, the NHS has been set productivity targets of 4% per year, as the Government seek to make savings of £20 billion over the lifetime of this Parliament. As the report identifies, the Government believe that those savings can be made in part by prioritising competition over co-operation. I find that questionable, and we need a cost-benefit analysis of the consequences in regard to the value for money of outsourcing. There has been a lot of criticism of PFI schemes, and questions have been asked about whether they provide value for money for the public purse. To date, efficiencies have largely been achieved by freezing staff salaries and cutting the tariffs paid to NHS providers. Neither of those is sustainable, and both fail to meet the spirit, if not the letter, of the Nicholson challenge.

There are signs of falling morale in the NHS, and that is due in no small part to the Government’s attacks on pay, pensions and conditions of service. It is not helpful that Ministers seek to blame NHS staff for problems caused by the Government’s cuts and reforms. These are not the innovative changes that we need to see from a restructured NHS. In the main, we are seeing the picking of low-hanging fruit. Some of the cuts are rash and damaging, and they are being made to satisfy the Government’s need for cuts across the board.

I understand that the current Secretary of State for Health has joined his predecessor in receiving a vote of no confidence from the health care professionals at the British Medical Association conference. I only hope that the next Secretary of State for Health will seek to work with health care professionals, not against them.

The NHS Confederation’s survey of NHS chief executives indicated that 74% of respondents believed that the NHS’s financial situation was either the worst they had ever seen or “very serious”. Despite the Government’s claim to have ring-fenced funding, which has been called into question, NHS executives are not confident that the situation they face is good for their organisations or their patients, with 85% expecting things to get worse in the next fiscal year.

There is no doubt—the figures are there in the report—that the NHS is facing the biggest financial challenge for a generation, as a result of unprecedented demographic changes, an increasing demand for health and care services, co-morbidities, and people living longer with chronic illnesses such as diabetes and dementia. The Nuffield Trust has warned that, unless we improve the way in which services are delivered, growing care needs will result in a shortfall of up to £29 billion a year in NHS funding by 2020.

The NHS faces new challenges in the 21st century. The last Labour Government corrected the chronic under-investment following 18 years of the previous Conservative Government. Investment in the NHS trebled under Labour. We built more than 100 new hospitals, replaced much of the ageing infrastructure, and developed the new walk-in centres, primary care centres and a new generation of modern community hospitals. There were extended GP opening hours, and more doctors and nurses than ever before.

Health and Social Care (Re-committed) Bill

Debate between Lord Beamish and Grahame Morris

Tuesday 6th September 2011 Commons Chamber

[Grahame M. Morris]

I do not find this at all funny. I would find it really worrying if this report is an indication of what is in store. It is rather ironic that the Secretary of State quoted from the Labour party manifesto. Perhaps it might be instructive if I were to quote from the Conservative party manifesto. It said that the Conservatives would

“defend the NHS from Labour’s cuts and reorganisations”.

If this Bill is not the biggest reorganisation that we have ever seen—[Interruption.] Well, it is, even though the Conservatives said that they would not proceed with any such huge reorganisation.

[Mr Kevan Jones (North Durham) (Lab)]

Would not the Secretary of State be able to clear that up tonight by giving a categorical assurance that no hospital will be transferred to or run by a foreign entity?

[Grahame M. Morris]

I am happy to give way to the Minister, if he wishes to give that assurance from the Dispatch Box. It would reassure staff and members of the public. Perhaps we can read something into the Minister’s reluctance to give such an assurance.

The Government, despite the spin, are delivering one of the most radical reorganisations ever and in the view of many Opposition Members it will undermine the basic principles of the NHS. When the Health Secretary was shadow spokesman for the then Opposition, at no point did he explain his plan to apply 1980s-style privatisation mechanisms to the NHS. I am an avid follower of health policy and the idea of creating an economic regulator—as we have discovered through a series of parliamentary questions, the costs of Monitor could be £500 million in a single Parliament—is again ironic when we hear the Government talk about waste and bureaucracy.

As for exposing the NHS to competition law, I accept the point made by the hon. Member for Southport (John Pugh), which was also made by my own Front Benchers, that it is not the provisions on the face of the Bill but the changes to the architecture of the NHS that will expose the NHS to European competition law—the same law, as we have heard, as applies to the utility companies. Health would be considered a commodity and £60 billion of the NHS budget would be handed over to private bodies, by which I mean those bodies that were the GP commissioning consortia, now renamed clinical commissioning groups. Despite the assurances about openness, transparency and accountability, those would be private-sector companies and my understanding is that they would not be open to FOI requests. That must be of huge concern to people who champion civil liberties, freedom and transparency. Over the past six years or so, we had no indication from the Secretary of State that he was planning such a radical change.

On the subject of the new failure regime, as set out in the amendments, having sat through the Public Bill Committee on the initial Bill as well as that on the re-committed Bill and having listened intently to the arguments, I cannot decide even now whether this is a U-turn or a side-step. I have read this huge document—the weighty tome that makes up the Bill, with all its various chapters and parts—as well as the impact study and the whole justification behind the Ministers’ arguments was that the NHS needed a market and a failure regime to boost productivity. Has that whole idea been left by the wayside?

Economic Development (North-East)

Debate between Lord Beamish and Grahame Morris

Tuesday 15th February 2011 Commons Chamber

[Mr Jones]

Well, it is a double whammy for those areas because not only has the money gone that was devolved to them from One North East, and which was spent very effectively in Northumberland, County Durham, Teesside and Tyne and Wear, but local authorities are now also struggling to afford to fund important things like tourist information centres. It is an absolute scandal for the tourism offer for a world heritage site such as Durham not to be well packaged.

It seems that this Government just do not get it. The Minister has never been to the north-east, for example, even though the right hon. Member for Berwick-upon-Tweed and I asked him to visit a few months ago. They just do not get it. By way of example, I cite the idea that regionalism is bad, whether it be the regional office or One North East, and that other sectors will somehow meet the funding challenge, when in fact they will not.

I ask the Minister and the Government to listen not only to politicians, but to the people in the region who know. They are not necessarily elected officials. They might be people like Geoff Hodgson, who has a highly successful business career in the publican sector, and who knows something about what the private sector in the region needs. The Minister should listen to people like him.

[Grahame M. Morris]

Does my hon. Friend share my concern about the coalition Government’s decision to suspend grants for business investment, which I understand brought £112 million into our region and supported 25,000 private sector jobs?

Hospital Services (North-East)

Debate between Lord Beamish and Grahame Morris

Tuesday 27th July 2010 Westminster Hall

[Grahame M. Morris]

There seems to be some confusion here with the figures. However, in my mind, perhaps in the minds of other Labour Members and certainly in the minds of the good people of Easington, it only shows what a bad decision it was. I do not believe that it is being made for the stated financial reasons, but instead seems to form part of some type of idelologicallybased course of action taken by the coalition Government.

It is clear now that the saving of £464 million—the figure that was widely quoted to the media at the time of the hospital’s cancellation—is completely misleading. At some point, I hope that we will also get to the bottom of the true costs to the taxpayer of cancelling and pulling the plug on this new hospital development, which, as my hon. Friend the Member for Hartlepool has indicated, has been in the planning since 2005.

On 2 May 2010, in an interview with Andrew Marr, the right hon. Member for Witney (Mr Cameron) talked passionately about how a responsible society should protect the vulnerable. This is what he said:

“The test of a good society is you look after the elderly, the frail, the vulnerable, the poorest in our society. And that test is even more important in difficult times, when difficult decisions have to be taken, than it is in better times.”

I am sure that many of my colleagues knew at the time, as I did, that that statement lacked substance.

Easington is one of the most deprived areas in the United Kingdom. Health inequalities still play a large role in Easington; there is shorter life expectancy and poorer quality of life. Life expectancy in Easington is a full two years lower than the national average. The proposed new hospital was part of a clinically led strategic reorganisation of health provision for one of the poorest areas in Britain, which would have gone some way to tackling some of the worst health outcomes in the country.

The latest figures that I have been able to access are the 2007 statistics on standardised mortality rates per 100,000 population. They show clearly that death from illness that is amenable to health care—that is, deaths that would have been preventable with health interventions—accounted for 256 deaths per 100,000 of the population in the Easington local authority area, compared to an average of only 195 across the rest of England and Wales. For all causes, the figure for Easington is 713, compared to 582 for England and Wales. For coronary heart disease, the figure is 112 per 100,000 in Easington compared to 90 per 100,000 across the rest of England and Wales. For cancer, the figure for Easington is 219 per 100,000 compared to 175 nationally.

[Mr Kevan Jones (North Durham) (Lab)]

Does my hon. Friend agree that one of the success stories in his constituency has been the local primary care trust’s anti-smoking policy—the area has seen some of the largest drops in smoking anywhere in the country? Does he also agree that the fact that that policy will be abolished too will add to the health inequalities in his constituency?

[Grahame M. Morris]

That is a very good point and the development of community health infrastructure has been integral to the proposal for the new hospital. It is key to improving health and tackling health inequalities.

I have some sympathy with the Minister, as it seems that the proposed hospital suffered at the hands of the Chief Secretary to the Treasury as he searched to save around £2 billion in June. However, regardless of the changing economic circumstances that saw Britain’s budget deficit improve by £10.4 billion from the original pre-election forecasts, I do not believe that it is too late for the Minister to give the proposed new hospital a second chance, following a reconsideration of the evidence.

Finance Bill

Debate between Lord Beamish and Grahame Morris

Tuesday 6th July 2010 Commons Chamber

[Mr Jones]

Yes, they will, and there is something else that they will do. Interestingly, the hon. Member for Ipswich, who made an excellent maiden speech, talked about prison reform, saying things that he really meant, on an issue to which he is committed. However, he will soon be disabused of that, when he finds that the prison reforms being put through the Ministry of Justice have nothing at all to do with the penal system, and everything to do with budget restraint.

As for the other measures , the VAT increase will have a disproportionate effect on my constituents and those in regions such as mine, because it is, in part, one of the poorest communities. As for the Liberal Democrats—we saw a half-hearted attempt earlier to defend the increase in VAT—the measure will indeed affect the poorest.

[Grahame M. Morris]

On the point raised by Government Members about the impact assessment, will my hon. Friend comment on the impact of the VAT increase on the third sector? I had meetings at the weekend, and I know that many in the voluntary and community sector rely on trading activity and are concerned about what the increase will do to their income levels.

[Mr Jones]

The increase is going to affect every single organisation that provides public services, including local councils––the increase will cost them a lot of money. As we saw earlier, certain commitments were given on VAT, and I have here the Liberal Democrat poster from 8 April—and I must say that it is very good. I am sorry if I am going to pour more scorn on to the Liberal Democrats, but I enjoy doing it, and I am sure that some of their Tory colleagues will enjoy it as well. The poster says:

“Tory VAT bombshell.

You’d pay £389 more a year in VAT under the Conservatives”.

The Deputy Prime Minister, the right hon. Member for Sheffield, Hallam (Mr Clegg) made quite a few comments on VAT before the election. He referred to it on the “Today” programme on 7 April 2010, saying that VAT

“let’s remember, is a regressive tax”.

What has changed since then? What is being proposed will affect the poorest in our society.

The Deputy Prime Minister is not the only one who has form in this area. When the then Leader of the Opposition appeared in Exeter in something called Cameron Direct on 8 May 2009, he said:

“You could try as you say put it on VAT, sales tax, but again if you look at the effect of sales tax, it’s very regressive, it hits the poorest the hardest. It does, I absolutely promise you.”

So what is different now? What has actually changed, apart from the fact that the Government now have their posteriors on the Treasury Bench and in their ministerial limousines?

--- Later in debate ---

[Mr Jones]

There will indeed be a double effect on those families. It is all very well saying that people can shop around, but in my constituency—a rural constituency but, as I said in my maiden speech, one with urban problems—they cannot do that when they have no access to a car and the only option is public transport. Those are the communities who will be hit hardest, and I am sure that they exist in all constituencies. The new hon. Member for North East Cambridgeshire, for instance, spoke of the pockets of deprivation in his own constituency. Those rural poor families will be hit harder than most.

[Grahame M. Morris]

The VAT increase will have an impact not only on small businesses and enterprises, but on working men’s clubs. Tonight there was a meeting of the all-party parliamentary group on non-profit making clubs, which is very concerned about the increase. Many clubs in our area are operating on the margins, and it will have an immediate impact on their costs because the transport costs are all passed on to them. Has my hon. Friend any thoughts about the impact on such clubs, which provide a real social centre for many people?

[Mr Jones]

As a member of the Sacriston workmen's club, I have to concur with my hon. Friend. As he knows, following the smoking ban, the change in the way people access alcohol and supermarket price cutting, many such clubs in the north-east of England have been struggling. Many have closed, sadly, in my constituency. We hear a lot about rural pubs, but we hear very little about the Club and Institute Union movement. In many places, including his constituency and mine, those clubs are the centre of the community. Once they have gone, they will not be replaced. The VAT increase will be a severe blow for them at this difficult time, when they are struggling already.