Oral Answers to Questions

Liz Kendall Excerpts

Tuesday 25th November 2014 Commons Chamber

[Mr Hunt]

We will absolutely go through a transparent process on that. My hon. Friend is right to talk about the CDF’s success, which is why we have put its budget up by 40%. As part of the fund’s success, we want to make sure that it is allowing access to the latest drugs and to drugs that really work. Obviously, science has moved on since the fund was set up four years ago, which is why we want to make room for new drugs and take off existing drugs where there is evidence that they are not working as well as possible. However, the process must be transparent.

[Liz Kendall (Leicester West) (Lab)]

Last Wednesday, the Prime Minister denied that there is a problem with cancer care, yet the target for cancer patients to start their treatment 62 days after a general practitioner referral has been missed for nine months in a row. Cancer Research UK says that this target is vital for ensuring swift diagnosis and treatment so that we have the best survival rates in the world. Some 15,000 patients have already waited too long. This is a serious problem requiring serious action, so what is the Secretary of State going to do?

[Mr Hunt]

I think cancer patients in the hon. Lady’s constituency will welcome the fact that under this Government Leicester hospital has 194 more nurses and 120 more doctors, many of them involved in cancer care.

Let me answer the hon. Lady’s question directly. There is pressure on one of the cancer standards, and that is because every year we are now diagnosing 460,000 more people than happened under the last Labour Government, who left us with such a disappointing survival rate. When that many people are being diagnosed, it of course puts pressure on the diagnostic labs and the people doing those processes. But Cancer Research UK is also saying that we are seeing record increases in survival from cancer, and that is happening because of this Government’s policies.

Care Workers

Liz Kendall Excerpts

Wednesday 5th November 2014 Westminster Hall

[Liz Kendall (Leicester West) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Robertson. Like all hon. Members who have spoken this morning, I congratulate my right hon. Friend the Member for Oxford East (Mr Smith) on securing this absolutely essential debate, particularly as this is annual living wage week. As Members of Parliament we all get hundreds of e-mails and letters from people calling for us to speak up for issues. I do not get a lot of e-mails from care workers because they are frantically working, but our job is to speak up for people who do not have a voice, which is what he has enabled us to do today. People have spoken passionately about this issue.

Although I do not have the experience of my hon. Friend the Member for Blaydon (Mr Anderson), one of the first things I did after becoming an MP was to do a shift with a care worker in my constituency. My goodness, was it an eye-opener. Amanda, from New Parks, loved her job, and she desperately wanted to care for people. She said that she never thought that she would make anything of her life, and doing that job gave her a real sense of fulfilment, but she was rushed off her feet. She was trying to fill in for staff who were off sick or who had left. She said to me, “The trouble is that girls get more money at Morrisons than they do doing this, and they get their hours set, so why wouldn’t they go and do something like that?” That was the start of my understanding of just what this means to people. From the other side, I have seen constituents and members of my family receive 15-minute home visits, which are not enough to get someone up, washed, dressed and fed. It is barely enough time to have a proper conversation, which causes problems for people who are left isolated in their own home.

Many hon. Members have spoken powerfully about how home carers are undervalued, underpaid and undertrained. Undervalued because they do not even get the dignity of having a decent contract—nationally, there are more than 300,000 care workers on zero-hours contracts. Underpaid because up to 220,000 care workers do not even get the minimum wage, let alone the living wage, when they are doing some of the most vital work in looking after people whom we care for and love, and who brought us into this world. And undertrained because around a third of care workers receive no ongoing training, yet they are doing some of the most vital, intimate and personal tasks.

We are seeing low staff morale and high turnover of around 20% to 30% annually. Vulnerable people do not even know who is going to come in and help to get them out of bed or take them to the toilet. I would want to know who is coming into my bedroom to get me out of bed, yet that is not the experience of many people. It is not just that the present situation is not good for care workers; it is not good for the people who use care or for taxpayers, either.

We are seeing ever-increasing numbers of elderly people ending up going into hospital when they do not need to be there, and getting stuck there, too. Delayed discharges from hospital are at their highest ever rate, costing more than £260 million in the past 12 months. That would pay for 37,000 people to have a whole year’s worth of home care. Where on earth is the sense in that?

Like my right hon. and hon. Friends, I believe that the Government are not doing enough to tackle the problem. Many hon. Members spoke about the new guidance for local authorities to look at whether their service providers are paying their staff below the minimum wage. I do not think that that is anywhere near strong enough. “Should” needs to be “must”. If people are not paying what they are legally required to, enforcement should be much tougher. It was a profound mistake for the Government to remove the Care Quality Commission’s role in assessing the quality of council commissioning. If the CQC was able to assess whether local councils were commissioning care properly, that would be a key thing to check them on.

In July, the Public Accounts Committee, chaired by my right hon. Friend the Member for Barking (Margaret Hodge), said that it was

“astonished that...seemingly little has been done to rectify”

the scale of non-payment of the minimum wage in the care sector.

In April this year HMRC replied to a freedom of information request that I submitted. It said that half of all the care providers that it had been investigating—more than 100 employers—had been failing to pay the minimum wage in some form, and that more than £1 million was owed to workers. Imagine that. If anyone had stolen—that is what this is—£1 million, action would be taken. I am disappointed that Ministers and HMRC have not named the providers involved. Despite the Minister saying that providers should be named and shamed, that simply has not happened in the care sector. I hope the Minister will explain why not.

Several hon. Members said we need to make sure that HMRC proactively looks at the underpayment of the minimum wage and not simply wait for care workers to ring the pay and work rights helpline. Only 19 workers did so in 2012-13. We know they are not being paid, but they are busy. They are rushing round. They have lives to live. We should have much more proactive measures.

[Mr Anderson]

My hon. Friend is absolutely right. People are busy, but they are also frightened. They have no protection. Employers have complete control over their lives with zero-hours contracts. If people complain, they will not get any more work. That is the truth.

[Liz Kendall]

My hon. Friend is absolutely right. I was going to come to that point. If someone is on a zero-hours contract, they will be too terrified to tell their employer that they are not paying the minimum wage. I am not yet convinced that the Minister is working closely enough with Ministers in the Department for Business, Innovation and Skills. According to an answer to a written question from my hon. Friend the Member for Stockton North (Alex Cunningham), the Minister has had just one meeting all year with BIS to discuss underpayment of the national minimum wage in the care sector. That is not good enough. We need more action.

Several of my right hon. and hon. Friends rightly said that £3.5 billion has been cut from local council adult social care budgets. Within that context, the pressures are building.

[Paul Burstow]

The hon. Lady and her Front-Bench colleagues want to convey the impression that in seven months’ time they will be in government and therefore making decisions about the allocation of resources for adult social care. Will she share her thinking?

[Liz Kendall]

I will, and I will come on to the extra money that we have committed to putting into health and social care. We are committed to a £2.5 billion transformation fund that will cover both the NHS and social care, and that includes money to pay for 5,000 home care workers. So we have said what we will do in addition to the ring-fenced money to try to kick-start the services in the community that patients and taxpayers need.

We have put care issues and exploitation in the care sector at the heart of our agenda. Baroness Denise Kingsmill conducted an excellent review for us on exploitation in the care sector. I encourage all Members to read it if they have not had a chance to do so already. She has set out tough, credible and realistic proposals, including on how to properly enforce the minimum wage, ban exploitative zero-hours contracts and end inappropriate 15-minute visits. She has called for better training for care workers and also for managers of care providers—that is essential—as well as support for ethical care charters such as that which Unison has promoted.

I want to say a little about what I saw yesterday, which was an inspiring example of a Labour council in Islington putting ethical care into practice. Yesterday I helped to launch and celebrate its new home care service contracts. Those will ensure that all home care staff are paid the London living wage—£8.80 an hour now, rising to £9.15 in January—including for travel time. Exploitative zero-hours contracts have been banned, and people are guaranteed a minimum of 16 hours a week.

The council is also giving far more say to the users of services so that they can decide how and when their hours of care will be provided, and, unless they specifically request a 15-minute visit, such visits will be ended, too. The changes to the contracts will benefit more than 500 home care workers, 9 out of 10 of whom are women. I met one yesterday, called Mary. When I talked to her about the difference the changes will make, she said, “It might not sound a lot for some people, but it means I can pay for my kids’ school lunches and make sure they have a decent hot meal in the evenings.” The changes will also benefit the 900 people whom the home care workers care for.

A Labour Government will back the actions of councils such as the Labour council in Islington. We will increase the fines for non-payment of the minimum wage to £50,000. We will champion the payment of the living wage through “make work pay” contracts, which give a tax break of up to £1,000 per worker to every company that signs up to the living wage. We will end the exploitative use of zero-hours contracts, too. As part of our £2.5 billion transformation fund, we will provide extra funding to support changes in the community and the services provided there, including 5,000 more home care workers.

I will end on a point that Islington council made. The changes cost the council more, but we have to think about the cost of not doing it: the cost to the NHS of avoidable emergency admissions and delayed discharges, and the cost to the taxpayer of people having to have their pay topped up when they want to be earning a decent living wage. There is a different way. Islington has shown the way. We will back its efforts and make sure we have a decent care system for those who work in it, those who use it, and all the families that rely on it.

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

It is a pleasure to serve under your chairmanship, Mr Robertson. I congratulate the right hon. Member for Oxford East (Mr Smith) on securing this debate on an incredibly important subject. I agree with him and the hon. Member for Strangford (Jim Shannon) that there are many great providers of care out there and vast numbers of extraordinarily dedicated care workers. Like the shadow Minister, I went out with a domiciliary care worker in London a while ago. He was from Sardinia, which makes the point that very large numbers of people from other countries, primarily from across the European continent, work in our care system. Without them and the dedicated work of care workers, the system would not survive. We should remember that in our debates about the movement of workers around Europe. Our health and care system depends on those dedicated workers, and the man I saw from Sardinia was a very impressive and dedicated man. He was earning a low income and not being paid for travel time between the stops in his working day, which I totally agree is completely unacceptable and a disgrace. I will come back to that issue a little later.

It is also important that we celebrate great care. I went to the first ever awards ceremony in my county of Norfolk that celebrates examples of fantastic care, and to see care workers who hitherto have never been recognised for the amazing work that they do was inspiring. Every part of the country should have similar exercises to acknowledge and celebrate great care.

Secondly, I wanted to comment on the point made by the right hon. Member for Oxford East that sometimes—indeed, quite often—the only companionship that people receive is from the paid care worker who visits their home once or twice a day. Does that not say that there is something profoundly wrong about our society, and if so, do we not all have to recognise that that must change? I have said this before, but we have inadvertently become a rather neglectful society. As our extended families have been dispersed far and wide, often older people are left rather stranded, living on their own, sometimes many miles—often, indeed, hundreds of miles—away from their loved ones. It is not a good society in which the only people seen by those older people are those who are paid to deliver care to them. The wider community and neighbours need to play a part in addressing this massive challenge that we face, whoever is in Government. There is absolutely a role for the total professionalism of paid staff, but the wider community must play its role, too.

There are amazing schemes such as the Cornwall pioneer project, in which volunteers work alongside GPs to combat people’s loneliness. There is also a brilliant community organisation called Friends and Neighbours in Sandwell, in the west midlands. That is a network in the poorest community in the west midlands, and yet volunteers give of themselves, and give companionship to people to give them their lives back. Those volunteers play a part in meeting this massive challenge we face.

Thirdly, part of the answer is for care workers to be far more embedded in joined-up and integrated teams of health and care workers. The work in Islington that the shadow Minister referred to is another of the brilliant and inspiring integrated care pioneer projects that join up health and care services and enable care workers to work alongside nurses, so that they recognise that they can possibly go on to become a nurse or a health care worker. Such projects give care workers a status and professionalism that they deserve, which can play an incredibly important part in this process.

Fourthly, I commend to right hon. and hon. Members an example from my county. The GP practice in the village of North Elmham, in the middle of Norfolk, has set up a social enterprise that provides domiciliary care to a widely dispersed rural area. As it is a social enterprise, it is able to pay its staff better. When staff stay and demonstrate reliability, they receive more pay. The consequence is that people know who their care worker is, there is continuity of care, and there is not, as the shadow Minister suggested is too often the case, a situation in which someone different turns up each night. I had a case—indeed, it involved Care UK—of an elderly lady finding a different man turning up each night to shower her, which was an assault on her dignity. The concept of locally based social enterprises, tied in closely to GP practices, seems to be an attractive way forward.

Fifthly, there is the issue of pay. To start with, I will say that Unison is right to campaign on pay; I support it in doing so, and I am very happy to work alongside it. The right hon. Member for Oxford East and others made the point that it appears that 220,000 people in the care sector are being paid below the minimum wage. That situation is completely unacceptable, and I hope that all of us in Westminster Hall today acknowledge that we find that practice to be totally unacceptable.

However, it was this Government who decided that Her Majesty’s Revenue and Customs should carry out a dedicated push in this sector to root out employers who are breaking the law in that respect. Indeed, I can confirm to the shadow Minister that I have specifically asked for a further dedicated focus on the care sector, because it is absolutely needed.

[Liz Kendall]

I am glad that that work is continuing. However, the Minister has said several times in the newspapers that care companies that do not pay the minimum wage should be named and shamed, and yet that has not happened. Why not?

[Norman Lamb]

I am grateful to the shadow Minister for raising that issue. When I was a Minister in the Department for Business, Innovation and Skills, I specifically pushed for a change in the rules to make it easier to name and shame poor employers. That process was not completed by the time I left BIS to go into the Department of Health, but I continue to push for it. Indeed, the rules were changed, so that whenever there is a notice of underpayment of the minimum wage, the employer is named.

There is a complication in the care sector, in that arrangements are often quite complex and reaching a final decision often requires an investigation to be carried out. However, I can assure right hon. and hon. Members that I anticipate the naming of poor companies within this sector in the relevantly near future. I totally support that process; there should be no hiding places for employers who break the law in that way.

Oral Answers to Questions

Liz Kendall Excerpts

Tuesday 21st October 2014 Commons Chamber

[Mr Speaker]

Order. The hon. Member for Caerphilly (Wayne David) is normally a very calm and reserved fellow—almost statesmanlike. This curious behaviour is quite out of character. He should take some sort of sedative. The hon. Member for Cardiff South and Penarth (Stephen Doughty) can probably advise him.

[Liz Kendall (Leicester West) (Lab)]

With hospitals set to be £1 billion in the red this year, the Secretary of State should be getting a grip of NHS finances. Instead, he is starting on yet another reorganisation. First, he put NHS England in charge of commissioning primary and specialist care. Now, NHS England wants to hand this back to clinical commissioning groups. Ministers have already wasted three years and £3 billion of taxpayers’ money. How much will this Secretary of State’s second reorganisation cost?

[Mr Hunt]

It is lovely spin from the party that carried out nine reorganisations in 13 years. The difficult truth for the Labour party is that this reorganisation that they fought so hard against has been a success. We are saving this Parliament £5 billion. We have reduced the number of administrators by 19,000. We have hired 10,000 more doctors and nurses with the money, and the result is that our NHS, in very difficult circumstances, is doing nearly a million more operations every single year. That is something that we on both sides of the House should welcome and be proud of.

NHS Services (Access)

Liz Kendall Excerpts

Wednesday 15th October 2014 Commons Chamber

[Liz Kendall (Leicester West) (Lab)]

It is a pleasure to close today’s debate and to follow my hon. Friend the Member for Luton South (Gavin Shuker), who spoke very powerfully. In fact, hon. Members on both sides of the House have spoken with great passion and commitment about the NHS and the vital role it plays in their constituents’ lives and in their families’ lives. Many hon. Members, including the hon. Members for South West Devon (Mr Streeter), for Bosworth (David Tredinnick) and for Morecambe and Lunesdale (David Morris), have rightly praised NHS staff for working tirelessly to deliver good quality services despite all the challenges they face.

However, we have also heard countless examples of what the Alzheimer’s Society, the Multiple Sclerosis Society, the Royal College of Nursing, the Royal College of Midwives, the Royal College of General Practitioners, the Royal College of Physicians, the Royal College of Paediatrics and Child Health, the British Medical Association and many others said in their letter to The Independent last week. It stated that

“Signs of a system buckling...are everywhere…The NHS and our social care services are at breaking point and things cannot go on like this.”

We heard from my hon. Friends the Members for Corby (Andy Sawford) and for Worsley and Eccles South (Barbara Keeley) about how more and more people are struggling to get an appointment with their GP, with one in four waiting at least a week and thousands waiting more than two weeks.

Hon. Members, including my hon. Friend the Member for Nottingham South (Lilian Greenwood), spoke about how the huge cuts to local council care budgets mean half a million fewer older and disabled people, some of the most vulnerable people in society, are getting vital services, such as home care visits or home adaptations. This is leaving their families struggling to cope and to pick up the pieces.

Fewer services in the community mean that increasing numbers of frail, elderly people end up ringing 999, going to A and E and getting stuck in hospital when they do not need to be there, causing them and their families distress and costing the taxpayer far more. Ambulance services are under huge pressure, as my hon. Friend the Member for North Durham (Mr Jones) said. Hospital A and Es have now failed to meet the Government’s lower four-hour waiting target for 63 weeks in a row. A and E performance over the summer has been worse even than at the height of last winter. Delayed discharges from hospital are at a record high and cost more than £250 million in the last 12 months alone—money that could have paid for a year’s home care for 37,000 older or disabled people. Where on earth is the sense in that?

Rising emergency admissions and delayed hospital discharges mean planned operations are going backwards, too. More than 3 million people are now on the waiting list. The 18-week maximum wait target has been missed for the last two months in a row, and the NHS has missed the 62-day wait for vital cancer treatment—

[David T. C. Davies]

Will the hon. Lady give way?

[Liz Kendall]

I will not. [Interruption.] If the hon. Gentleman is going to talk about Wales, 90% of patients get their treatment within that target, compared with 84% here, so let me save him some time and bother.

The Government’s failure to keep people out of hospital and keep waiting lists under control, means the NHS is facing a looming financial crisis, too. Two-thirds of all acute hospitals are already in deficit to the tune of £500 million. They predict they will end the year £1 billion in the red, piling on the pressure for even greater service cuts and worse standards of care in future.

The tragedy is that it did not have to be this way. After 13 years of investment and reform, the previous Labour Government left the NHS with the highest ever patient satisfaction rates and the lowest ever patient treatment waits. But we were not complacent. We understood that the NHS had to face up to even bigger challenges: our ageing population, the increase in long-term conditions and huge medical advances, at a time when there is far less money around. For that reason, we had a plan in every region to reform front-line services, through Lord Ara Darzi’s NHS next stage review, by delivering some services in specialist centres so that patients got expert treatment 24/7 and by shifting other services out of hospitals and into the community. It was a move towards prevention joined up with social care to help people stay living at home. Instead of going ahead with our reforms, however, the Government scrapped them and forced through the biggest backroom reorganisation in the history of the NHS, wasting three years of time, effort and energy, and £3 billion of taxpayers’ money that should have gone on patient care.

The Health Secretary told the House today, and said on the “Today” programme, that the Government had saved £1 billion.

[Mr Jeremy Hunt]

The NAO said it.

[Liz Kendall]

I actually picked up the copy of the report he left behind, and I found his highlight. It reads:

“The estimated administration cost savings outweigh the costs of the reforms”,

but it does not mention the £1 billion figure. In fact, paragraph 4.10, on the reliability of the Department of Health, states “we found…limited assurance” in the figures. It also states that

“strategic health authority staff did not verify the figures submitted to them by primary care trusts”

and that it

“saw no evidence that the”

Government

“challenged these figures.”

Far from being independently verified, as the Health Secretary claims, they have been made up on the back of an envelope. [Interruption.]

Government Members can complain, but we have constantly argued that the NHS reorganisation has been the single biggest mistake made by the Government, and now we find out that members of the Cabinet agree. An ally of the Chancellor told The Times:

“George kicks himself for not having spotted it or stopped it”.

A former No. 10 adviser says that

“no one apart from Lansley had a clue what he was really embarking on—certainly not the prime minister”.

So we have a Chancellor, who is meant to safeguard public money, failing to stop billions of pounds of waste and a Prime Minister who claimed the NHS was his top priority, but was too confused or complacent to bother to understand his own plans. The Conservative party still does not get it. One Downing street adviser is quoted as saying:

“A lot of work had gone into persuading people that David Cameron believed in the NHS, had personal experience and cared about it. Then the Conservatives came in and forgot all about reassurance. Lansley managed to alienate all the professional people in Britain who were trusted on the NHS.”

The Government’s NHS reorganisation was not just terrible politics; it is terrible in practice for patients, taxpayers and NHS staff. I remind hon. Members that the Health and Social Care Act 2012 did not just create 221 CCGs, 152 health and wellbeing boards, NHS England, Public Health England and Health Education England; it also created four regional NHS England teams, 27 local area NHS England teams, 16 specialist commissioning units—well, there were 19, but at least two have already been merged—and 10 specialist commissioning units. That is on top of Monitor and the Care Quality Commission. It is a system so chaotic and confusing that no one knows who is responsible or accountable for leading the changes patients want and taxpayers need.

And now, just when we thought it could not get any worse, another major new reorganisation is under way. NHS England was commissioning primary care and specialist services, but in May it announced it wanted to give primary and specialist commissioning back to CCGs to try and patch up the fragmentation created by the Government's own plans. How much will this second reorganisation cost patients and staff?

Patients, staff and taxpayers cannot afford another seven months, let alone another five years, of this Government. They need a clear plan to restore care standards and restore care services so that they are fit for the future. Opposition Members would use the savings from scrapping the cost of competition in the NHS to guarantee new rights for patients to see their GP at a time that is convenient for them. We would raise £2.5 billion from a mansion tax, clamping down on tax avoidance and a levy on the tobacco companies to fund more GPs, nurses, midwives and homecare workers to transform services, particularly in the community. We will support carers with new duties on the NHS to identify family carers, a single point of contact for information and services and ring-fenced funding for carers’ breaks. Our plan for whole-person care would ensure the full integration of physical and mental health and social care services into one service with one team to meet all of a person’s needs.

At the next election, there will be a real choice on the NHS: a choice between care going backwards and money wasted under the Conservatives or Labour’s plans to fully join up services to get the best results for patients and the best value for money. It will be a choice between the Conservatives who have broken their promises to protect the NHS, throwing the system into chaos and blaming staff, or Labour who will make the real reforms we need so that people get personalised care in the right place at the right time. It will be a choice between the Conservatives’ unfunded plans to cut taxes for the wealthiest or Labour’s fully funded plans to reform the NHS and care services on which we all rely. I commend the motion to the House.

Regulatory Reform

Liz Kendall Excerpts

Tuesday 9th September 2014 Commons Chamber

[Liz Kendall (Leicester West) (Lab)]

The draft order makes important changes, so I welcome the fact that we can debate it properly on the Floor of the House. Hon. Members will forgive me if I say that the reason we are here today is to try to clear up yet another problem created by the Government’s NHS reorganisation and by the Health and Social Care Act 2012, which will go down in the annals of parliamentary history as one of the worst pieces of legislation this House has ever seen.

[Richard Fuller (Bedford) (Con)]

Will the hon. Lady give way?

[Liz Kendall]

No. I will make some progress. The hon. Gentleman may want to listen to what the Secretary of State for Health admitted in a letter to the chair of Healthwatch England on 11 August:

“The Health and Social Care Act, when it established CCGs, did not make provision for CCGs to form joint committees and other CCGs. PCTs previously had this provision in legislation and many formed joint committees to progress partnership work.

Health organisations, including CCGs, have expressed concerns about CCGs’ inability to form joint committees that are able to make binding decisions. This inability has brought many practical challenges in working together on issues that cut across boundaries, such as continuing healthcare, patient specific funding requests and service change”

across the country. I do not know whether the Minister wants to explain why the Health and Social Care Act removed that provision, as the Health Secretary admitted in the letter to Healthwatch England. Does he want to stand up? If not, I will make some progress.

The Minister was fortunate not to be on the Committee that looked at the Health and Social Care Bill twice, so he will not know that Opposition Members repeatedly warned during its passage that CCGs would often be too small to secure effective changes to services across wider areas. We have consistently made it clear that the only way we can get the big changes we need to be able to improve care for patients, including by specialising some services in regional centres and shifting others out of hospitals into the community and towards prevention, is by working in partnership across larger areas.

In principle, we support the need for collaboration and for CCGs to come together both with one another and with NHS England, particularly in wanting to commission good services across primary, secondary, community and specialist care. However, serious concerns have been raised about the draft order by local healthwatch organisations, Healthwatch England and some of the organisations that responded to the consultation, and my hon. Friends may want to raise real concerns. I will go through the concerns in some detail.

The Minister has talked about the fact that CCGs will remain autonomous, but many of them are concerned that that is not written into the draft order. Many CCGs feel that they are coming under increasing pressure from NHS England and some of its local offices. They are concerned that the draft order might take away their autonomy, forcing them into committees and decisions that they do not think are in the best interests of local people.

[Norman Lamb]

Will the hon. Lady give way?

[Liz Kendall]

If the Minister will give me two seconds, before I allow him to intervene I want to read out what NHS Clinical Commissioners—the independent collective voice of CCGs—said in its response to the consultation. It said that it

“would not want the Legislative Reform Order to become a ‘back door mechanism’ for reconfigurations.”

It asked for

“some assurance the change will continue to respect the decisions of CCGs as statutory bodies”,

and it insisted that

“CCGs must not be pushed into shared arrangements with NHS England if it is not in the interests or needs of their population”.

I have heard the Minister’s words about that, but the draft order has not been changed. Perhaps he would like to say more about it.

[Norman Lamb]

It is worth putting it on the record again that this does nothing to change the legal duties of a CCG and nothing to put any pressure on a CCG to enter any arrangement, either with other CCGs or with NHS England. If a CCG feels under pressure, it has every right to resist it, if it feels that to do so is in its interests or those of its local community. This is entirely voluntary. With regard to the legal duties, nothing changes.

[Liz Kendall]

If one of the 22 CCGs in the east midlands, part of which I represent, decided that it did not want to come together to commission one body to perform NHS continuing health care, for example, because it did not like it, could it say no?

[Norman Lamb]

Absolutely. There is nothing in the proposed amendment that could force any CCG to do anything. I suspect that in such circumstances common sense might prevail, as everyone recognises that on something such as NHS continuing health care, collaboration makes a lot of sense, as the shadow Minister indicated, but there is nothing to force anyone to do that.

[Liz Kendall]

Will the Minister also clarify that if NHS England wanted to form a joint committee with CCGs in the area, it could not force them into it?

[Norman Lamb]

This is a good exchange of views. Again, I can confirm that this is about a voluntary arrangement between a CCG or CCGs and NHS England. There is no compulsion at all.

[Liz Kendall]

I am very grateful to the Minister, who has perhaps been much clearer on that point than the Minister in the other place was.

The Minister has been clear that CCGs will not be forced into joint committees, but the second concern relates to majority voting in the committees. He will know that the Regulatory Reform Committee’s report cites a couple of CCGs that have been concerned that

“Joint committees would be able to take majority decisions on behalf of their constituent CCGs and NHS England, and so individual CCGs might find themselves accountable for implementing policies that their members did not consider to be in the best interests of the local population.”

To put it bluntly, if one or two CCGs on the committee disagree, they can be outvoted. Is that the case, and would it be possible for NHS England to have the casting vote on a committee?

[Norman Lamb]

It is helpful to respond straight away on these specific points. Again, I stress, as I think I made clear at the beginning, that it is up to the participating CCGs to determine what voting arrangements should be in place. If they felt that unanimity was required in order to protect the interests of the community they serve, they could make that a condition of entering the joint committee. It is entirely up to the participating CCGs to agree the rules.

[Liz Kendall]

I am grateful to the Minister for that helpful clarification.

The third concern has been raised by the Association of Directors of Adult Social Services and by the Local Government Association. They are concerned that any joint arrangements between CCGs, or between CCGs and NHS England, must be fully aligned with the geographical boundaries and strategies of local health and wellbeing boards. That is not only because we have to get health and social care working together, with council care services and the NHS, but because of accountability issues. Perhaps the Minister will say something about that later.

The last two concerns about the draft order are, for me, the greatest. The fourth is about how the joint committees will be held to account for the decisions they take and how patients, the public, local healthwatch, health and wellbeing boards and Members of this House can know what decisions are taken and hold the joint committees to account, because I understand that they will not be required to meet in public. I raise that concern because it has been raised in two letters from the chair of Healthwatch England to the Secretary of State. In her first letter on 16 July, she wrote:

“I am concerned about the impact this reform could have on the statutory role of local Healthwatch, the integrity of local accountability mechanisms, and meaningful public involvement in decisions about service redesign.”

She goes on:

“Whilst I recognise the important role CCG collaborations can play in the effective commissioning of health and social care and the transformation of traditional service models, I am sure you will agree that it is vital they are accompanied by strong accountability and engagement mechanisms. This is of particular importance given the scale of decisions being made by joint committees, and our anticipation that many more of these joint arrangements will be put in place. Without these safeguards in place, the public are far less likely to understand, or be accepting of, the changes that happen in their community.”

She recommends that the draft order be strengthened, and makes four proposals:

“Ensure CCGs acting in collaborative arrangements have in place adequate mechanisms meaningfully to engage the…community.”

She suggests a

“mandatory non-voting constitutional seat on Committees…for local Healthwatch”

and a

“duty on all lead or co-ordinating commissioners to have due regard to existing local agreed priorities…(including Joint Strategic Needs Assessments and Health and Wellbeing Plans).”

Finally, there should be

“a duty on all lead or co-ordinating commissioners to act within existing local accountability mechanisms”

including local health and wellbeing boards.

When the Secretary of State replied to Anna Bradley, he said he felt that mechanisms for public accountability were in place and that there would be no proposed strengthening of the order. In her reply to him on 20 August, Anna Bradley stated:

“I do not yet share your confidence that the new joint committee arrangements will address our concerns about transparency and accountability.”

The Government said throughout the Health and Social Care Act 2012 and all their reforms that there should be “No decision about me without me”, but the patient and public voice, local and national Healthwatch, has said it does not believe that that strong patient and public voice will be effective under the proposed order. The Minister needs to respond to that.

Finally—this is a particular concern of mine—one decision that joint committees can take concerns individual patient-specific funding requests for things such as NHS continuing health care. Any hon. Member whose constituent has applied for that kind of funding, or funding for a number of different areas, knows that it can be difficult to get to the bottom of those decisions. I had a particular problem with Greater East Midlands commissioning support unit, which manages continuing health care for the 22 CCGs in the east midlands. I have barely been able to get any information out of it about the bad decisions it has taken, and that is a real worry because I am concerned that the joint committees will repeat that. How will we know how those decisions are taken or hold them to account?

[Norman Lamb]

Perhaps the hon. Lady will give me details of that concern in her local area. It is important that we hold the different parts of the system to account, and she should be able to establish the position. I am happy to pursue that matter for her if she would like.

[Liz Kendall]

I am grateful to the Minister. I will forward him my concerns, just as I have done to my local CCGs and the chief executive of NHS England.

To conclude, Healthwatch raised these concerns in relation to a particular issue in Greater Manchester and the Healthier Together project, where 12 CCGS have grouped together to reconfigure services. The local healthwatch is concerned that under the draft order some of the problems it has seen with Healthier Together could be replicated. For example, I understand that governance meetings for Healthier Together started to take place in public only in March 2014. That was after major decisions—such as the model for service reconfiguration—were discussed in a closed session of that committee. The local healthwatch remains concerned about the lack of clarity on planned public involvement in Healthier Together in future, and, like the local healthwatch, Healthwatch England is concerned that the joint committees will not be accountable to patients and the public.

Hon. Members across the House will say that previous primary care trusts were sometimes not open and accountable, and I may have shared some of those concerns. This is a chance to put things right, but I am concerned that the draft order is not strong enough and I know other hon. Members will also raise that point.

--- Later in debate ---

[Norman Lamb]

I am grateful to all Members for their contributions to this debate. Regarding the shadow Minister’s contribution, I am pleased to hear that she is supportive, at least in principle, of this capacity to facilitate greater collaboration at a local level. As my right hon. Friend the Member for South Cambridgeshire (Mr Lansley) said, it is rather ironic that this is all about a reformed health system that has much better clinical and democratic legitimacy than the one we inherited from the Opposition. I notice that no one is out there waving banners demanding the return of the primary care trust. Ultimately, that body had no accountability to the local community—[Interruption.] No, it had no accountability. Its accountability was entirely upwards to the strategic health authority and to the national level.

[Liz Kendall]

That is completely over the top. Sometimes I have had great trouble getting any answers out of my CCG. Sometimes they have been good and sometimes they have been bad. I have also had great trouble getting anything out of the commissioning support unit. The Minister should not paint some super rosy picture of fantastic accountability and patient involvement, as there are still some real issues.

Oral Answers to Questions

Liz Kendall Excerpts

Tuesday 15th July 2014 Commons Chamber

[Norman Lamb]

That is absolutely right, but Sir Simon Stevens took the view that it was essential to get the voluntary sector much more involved in the whole process. There are brilliant organisations such as Mencap and the Challenging Behaviour Foundation which are absolutely committed to achieving change, and the more we can work with them to achieve that change, the more likely we are to be successful.

[Liz Kendall (Leicester West) (Lab)]

After the appalling scandal at Winterbourne View, the Minister promised to stop people with learning disabilities being sent to assessment and treatment units for long periods. He has spectacularly failed: 2,600 people are still in ATUs, including 150 children; more people are now going into these units than are coming out; and half are still on anti-psychotic drugs or subject to physical restraint. Change will only happen with real leadership, but in answer to a parliamentary question, the Minister said he had not even met one of his colleagues at the Department for Communities and Local Government. He must now set a clear, non-negotiable deadline to end this practice in two years’ time and to secure public commitments from the Health Secretary, the Communities and Local Government Secretary and NHS England’s chief executive to make sure it happens.

[Norman Lamb]

I caution against sanctimony, because this scandal continued under the last Labour Government, who did nothing to get people out of institutional care. At least this Government are absolutely committed to changing that. What we discovered is that changing the culture is a lot more difficult than I had hoped, but we are absolutely determined to achieve the change, which is so necessary.

Oral Answers to Questions

Liz Kendall Excerpts

Tuesday 10th June 2014 Commons Chamber

[Mr Hunt]

First, I thank the hon. Gentleman for the work that he does locally, in particular with people such as James Titcombe, who has campaigned extensively to improve the quality of care at Morecambe Bay. I assure the hon. Gentleman that whatever the problems are at Morecambe Bay, we will be transparent and open, and we will make sure that we deal with them promptly. That is why we have had these independent inquiries. We will look closely at what the report says and make sure that we act quickly.

[Liz Kendall (Leicester West) (Lab)]

The College of Emergency Medicine says that the use of agency doctors has become endemic in the NHS, and that hospitals are increasingly relying on more expensive agency nurses, just as Labour warned when jobs and training places were cut. It is clear that NHS finances are going backwards under this Government. Will the Minister now confirm Monitor’s latest figures, which show that annual spending on agency staff in foundation trusts has soared to £1.4 billion, a staggering 150% higher than trusts planned at the beginning of the year, and will he explain how that makes any financial sense?

[Mr Hunt]

Let us look at why the number of agency nurses has increased. It is because trusts have responded to the Francis report, published just over a year ago, and are seeking to end the shocking under-staffing of wards that was endemic under the last Labour Government. Of course we want people to recruit full-time nurses on proper contracts, and that is happening. That is why we have 3,000 more nurses—not agency nurses, but proper full-time nurses on proper NHS contracts—than when the hon. Lady’s Government were in power, and we will continue to make progress.

Health

Liz Kendall Excerpts

Monday 9th June 2014 Commons Chamber

[Liz Kendall (Leicester West) (Lab)]

We have had a wide-ranging debate. I listened carefully to the powerful speech by the right hon. Member for North Somerset (Dr Fox)—I am sorry he is not in his place—on his concerns about Russia, which I share, and to the thoughtful contribution made by my right hon. Friend the Member for Neath (Mr Hain) about the Government’s pension reforms. I for one am sorry that this will be his last contribution in a Queen’s Speech debate and he will be sorely missed by Members on both sides of the House.

The main focus of the debate has been the NHS and social care. My right hon. Friend the Member for Newcastle upon Tyne East (Mr Brown) and my hon. Friends the Members for Mitcham and Morden (Siobhain McDonagh), for Ilford South (Mike Gapes), for Hammersmith (Mr Slaughter), for Wythenshawe and Sale East (Mike Kane) and for Middlesbrough South and East Cleveland (Tom Blenkinsop) spoke passionately about their local services and the pressures they face. Those pressures are being experienced by services across the country as our population ages and more people are living with long-term conditions, and the biggest challenge facing us is to reform front-line services to get better results for patients and better value for taxpayers’ money when there is far less money around.

Some services must be provided in specialist centres so that patients get expert treatment 24/7, but there must be a fundamental shift in other services out of hospitals into the community, focused on prevention and joined up with social care so that people can stay healthy and living independently at home. The last Labour Government had plans to deliver these changes in every English region through Lord Darzi’s NHS next stage review, and the single biggest mistake by this Government on the NHS was to scrap those plans and instead waste three years and £3 billion on the biggest backroom reorganisation in the history of the NHS.

Ministers do not want to talk about their reorganisation and their failure to make the real reforms that patients will need in the future. The Queen’s Speech should have included a Bill to modernise the regulation of doctors and nurses, in order to improve the safety and quality of care. That was recommended in the Francis report, it is what the General Medical Council and the Nursing and Midwifery Council want, and it is what patients desperately need, but Ministers have failed to deliver. They are desperate to avoid another NHS Bill after their disastrous Health and Social Care Act 2012, especially in the year before a general election, but let me remind hon. Members of the mess made by that Act.

Ministers said they would cut bureaucracy, but instead they created 440 new organisations: NHS England; Public Health England; Health Education England; four regional NHS England teams; 27 local area teams; 19 specialist commissioning units; 221 clinical commissioning groups; and 152 health and wellbeing boards. It is a system so confusing and dysfunctional that no one knows who is responsible or accountable for leading the changes that patients want and taxpayers need to ensure that the NHS is fit for the future.

Ministers promised that their reorganisation would save money, but £1.4 billion has been spent on redundancy payments alone and more than 4,000 people who were made redundant have now been rehired somewhere else in the system. And as if this chaos and confusion was not bad enough, the new chief executive of NHS England says there has got to be yet more change, with yet another reorganisation of specialist commissioning, because costs have spiralled out of control, and a reorganisation of NHS England’s regional and local area teams. As my right hon. Friend the Member for Leigh (Andy Burnham), the shadow Health Secretary, said, this truly is the reorganisation that never ends.

The real cost of the Government’s failure on the NHS does not stop with their reorganisations. Labour Members warned that handing responsibility for local GPs to a national quango such as NHS England, scrapping the 48-hour waiting target and removing Labour’s incentives for evening and weekend appointments would mean GP services going backwards and, as my hon. Friends the Members for West Ham (Lyn Brown) and for Scunthorpe (Nic Dakin) said, that is exactly what has happened. A quarter of all patients now say they cannot get a GP appointment in the same week, let alone on the same day. We warned that cancer care would go backwards when the Government abolished vital cancer networks, and that is exactly what has happened. Two weeks ago, the NHS missed the cancer waiting time target—the first time any cancer target has been missed since 2009. We warned that disproportionate cuts to mental health services would mean worse care for patients and extra costs elsewhere in the system, and that is exactly what has happened. Patients are being sent hundreds of miles away because there are not enough beds locally, causing them and their families terrible distress and costing taxpayers millions of pounds extra.

We warned that slashing council care budgets was a false economy that would mean fewer elderly and disabled people receiving the support they need, forcing them into hospital and piling pressure on families and local A and E units. As my hon. Friends the Members for Worsley and Eccles South (Barbara Keeley), for South Shields (Mrs Lewell-Buck) and for Westminster North (Ms Buck), as well as the hon. Member for Newton Abbot (Anne Marie Morris), rightly said, that is exactly what has happened. Fewer elderly people are getting vital help, such as home care visits or support from district nurses, so more of them are ending up in hospital and getting stuck there for longer.

We have had the worst year in A and E for a decade, with a million people waiting for more than four hours. Delayed discharges are at their highest ever for this time of year. These delays cost £268 million last year, which could have paid for 20 million hours of home care. Where is the sense in that?

Rising emergency admissions mean planned operations are going backwards too. Three million people are now on hospital waiting lists, which is up by half a million people since 2010. Last year, 64,000 operations were cancelled—the highest figure in a decade.

The combined effect of the Government’s disastrous reorganisation and their incompetent decisions means that Ministers have lost a grip of NHS finances too. This year, trusts are in deficit for the first time in seven years, and twice as many foundation trusts will be in deficit compared with last year. The NHS trust deficit will be three times higher than they predicted even at the beginning of this year. The real tragedy is that all that could have been avoided if Conservative Ministers had not been blinded by politics and ideology and if Liberal Democrat MPs had had the guts to oppose them.

The truth is that there was nothing on the NHS in the Queen’s Speech because the coalition Government have no plan and no idea how to solve the problems they have created. In contrast, a Labour Queen’s Speech would repeal the Health and Social Care Act so that services can work together in the best interests of patients and get the best value for taxpayers’ money. A Labour Queen’s Speech would use savings from scrapping the costs of competition to guarantee new rights for patients to see their GP at a time that is convenient for them. A Labour Queen’s Speech would end the scandal of inappropriate 15-minute home care visits and exploitative zero-hours contracts so that elderly and disabled people get the quality of care they deserve.

A Labour Queen’s Speech would deliver the real reforms that patients and their families need to create one health and care system and ensure truly personalised care: integration, not fragmentation; wise expenditure, not waste; putting people first, not playing politics with their health and the services families rely on. That is what patients want, what taxpayers need and what our constituents deserve, and that is what a Labour Government will deliver.

Oral Answers to Questions

Liz Kendall Excerpts

Tuesday 1st April 2014 Commons Chamber

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

The evidence from Winterbourne View was utterly shocking. The Mind survey subsequently revealed that restraint is used far too much across the health system. We committed to reviewing the guidance, and I am pleased to say that we will publish new guidance later this week to address the very point my hon. Friend raises.

[Liz Kendall (Leicester West) (Lab)]

The Government’s damaging reorganisation has weakened the grip on NHS finances. Figures slipped out the day after the Budget show that NHS hospitals are in deficit for the first time in eight years, hospital trust deficits are three times higher than they were a year ago and twice as many foundation trusts are in the red. Will the Secretary of State now commit to publishing the final year-end figures for all hospitals in one annual account so that the House can hold him to account for his mismanagement of public money?

[Mr Jeremy Hunt]

It is financially challenging for the NHS, but we will not lose control of NHS finances, as happened under Patricia Hewitt. I remind the hon. Lady that for nine of Labour’s 13 years in office the NHS trusts sector as a whole was in deficit. We are getting a grip of those problems. We will publish the figures she wants, but the reason it has been particularly challenging this year is that hospitals have responded to the Francis report and hired 3,500 additional nurses to ensure that we have proper care on our wards.

Care Bill [Lords]

Liz Kendall Excerpts

Tuesday 11th March 2014 Commons Chamber

Let me deal with some of the very good contributions that have been made to the debate. My right hon. Friend the Member for Charnwood (Mr Dorrell) made a characteristically strong contribution and we should take note of it. The purposes and benefits of the care.data programme, and of joining up and properly putting together patient data, have to be a universal good. What we do not always understand in the health service is how the different parts of the system integrate and join together. My right hon. Friend made it clear that if we want to understand what good joined-up care and good integrated care look like, it is very important that we ensure we have the right data to understand that. If we want to know how we better keep people out of hospital and better look after people with multiple medical comorbidities—my right hon. Friend the Member for Sutton and Cheam (Paul Burstow) discussed that—we need to understand what good care looks like, where we can make better community-based interventions and where we can put in place better care pathways to understand what that good care looks like and ensure we improve patient care. That is one of the overriding benefits and improvements that this system will put in place, and it is long overdue.

[Liz Kendall (Leicester West) (Lab)]

We all want to see better, more integrated care, so why did Ministers not keep a closer eye on the cock-up that has been made with care.data?

[Dr Poulter]

It was very clear, as NHS England has acknowledged, that the communication exercise put forward was not ideal. That is part of the reason why we are debating the issue today. I hope I have brought further reassurance to hon. Members about the fact that the 2012 Act does put in place robust safeguards, which were not in place under the previous Labour Government. We have put in place the safeguards through that Act and through the Government amendments we have tabled.

--- Later in debate ---

[Grahame M. Morris]

I want to make a few points in support of amendment 30, which would delete clause 119 on the basis that the TSA was never designed to deal with reconfigurations across an entire region. Despite the assurances given by the right hon. Member for Charnwood (Mr Dorrell) and Government Front Benchers, the potential remains for this mechanism to be used as a back-door route to making changes and closures at hospitals.

I also declare my support for new clause 16. However, although it would ameliorate the worst parts of clause 119 by ensuring that local commissioners in non-failing areas had a veto over any decisions affecting their trust, it is not, as colleagues have said, a perfect solution.

Clause 19—or, as 38 Degrees and other campaigning groups refer to it, the hospital closure clause—should not stand part of the Bill. I had the honour to serve on the Bill Committee for what is now the Health and Social Care Act 2012 and I attended 39 out of 40 sittings. I missed one because I attended a Health Committee sitting at which the then Health Secretary was giving evidence about NHS England, which was previously called the NHS Commissioning Board, and I did not want to miss that.

I sat through that Bill Committee and listened to the Government’s reasons for their reorganisation. We were told that it would deliver a decentralised service and put power in the hands of clinicians. To be frank, clause 119 makes a mockery of that claim. Far from delivering a decentralised service that puts power in the hands of clinicians, the Secretary of State seems to be seeking to take power away from GPs and local communities in order to further reconfigure the NHS for purely financial reasons.

To suggest that the trust special administrator regime is a natural extension of the existing legislation is a gross distortion. The TSA process was never intended to be used as a back-door way to make unpopular reconfigurations. Potentially, clause 119 could take control of every NHS trust and foundation trust away from the public, leaving no hospital bed in the country safe. It should not stand part of the Bill.

If the Bill is enacted, clause 119 will mean that the NHS in England will face further wholesale, top-down reorganisations. The clause could be used as a method to achieve that. I do not think that anyone in this House wishes that to happen. I am sure that, in their hearts, some Government Members do not want that, and certainly no one in the country voted for it. Our problem is that there would be virtually no accountability to local people.

The successful legal challenge brought by the London borough of Lewisham and the Save Lewisham Hospital umbrella campaign—I pay tribute to their efforts, which have brought about this situation—showed conclusively that the Secretary of State did not have the power to axe Lewisham’s accident and emergency and maternity wards as a solution to problems in the neighbouring South London Healthcare NHS Trust.

Clause 119 is designed to allow the Secretary of State to do what he failed to do in Lewisham—to close down thriving and financially sustainable hospitals on a whim, without full and proper consultation. To suggest, as was said in Committee, that a tokenistic meeting with a local authority overview and scrutiny committee would assuage public concerns does not hold water. We must rebuild trust: we need full and proper consultation with patients and the public, and we need agreements with clinical commissioning groups. I am somewhat surprised at the willingness of Government Members, who have championed the cause of GP-led commissioning, to subvert the role of CCGs in that respect.

[Liz Kendall]

As a fellow member of the Health and Social Care Bill Committee, does my hon. Friend remember that we warned the Government that although there were clearly problems with strategic health authorities, those bodies could take a wider view of the health economy, and that having very new, young and small clinical commissioning groups that are all separate meant that it would be very hard to take such wider views? Does he remember that we warned the Government in those debates, and does he agree that they are doing this top-down reorganisation now precisely because there is no mechanism for delivering wider health views?

[Grahame M. Morris]

I do remember those debates, some of which were very long and acrimonious. I still have the scars on my back. They are a badge of honour, and I am proud to have been in the trenches with hon. Members fighting to preserve our NHS and to save it from the Trojan horse of privatisation.

To return to the matter in hand, the trust special administration process will bring drastic changes to hospital configurations. It represents a move away from the principle of reconfiguration of services on the basis of clinical need in favour of doing so solely on the basis of financial considerations. The justification process starts with the need to save money.

There have been attempts to reassure hon. Members and the general public that the trust special administration process would be enacted only in exceptional circumstances. As in our earlier exchanges about clause 119, hon. Members need to be alive to the situation confronting many NHS trusts, including the fact that about 30 trusts have been identified as being in particular financial difficulties. Those circumstances are not exceptional: come the end of the year and next year, there is a very clear and present danger that they will be not exceptional but normal.

In this situation, the NHS and foundation trusts are struggling, for a variety of reasons, to do more with less. I accept that the burden of the private finance initiative is one of those reasons, but there are others. There have been problems where walk-in treatment centres have closed. NHS spending has fallen in real terms. Almost a third of NHS trusts in England now forecast a deficit at the end of the financial year. There is growing pessimism about the financial health of the NHS, and figures suggest that the number of trusts undergoing the trust special administration regime will grow. As I have said, some 30 trusts have been identified as at risk of closure were clause 119 to be enacted as part of the Bill. Under this Government, it seems that the exceptional circumstances that would trigger the trust special administration process would no longer be exceptional.

I advise hon. Members who want to avoid soon having to take part in campaigns to save accident and emergency or maternity wards in their own constituencies —as has been done by my right hon. Friend the Member for Lewisham, Deptford (Dame Joan Ruddock), my hon. Friends the Members for Lewisham West and Penge (Jim Dowd) and for Lewisham East (Heidi Alexander), and the hon. Member for Stafford (Jeremy Lefroy)—to support Labour’s amendment 30.