Former British Child Migrants: Payment Scheme

Lisa Nandy Excerpts

Tuesday 26th February 2019 Westminster Hall

[Lisa Nandy (Wigan) (Lab)]

I beg to move,

That this House has considered the former British child migrants payment scheme.

It is a pleasure to serve under your chairmanship, Mr Hollobone, on this very important issue. This is not the first time that we have debated the issue in this place, and I am very pleased to say that since the last time that we had a debate on it, the Minister has managed to get the Government to move, for which we are extremely grateful. Former child migrants across the world have contacted me in the last few months to talk about how grateful they are for that movement. However, there are outstanding concerns and worries, and as the Minister knows, many of the people affected are getting older and so time is of the essence.

It is almost a year since the report by the independent inquiry into child sexual abuse—IICSA—shone a damning spotlight on the severe sexual, physical and emotional abuse experienced by many of the thousands of child migrants sent abroad unaccompanied as a result of the policy of child migration practised by successive post-war Governments. The report exposes the harrowing abuse that took place before the children travelled, during the journey and after they migrated. It often continued for years and took place at the hands of more than one perpetrator. For some children, the most devastating aspect of the experience was being lied to about their family background and even about whether their parents and siblings were alive or dead.

The experience that many of the former child migrants had has had a lifelong impact on their physical and mental wellbeing, their educational attainment and their future employment prospects. The child migration programmes effectively ended some people’s lives just as they were beginning. Over the last few months, I have also been contacted by many of the partners and children of former child migrants to talk about the impact that there has been on them, too. This is not just about children losing their parents and parents losing their children; it is about generations being separated—grandparents being separated from grandchildren and young people growing up and not knowing any family beyond their parents at all.

While acknowledging the failures of the institutions, including charities and churches, that were involved in the process of migrating children, the report, as the Minister knows, overwhelmingly concluded that Her Majesty’s Government were primarily to blame for the existence of the programmes after the second world war and that successive British Governments, of all political persuasions, allowed them to remain in place despite a catalogue of evidence showing the treatment that children were receiving. That is surely one of the most shameful periods in British history.

However, things went silent until well into the 1980s, when Dr Margaret Humphreys and the Child Migrants Trust sought to bring the matter to public attention. The policy position maintained throughout the 1990s and 2000s was that the Government may have been aware of

“allegations of physical and sexual abuse”,

but that

“any such allegations would be a matter for the Australian authorities”,

as former Prime Minister John Major put it. It was not until 2010—it was nine years ago to the day on Sunday—that then Prime Minister Gordon Brown publicly apologised to former child migrants on behalf of Her Majesty’s Government and established the family restoration fund, which was endowed with £6 million to help former child migrants to reunite with their families in Britain.

Despite that scheme, IICSA found last year that the UK Government had failed to provide adequate redress to the more than 2,000 surviving former child migrants and it recommended that financial redress be established without delay, with payments beginning within 12 months; the relevant date is 1 March 2019. The report recommended an equal award for each applicant, on the basis that they were all exposed to equal risk of abuse. Given the age and ill health of surviving former child migrants, it stated that action was urgently needed. However, it took the Government almost 10 months to publish a formal response to the recommendations. During that time, 36 former child migrants died, meaning that they would never see the justice that they so badly deserved or the redress that they were owed.

When the Government did publish their response, they accepted the recommendations on financial redress, for which we are extremely grateful, and confirmed that they would establish a scheme to ensure that each surviving former child migrant receives an ex gratia payment as soon as possible. It was also very welcome that the Government acknowledged that the delay in establishing the scheme had had a major impact, and stated at the time that they would accept claims in respect of any former child migrant who was alive on 1 March 2018, when IICSA’s report was published.

I was alerted to the fact that the scheme had happened by the Minister’s office. I was alerted to the fact that the details of the ex gratia payment scheme had been published via the Child Migrants Trust. The details appeared on its website on 31 January 2019. It was stated that each eligible former British child migrant would receive £20,000 and that the Child Migrants Trust would support applicants in establishing their identity as former British child migrants. I understood that payments would then be administered by the NHS Business Services Authority.

I have a number of questions for the Minister, which I sent to her in advance; I hope that that will help her to answer them today. They are not my questions, but questions that have been raised with me by the many former child migrants who survive around the world. As the Minister can imagine, they were delighted when details of the scheme were published, but that delight quickly turned to anxiety because many of the details are not currently in the public domain.

First, many former child migrants are very concerned about the lack of involvement that they have had in the Government’s response to IICSA and the development of the payment scheme. I do understand that the Minister was alive to the possibility that some of the former child migrants needed to see justice and see it quickly, but it would be very helpful if she could tell us what consultation has happened with former child migrants. The president of the International Association of Former Child Migrants and their Families wrote to the Home Secretary on 10 January to voice concerns that there had been no consultation with survivors of the programmes and to request a meeting regarding the Government’s response, but to date no response has been received to that letter.

This Minister will be aware, because I have raised it many times in the House, including with the Prime Minister, that there has been confusion about which Department was responsible for this issue in the past. That has been one of the problems that the former child migrants have had. It seems to me that those people who have spent decades feeling and being ignored by the British Government are entitled to a speedy response from their Government now, when they are seeking answers towards the end of their lives. I would be grateful if the Minister would acknowledge those concerns and agree to meet representatives of the international association of child migrants and the Child Migrants Trust to discuss these issues further.

I have also been asked to raise concerns about the payment amount. It is unclear how the figure of £20,000 was reached. IICSA’s report stated that any financial redress scheme should make a

“real, immediate and lasting difference to the lives of the former child migrants.”

Without any consultation, can the Minister be confident that the £20,000 amount lives up to that recommendation? Could she tell us how it was arrived at? By comparison, the average payment issued to claimants under the recently established Australian scheme, which is open to former British child migrants, is the equivalent of £43,000, with a cap at £82,000.

The Government did respond to a question that I tabled on the methodology that was used and stated that the methodology was based on the Northern Ireland historical institutional abuse inquiry, which in 2018 had recommended the amount of £20,000 for former child migrants sent from Northern Ireland. However, I have been unable to find any information from the Northern Ireland Executive about what methodology was used and how this figure was calculated, so I would be very grateful if the Minister could explain how the amount was arrived at.

I would also be grateful for some clarity about the tax arrangements, because there is little detail on the Child Migrants Trust website and the Child Migrants Trust is unclear about the process. Will the payment be taxable in the UK or in any other country where the claimants live and will receive payment? After all this time, and many broken promises, there is not a great deal of trust out there—there is a huge amount of anxiety. At the very least, the former child migrants who have suffered appallingly at the hands of successive Governments are entitled to know from this Government what they will actually receive and whether the payment will affect any other benefits that they are receiving.

On the application process, I am aware from my work with the Child Migrants Trust that it has excellent contacts throughout the child migrant community and an established track record in verifying child migrants for eligibility for the use of its services and for redress schemes in other countries. I can well understand why the Government were keen to ensure that it took a central role in the process, but I am concerned about whether it has the capacity to administer the new scheme, particularly in the timescale set out by IICSA, which would give it only a few days to process the applications.

There is also concern about the Child Migrants Trust’s ongoing capacity issues. As I understand, it has not been offered any additional resources to deal with the increased workload. It has already received hundreds of inquiries about the scheme and, with an estimated 2,000 potential claimants, it is important that it has the resources to handle claims in an efficient, thorough and sensitive way to ensure that the people who are eligible for the payment actually get it.

Given that the payment scheme is likely to introduce new former child migrants to the work of the Child Migrants Trust, it is anticipated that there will be an increase in demand for its other services, such as the family restoration fund and counselling. Will the Minister look at the trust’s long-term funding to make sure that it can do what the Government have asked it to do and continue to provide vital ongoing services to former child migrants?

There are concerns about the eligibility criteria. I have been contacted by several individuals who were migrated with a family member or guardian present on their journey and who may not be eligible under the scheme. The Government have stated that

“children who went overseas with their parents or guardians, or were sent overseas”

with apparent permission from

“their parents or guardians, are clearly in a different category: they were not the responsibility of local authorities or Government organisations in the United Kingdom and their parents or guardians made the arrangements voluntarily.”

Several people have contacted me to say that they disagree with that position. They say that from the early 1960s, some child migrant schemes arranged for children to be accompanied on the journey by migrating parents before being taken into a child migrant institution. Once in an institution, they were treated in exactly the same way as other children and exposed to the same risk of physical, sexual and psychological abuse as every other child.

Others have pointed out that excluding those

“sent overseas by their parents or guardians”

could be problematic. They tell me that after 1946, the British Government required all British child migrants to have the signed approval of their parents or guardian before they could be sent. IICSA heard evidence of some cases where carers illegally signed those approvals, but the authorisations were overwhelmingly signed by parents or guardians. By signing their approval for children to go, are the parents now deemed to have effectively authorised them to be sent and if so, will those children be ineligible for payment?

There is an urgent need for clarity and detail about the eligibility criteria for the scheme to ensure that the maximum amount of people put at risk by the programmes can receive the payment. Those who are deemed ineligible are entitled to a clear and sensitive explanation for that decision.

I am concerned about the way that the payment scheme was announced and the amount of promotion that has taken place. As I understand, the details of the scheme were announced solely in the form of a note published on the Child Migrants Trust website. There was no oral or written statement to outline the details of the scheme to Parliament and there was no press release from the Department of Health and Social Care, despite the scheme potentially costing a significant amount of public money. The details of the scheme are still not published on the Department’s website or on gov.uk.

It seems that the job of raising awareness of the scheme has fallen completely on the shoulders of the Child Migrants Trust, which is doing an excellent job of using its networks to promote the scheme, despite no extra resources having been committed to help it. In answer to a question that I asked about the establishment of a communications strategy, the Government indicated that they had publicised the scheme through the high commissions of receiving countries. Can the Minister provide further details about that work and what it hopes to achieve? Can the Minister also tell us what the Government’s future communication strategy will be?

The future funding of the Child Migrants Trust and the family restoration fund is a key concern. The Minister will be familiar with the work of the family restoration fund and its life-changing impact. It has been funded by successive Governments, including this one, and it continues to make a real difference. Since it was established in 2010, it has facilitated 1,248 visits. The IICSA report states clearly that

“the establishment of the Redress Scheme should not be used as a reason for reducing funding for the Child Migrants Trust or the Family Restoration Fund”.

In the Government’s response to the report, they seemed to agree and recognised

“that the Family Restoration Fund continues to provide a valuable service.”

However, they also stated that they

“will continue the Fund until the end of the scheme, by which time the Fund will have provided over £8 million to support reunions, over more than a decade.”

When I asked about future funding for the family restoration fund, I was told that it was a matter for the upcoming spending review, which has caused real concern that it will cease to exist after its funding ends later this year. The Minister previously extended funding in 2014 and 2017. The fund should not end until there is no further demand. In fact, the findings of the IICSA report underline how vital all the services provided for former child migrants are. It would be unfair if child migrants applying for the payment scheme in 2019 could also apply for restoration fund support but those applying afterwards could not benefit from that service.

The Minister and I have had public and private conversations about the raw emotional impact of the scheme on child migrants. I am grateful to her for listening to our concerns about the timing of the announcement that compensation would be made and for making sure that no bad news was delivered just before Christmas when many people are struggling to cope.

The Minister will be aware, however, that even such a positive announcement can open up some difficult emotions for people who are dealing with it, which might bring them into contact with services for the first time. This may be the moment when, after a lifetime apart from their families, people think that they need and wish to seek support as they come to the end. A clear commitment from the Minister that the money provided for the redress scheme will not be used as an excuse not to fund the family restoration fund, and a longer term commitment to the fund, would be extremely welcome.

All over the world, people are watching this debate who were taken from their families at the beginning of their lives. They have had to fight all the way to survive and for justice. There have been many moments in their lives when we collectively, as a country, have fallen well short of what they deserved from us by kicking the issue into the long grass and denying them the justice and support that they were entitled to. That has caused them severe harm, but they are still there—fighting and campaigning. As we bring this shameful chapter in British history to a close, the least that we can do is issue them with the payment, the clarity and the support that they deserve.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

I would normally start by saying that it is a pleasure to engage in the debate, but to be honest this has not been the most comfortable of subjects on which to speak on behalf of the Government. As we have heard, this was a shameful episode in our history, and all the more shaming that it was under successive Governments of different colours. I think everyone in the room would wish to dissociate themselves from that kind of behaviour.

However, I congratulate the hon. Member for Wigan (Lisa Nandy) on bringing the matter to my attention, again. She has been my conscience on this. Quite rightly, because, as she mentioned, we had the recommendation almost a year ago and it took time to get cross-Government agreement on how to take it forward. Having got that agreement, it was my desire that we make progress with the implementation but, by definition, that has left a number of questions unanswered. I hope that some of the points I make today will answer some of those outstanding questions and settle any anxiety that the child migrants have. Ultimately, they have not been dealt the best cards over the years and it is important that we do our very best to redress the situation. I pledge to continue to do my best in that regard.

The hon. Lady rightly highlighted that there was confusion about who owned the policy, and that is one reason it has taken so long. This all came about because of the child abuse inquiry, which sits under the Home Office, but historically the Department of Health has had responsibility for child migrants generally, and that led to the confusion. I really hope that we can settle the matter more formally, so that we can have more certainty for the child migrants. While I am in this place, the hon. Lady can rest assured that she can always nag me if things go awry, and history tells me that she will. All power to her elbow for doing that, because it is important that we do this right.

Once we had made the decision to make the payments, it was important to make the announcement quickly, not least because some of the individuals are elderly—I am advised that the eldest is 102. Speed is of the essence, to ensure that everyone can get some enjoyment from the payments.

The hon. Lady has once again demonstrated her commitment to ensuring that the welfare of those children is not forgotten; we should never forget what was done in our name. The policy was misguided and wrong, and has caused suffering and distress. The conclusion of the child abuse inquiry was that payment should be made not because people were exposed to abuse—compensation exists for that—but because of the very fact that organisations of the state sent the children away without consent. It is in that spirit that we have adopted the recommendation, recognising that organisations of the state exposed the children to harm, regardless of whether any harm materialised. As a consequence, we have taken the opportunity to announce the payments.

All Members have made very fair points about how the scheme has been communicated. That came about, again, because of the speed with which we wanted to make the announcement. It is also worth noting that the Child Migrants Trust has extremely good relationships with the affected people, so although it was not bells and whistles, we were, in a way, using the right channels to get to those who needed to know. However, we will reflect on what has been said and consider whether and how best to disseminate more information, recognising that not all those affected are necessarily in contact with the trust and it might be a pleasant surprise for them to know about the scheme.

As I mentioned, the payments are on the basis of being exposed to risk; they are not compensation for abuse. We have announced that each former child migrant will receive £20,000 in recognition of that exposure. It is only fair that, in recognition of the passage of time since the recommendation, we backdate the payments to 1 March 2018. As the hon. Lady mentioned, a number of the individuals have passed away since that date, and we will honour any claim made in respect of a deceased migrant.

[Lisa Nandy]

The wider communication of the policy is important precisely because of that group of people who have passed away. I imagine that their relatives would be much less likely to look at the Child Migrants Trust website and much more likely to look at gov.uk or the Department of Health and Social Care’s site. If the Minister would at least consider putting something on the Government’s website, that would be helpful.

[Jackie Doyle-Price]

I will take that point away. Part of me thinks that it will be appropriate to do that once we have all the details written down; none the less, I will reflect on what the hon. Lady says, because she is right. The very act of making the payments is in itself an acknowledgement that the Government have failed their own citizens. If individuals are no longer here to enjoy the benefits of the payments, they would have wanted their families to do so, and we need to make every effort to ensure that they can.

As I have said, this is not compensation; it is a payment for the fact that the individuals were deported by organisations of the state and were put at risk of harm. There are other routes to compensation for migrants who suffered harm or injury and this payment is in addition to and does not interfere with that; it does not affect the rights of any individual to pursue avenues of compensation. The scheme provides for an equal award for every applicant, regardless of income. Essentially, we want to make it simple, and to get the payments out to those affected.

Setting the amount was difficult, because it is impossible to put a figure on the costs, the damage and the harm; in that sense, it is difficult to come up with any calculation. But we have engaged with the Child Migrants Trust, which many migrants trust to represent their views, and have consulted it on the design of the scheme. We did not want to go through a formal consultation process for exactly the reasons we have discussed: we wanted to act promptly and in a way that would get the money out as soon as possible. In setting the sum at £20,000, we have taken note of the recommendation of Sir Anthony Hart’s report into institutional abuse in Northern Ireland. He recommended that the payment should be a sum sufficient to recognise the injustice that young children suffered through being sent to a far-away land and losing their sense of identity as a result. He recommended the figure of £20,000, and on that basis, we considered it to be an appropriate figure for a UK-wide scheme. Again, it is important that we do not have any discrimination between the four nations; it is right that we deliver this scheme in a way that is consistent across them.

[Lisa Nandy]

It would be helpful to those child migrants if we could get some clarity about why Sir Anthony Hart came up with that amount. The aim is not necessarily to question that amount, but if we are seeking to put a figure on the level of harm and dispossession that was caused, those child migrants would appreciate—and indeed are entitled to—an explanation of how the amount was arrived at. If the Minister’s office could help us find out how that figure was arrived at in Northern Ireland, that would help many of those child migrants to put together an important piece of the puzzle.

[Jackie Doyle-Price]

That is a fair challenge. With the caveat that any figure would not be adequate to compensate for harm, some methodology about why that figure was arrived at would be helpful.

The issue of eligibility has been raised on a number of occasions. The only condition that needs to be met is that a claimant is a former British child migrant sent from the United Kingdom and Crown dependencies before 1971, meaning anyone who was below school leaving age and was sent by a church, state, voluntary or other organisation to one of the receiving countries: Australia, New Zealand, Canada and Zimbabwe, formerly Rhodesia. However—to answer one of the hon. Lady’s questions—they must not have been accompanied by an adult family member or guardian, sent by an adult family member or guardian, or sent to live with a member of their birth family, because this payment is rooted in the fact that these were people who were sent by organisations of the state. I recognise the point made by various hon. Members that those sent by family members may also have been exposed to abuse, but again, the scheme does not alter those people’s routes for seeking compensation in other ways. This scheme is the Government taking responsibility for decisions made in their name, rather than for those made by families.

We have kept the eligibility criteria as simple as possible, to make the process of claiming the payment as simple as possible. Those eligibility criteria are the same as those being used for the family restoration fund, and are the same criteria that the Child Migrants Trust has used over many decades to determine who can access its services. Clearly, we want to make the application process as simple as possible, and as the hon. Lady has mentioned, we have asked the Child Migrants Trust to act as the first point of contact for child migrants who wish to apply for payments. I have heard the hon. Lady’s points about resource: we are in close contact with the Child Migrants Trust and give it support as appropriate. I hope, given the extensive network of contacts that the trust has, that this work should not prove massively onerous; in fact, in some respects, it may be helpful to the trust’s wider work.

[Lisa Nandy]

It would be helpful to the Child Migrants Trust if the Minister were to agree to a further meeting with the trust to discuss some of those outstanding concerns. I would be grateful for an assurance that she will do that.

[Jackie Doyle-Price]

We will of course continue to engage with the Child Migrants Trust, especially given that we want to be sure that in rolling out this scheme, we are getting to as many people as possible and doing it as efficiently as possible. I do not think anyone is better placed to advise us than the Child Migrants Trust.

The trust will reach out to all those who it has supported in the past to help them to apply for the payment. I know that it has already promoted the scheme widely, and it has also contacted all of the known sending agencies—those organisations that were responsible for sending children. We are aware that there has been extensive coverage in the Australian media, but we will look at where there is a need for further active communication, and how best to do that. We expect the high commissions in Australia, Canada, New Zealand and Zimbabwe to have extensive contact programmes, making sure that they are using their networks to make people aware of the scheme. Those former child migrants who have not previously been supported by the Child Migrants Trust will need to go through a separate application process, but the trust has given undertakings that it will help those people to do so. We have evidence that a number of child migrants who were not previously in contact with the trust have made contact, which is an indication that the message is going out. We have put some details of the scheme on the Government’s website, but I will make sure that we keep that website properly updated so that it is signposting people to where they can access help.

The hon. Member for Wigan is right that although the Child Migrants Trust will accept applications, the actual application payments will be made by the NHS Business Services Authority. The aim is to make those payments within 60 days, but more quickly if at all possible: we are determined to get these funds to those who should benefit from them as quickly as possible. Some reference was made to tax and benefit issues, and I am clear that every one of those beneficiaries should receive that £20,000 in its entirety, free of tax and separate from benefits, but that is not entirely in our gift. We are having conversations with overseas Governments about that issue, and we will also look at what needs to be done for those who are resident here so that they are not adversely affected.

Again, part and parcel of having made an announcement very quickly and then trying to get a scheme going is that we do not have firm answers on all of these subjects. I assure the hon. Lady that I am determined that these people should get this sum in its entirety, and I will do my best to make sure that that is the case. It should be noted that the majority of recipients live in Australia, with significant numbers living in other countries and only a very small number living in the UK. Experience tells us that the Australian Government are sympathetic to this group of people, so I hope that we can make representations that are received sympathetically, even though we have no power to dictate the tax, welfare and benefits arrangements of other countries.

I hope that hon. Members are reassured by some of the details that we have announced. Clearly, the scheme is not as buttoned down and finished at this stage as we would like it to be, but the fact that we have proceeded to implement this decision as soon as it was taken is an indication of how committed we as a Government are—and, in fact, all political parties are—to putting right a wrong that, frankly, has been a cause of shame for so many of us. Nothing can repair the damage that has been done to those individuals. We can acknowledge it, we can apologise, and we can make these payments, but the most important thing that all of us in this room can do is to make sure that nothing so unjust ever happens in the name of the state again. At a time when some of our colleagues are distracted by other issues, this debate is a reminder of why so many of us got involved in politics in the first place—to fight for justice, to right wrongs, and to champion the rights of people who perhaps have not had them championed before.

I will conclude by again congratulating the hon. Member for Wigan, who has been dogged in her determination to do right by this group of people. In doing so, she has made my life uncomfortable from time to time, but I thank her for it, because that is what this place is all about. We will make sure that we deliver as we have promised.

[Lisa Nandy]

I am very grateful to the Minister for that comprehensive response and for taking so many interventions. I am grateful to all the Members who have spoken in the debate. I have given her a hard time over the past year or so, and she has taken it on the chin and responded. It was she who came to this place and said that it was incredibly difficult to get things through Government with everything going on with Brexit. I have seen that for myself—we have all seen it—and I know she has fought hard to get us here. I thank her on the record for that and for her ongoing commitment to try to resolve the outstanding issues.

There was one issue about the family restoration fund that I might write to the Minister about to try to get some more clarity, given the uncertainty about the ongoing nature of that scheme. I was glad to hear about the level of urgency within Government to try to resolve some of the issues and the ongoing commitment to meet and work with the Child Migrants Trust as we move forward. I suspect that this debate will not be the last time she hears from me on this subject.

I am reminded by the Minister’s closing remarks that far too many people do not have a voice. I hope that those who have been watching today—the people affected and the families of those who are sadly no longer with us—will feel that at least they have had a voice today because of the efforts of some of us here in this room. I hope we have reassured them that they will continue to have a voice going forward. The independent inquiry into child sexual abuse was established by the Prime Minister, the then Home Secretary, to learn the lessons from the past and ensure that such things never happen again. It seems to me that that cannot be done without seeking to right some of those historic injustices. We have made a small step forward to keeping children safe in the future here today.

Question put and agreed to.

Resolved,

That this House has considered the former British child migrants payment scheme.

Oral Answers to Questions

Lisa Nandy Excerpts

Tuesday 27th November 2018 Commons Chamber

[The Minister for Health (Stephen Hammond)]

My hon. Friend is right. I welcome the trust’s recent announcement that it now has enough middle-grade doctors and nurses to keep the Prince Royal Hospital’s A&E open 24/7. It has been receiving some excellent support from NHS Improvement, and I hope that it will achieve similar success in improving the quality of care as that support continues.

[Lisa Nandy (Wigan) (Lab)]

T3. It has been eight months since the child abuse inquiry that the Prime Minister set up recommended urgently that compensation be paid to the survivors of the child migration programmes. The Prime Minister said that she would act; she did not. The Minister said that she would respond; she has not. Twenty-two people have died since that report was published. How can we believe a single word said by the Government today, when so many promises to people who deserve better have been broken? Where is the response to this report?

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

The hon. Lady makes a very good point. When we last discussed this matter over the Dispatch Box, I said that it was my ambition to come back to her as soon as possible, but we have to agree a cross-Government response, which is imminent. However, she is quite right; we really need to respond as soon as possible.

Child Migration Programmes (Child Abuse)

Lisa Nandy Excerpts

Tuesday 3rd July 2018 Westminster Hall

[Lisa Nandy (Wigan) (Lab)]

I beg to move,

That this House has considered child abuse in the child migration programmes.

Thank you, Mr Hollobone, for allowing me to shine a spotlight on what I can only describe as a state-sponsored system of child abuse. The former Prime Minister, Gordon Brown, said recently that it was

“bigger in scale, bigger in geographical spread and bigger in the length of time that it went on undetected”

than possibly any other national sex abuse scandal in our history.

For five decades from the 1920s until the 1970s, more than 130,000 children were sent into care overseas in countries including Australia and what was then Southern Rhodesia. Charities, churches and the UK Government participated in the scheme, known as the child migration programmes.

Many of those children were physically and sexually abused. Children as young as 12 were subjected to backbreaking work. Many were psychologically tortured. Some of those children were as young as three years old. They were separated from parents and siblings and many were wrongly told that their families were dead. Children reported being abused in institutions in England before they were then abused again in institutions in the countries that they were migrated to. They were abused by staff, by visitors and by other children. Some were also abused in transit. I will briefly share two of their stories. It is impossible to understand the full horror of this period in our history without hearing some of what happened. I apologise in advance, because it is extremely distressing.

Marcelle O’Brien was only four years old when she was migrated to Australia by Fairbridge. She was bullied. She was locked in cupboards. She was mentally abused. She was sexually assaulted and repeatedly raped by a succession of men. Like so many others, she continued to live with the horror of what had happened until well into adulthood, suffering mental breakdown and periods of manic depression. It was only when she found the Child Migrants Trust that she felt able to talk about what had happened.

Michael O’Donoghue recounted his horrific experiences at the hands of Christian Brothers in Clontarf in Western Australia. He was beaten. He was raped. He endured electric shock treatment. Along with 15 other children, he was forced to watch their pet horse murdered in front of them on what was known as “special punishment day”—one of a series of regular collective punishment days that those children had to endure.

What has since emerged is how many warnings were overlooked, ignored and covered up. For decades, successive Governments ignored those warnings and continued to send children to harm.

[John Howell (Henley) (Con)]

The hon. Lady is telling some very powerful stories. Has she come across the Lanzarote convention, which was produced by the Council of Europe and signed by the British Government in March, and is she aware of the work the Council of Europe has been doing to highlight the problem of child abuse among refugees? I think that would help her case enormously.

[Lisa Nandy]

I am very grateful to the hon. Gentleman for attending this debate and for raising that point. One of the reasons why it was important for me to bring this issue to the House for the first time for a full debate is that many Members have a strong interest in this area and in pursuing justice for the affected families. It is important that those suggestions are heard, and I hope the Minister has heard them.

Like Marcelle O’Brien, many of those who survived that horrendous period are still living with the consequences. Four years ago, the Prime Minister—then the Home Secretary—commissioned an independent inquiry into child sexual abuse. MPs from various parties, including me, welcomed that decision. The inquiry’s first full report is on this subject, and it is damning.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Lady on bringing this issue to Westminster Hall. It is a pity that there are not more Members here to contribute, but I commend her for leading the charge. Does she agree that, given that every child migrant was exposed to an equal level of risk due to the failings in the system she has referred to, they must all be entitled to an equal level of redress?

[Lisa Nandy]

I am grateful for the hon. Gentleman’s interest in this issue. Although I agree that it would be great to see more Members of Parliament in the Chamber, one of the problems is that this issue did not get the coverage or attention it deserves until relatively recently. I hope that by bringing it to the House, I will help more Members to understand what is happening and more survivors to come forward so we can start to see action, which is long overdue. The hon. Gentleman makes a very important point: the report recommends equal compensation for equal risk. I have no desire to see survivors and victims have to prove what happened to them and recount those horrific stories again. The report was absolutely right to make that recommendation, and I would be grateful if the Minister could respond to it.

I mentioned the first full report from the wide-ranging, comprehensive inquiry into child sexual abuse. It acknowledges the role of churches and charities in causing harm to children, but it concludes that the British Government were primarily to blame for the continued existence of child migration programmes after the second world war. They failed to act, even when warned about allegations of sexual abuse. The report is devastating in its conclusion that

“the main reason for HMG’s failure to act was the politics of the day, which were consistently prioritised over the welfare of children.”

The Government did not want to risk their relations with Australia or to offend the voluntary societies that participated in the scheme. Ministers in successive Governments were cowed by the patronage and power of those who were involved in the schemes.

Despite that, the children were stronger. The truth began to emerge more than 30 years ago, thanks to their determination and courage. Even in the face of their bravery, successive Governments failed to accept responsibility. As the current Government recently acknowledged, the UK Government continued to maintain that it was a matter for the Australian Government until well into the 2000s. It is only because of the Child Migrants Trust, led by Dr Margaret Humphreys, who has rightly been described as the “conscience of Britain” on this important human rights issue, and a number of brave and persistent survivors here and across the world, many of whom will be watching this debate with interest today—some have had to stay up quite late to do so—that this became a matter of public attention that is still being pursued now.

The report of the independent inquiry into child sexual abuse was published four months ago. It recognised the importance of the public apology made by Gordon Brown in one of his last acts as Prime Minister, and of the family restoration fund, for which he and Andy Burnham, the then Health Secretary, found £6 million, and which has enabled more than 1,000 people to be reunited with their families. The current Government have since announced an additional £2 million for that fund, for which I am grateful. It is very welcome. I will return to that subject in a moment.

The report made just three recommendations: that the sending institutions that have failed to apologise publicly and in person to the children abused in their care do so; that all institutions that sent children abroad put in place robust systems for retaining and preserving easily accessible records of individual child migrants; and, finally, that adequate financial redress be made to the more than 2,000 surviving former child migrants. It also made it clear that this is urgent—many have died and others are dying, and it was unequivocal that the scheme must be up and running within 12 months.

In the four months since that urgent, devastating report was published, the silence from the Government has been deafening. Confusion about which Department is responsible has reigned. The Home Office made a short statement in March, when the report was published. The Department of Health and Social Care later responded to written questions. After four weeks of back-and-forth between those two Departments, I resorted to raising a point of order in the Chamber. In response, I was told that I could seek to raise the matter with the Prime Minister, which I did. I had to resort to going to the Prime Minister a month after the report was published just to get clarity from the Government about which Department is responsible. Four months on and multiple attempts later, the Government are still no clearer about their response and have still not told us when it will be made.

I am not the only one who has hit this brick wall. The Australian law firm Hugh James, which acts for former child migrants, shared with me a letter it sent to the Health Secretary. It said:

“We hand delivered a letter concerning this matter to the FCO on 26 April 2018. We served the enclosed letter on the Prime Minister’s Office on 29 May 2018. On 5 June 2018 we were informed by the Prime Minister’s Office that both of our letters were passed to your department. We are disappointed we are yet to receive a response from you and we ask you to contact us as soon as possible.”

That was two weeks ago. I ask the Minister, when will that firm get a reply on behalf of those former child migrants?

I want to say something really serious to the Minister today. The Child Migrants Trust tells me that, in the time that the Government have sat on the report, 10 former child migrants have died. Ten people died not knowing whether the Government will now draw a line under one of the darkest periods of our history, and whether they are committed to truth, redress, justice, and learning lessons to ensure this never happens again. That is the legacy those people deserve. Still now, the state, which did so much harm to them at the beginning of their lives, continues to do harm to them all the way through until their death. That cannot go on.

Will the Minister explain the reason for the delay within Government? Will she assure us that this is now the highest priority and is being dealt with a matter of urgency? As well as being a clear question of justice, this goes to the heart of whether any of us can have confidence in the child sex abuse inquiry that the Prime Minister established. She told the House when she set up the inquiry that she believed it to be essential that the lessons that come out are not only learned but acted upon. As the Minister knows, the inquiry has been beset by problems since. It has been through four chairs and has faced serious allegations of misconduct. It has cost £64 million so far—the costs are rising—and has lost the confidence of many victims’ and survivors’ groups, which have walked away over that time. Many, however, continue to invest time and energy in the inquiry, because they hope that it will make a difference. That first report must have been a sign of encouragement to them that the inquiry would not shy away from asking the difficult questions and telling the truth.

Now the Government must show that they are serious about taking action, and get on with doing so. It has been four months, and at least 10 people have died in that time, so will the Minister tell us today, do the Government accept the report’s three clear recommendations? If she cannot tell us today, will she at least commit to a full and formal response to the report before the summer recess? That request comes directly from child migrant groups, and I would be grateful for a clear answer.

The inquiry made huge progress in ensuring that apologies were made. Many organisations, including the Children’s Society, where I once worked, took the opportunity afforded to make a welcome but long-overdue apology. Will the Minister tell us, however, what progress has been made to ensure that the records are kept and made available? I have been told that the Prince’s Trust—it took over Fairbridge, which was involved in the child migration programmes—has not yet made all its records available. Have the Government contacted the agencies listed in the report to ensure that such measures are in place? What has been the response of those agencies? If the Government have not yet done that, will she commit today to doing so?

What progress has the Minister made on the question of financial redress? Has she assessed the numbers of those who might qualify? Has she done a scoping exercise to determine potential costs? In the past four months, what discussions have the Government had with the independent inquiry into child sexual abuse and the Child Migrants Trust about implementing the recommendations? Does she accept the principle, mentioned by the hon. Member for Strangford (Jim Shannon), of equal compensation because children were exposed to equal risk?

Let me compare the UK Government’s response and their position with Australia’s. In December 2017, a royal commission in Australia published the results of its five-year investigation into child abuse and recommended a national redress scheme. Within two months the Prime Minister had responded and set a deadline of 1 July. Legislation was fast-tracked through Parliament last month, and the scheme began accepting applications on Sunday, as promised. The scheme offers not only monetary payments but access to counselling and a direct personal response. Survivors who are elderly or ill will be fast-tracked but, in any case, the promise has been made that claims will be processed within weeks. Redress payments will not be taxed. The average payment is expected to be about 76,000 Australian dollars, which is about £42,000 in our money.

Surely it should shame us that the country the child migrants were sent to is responding, but not the country that sent them there—the country that was responsible for their care and welfare at the time. How can it be right that the Australian Prime Minister can respond to a report with 409 recommendations in only two months, but our Prime Minister cannot respond to a report with only three recommendations in more than double that time? Has the Minister made contact with Ministers and officials in Australia to understand how they established that scheme and to learn the lessons? Will she tell me today that the Government at least accept the principle of financial redress? Will she confirm that a scheme will be up and running by March next year, as per the IICSA’s recommendation?

The Minister is aware that when Gordon Brown made a formal apology in 2010, the full extent of the abuse was not known. He and many of the survivors therefore believe that a full apology is overdue. In this matter, I have to disagree with the conclusion of the independent inquiry’s report—not to recommend a further apology—because the harms caused by the migrant programmes are many and complex. That is why it matters that we recognise not simply the harm done to children by separating them from their families and countries, but the additional sexual, physical and emotional abuse laid bare so starkly by the report and the harm of our failure to confront it over successive Governments and many decades. Will the Minister commit to that today, or at the very least provide us with a date by which time the Prime Minister will respond to that specific request?

Another pressing need is a commitment to continue the family restoration fund beyond 2019. One thousand people remain to be reunited with their families, and there is a waiting list. I welcome the Government’s commitment so far, and the £2 million that they made available to the fund, but its continuation is of central importance. Many of the mums and dads of the former child migrants went to their graves not knowing what had happened to their children or even whether they were dead or alive. They never found out that they had become grandparents, and they never saw or got to hold their children ever again.

The family restoration fund has enabled some of those deep wounds at least to start to heal, and important work remains to be done before it is too late. The Minister knows, as I do—as we all do—that many of the former child migrants have died and that others are seriously ill and dying. Every day counts. The fund will enable nothing less than a restoration to families of the rights stripped away from them many decades ago. Will she give us a commitment that the fund will be continued until all the former child migrants have been able to seek to be reunited with their families?

This has been one of the most shameful episodes in British history. For 30 years we have known about the scandal but failed to act. The harm that was done then is compounded by our knowledge that it continues to cause harm to people in this country and across the world, yet still nothing is done. The secretary of the International Association of former Child Migrants and their Families, Harold Haig, put it movingly when he said on the day of the formal apology by Prime Minister Gordon Brown, that

“our thoughts are with those child migrants who have died and particularly those who ended their lives because the wounds were too deep and too painful”.

At least 10 people have died that we know of since the report was published four months ago. I hope that the Minister will tell us today that no more will die suffering harm from the British Government, and that we shall finally deal with one of the darkest periods in our history.

[Mr Philip Hollobone (in the Chair)]

Lisa Nandy will have some minutes at the end of the debate to sum up. I call John Howell, but, in doing so, given all the blowers on in the Chamber this afternoon, I stress the need for the hon. Gentleman to raise his voice, so that I can hear and, more importantly, so that Hansard can record his words faithfully.

--- Later in debate ---

[Stuart C. McDonald (Cumbernauld, Kilsyth and Kirkintilloch East) (SNP)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I sincerely congratulate the hon. Member for Wigan (Lisa Nandy) on securing the debate.

This is a distressing and shocking subject that has not had the attention that it deserves since the IICSA report in March. She has done us and, more importantly, the victims of this appalling treatment a good service by bringing it to the House, ensuring that what happened in the child migration programmes is spoken about in Parliament and ensuring that action is taken to redress the grave injustices. I thank the hon. Member for Henley (John Howell) for highlighting the significance of the Lanzarote convention. I am not particularly au fait with it and will have to consider it further.

I agree that the IICSA report was comprehensive in its investigation of these programmes. It was thorough and thoughtful, and its conclusions entirely reasonable. I support the calls made today for the implementation of its key recommendations. Like the hon. Lady, and as a member of the Home Affairs Committee, I had considerable concerns about how the inquiry was operating in its early days. This report is a sign of encouragement for victims and it gives us an indication that the inquiry has got its act together and will be able to carry out the function that was intended for it.

Similarly, we should not forget the inquiry established by the Northern Ireland Executive into historical institutional abuse, which was chaired by Sir Anthony Hart. Its report contained a very thorough chapter on the child migrant programme that saw children from Northern Ireland sent to Australia. In Scotland, the work of the child abuse inquiry under Lady Smith is to include a specific investigation on child migrants, and work is under way to identify those who may have suffered abuse in Scotland or after being sent abroad.

The reports from the IICSA and Northern Ireland acknowledge that there must be some caution in criticising 20th-century conduct through the lens of the 21st century. Some people quite clearly did believe that migrating children was right, whether because of misguided beliefs about safeguarding the child’s moral or religious wellbeing, removing the child from danger or being economically sensible, or because it was thought that there was a need—believe it or not—to populate the empire with white British stock. As the reports make clear, even looked at by the standards of the time, the programmes were shockingly ill-conceived and the actions and supervision fell drastically short of the expected standards. Concerns about the programmes were repeatedly ignored and little effort was made to ensure that the children “exported” were safe.

The pattern that emerges in the reports is similar. Many had already suffered forms of abuse in institutions on these shores. The process of selection itself was a form of abuse. Overwhelmingly they were being separated from family and they were often lied to about what had happened to their family members or even their own identity. The views of the children and their parents were ignored. Many were abused in transit and many more were abused on arrival in Australia and other destinations. Thousands of children suffered that fate.

Both the IICSA and the Northern Ireland inquiry reports remind us that there is no substitute for the testimony of those who were put through this awful process—we have already heard that from the hon. Lady. It is only because of the courageous testimony of survivors that their reports are so thorough and comprehensive. I pay tribute to all those witnesses and to the Child Migrants Trust for supporting them through the process.

The Northern Ireland report highlighted this particular passage as typical of what all survivors of this process would say:

“We were exported to Australia like little baby convicts. It is hard to understand why they did it. I know the theory—to populate Australia. I still cannot get over the fact that I was taken away from a family I never got the chance to know. I was treated like an object, taken from one place to another. I found it very hard to show affection to my children when they were young. I have improved as the years have gone on. I have a nightmare every night of my life. I relive my past and am happy when daylight comes.”

That witness died before he could sign his witness statement, which emphasises the hon. Lady’s point about the urgency of a response from the Government, especially in the light of the 10 deaths since the IICSA report.

As has been said, successive Governments were outrageously slow to respond. The hon. Lady already emphasised the IICSA’s conclusion, which states:

“it is the overwhelming conclusion of the Inquiry that the institution primarily to blame for the continued existence of the child migration programmes after the Second World War was Her Majesty’s Government”.

The programmes were

“allowed by successive British governments to remain in place, despite a catalogue of evidence which showed that children were suffering ill treatment and abuse, including sexual abuse.”

That continued even after the damning Ross report of 1956. It is stomach churning to read in the IICSA report that that was because, as the hon. Lady said, politics trumped child welfare. I quote it again:

“HMG was reluctant to jeopardise relations with the Australian government…and also to upset philanthropic organisations… Many such organisations enjoyed patronage from persons of influence and position, and it is clear that in some cases the avoidance of embarrassment and reputational risk was more important than the institutions’ responsibilities towards migrated children.”

[Lisa Nandy]

One of the things that is important to many former child migrants is that this never happens to children again. The story that the hon. Gentleman tells, of a Government cowed by the power and the patronage of those involved, is a story that quite honestly could be repeated today. We have seen it time and again throughout history. That is why it is so important that we get a full formal response to this report from the Government. The inquiry was set up to learn the lessons from history, to make sure this never happens again. I fear that we are not doing that. Does the hon. Gentleman agree that it would be really helpful for the Minister to respond specifically to that point when she replies?

[Stewart Malcolm McDonald]

I absolutely agree and I look forward to hearing the Minister’s response.

On compensation payments, both the Northern Ireland report and the IICSA report recommend compensation for those sent abroad on the child migration programmes, over and above the compensation they might receive for other wrongs and abuse suffered. The Northern Ireland report says that would be in recognition of

“the injustice they suffered as young children by being sent to a far away land and losing their sense of identity as a result”.

Similarly, the IICSA recommends a redress scheme for all surviving former child migrants, with each awarded the same sum in recognition that they were all

“exposed to the risk of sexual abuse”.

Because of the age of the surviving migrants—there are 2,000 or so alive today—the IICSA report rightly suggests that the scheme be established urgently, so that payments can be made within 12 months. None of that should interfere with or affect any other forms of ongoing support that are being provided.

This was a truly appalling episode in British history and it will be until we have resolved it. The Government must do what is right by the survivors and other children, and compensation should be paid urgently as per the recommendations of the inquiries.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

It is a pleasure to serve under your chairmanship, Mr Hollobone.

I thank the hon. Member for Wigan (Lisa Nandy) for securing the debate. It is difficult for me to disagree with anything she said. It is four months since the report came out and, dare I say it, we are all a bit distracted by the soap opera that is Brexit, which means that on some of these issues the eye has been taken off the ball. One reason I am grateful to her, therefore, is that this debate helps me to focus some of my colleagues’ minds. She alluded to the fact that this issue affects not just my Department and that we need agreement across Government. I thank her for the opportunity to say where the Department of Health and Social Care is on the issue.

I am pleased to hear that some of the child migrants are watching the debate with interest. I would like to convey to them that we are taking this seriously and will respond to the issues raised in the report. I thank the hon. Lady for showing such interest and passion in speaking on their behalf, because they deserve our support.

I do not think anyone in the Chamber disagrees that the child migration policy was so misguided and harmful and caused such suffering and distress. For us as Members of Parliament in the 21st century, it beggars belief to think that any British Government could think that was a reasonable policy. It clearly caused great suffering and distress to children, who should be protected by institutions of the state. It is crucial that we learn from the mistakes of the past in order to protect and safeguard future generations of children from abuse.

We should never be complacent. We have seen with the likes of Savile how organisations can collude to protect themselves from the worst kinds of allegations, and that continues to this day. Only last week we heard about Gosport, where there was massive collusion on real harm, which causes such distress. All citizens require our support as Members of Parliament to make sure that never happens again.

The hon. Lady told the most harrowing stories, perpetrated by organisations that purport to be Christian, and we heard many examples of cover-ups of abusive behaviour towards children, which I sincerely hope will be further highlighted by the child abuse inquiry. The hon. Member for Washington and Sunderland West (Mrs Hodgson), who spoke from the Opposition Front Bench, used the term “dehumanising,” which conveys exactly what we are talking about. That is what was done to those children.

We are four months on from the publication of the report, which asked that we take action within a year, so there are eight months to take action. I would like us to give a formal response much sooner—I intend to do so before the summer recess, as everyone has asked. Perhaps in some respects it will be useful to reflect on the points made in this debate for that formal response. All the questions that hon. Members have asked deserve to be answered as part of that, so I thank them for making those points.

[Lisa Nandy]

I would be grateful if the Minister addressed the two additional requests I made, which former child migrants have also made: for a full apology for the extent of the abuse we now know about; and for the further funding required for the family restoration fund.

[Jackie Doyle-Price]

We will indeed consider that. As the hon. Lady will be aware—she alluded to this—we are supportive of the family restoration fund and continue to work with the Child Migrants Trust to ensure that we are supporting that work as effectively as possible. Ultimately, we cannot apologise enough for what we have put these people through. We will pick that up as part of the response.

I talked about how institutions collaborated to cover up harm generally. That is why the independent inquiry into child sexual abuse is so crucial, and why we need to look at historical abuse as well as more recent events; otherwise, we will end up turning a blind eye to the same behaviours. As the whole House knows, this is very much an interest of the Prime Minister. She established the inquiry and she wants to shine a light on all such practices so that we can genuinely protect people from sexual abuse in future. Only by getting to the truth and exposing what went wrong in the past can we genuinely learn those lessons. We have now given a voice to victims and survivors. We have given them a chance to tell their stories, which will enable them to start moving on and to draw a line under the suffering that institutions of the state allowed to happen.

As we have heard, the number of children who were migrated is significant: 130,000 in total and 9,000 since the war. As the hon. Lady says, 2,000 of them are still alive today. The intention was well-meaning, but we know that, despite the good intentions, many children suffered terrible emotional, physical and sexual abuse. As she says, although it happened far from our shores, the fault does not lie entirely with overseas Governments. Having established the policy, we owed a duty of care to those people.

As has been mentioned, some children were sent from this country without their parents’ knowledge or consent and without any necessary approval. The obliteration of individual rights in such circumstances is truly abhorrent, and it shocks me that Great Britain, the mother of the free, could behave in this way to any one of its subjects. It is utterly shocking. We know that some parents were even told that their children had died, when in fact their names had just been changed when they were sent abroad. That is totally unthinkable.

It is right that the child migration programme was captured by that inquiry and very important that we looked at it as a matter of urgency, given the age of some of the survivors. All hon. Members will know that the Department of Health collaborated fully with the inquiry, as it did with all other investigations. We responded to all requests for information and gave full access to our files and records, as well as giving comprehensive evidence to the inquiry hearings.

The hon. Lady will also be aware that the inquiry heard harrowing testimonies from former child migrants. She has referred to some of those stories today. Essentially, everyone turned a blind eye to allow the conditions for that abuse to flourish. It is quite right that the inquiry concluded that systematic hardship and abuse did indeed occur as part of the programmes, and that insufficient protection and safeguards meant that they were allowed to continue for far too long.

The physical and emotional damage in childhood has had a lifelong negative impact on many former child migrants. I know that those watching today will agree that some still struggle to overcome their experiences, which continue to blight their lives and those of their families—not to mention the health consequences. I hear the hon. Lady’s message that since the report was published we have lost a further 10 survivors. That underlines the case for our responding to the report as soon as possible, and I give her my undertaking that I will do my level best to get that out as soon as possible.

One thing that we are grappling with within Government is whether there are issues of precedence in how we address the recommendations of the report. In particular, given the breadth of what the inquiry will be looking at, we have to be careful how we pitch it. That discussion is taking place at the highest level among Ministers. The spirit in which we established the inquiry will be ruined if we do not take those discussions seriously. I convey that message to all hon. Members. In her speech, the hon. Lady referred to a letter from solicitors pending legal action. I have seen that correspondence and it is receiving attention, so I can give her that assurance too.

I appreciate that I am not giving the answer that hon. Members would like, because they are all rightly impatient for the response. I hope that they will accept that we are carefully considering the report’s recommendations and are committed to responding as soon as we can, given the advanced age and declining health of the people we are talking about. Frankly, that is the only way to avoid neglecting them further. We should not shy away from our responsibilities now and there should be no dispute about the Departments that are responsible. The Department of Health and Social Care and its predecessor Departments have led the Government on these issues since they were first identified by Margaret Humphreys in the 1980s. I add my voice to those who have paid tribute to her today. She provided the challenge that made us all face up to what went on in our name in the past.

To conclude, the work of the child sex abuse inquiry brings to our attention the need for change in our approach to child sexual abuse. We should never turn a blind eye. We should always listen. We must also acknowledge that, since the moment when Gordon Brown first apologised for the treatment of child migrants, successive Governments have ensured that we have done our best to support and do right by them. The cross-party formal national apology to child migrants in 2010 was testament to how committed we all are across the House to righting some of the wrongs of the child migration programmes in a way that is meaningful to child migrants themselves. It is what they told us they wanted.

As the hon. Lady said, we have funded the Family Restoration Fund, which has funded around 1,200 trips to reunite families and rebuild family ties. It is important that we continue to support that work and to work with the Child Migrants Trust to deliver it.

Finally, I will say some last words to the former child migrants who, despite enduring such a damaging start to their lives, have managed with great courage to overcome their past and to positively shape their future. We owe it to them to learn the lessons of the past, and the inquiry’s work is designed to do that. I do not think that anyone can pay sufficient tribute to their stoicism and courage in moving on and shaping their lives—but they are quite right to remind us how we failed them.

I wish again to thank the hon. Lady for securing the debate, and I thank all hon. Members who have contributed to it. We will note the points that have been made as we develop our response to the child migration report, which I hope to share with everyone in the not-too-distant future.

[Lisa Nandy]

I thank all hon. Members who have taken part in the debate, and I thank the Minister for her honesty in how she has approached this, given the serious delays and their impact, which we have discussed. I thank her, too, for her personal assurances on this matter; I believe they are genuine and I am encouraged by that. I hope that others listening to the debate will also be encouraged. I am particularly grateful to her for committing to a formal response before the recess and for considering the additional requests that I made during the debate.

Given the importance of this subject and the fact that it was the British state that caused this harm and continues to cause this harm, I hope that the formal response will also be made as a statement in the House, so that colleagues have the opportunity to question Ministers about it and it is given the prominence by Government that it deserves. When this matter was finally given to the Department of Health to respond to, there was a concern—and it remains—that the fact that the Department was historically responsible for child welfare but is no longer might mean there would be delays and that due expertise would not be brought to bear. I am grateful to the Minister for recognising that this is a cross-party issue that demands attention at the highest levels, from the Prime Minister and Cabinet colleagues.

We will not let this go. It was one of the darkest periods in British history, and it affected not just those former child migrants, but their families. They deserve redress; they deserve a full apology; and all of them, whether they are alive today or not, deserve a legacy of ensuring that this never happens to another child.

Question put and agreed to.

Resolved,

That this House has considered child abuse in the child migration programmes.

Oral Answers to Questions

Lisa Nandy Excerpts

Tuesday 19th June 2018 Commons Chamber

[Stephen Barclay]

My right hon. Friend is right to champion this, as he did through the recent Adjournment debate, when he set out the case in more detail. We recognise, as we did at the last Health questions and in the Adjournment debate, that there are significant issues with the local hospital, and that is why it is working very actively on its bid for capital funding.

[Lisa Nandy (Wigan) (Lab)]

T4. Four months ago, a damning report exposed the extent of abuse inflicted on children for decades sent overseas by this Department. It said that compensation must be paid, and urgently, because people have died and others are dying. It took a month for the Prime Minister to work out which Department was responsible, and another month for the Health Minister, the hon. Member for Thurrock (Jackie Doyle-Price), to tell me she was formulating a response. Has she got a response today, or is she honestly going to stand at that Dispatch Box and tell me and all those survivors that the Prime Minister has spent £64 million of public money on a report that the Minister is now trying to bury?

[Jackie Doyle-Price]

I reject that accusation; we are far from burying it. The Prime Minister is looking at responding to the interim report. I will repeat what I said to the hon. Lady when she last asked this question. We are quite clear that the child migrant policy was wrong. We have apologised for that policy, and we have established a £7 million family restoration fund. The response from the Government to that report will be laid in due course.

Oral Answers to Questions

Lisa Nandy Excerpts

Tuesday 8th May 2018 Commons Chamber

[Mr Hunt]

There are still many things to tackle when it comes to patient safety, but I think the NHS has risen magnificently to the challenges in the report. There are nearly 45,000 more doctors and nurses across the system. Although there is more to be done, much credit should go to the NHS.

[Lisa Nandy (Wigan) (Lab)]

This week marks two and a half months since the independent inquiry into child sexual abuse recommended that compensation be paid urgently to children sent abroad by their Government and subjected to the most appalling child abuse. In that time, the Secretary of State’s Department, despite repeated requests for action, has made not a single statement. Many former child migrants have died and others are dying. How many more will have to wait, and die waiting, for justice before this Government get their act together and pay them the compensation that is owed?

[Jackie Doyle-Price]

We have been quite frank about the fact that the child migration policy should never have happened and this Government have apologised repeatedly for it. I can assure the hon. Lady that I am currently working with officials to come up with a formal response to the committee of inquiry.

Breast Cancer Screening

Lisa Nandy Excerpts

Wednesday 2nd May 2018 Commons Chamber

[Mr Hunt]

I thank my hon. Friend for her excellent advice, which gives me the opportunity to repeat that the advice for women about looking after their breasts and making sure they are alert to potential breast cancer remains unchanged. All women should take great care over this and should always come forward to see their GP or local cancer service if they have any concerns or doubts.

[Lisa Nandy (Wigan) (Lab)]

I thank the Secretary of State for his statement. There is no other way to describe what has happened than utterly, utterly heart-breaking, and it is hard to imagine what some of the worst affected families will be going through over the next few weeks.

I am grateful to the Secretary of State for his assurance that capacity will be expanded to ensure that women can now access screening, but unless he puts further resources into the system, other people will go to the back of the queue as a consequence. In my region of the north-west, one in five posts are currently vacant, and for far too many women in this country where they live currently determines whether they live or die. So will the Secretary of State put in the additional resources needed to make sure all women can get the screening they need when they need it?

[Mr Hunt]

I thank the hon. Lady for her comments. We have many other occasions to have a broader discussion about resourcing of the NHS, but I recognise what she says: in the specific situation we are in now, with the people who will need additional scans and additional treatments over and above what the NHS would have otherwise done, we will need to find additional resources to make sure others are not disadvantaged.

Oral Answers to Questions

Lisa Nandy Excerpts

Tuesday 24th February 2015 Commons Chamber

[Norman Lamb]

I thank my hon. Friend for that question and join her in paying tribute to the work of so many people: volunteers, loved ones and the professionals working in the community. The whole emphasis should be on ensuring that we respect people’s choice about where they want to be and that they get the best possible care. Later this week, the independent review of choice at the end of life will be published and I hope that it will inform discussions. I am completely with her in trying to ensure that we can achieve this.

[Lisa Nandy (Wigan) (Lab)]

One of my constituents recently went through a lengthy, distressing and difficult process to get NHS continuing care for his wife. If we remove the distinction between NHS and social care, many people across this country, including my constituent, will be spared this distress and difficulty at one of the hardest times in their lives. We know that funding should be put where it is needed and we know that that will be more cost-effective in the long run and will be better for patients, so why will the Minister not act?

[Norman Lamb]

Actually, we are all agreed on this. We all want free care at the end of life, but whoever is in power after the election in May will have to ensure that we understand fully the costs. There is a lot of evidence, and the evidence is growing. We are having very good discussions with groups involved in care at the end of life and we all want to achieve a solution. Of course, the truth is that very many people are receiving free care at the end of life, but they are in hospital, where they often do not want to be. I am completely with the hon. Lady in trying to achieve this.

Healthier Together Programme (Greater Manchester)

Lisa Nandy Excerpts

Tuesday 22nd July 2014 Westminster Hall

[Kate Green]

The hon. Gentleman is absolutely right, and I am pleased to see that the hon. Member for Macclesfield (David Rutley) is also present this afternoon. The ripple effect of the consultation, on hospitals in neighbouring areas and indeed—as I will go on to talk about—on the wider north-west and northern region of the country is quite significant in one reading of what is going on.

It is true that the pressures of rising demand on the NHS are well recognised, as are the cost constraints on social care provision. However, my constituents in Trafford were told all that three or four years ago, and we went through our change programme. We feel that we have been here before and, for us, this is groundhog day and a bit worse than that. We underwent the consultation “A New Health Deal for Trafford”, which took place in 2012 and culminated in the downgrading of Trafford general hospital. Looking at how the current consultation has been launched, I am concerned that a number of lessons that were learned from that Trafford process are being totally ignored.

I say clearly that I am not against sensible reconfiguration of acute services. I am very much in favour of concentrating expertise and specialisms in a small number of expert sites. I am entirely in favour of as much provision as possible being pushed into the community to front-line, preventive, community-based care, and of keeping people at home to receive that care for as long as possible.

However, if this is a consultation about the provision of integrated community-based care, it is not possible to go down the road of consulting about that provision and withdrawing services in acute settings before we are clear what the landscape and the reality of that community provision is. Nor is it possible to go down the route of suggesting that some acute services might be rationalised or closed when existing acute services are under so much pressure already. In particular—I know that my hon. Friend the Member for Wythenshawe and Sale East (Mike Kane) will talk about this issue too—one consequence of the downgrade of Trafford general hospital’s accident and emergency provision is that during the past nine months the waiting times and queues at Wythenshawe hospital have been significant, with little sign yet that they will be reduced.

In addition, I point out that we have some real uncertainty. My hon. Friend the Member for Blackley and Broughton mentioned the uncertainty that exists around trauma services, maternity services and so on, but we also have uncertainties in Trafford in relation to some of the primary provision that will be in place. We know that the NHS local team and the clinical commissioning group envisage a two-hub model of primary care and community-based care for our borough. The provision in the south is largely established, but in the north—including in my constituency, where we have some of the worst health outcomes in the borough—we are still completely unsure what sort of hub will be put in place, as the NHS local team and NHS England are quite unable to tell us what the funding for that kind of hub model will be.

I know that the Secretary of State for Health is aware of that particular situation and I am grateful to him and his office for what they are doing to try to unscramble it, but from the point of view of my constituents the idea that they will be consulted on a major reconfiguration, either of primary care or of acute services, does not inspire their confidence, because currently they simply see deficiencies in those services and particularly because they believe that their voice counts for little when it comes to the decision that will ultimately be taken.

Not only is there pressure in the system, but the NHS seems to make some really perverse decisions as it goes along, because of its rather hand-to-mouth approach to planning this kind of reconfiguration and strategic change. When the decision was taken to downgrade the A and E services at Trafford general hospital, the hon. Member for Altrincham and Sale West (Mr Brady) and the late Paul Goggins, my good friend and former colleague, managed between them to secure around £11 million of new investment in Wythenshawe hospital to provide for the extra capacity that it would need. We are now unclear, of course, about what will happen with that £11 million of investment; it would be good if the Minister could put it on the record today that it will continue. Given that the hospital cannot envisage even its short to medium-term future, that is a worrying situation.

We saw something similar in Trafford, when investment of around £300 million in the intensive care unit was pretty well written off two years later when the new health deal for Trafford was implemented and the ICU was closed down. That may have been the right decision, but it was certainly a waste of money if investment was being poured into a hospital just two or three years before the whole status of that hospital was changed.

[Lisa Nandy (Wigan) (Lab)]

I am grateful to my hon. Friend for giving way, and I apologise for being late for the start of this debate, Mrs Riordan.

Does my hon. Friend agree that part of the problem with the process is that it does not take into account the particular needs, circumstances and history of our individual communities? For example, in Wigan we have invested in a number of our specialist services. However, we are a big borough, we have our own particular health challenges and we have real transport issues as well, which are different from those affecting other areas of Greater Manchester. Quite simply, a centrally driven top-down process that lacks any kind of democracy whatever, as far as I can make out, is not capable of delivering the sort of services that we need in our areas.

[Kate Green]

I absolutely agree with my hon. Friend, and the issue about democracy that she raises is one that we are all particularly concerned about.

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[Lisa Nandy]

I agree with almost everything the hon. Gentleman has said. Is not the tragedy of this process that, as he and my hon. Friend the Member for Blackley and Broughton (Graham Stringer) said, most of us could get behind some principles underlying the proposal, including greater care in the community locally when people need it, greater specialism and supporting people to get care outside hospital? There is consensus on all those things, but the way the process has been handled, as has been compellingly outlined, has left people feeling that there is simply no point getting involved.

[Mr Nuttall]

The hon. Lady makes a good point. The vast majority of the public would, in an ideal world, like every service to be provided at their local hospital, so that they could have everything just by travelling a couple of miles. In a perfect world, they would have every conceivable treatment available at their nearest hospital. However, they have long since accepted, and we all know, that that is not possible. The clearest example of that in Manchester is, of course, cancer care and Christie’s. People accept that if, sadly, they are diagnosed with cancer, they will have to travel to a specialist cancer care hospital, where they will get better treatment.

It gets a bit more difficult when moving further down the specialism chain. Certainly, we were at the front line in that regard, as were Rochdale and other areas in Greater Manchester, when maternity services were being considered, because people felt that such services ought to be available everywhere. Of course, there are drivers behind this, if truth be known—if truth could be expounded by the health chiefs—in that, whether we like it or not, it comes back to the working time directive, for example, which has had an effect on the configuration of doctors’ working hours.

Medical negligence claims against the health service have also had an impact in this regard. I can understand that, coming from a legal background. People are better protected if they are in an environment where greater numbers of people are working together to watch each other’s backs. That is another driver of these reconfigurations, as some people like to call them.

To get back to the points I was making before that intervention, one of the problems with this consultation, which the hon. Member for Blackley and Broughton mentioned, is that the website and the documents are littered with unintelligible gobbledegook half the time. I am not being patronising, because I do not understand half of it myself, to be perfectly honest. Most people will look at that website and think, “Frankly, it goes over my head.” That will be their general view. I accept that the website and the documents sway wildly the other way as well and have apple pie and motherhood statements that absolutely everyone will agree with, such as “Do I want mum to get that good treatment if she goes into hospital?” No one will say no to that, will they? It is a complete waste of time and effort, and I cannot believe that highly qualified individuals have put together this mishmash of a website and consultation. It is not clearly thought through.

I have no idea of where this will end in terms of the hospitals where there is an option, but I know that my constituents in Bury want access to an accident and emergency department at their local hospital. Going back to what I said about the specialism ladder, by definition, one expects things such as accident and emergency to be available at the nearest general hospital. That is what my constituents will be looking for. If these services are salami-sliced away from Bury, my constituents will be concerned that they will be left with a hospital in name only—one that does not provide them with the services that they have come to expect.

I echo what has been said about Healthwatch England. Bury Healthwatch has e-mailed me and wants me to put on record its concerns about its involvement in this process. I appreciate that it is a new body, but clearly there are problems with the introduction of the legislative order for clinical commissioning groups, the Legislative Reform (Clinical Commissioning Groups) Order 2014. Healthwatch England has written to the Secretary of State about that. I understand that the order will come into force on 1 October. I can only assume that, to meet that deadline, those problems will be dealt with in our September sitting.

To be perfectly honest, demand for health care services will always outstrip supply, under any Government. It does not matter whether it is a Labour Government or a Conservative Government; people’s desire to be healthy and their need to feel that they and their loved ones are receiving the best possible treatment will always result in demand being greater than the ability of the public purse to meet that demand. That is of course largely driven by the fact that so many people think that our NHS is free. Of course it is not free. We all know that it is not free.

In the current year, the NHS is spending something like £119 billion. It is a huge consumer of public funds, and rightly so. It is right that the Government have protected the health care budget. Notwithstanding that, there are pressures, because the population is getting older and new treatments are being discovered and becoming available all the time. I am grateful for the opportunity to put on record my constituents’ concerns, and I am conscious of the fact that others want to put similar concerns on the record.

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[Jonathan Reynolds]

I do agree. That is a matter of extreme concern to me. My understanding is that we have been given a cast-iron pledge that there will be no hospital or A and E closures as part of Healthier Together. The problem with all hospital reconfigurations anywhere—it happened with the maternity services consultation—is that they always appear to people to be about cuts. It is hard to get across the argument that they are about improving services. There is some mixed messaging about the primary outcome of such a process.

My principal problem with specialisation is the one that arises with specialisation in any field. Greater Manchester’s geography makes it hard to get from one borough to another. Public transport and the railway system are not configured to operate in that way. I should love the opposite to be true—if we had the resources and local autonomy to make public transport work differently. That will come one day, I think, but it is not true at the minute. I did not by any measure expect to become an MP in the 2010 general election, and my daughter was booked in to be born at St. Mary’s, because I worked in the centre of the city and it was easier to have appointments there than to get back to Tameside for them. Frankly, we were concerned about the possibility of labour starting in Tameside at the wrong time, because of the journey to get to St Mary’s and what that might mean. I think that that would be the same for many people, whatever the health issue: the journey is not easy in a car, but by public transport it is almost untenable. That would be people’s primary concern when they thought about the outcome of such a consultation

[Lisa Nandy]

I am grateful to my hon. Friend for raising that matter, because I do not think that the Healthier Together team has given it enough thought. My constituency has not only chronic transport problems, including traffic and the fact that some areas of the borough are densely populated and quite far from the existing hospital, but also large, tightly knit families who often do not have a huge number of resources. When a loved one is suddenly taken ill, the whole family wants to visit, which is particularly problematic and something that the team has not thought about. Does my hon. Friend agree?

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[The Minister of State, Department of Health (Norman Lamb)]

It is a pleasure to serve under your chairmanship, Mrs Riordan. I congratulate the hon. Member for Blackley and Broughton (Graham Stringer) on securing the debate. The opportunity to debate important issues at the start of a process is welcome. I also thank my hon. Friend the Member for Bury North (Mr Nuttall) and the hon. Members for Wythenshawe and Sale East (Mike Kane), for Stalybridge and Hyde (Jonathan Reynolds), for Stretford and Urmston (Kate Green) and the shadow Minister—[Interruption.] I thank my hon. Friend the Member for Harrogate and Knaresborough (Andrew Jones) for ensuring that I also thank the hon. Member for Wigan (Lisa Nandy) for her important interventions.

The impression that I got from all hon. Members is that there is a recognition that things need to change and of the importance of developing an integrated system of out-of-hospital support and strong primary care. Some hon. Members also recognised the importance of specialisms in specific cases, but concerns centred on the nature of the consultation. The shadow Minister was extremely fair in describing the process’s objective as a good one and the hon. Member for Wythenshawe and Sale East said that the aim is right, so there is something of real value to achieve here if it is possible. I completely understand, however, why hon. Members feel the need to speak up for and express concerns on behalf of their communities.

[Lisa Nandy]

rose—

[Norman Lamb]

I will give way in a moment, but I was about to comment on the intervention of the hon. Lady, whom I rudely left out of my list earlier, in which she mentioned the lack of democratic legitimacy. The reforms have strengthened legitimacy. Until the reforms, there was no local democratic accountability for the NHS, but every area now has a health and wellbeing board. Interestingly, Lord Peter Smith, who I think is from the hon. Lady’s own community, said:

“We accept the case for change made in this consultation document…Remember it is not buildings that deliver good health care, it is the dedicated NHS staff who make it possible.”

To pick up on the point made by the hon. Member for Stalybridge and Hyde, Lord Smith, a local Labour leader, also talked about the move being towards greater integration:

“We are clear that this improvement in integration and in GP services needs to be up and running before the changes to the hospital services are introduced”—

clear support there for the objective.

[Lisa Nandy]

The Minister is right. Like the leader of my council, I accept the case for greater integration. I wanted to make one point, because the Minister seems to be suggesting that the concerns centre only on the consultation. I have a real concern, which I am not sure has been expressed clearly so far, about how the consultation sets up hospitals as either specialist or local.

My hospital specialises already, and it is rightly fighting to retain that because good outcomes are delivered. That does not mean that my hospital can, or should, do everything. Indeed, many of my constituents travel, for example, to the Christie for cancer care, as the hon. Member for Bury North (Mr Nuttall) said. There is, however, a real issue about some hospitals being specialist and some being local, but with nothing in between.

[Norman Lamb]

I take that concern on board, and the hon. Lady should respond to the consultation. It is really important for hon. Members to do that.

Incidentally, I should say something on behalf of my hon. Friend the Member for Cheadle (Mark Hunter), because he is a Whip and so is unable to speak in the debate, although he has attended it all. He has expressed particular concerns about the potential implications for the University Hospital of South Manchester and Stepping Hill, and about options 4.1 and 4.2. It is important that I place that on the record.

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[Norman Lamb]

The hon. Lady has moved on, so let me make some progress.

It is important to recognise that we are discussing proposals that originated with local clinicians. Dr Chris Brookes, who is not a politician or a bureaucrat, who too often get condemned, but an accident and emergency consultant and a medical director of Healthier Together, says—

[Lisa Nandy]

Will the Minister give way?

[Norman Lamb]

May I make this point? I am sure that the hon. Lady will be interested to hear it. Dr Brookes said:

“Currently, there are too many variations in the quality of treatment, whether its emergency surgery or getting to see a GP when you need to. Not one of our hospitals in Greater Manchester meet all the national quality and safety standards.”

I am sure that all hon. Members present are concerned about that. He goes on to say something which, if we think about it, is shocking:

“At present your chance of being operated on by a consultant surgeon in an emergency at the weekend is much less than midweek. Your chance of recovering well from surgery carried out by a consultant is greatly improved.

But it’s not just about hospitals. It’s about access to a GP, and better community-based services—more services provided locally or at home and joining up the care provided by local authorities.”

That is a clinician making the case for integration.

Before I turn to the Healthier Together changes, it is probably best to make a few points about service changes in the NHS generally and Government policy towards them. The Government are clear that the design of health services, including front-line services and A and E, is a matter for the local NHS and, critically, the health and wellbeing boards, which have democratic accountability. Our reforms put doctors in charge of the care that people receive and how it is delivered to best serve their populations.

The NHS has a responsibility to ensure that people have access to the best and safest health care possible, which means that it must plan ahead and look at how best to secure safe and sustainable NHS health care provision—not only to meet today’s needs, but to plan ahead for next 10 or 20 years.

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[Norman Lamb]

I really cannot. I have been pretty generous in giving way many times, so I will make a bit more progress.

It is therefore for NHS commissioners and providers to work together with local authorities, patients and the public in bringing forward proposals that will improve the quality and sustainability of local health care services. Government policy has been to emphasise local autonomy and flexibility in how NHS organisations plan and deliver service changes, subject to meeting legal requirements, staying within the spirit of Department of Health guidance and ensuring schemes can demonstrate robust evidence against four tests. Those are that there is support from GP commissioners; there is a focus on improving patient outcomes; that schemes consider patient choice; and that they are based on sound clinical evidence.

I recognise that change is often difficult to achieve because the consequences of not getting it right could be so profound—hon. Members have been absolutely right to raise their concerns. It is therefore right that the NHS does not rush into change without fully understanding all the potential consequences, sometimes including unintended consequences. Change can be difficult to explain to patients who have had quite reasonable anxieties exacerbated by speculation—in many cases, in the media—about whether this or that service might close. Services are sometimes described as closing when in fact they are simply being provided in a neighbouring facility or changing for the better in response to advances in treatment.

For example, my hon. Friend the Member for Macclesfield (David Rutley) referred to the possibility of hospitals closing, but I am not aware of any proposal to close hospitals. When we communicate to patients and the public, it is important that we are clear on what this issue is and is not about, so as not to raise anxieties. From my perspective, we have to be careful to avoid ramping up anxieties inappropriately by playing on fears. We see that too often; unfortunately, it stifles genuine debate and discussion about what health services will need to change in order to do better in future. But I applaud all hon. Members for speaking in this debate very reasonably and about legitimate concerns.

The right hon. Member for Leigh (Andy Burnham) has agreed that the NHS needs to have the freedom to change the way services are provided. He said:

“If local hospitals are to grow into integrated providers of whole-person care, then it will make sense to continue to separate general care from specialist care”—

the point made by the hon. Member for Wigan a moment ago—

“and continue to centralise the latter. So hospitals will need to change and we shouldn’t fear that.”

Perhaps the hon. Lady will take the point better from her party’s health spokesperson than from a Minister, but the right hon. Member for Leigh was making the case for the specialisation of services.

[Lisa Nandy]

I thank the Minister for being so generous in giving way. He seems to be setting up straw men that he then batters down. As far as I can work out, there is no disagreement from me or any Member on either the Government or Opposition Benches about the need for specialisation, integrated health care and locally delivered services. That is not what we are talking about. We are talking about a process that lacks democracy, that has been top down and centrally driven and that the public have lost confidence in.

[Norman Lamb]

To be fair, when I indicated earlier that the issue is about process, the hon. Lady came back at me—as is her right—to say that it is not just about process but about the model of separating specialisms from general hospitals. I therefore quoted what the shadow Secretary of State for Health had said in that regard.

I turn to the specific case raised by the hon. Member for Blackley and Broughton in this debate. Healthier Together was launched by the NHS in Manchester in February 2012 and is part of the Greater Manchester programme for health and social care reform, which seeks to improve outcomes for all Greater Manchester residents. The scheme is substantial, involving 12 CCGs and 12 hospital sites across Greater Manchester. As the consultation sets out, the case for change aims to improve access to integrated care and primary care, community-based care and in-hospital care services, including urgent and emergency care, acute medicine, general surgery and children’s and women’s services.

The House should appreciate that although those are the services being looked at, there are interdependencies with the core in-hospital services, including anaesthetics, critical care, neonatal services and clinical support such as diagnostic services. Changes in one area might have consequential effects elsewhere, as hon. Members have pointed out, and those effects have to be fully understood.

I should also repeat that the proposed changes are not a top-down restructuring. They are led by local clinicians who know the needs of their patients better than anyone. They believe that the clinical case for change—

Accident and Emergency

Lisa Nandy Excerpts

Wednesday 18th December 2013 Commons Chamber

[Lisa Nandy (Wigan) (Lab)]

My A and E in Wigan is, like so many others across the country, under significant pressure at present. Earlier this year we saw an unprecedented rise in A and E attendances. That is a result of a series of problems, including the difficulty in getting GP appointments, as outlined eloquently by my right hon. Friend the Member for Leigh (Andy Burnham), but I think the single most significant cause is the cuts that have been made over the past three and a half years to social care. Does the Minister have any idea what those cuts and the unfair distribution of them—my constituency of Wigan has been cut three times more than Windsor— have meant to people in their lives?

I want to say something about the situation of older people. I have been shocked over the past couple of years by what is happening to older people because of the deep and front-loaded cuts to social care, which have left councils with no option but to cut services. Over the last two years we have seen an unprecedented rise in the number of over-90-year-olds coming into my local A and E and others across the country by ambulance.

[The Minister of State, Department of Health (Norman Lamb)]

The hon. Lady talks about the situation in social care and of course I understand that there is real pressure, but will she welcome the fact that in 2012-13 there were 37,473 fewer days lost in delayed discharge due to social care, so in other words social services are doing better now than they were in previous years?

[Lisa Nandy]

In the very short amount of time that I have got I will simply echo the words of my hon. Friend the Member for Stretford and Urmston (Kate Green) who said to the Secretary of State that she thought people would be staggered by the complacency of Members on the Government Benches and would not recognise the picture they paint, which stands in stark contrast to the lived experiences of my constituents, some of whom are old and vulnerable and deserve so much better than this. Behind the increase in the number of admittances to hospital lies a picture of older people who are living alone at home, worried, lonely and ill.

The Minister’s Government have not caused all of this, but, like my right hon. Friend the Member for Leigh, I have talked about my concern about what has happened in social care and the rise of zero-hours contracts and choosing the lowest bidder over recent years, so, by God, I must also say this: his Government have made the situation so much worse. By the end of next year the budget of my council in Wigan will have been cut by £66 million, and we were told this summer that another 10% is still to come. We have done everything. We have pared that organisation to the bone. The truth is there are no more efficiencies to be had; there are only cuts.

I say this to the Minister as well: this is not just about councils, because what this Government have done, and the Darwinian approach they have taken to the voluntary sector, has severely undermined the capacity of charities to respond to this crisis at the very time when they are needed most. This is the true meaning of the big society.

We are seriously disrupted in Wigan—

[Norman Lamb]

rose—

--- Later in debate ---

[Lisa Nandy]

I will not give way to the Minister because I presume he will be winding up the debate and I hope he will spend the rest of his time listening to Members rather than trying to explain away such an appalling record.

I cannot understand why, despite all the pressures already being put on my A and E by this Government and despite its still being consistently one of the highest performing A and Es across the north-west, we are being disrupted by the Healthier Together programme, which has caused so much anxiety in Wigan.

[Grahame M. Morris]

Will my hon. Friend give way?

[Lisa Nandy]

I will give way very briefly to my hon. Friend.

[Grahame M. Morris]

I want to reinforce that point in relation to Durham county council. I have just been advised that Library figures show that it is facing cuts of £222 million between 2011 and 2017. That must have a huge impact on social care and a consequential impact of increased demand in A and E.

[Lisa Nandy]

My hon. Friend is absolutely right, as always.

The Healthier Together programme has, at this time, caused huge anxiety across Wigan. In June, documents leaked to my local paper the Wigan Evening Post revealed plans to reclassify hospitals as red and green, with several hospitals downgraded, as my hon. Friend the Member for Stretford and Urmston knows only too well. That prompted real fears across Wigan that it would lose its well-regarded 24-hour A and E. The decision appeared to be based on population, not on the performance of hospitals. In September when I visited the Healthier Together offices in Manchester to explain my concerns with my hon. Friend the Member for Bolton West (Julie Hilling), I was surprised to see, at a time of funding pressures that are causing real pain, how expensive those offices were, situated in the middle of Manchester. Imagine my surprise, Madam Deputy Speaker, when Healthwatch Wigan found through a series of Freedom of Information Act requests that the total cost of the Healthier Together programme in Greater Manchester to date has been £3 million, with £1.3 million of that spent on third-party organisations. The NHS would not reveal who or what that money was spent on. To date, the programme could, in total, have paid for 90 new nurses, 20 A and E doctors or 9,000 bed days at Wigan infirmary. Instead, this hugely expensive programme has caused huge anxiety across my local area, and communication has been dire. I am not alone in thinking that that is a shocking waste of money.

Despite the chaos caused by this Government, our A and E works well: it is a consistently high performer. We are a big borough, with huge transport constraints. To ask people to travel to the nearest alternative hospital in Bolton just is not feasible. It is 15 miles away, which is at least half an hour by car. What the Minister may not know or understand is that many of my constituents do not have cars or the money to take several buses or use public transport. Our borough typically has large, tightly knit families. When someone’s granddad goes into A and E, not just them and their mum and dad but the entire family visit him, which will be impossible if this shambolic programme goes ahead.

The Secretary of State has caused real anxiety by acting unlawfully in respect of Lewisham A and E, announcing the single biggest closure programme the NHS has seen at a time of unprecedented pressure on A and E, and making changes in the Care Bill that will enable the closure of high-performing hospital services such as those in Wigan. Will the Minister give me a cast-iron guarantee that decisions will be made on clinical, not cost grounds, and will he reassure us that financial constraints do not come into this? Will he tell my constituents that the real-life situation of local people—transport, family networks, income and all the things that have a huge impact on people’s well-being—will be considered by this Government before any decision is taken that affects my constituents’ lives?

Changes to Health Services in London

Lisa Nandy Excerpts

Wednesday 30th October 2013 Commons Chamber

[Mr Hunt]

My hon. Friend speaks wisely. It concerns me, as it does her, that these processes take so long. When it comes to changes in A and E and maternity services, exhaustive public consultation is necessary, because they cause such great public concern, but we also need to deal with these issues in a much more timely way, particularly when it involves sorting out the problems of failing hospitals. I agree with her, therefore, and I am looking at what can be done to speed up all these processes, while retaining the appropriate consultation with the public.

[Lisa Nandy (Wigan) (Lab)]

Does the Secretary of State have any idea of the concern he is causing up and down the country? In Wigan, we value our 24-hour A and E service; we do not want it downgraded, and we do not want it closed. Will he clarify his proposal for the future of Ealing A and E? Is he proposing a type 1 service? Also, will he give me a cast-iron guarantee that any future decision about our local hospital will be made on the basis of people’s lives, not cost?

[Mr Hunt]

I can assure the hon. Lady that decisions about the future of A and Es will be based on what is best for patients and on what will save lives and get the best outcomes—that will apply in her constituency, as it will in mine and every other constituency—but that will sometimes mean a difficult decision if we have a change that doctors strongly support, but about which members of the public are anxious. I have said that services at Ealing will change, but that there will be proper public consultation and that at the end of the process there will still be an A and E. The recommendation from the process was that the A and E should close, but I said, “No, I think there should be an A and E at the end of the process.” I am injecting that much certainty, therefore, but I am not going to micro-manage the local NHS by saying precisely what those services should be.