NHS Outsourcing and Privatisation

Louise Ellman Excerpts

Wednesday 23rd May 2018 Commons Chamber

[Mr Hunt]

As the shadow Health Secretary knows perfectly well, the way that this House works is that Oppositions often vote against the Government when they disagree with elements of a Bill, but that does not mean that they disagree with the principles of the Bill. I remember the hon. Gentleman’s party voting against the Care Act 2014. That does not mean that they disagreed with the principles behind it.

[Mrs Louise Ellman (Liverpool, Riverside) (Lab/Co-op)]

The circumstances around the recent collapse of Carillion have left Liverpool with an unfinished hospital. Negotiations with a potential new contractor are under way but may require ministerial involvement because of the involvement of other Departments. Will the Secretary of State give me an absolute assurance that he will do whatever he can within his power to ensure that that new hospital is completed as soon as possible?

[Mr Hunt]

I can give the hon. Lady that assurance. I am most grateful to her for raising that issue and reassure her that my hon. Friend the Minister of State responsible for hospitals was at the hospital on Friday, going into detail about how we make sure that there are no delays on that issue.

Medicines and Medical Devices Safety Review

Louise Ellman Excerpts

Wednesday 21st February 2018 Commons Chamber

[Mr Hunt]

I commend my right hon. Friend’s campaigning, but I am afraid I have to disagree with him. This is an important step forward; we are absolutely going to be led by the science—we have to be led by the science—and we are giving Baroness Cumberlege full rein to look at what the expert working group did, and to challenge it if she thinks fit.

[Mrs Louise Ellman (Liverpool, Riverside) (Lab/Co-op)]

The expert working group that the Government set up on Primodos changed its own terms of reference. It refused to look at all the scientific evidence and it did not have the confidence of the families affected. How will the Secretary of State’s proposals be any different?

[Mr Hunt]

This is something for Baroness Cumberlege to consider, but the broader point is right. We have for too long in each of these three cases, and in others as well, had processes that have not had the confidence of patients. That is why we are proposing today not just specific measures on each of the three issues, but a broader look at the regulatory structure to make sure that patients’ voices are louder and we avoid precisely what the hon. Lady said.

Hormone Pregnancy Tests

Louise Ellman Excerpts

Thursday 14th December 2017 Commons Chamber

[Mrs Louise Ellman (Liverpool, Riverside) (Lab/Co-op)]

I raise this important issue on behalf of my constituent, Anne Darracot, and other affected constituents, and because it is a national scandal—the tragedy of babies being stillborn or born with severe foetal abnormalities after their mothers were given the hormone Primodos as a pregnancy test between 1953 and 1975. In many cases, Primodos was handed out in the GP surgery.

There has been a double failure: inadequate regulation and the failure of successive Governments to investigate what happened in an open, comprehensive and acceptable way. Hon. Members have highlighted the flaws in the findings of the expert working group set up by the Commission on Human Medicines, which reported in November this year. Those concerns include the unexplained change in the group’s terms of reference, from assessing the possible association between Primodos and foetal abnormalities to establishing a much-harder-to-prove causal link. They include the questions raised by the group’s selective use of research and the limited evidence that it considered. Nick Dobrik’s categorical denial of the Government’s claim that he, a trustee of the Thalidomide Trust, has approved the report damages confidence in the process.

The significant changes made between the production of the inquiry’s draft report and of its final conclusion undermine trust in the findings. Indeed, the draft conclusion stated that due to scarcity of evidence

“it is not possible to reach a definitive conclusion”.

By contrast, the final published conclusion was that the evidence did not support “a causal association” between the use of Primodos and birth defects or miscarriages. In short, there is no confidence in the working group’s findings.

What is required now? First, we need an admission that the current situation is unacceptable and that the working group’s report is inadequate. Above all, there must now be a judge-led public inquiry to consider all the available evidence. That was first called for by the late, lamented Jack Ashley MP as far back as 28 May 1978. The inquiry must secure the confidence of the people affected, involving them from the beginning in setting up its terms of reference and involving them continually as the inquiry progresses. That is the only way the report produced can have the confidence of the people most affected.

A wide range of witnesses should be called under oath. All research—whether conducted here in the UK, in Europe or internationally—should be considered. More research may be required, but that should not unduly delay the findings and conclusions of the inquiry. Regulatory failure should be part of the investigation. All research must be considered and evidence must be collected and assessed from a wide range of sources. There must be no cover-ups. That is the only way forward. The women and families affected by Primodos are still suffering from their loss. They are still grieving and will not give up. They and all of us deserve no less than the truth.

Health and Social Care Budgets

Louise Ellman Excerpts

Tuesday 14th March 2017 Westminster Hall

[Mrs Louise Ellman (Liverpool, Riverside) (Lab/Co-op)]

I congratulate my hon. Friend the Member for Hackney South and Shoreditch (Meg Hillier) on securing this important debate. I want to draw attention to the crisis in social care in Liverpool. The background is the severe cuts put on a city with a very low council tax base. Some 80% of Liverpool’s properties are in council bands A and B. Cuts to Government funding will reach 68% by 2020, resulting in a £90 million cut in funding for adult social care. The consequences up to now have been a reduction in social care packages from 14,000 to 9,000.

There are two aspects to social care: domiciliary care that enables people to live independently in their own homes, and social care that enables people to be discharged from hospital. Both are equally important. I certainly welcome the announcement of an additional £27 million for Liverpool over the next three years from the £2 billion additional allocation. That money is very important and has staved off an immediate crisis, but it will be eaten up by demographic changes.

For example, the increase in the number of people aged 65 and over will lead to an £8 million increase in cost next year. The increase in funding required to implement the living wage means that an additional £25 million is required by 2019-20. Welcome as that £27 million is, it will be eaten up by those increases. The situation is compounded by an error by the Department for Communities and Local Government in assessing how much funding could be raised from Liverpool’s council tax. I gather that that error has now been rectified, but it confused the situation.

What do we need? Additional funding now is welcome, but we need long-term consistent funding related to need and more integration between the national health service and social care. I recognise the problems that the Chair of the Select Committee, the hon. Member for Totnes (Dr Wollaston), identified, but a move towards integration is essential. Liverpool is innovative and is already trying to do that, but it needs funding and general support from the Government to enable it to work constructively with the NHS.

Social Care (Liverpool)

Louise Ellman Excerpts

Tuesday 7th March 2017 Westminster Hall

[Mr Philip Hollobone (in the Chair)]

Would those who are not staying for the next debate please be kind enough to leave quickly and quietly? I see we have some of Liverpool’s finest in the Chamber.

[Mrs Louise Ellman (Liverpool, Riverside) (Lab/Co-op)]

I beg to move,

That this House has considered social care in Liverpool.

It is a great pleasure to serve under your chairmanship, Mr Hollobone. This is the third occasion on which I have raised the issue of adult social care in Liverpool in this place over the past two months. That is because major cuts in Government funding combined with rising needs are creating a situation where too many people are left feeling vulnerable in their own homes. Scarce hospital beds are occupied by people who are clinically fit to be discharged but cannot leave the hospital because social care is not available. That is bad for those individuals and for the national health service.

I realise that this is a national issue, but the debate puts the focus on the specific challenges that Liverpool and the Liverpool city region face. Mayor Anderson and Liverpool City Council have done their very best to protect the people of Liverpool from the impact of unprecedented Government cuts, but adult social care has not escaped the consequences of the Government’s actions over a long period.

Adult social care covers a wide range of services, including domiciliary support—helping to dress, feed and bathe people in their own homes and, where appropriate, ensure that the correct medication is taken. Depending on the individual situation, that could involve several visits a day to an individual’s home. In other cases, it might require one visit a day, but whether it is one visit or several, it is absolutely essential to allow that individual to lead an independent life. The provision of adequate adult social care enables many people to remain safely and confidently in their own homes, rather than feeling vulnerable or having to move to more expensive and much less satisfactory residential care. Adequate adult social care can bring peace of mind and provide a lifeline.

Let us look at what has been happening to Liverpool City Council’s funding. Liverpool has now lost 60% of revenue support from the Government since 2010, and by 2020 that figure will have risen to 68%. Furthermore, having looked at revenue support systems, the Government plan to eliminate revenue support entirely under a new funding settlement. That will have serious consequences for a city with a low tax base and with 80% of its population in council tax bands A and B.

Liverpool council is a very responsible authority and has already identified £90 million of additional cuts that it is required to make in the coming financial year. The council continues to do its best to protect services, but it has not been able to stop substantial cuts to its spending on adult social care, which has been reduced from £220 million in 2010 to £154 million in 2016. It is anticipated that that figure will be reduced to £130 million by 2020.

Yes, the Government have their better care fund and yes, the local authority has a limited ability to raise an extra precept. The better care programme is expected to allocate £39 million to Liverpool when its funding is due to be reduced in such a significant way, but that will still leave a massive gap. Neither the Government’s better care fund nor the council’s ability to raise extra tax can fill the gap caused by the withdrawal of central Government funding. The scale of that withdrawal is unprecedented.

At the same time as the Government are reducing support, demographic pressures and costs are increasing. The Office for National Statistics estimates that the percentage of people in Liverpool aged 65 years or more will rise from 14.6% in 2015 to 16.1% in 2024. It is wholly unrealistic to expect people in the fourth most deprived local authority in the country to fill the gap. The sums simply do not add up. To illustrate the situation, a 1% increase in council tax in Liverpool will raise £1.4 million; a 1% cut in central Government funding means a loss of £3 million. That is a totally unacceptable situation and one that cannot continue without inflicting severe cuts on services that are very important to the people of Liverpool.

I said that Liverpool was the fourth most deprived local authority in the country, which is correct, and there is great poverty in the city, but Liverpool City Council, through its pioneering spirit, its enterprising approach and its ability and willingness to innovate and work with others has been able to move Liverpool from being the most deprived local authority in the country to that No. 4 position. It is bad to be the fourth most deprived authority, but it is a tribute to the city council and its partners that they have been able to make progress in Liverpool. Furthermore, that progress has been made without proper funding from Government—indeed, Government funding has reduced, and that is the critical feature.

Social care packages in Liverpool have already been cut from £14,000 to £9,000, which has affected many vulnerable people, and many more are anxious. Many people in great need are being reassessed to see whether the care they receive can be maintained, which often induces great anxiety and apprehension, even if ultimately their care remains similar to what it was. That, too, is an important factor that is not always considered.

On the day that I visited the Royal Liverpool university hospital, 135 patients who were clinically fit to be discharged remained in their beds because social care was not available for them at home. That was in spite of the efforts of hospital and local authority staff to find suitable care packages for them—the money was simply not there. That figure, the accurate one for the day I visited the hospital, reflects the general situation and shows one of the problems caused by the cuts to social care in Liverpool. Those cuts have arisen solely because of cuts in Government funding.

The situation affects many people, and it can only deteriorate unless action is taken. What should be done? Let us look at what is happening now. Mayor Joe Anderson, cabinet member Paul Brant and Liverpool City Council as a whole must be commended for their work to promote partnership with the NHS and innovation, which involves new work with the clinical commissioning group and GPs to integrate health and social care. “Step Up” centres for intermediate care are being pioneered and the council plans to promote innovatory joint work with community health services. A joint working party is considering new ideas.

All those things are extremely important and demonstrate the city council’s willingness to innovate and work with other partners. Such work should be supported better by central Government. Whatever innovation takes place in Liverpool and however much the council is willing to work with other people and for integration, Ministers cannot escape the fact that more funding is needed. The issue is long term, but the crisis is now and immediate action is required. It is a crisis that Liverpool City Council cannot resolve on its own, nor can the people of the city fill the financial gap unaided.

I call on the Government to recognise their responsibilities and to announce an immediate allocation of targeted funding for adult social care in Liverpool. I recognise that that must be part of a national approach, but funds must be targeted to meet the needs of local communities. That will enable vulnerable people to live independently and safely in their own homes, as well as enabling the NHS to deploy its resources efficiently. Liverpool City Council should be congratulated on the resilience, innovation and flexibility that it has displayed, but it cannot resolve the crisis alone. I call on the Minister to act as a matter of urgency.

[Mr Philip Hollobone (in the Chair)]

I am required to call the Front Benchers at 5.40 pm and the debate may run until 6.03 pm. That gives us 32.5 minutes of Back-Bench time and three Members have given me their names, the first of whom—who wrote a very nice letter—is Maria Eagle.

--- Later in debate ---

[Mrs Ellman]

I am very pleased that so many of my hon. Friends who represent Liverpool are here today; in fact, we almost have a full house. My hon. Friend the Member for Liverpool, West Derby (Stephen Twigg), although he is abroad with the International Development Committee, which he chairs, is here with us in spirit and in thought. It shows how important the issue is to Liverpool and to the city region. We may dispute specific figures, but there is undoubtedly a massive gap in the funding to meet the needs of people in our area, and the biggest reason for it is the massive and ongoing cuts in Government funding. Whatever individual figures we might dispute, those are the basic facts, and they are not in dispute.

I thank the Minister for much of what he said, for his recognition that there is a problem and for his willingness to meet representatives of Liverpool City Council when he is in Liverpool on Thursday. I accept that invitation on their behalf; I am pretty sure that they will agree. It is a welcome move, but nothing can detract from the fact that we need significant additional funding to make services available to all the people who need them. The problems are in two areas. The issue relating to the NHS and discharges from hospital is very important, but it is not the only issue. Care packages that enable people to live independently in their own homes are essential, but in Liverpool the number of packages has already been drastically reduced from 14,000 to 9,000, and we do not know how much lower the figure will fall.

I was pleased to hear the Minister talk about light and hope—I thought that it was very encouraging—but the first test will be tomorrow in the Budget. I am sure that we will all scrutinise what is said carefully; let us hope that it brings light and hope to the people of Liverpool.

Question put and agreed to.

Resolved,

That this House has considered social care in Liverpool.

NHS and Social Care Funding

Louise Ellman Excerpts

Wednesday 11th January 2017 Commons Chamber

[Mrs Louise Ellman (Liverpool, Riverside) (Lab/Co-op)]

It is important to talk more widely about the NHS—about its importance and its funding and perhaps about its organisation, too—but the purpose of today’s debate is to highlight the current crisis in many parts of our national health service and to ask the Government to do something about it.

Our national health service is undoubtedly highly valued, has dedicated staff and provides excellent services. In many parts of the country it is under pressure, however, and today’s debate calls for specific actions to address that crisis. It calls for more funding for social care now, and for an improved settlement for both the NHS and social care in the next Budget. So in our general discussion about how things might be reorganised and changed in the future it is important not to lose focus on the current problems, and those are the reasons for today’s debate.

There has been a lot of discussion about what is happening in hospitals—that will inevitably be the case, as in many areas there is a crisis in A&E and great pressure on hospital services—but reference has also been made to services provided by our NHS outside hospitals, in the community. It is important that we focus on those as well, not just because they are important in their own right, but because if they are working effectively they can prevent hospital admissions from occurring and improve people’s health. Those services include community health services, which involve GP practices—the bedrock of our NHS—and the nurses, physios and pharmacists. They also include social care, where the NHS has some responsibility, although local authorities, which are under ever-increasing pressure, are primarily responsible.

I am extremely concerned about the cuts that the Government have imposed on community pharmacists. Pharmacists are essential to our NHS. They are part of the NHS, but in the main are privately run. They offer advice as well as specific services, and where pharmacists can give proper advice and services they can often prevent people from having to go to their GP, let alone to hospital. It is a matter of great concern that the Government’s plan for cuts to community pharmacies will put pharmacies in areas such as mine in Liverpool at risk. I also deplore the reduction in independent pharmacies, which provide an excellent service. I ask the Government to think again about their cuts to community pharmacies, which form a vital part of our health service. Once they are closed, it will be far too late. The Government should act now. They should not go ahead with those cuts, which will have a dramatic effect in Liverpool and elsewhere in the country.

I also ask hon. Members to think a little more about what is happening in social care. In Liverpool, we are facing a major crisis in social care, as local authority funding has been cut severely and is to be cut again. Liverpool City Council’s budget has already been cut by 58%, and £90 million of further savings have been demanded over the next three years—half of that to be achieved in the next year. One result of that has been a severe reduction in social care provision: 40,000 social care packages have been reduced to 9,000, and there are many more cuts in the pipeline.

Providing social care is essential not just to enable people to leave hospital when they are healthy enough to do so—although that is important—but to enable them to live a constructive life. Many people are now fearful of possible cuts to their social care packages. They believe that they will be unable to lead a reasonable life in their own home if their essential services are cut. I ask the Government to think again about what they are doing. They tell us that the better care fund is an answer, but that is simply not the case. In Liverpool, £39 million has been proposed for the social care fund for the coming years, but that will simply scratch the surface of the problem. In poor areas such as Liverpool where it is difficult to raise money, a 1% increase in the council tax fund would raise only £1.4 million. Neither of those measures, either singly or put together, will address the looming and very real crisis in social care. I urge the Government to look again at this, rather than offering platitudes about other funding being available. That funding is not there, and there are no plans for it to be there. A new approach needs to be taken to this urgently; something needs to be done.

The subject of mental health has been raised by a number of Members. I should like to mention two instances from my constituency. The first involves someone who can live a reasonable life at home with some assistance, but that assistance has now been withdrawn. Among other things, it involved helping the person to open letters to deal with normal queries, but that has now gone and she is facing great problems.

The second example involves Mr B, who faces very serious mental health conditions. Indeed, he has an incapacitating condition, which means that he cannot work. He was promised specialist help at the Tuke Centre in York, but that offer was withdrawn because it was made in error. That is unforgivable. I have followed this through, and Mr B was promised local treatment, although it was unclear whether that treatment would be appropriate. However, that treatment is not now being offered in the way that was previously suggested. I have followed that up, but 14 months on from the time when Mr B was first offered help for his incapacitating and extremely serious mental health condition, nothing has happened. That is simply not good enough, and I shall be pursuing the matter further.

Those are just two illustrations of how the cruel cuts in mental health services are affecting individuals. I agree that we should perhaps look more generally at funding for our national health service, but the crisis in local services is happening today. The Government are responsible now, and they must act.

UK Ebola Preparedness

Louise Ellman Excerpts

Monday 5th January 2015 Commons Chamber

[Mr Hunt]

That being the case, I will ask the Secretary of State for International Development to write to the hon. Gentleman with her assessment of how satisfactorily that process is handled in Sierra Leone.

[Mrs Louise Ellman (Liverpool, Riverside) (Lab/Co-op)]

Will the Secretary of State tell us more about the support given across all Departments in finding treatments for Ebola, including support for the current trials being conducted by the Institute of Infection and Global Health at Liverpool university under Professor Tom Solomon?

[Mr Hunt]

We are giving strong support to that important work. Our support is being led in the Cabinet Office by my right hon. Friend the Minister for Government Policy and Chancellor of the Duchy of Lancaster, who is bringing together all the Departments that can provide it. The sooner we can obtain a vaccine or a treatment that works, the better, and this could prove to be a very important part of the process of turning the tide.

Ebola

Louise Ellman Excerpts

Monday 13th October 2014 Commons Chamber

[Mr Hunt]

We are absolutely redoubling our efforts, and we are looking at what screening procedures are needed at regional airports. The screening and monitoring procedures that I outlined are starting at Heathrow terminal 1 tomorrow; they will be rolled out progressively across Heathrow, Gatwick and Eurostar terminals over the next two weeks. We are satisfied that that will reach the vast majority of people travelling from the affected countries. Any decision to expand those arrangements to other regional airports will be taken on the basis of the scientific advice that we receive about risk.

[Mrs Louise Ellman (Liverpool, Riverside) (Lab/Co-op)]

Liverpool university’s Institute of Infection and Global Health, and the Liverpool School of Tropical Medicine, have done a great deal of work to address the problem of the transmission of Ebola. Does the Secretary of State’s work involve their recommendations, and do his proposals for combating Ebola, particularly as regards international travel, address the issues that those institutions raise?

[Mr Hunt]

The hon. Lady is absolutely right to say that we have fantastic research on the spread of infectious diseases at a number of institutions in this country, including in Liverpool, and we are not only using that research in the battle that we are leading in Sierra Leone, but making it available to partner countries leading the battle in other parts of west Africa. The advice that I get from my experts, from Public Health England and from the chief medical officer takes full account of the research done in places such as Liverpool.

Oral Answers to Questions

Louise Ellman Excerpts

Tuesday 11th June 2013 Commons Chamber

[Mr Hunt]

My hon. Friend is right. There has been a £600 million real- terms increase in spending, something that the right hon. Member for Leigh (Andy Burnham) said was irresponsible. He will have to do a U-turn on this, and it will be an embarrassing one. He has talked about cuts in every single debate in the House and it turns out that those cuts never happened.

[Mrs Louise Ellman (Liverpool, Riverside) (Lab/Co-op)]

Life expectancy in Liverpool is 10 and a half years less than it is in Kensington and Chelsea. Does the Secretary of State think that he has any responsibility to address that?

[Mr Hunt]

Yes I do, which is why we have published a website today that gives much more detail than there ever has been before about health inequalities. it is why, nationally, the Government have been responsible for a huge amount of initiatives to boost public health, including calorie labelling in restaurants, action on point of sale display tobacco advertising, alcohol unit labelling and a range of other things. We will play our part.

Future of the NHS

Louise Ellman Excerpts

Monday 9th May 2011 Commons Chamber

[Mr Lansley]

The hon. Gentleman will know, because the Minister of State, my right hon. Friend the Member for Chelmsford (Mr Burns) has told him in the past, that when NHS trusts are moving to foundation trust status, there will be an agreement, but it is not about privatisation. When the hon. Gentleman’s party was in government, it said that the only way Hinchingbrooke NHS trust could turn its management around was for it to be prepared to look for the best possible management. That is the extent of what we are talking about, and it was done under his Government.

This will require change. We are not going to spend £5 billion on bureaucracy. We are not going to let the number of managers double in future as it did under Labour, and we are not going to let the number of managers increase six times as fast as the number of nurses. Since the general election, we have 3,500 fewer managers and, as a consequence, 2,500 more doctors and 200 more nurses.

[Mrs Louise Ellman (Liverpool, Riverside) (Lab/Co-op)]

On 19 March, the interim chief executive of Monitor said that under this Bill, doctors talking to providers about health care would be the same as Marks & Spencer talking to their suppliers about which brand of washing powder to buy. Is that the Health Secretary’s vision for the future of the national health service?

[Mr Lansley]

No, not at all, and I do not believe that Monitor believes that either. The hon. Lady can see that the proposal in the Bill is clear. It was the Labour Government who established Monitor as a regulator and who introduced competition into the NHS. The Labour Government did all those things, but Monitor’s job is not to impose competition rules but to deliver what is in the best interest of patients.