Income Tax (Charge)
Marie Rimmer Excerpts(2 weeks, 2 days ago)
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Ms Marie Rimmer (St Helens South and Whiston) (Lab)
This Budget will deliver to communities such as mine. May I begin by welcoming the mineworkers’ pension scheme resolution? It means that £1.5 billion of miners’ pension payments to their fund will be distributed among 112,000 former miners and their families. It is absolutely right that an injustice has been corrected, for those people have waited far too long. It is also shameful that the last Government failed to budget for the resolution of the Post Office Horizon and infected blood scandals, and I applaud our Chancellor for correcting that now. I urge the pensioners who will not receive the winter fuel allowance—those who are just missing out—to apply for universal credit; in St Helens, £6.5 million remains unclaimed. I regret that we have been unable to remove the two-child cap, or deal justice to the WASPI women.
Let me now turn to the issue of local authority funding for adult and children’s social care. Local councils bore the brunt of austerity; successive Government cuts since 2010 have left them in dire straits, which disproportionately affects the people who are most likely to access social care. There have been increasing pressures to find savings, which has not only cut services and jobs but seriously limited the ability to invest in cost-effective preventive services. Some 73% of the budget of St Helens borough council is spent on adult and children’s social care. I welcome the Chancellor’s 3.2% real-terms increase in local government funding, including the £600 million to support social care—
Ms Rimmer
No.
It is good that, in the short term, a Labour Government will target additional grant funding at the councils that are most in need, but that needs to be the start of a process that will reverse years of financial decline. For too long, local council funding formulas have worked against underprivileged communities, and the areas that need funds the most often do not receive their fair share. Sadly, that creates a downward spiral, with an ever-increasing percentage of local government funding being spent on social care. This is not sustainable.
As I have said, 73% of our council’s budget is spent on social care. Moreover, the 48 members of the Special Interest Group of Municipal Authorities are unable to invest in their local areas in the same way as their counterparts because of the funding formulas. One in four households in England live in a SIGOMA council area. At present, social care services are a postcode lottery, and that needs to be addressed. We need a methodology that takes actual needs into consideration, and ensures that the funding follows. However, I applaud the Chancellor for providing £250 million for children’s social care and £600 million for adults.
Hospice Funding
Marie Rimmer Excerpts(7 months ago)
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Mrs Hamilton
I absolutely agree with what my hon. Friend says. We absolutely need those models. As I go through my speech, I will be agreeing with what she has just said.
John Taylor Hospice in my constituency, which is run by Birmingham Hospice, does unbelievably important work to support my constituents and their families in Erdington, Kingstanding and Castle Vale. The staff work day and night to make sure people are cared for while they are ill, and I could not be prouder to support them in this Chamber today. I must add that I have worked there in the past. Birmingham Hospice cares for almost 1,000 local people with a life-limiting illness every day. Last year, it cost more than £16 million to run its services, some 40% of which needs to be recovered through fundraising income. Over the past few years, the hospice has seen a significant increase in costs, including the price of energy, food and vital medicines, and a shortfall in funding for staff pay awards. At the same time, fundraising has declined across the hospice sector with the cost of living crisis hitting poorer areas like mine the hardest.
Birmingham Hospice is currently losing £200,000 a month. With inflationary costs and falling voluntary income, the only option to keep the hospice going is to reduce the services it provides. A reduced service will increase inequality across our city of Birmingham and the country. Sadly, more people will die in hospital or A&E as a result, when they could have had outstanding care at the hospice or at home with the support of the community team.
The hospice is dedicated to ensuring that outstanding care at the end of life is available to all, but it has recently been in the difficult position of having to make essential staff redundant to maintain financial security. That is not just happening in Birmingham; nationally, Hospice UK estimates that 100,000 people in the UK who could benefit from palliative care die without receiving it each year. Hospices play a huge role in alleviating pressure on our NHS, and they do not have the ability to reset their budgets on 1 April each year, as the NHS does. Instead, their deficits continue and the valuable care that they provide to local communities such as mine is at risk of being lost. I have worked in the health service all my adult life. When we speak about hospices, we rarely mention the vital role that they play in providing respite care and support to the family of someone who is ill.
Ms Marie Rimmer (St Helens South and Whiston) (Lab)
I thank my hon. Friend for her wonderful contribution to the debate. Many people want to stay at home—I have stayed with four people right through to their deaths at home—but hospices give a different care from hospitals. If you go into hospital, you might not get into the hospice. We have 10 beds in the most beautiful hospice, which is funded 71% from fundraising. If they are not in a hospice, and they do not have care at home—not everybody can do it at home; they might not have the family to provide the care they need—they can end up in a hospital for hours. Does my hon. Friend find that in her area? They can get triaged in an ambulance outside the hospital, and they do not get the palliative care and support, and their families do not get support—it is a completely different service. Do you agree that we should be looking for more hospice care, not less, but we should not be changing it to a hospital ward? It is a different atmosphere in a hospice. Do you find that is the case? That is not decrying hospitals, but hospital is not somewhere to die.
Mrs Hamilton
I absolutely agree with your sentiments and statement. As was said earlier, we need to move away from looking at individuals to look at population health and how we will support the local community. I will move on swiftly so that I can finish.
My constituency is the fifth poorest in the UK, and our communities are in some of the UK’s so-called left behind neighbourhoods. For places like mine, respite care is so important to ensure that carers get the break and support they need to keep them doing the incredible work that they do.
I am a nurse, and it breaks my heart that the NHS is in the worst state it has ever been in. Throughout the 14 years of this Tory Government, I have seen doctors striking, nurses striking, technicians striking, people queuing around the block for a GP appointment, people pulling out their own teeth, the highest waiting times in history, and complete disdain for the service that quite literally serves us from birth to death. We must have a national care service and we must properly invest in our NHS. It is no longer acceptable for hospices to rely on charitable donations to try to survive. Now more than ever, our hospices and our NHS need a Labour Government.
Rachael Maskell (York Central) (Lab/Co-op)
I congratulate everyone who has spoken in the debate. The House has come together to highlight something that I am struggling with: when people are at their most vulnerable, they are having to beg for money to fund important services. That should not be the case, yet here we are with an NHS that is clearly not functioning and other services are also feeling the pain. The reorganisation of the NHS devolved powers to ICBs, but we must remember that it is the responsibility of the Government to ensure that the structures function. That is not happening at the moment, and our constituents are losing out. A word that keeps echoing in my mind, rolling off our lips as it always does, is the NHS: the “national” health service. Yet we are hearing about a postcode lottery, where different areas have different experiences, with different ICBs funding to different tunes and where you live accounts for how you die. Surely, we are better than that? In the words of one clinician about the extraordinary provision at St Leonard’s Hospice in York:
“Having worked with people at the end of life through my career, I didn’t know care like that was possible.”
However, as with all hospices, if funding is not addressed, such care will not be possible.
It was this Parliament that inferred the duty, through the Health and Care Act 2022, to address the inequality in access to palliative and end of life care, so that everyone can have the best clinical and holistic support possible, if the right funding is stabilised and put in place. Currently, however, we know that many people—Hospice UK says one in four—are not accessing palliative care. That is 150,000 people every year who die without the support they require. That number is set to rise 25% by 2048 and, according to Marie Curie, by 13% in the next decade. This debate cannot just be about what happens now, but what happens in the future.
In York, the hospice ran an £800,000 deficit last year. The hospice at home funding has remained static for the past seven years, while demand has doubled and the ICB has provided just a 1.2% increase. Sue Ryder believes that the real cost increase over the past year was 10%. Hospice UK figures released say there has been an 11% increase for the payroll this year to around £130 million. Martin House, the local children’s hospice, costs £9.9 million to run. With a total income of £8.6 million, it had a £1.3 million deficit. Only 18% of its funding came from the statutory sources, £1.1 million came from the national children’s hospice grant and £700,000 came from the ICB. Hospice UK estimates a £77 million deficit for the financial year just past—the worst for 20 years.
As demand and costs are rising, the funding is not rising to match. As of 12 April 2024, St Leonard’s hospice in York did not know how much money it was getting from the ICB: left to carry all the risk and left to depend on its reserves, and that, of course, not guaranteed for the future. Martin House, which is also using its reserves to expand its services, knows that it will have only six months of reserves. It certainly does not know what is happening with its funding after this financial year.
The children’s sector, yes, has received a grant, but what comes next? We cannot just run our hospices by running marathons and running charity shops. It is driving inequality. In areas of greater deprivation, fundraising is even harder and therefore the hospices are getting even less money.
Ms Rimmer
I thank my hon. Friend for giving way and I thank the hon. Member for Hastings and Rye (Sally-Ann Hart) for securing the debate. It has been a wonderful and sincere debate, but does my hon. Friend agree that there should be more equality between care at home—hospice at home—and care at the hospice? There is no doubt that there is nothing better than care in a hospice—absolutely no doubt. I have nursed four members of my family at end of life, and getting clinical support at home when it was needed was always a problem—my brother had to search for morphine at night. Does she agree that staff are funded even less and are on the minimum wage?
Rachael Maskell
I am really grateful to my hon. Friend for raising those points and I will come on to the issue of hospice at home. We know it is absolutely vital that people can choose where they die. Not everyone wants to die in a clinical setting—indeed, a hospice is barely a clinical setting—but many choose to die at home and they should be able to receive the care they need. She is right. We must have integration with the rest of the NHS. A district nurse may not be able to push palliative care to the extent that a palliative care specialist would in providing pain relief and the support somebody needs at the end of life at home. We need it to be timely and we need to ensure it is fully funded. The Health and Social Care Committee found that when it visited Royal Trinity hospice, as part its assisted dying inquiry. The point was made that we need to ensure we have the training so that clinicians have the competencies and the confidence to administer the pain relief and the palliative care that is necessary, and to ensure that the service is available universally. It is not and that must be addressed.
In York, of the 1,000 people who benefited from St Leonard’s hospice last year, 50% received hospice care at home. That number will grow over time and we need to ensure those services are there as they are needed. Of course, we know that if people are not on that pathway they end up in the acute service. They are put through the trauma of A&E, costing the NHS goodness knows how much, and then they do not get the care they need. Trinity Hospice talked about what it was doing to divert people away from that pathway and into proper care, either at home or within its wider services. There is much still to secure on that front.
If I may, Mr Deputy Speaker, I will raise just one more major point before I close, which relates to inequality. We know there is real inequality at the end of people’s lives. Some of it is based along socioeconomic lines, and some of it is emphasised within minority communities. We need to deal with that to ensure we have universal provision, address the death literacy of our nation, and ensure the support is there when it is needed. I am particularly concerned about the lack of comprehensive funding for our palliative care services.
I urge the Minister to look at funding staffing costs, which are 69% of all funding. It has been suggested by Marie Curie that 70% of funding come from the state, and I think that is about right. We can phase that in, but we need to ensure we address the inequality that is driven through the system. We need to put in the research that is needed, so there is better data on who is accessing care and who is not, and we need to ensure that we are pushing palliative care as far as we can. If we do not, and we debate assisted dying, I am worried that people will be fearful that they will not be able to access the care that could be possible should that service be properly funded. I really urge the Minister to make that a priority before that debate takes place. Mr Deputy Speaker, I will end on that point.
Future of the NHS
Marie Rimmer Excerpts(1 year ago)
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Ms Marie Rimmer (St Helens South and Whiston) (Lab)
It is a pleasure to serve under your chairmanship, Mr Pritchard. I pay tribute to my hon. Friend the Member for Wirral West (Margaret Greenwood) for securing this vital debate today. I also wish to pay tribute to all those who work in St Helens South and Whiston hospitals and those who work in social care for St Helens Borough Council, as well as all the other agencies—police, housing—involved in our health and social care integrated service.
Our NHS is struggling: waiting lists are far too long; cancer survival rates are too low; and too many patients are kept in hospital when they could be, and want to be, at home. None of that can be fixed unless the NHS and social care is staffed to adequate levels. Right now that is not the case. Far too many medical professionals who are trained here are leaving the service. Not enough doctors and nurses are being trained here at home. That is a problem not just for recruitment but for retention.
Recruiting new staff is not good enough if the experienced are leaving. That is true of most professions, yet for some reason the Government are not doing more to retain the skills and expertise we so badly need. It takes years to train a doctor. Once they leave the NHS, they take their years of training and expertise with them. Instead, the Government try to plug the gaps by spending £3 billion a year on temporary or agency staff. A short-term solution to a long-term problem does not work. The UK is left with fewer practising physicians and nurses per person than the EU average.
One way the Government are attempting to fill the gap is by hiring physician associates, who are expected to perform duties similar to a doctor’s without the required training. Physician associates are not empowered to prescribe, so doctors are charged with the duty of prescribing for the patients. That is one of the many problems that our NHS faces caused by the workforce crisis. The remedy to the crisis is a two-pronged approach. First and foremost, the number of medical school places needs to be dramatically increased. The same needs to be done for nursing and midwifery clinical placements. The only sensible and viable long-term solution to the NHS staffing crisis is to train more homegrown professionals and to value them. Medical school placements need to be prioritised in current understaffed areas to help reduce the health inequality that exists across our country, which covid tragically put a spotlight on. Any long-term NHS workforce strategy needs to address that issue.
The second part of the approach needs to be retention. There is no better short-term solution than to keep as many trained medical professionals in the NHS as possible, yet this is more than just a short-term solution. Keeping experienced and skilled staff in the NHS helps us both now and in the future, and is about more than simply money. The general working terms and conditions, whether that is work-life balance, job flexibility or pension allowance, need looking at.
Yes, it costs money to improve the living standards and working lives of our medical professionals. What costs more money is having to recruit temporary or agency staff to plug the staffing gaps and losing the existing expertise in the workforce. What costs more money is having to send patients to private appointments due to lack of NHS staff.
Our doctors deserve respect. The title “junior doctor” can be misleading to the public. Junior doctors are trained professionals who could have 10 years, or up to 20 years, under their belts. The term “junior doctor” does not give doctors the respect they deserve with their skills and experience. Adopting the use of “postgraduate doctor” or another term would be more befitting and give doctors more of the respect they rightly deserve. The Government should be speaking to those doctors to find out how to improve their working conditions.
Believe me, I was horrified when I learned of the working conditions, and I thought I knew quite a bit about health. In some hospitals, the NHS staff—doctors—are lucky if they have a mess like a sixth form might have. Surely our doctors are worth more than that. Solving the NHS workforce crisis cannot just be a one-off solution. There needs to be continuous assessment of our future needs as a country, so we do not find ourselves in this situation again.
It takes years to train medical professionals, so the Government must plan continuously and years in advance. That is what a Labour Government will do; Labour will provide the short-term solutions along with a long-term strategy to ensure our NHS is never in the state that the current Government have driven it to. Looking after the health of the nation must be the top priority of any Government; looking after the health and wellbeing of all NHS staff is simply a must.
Mental Health Treatment and Support
Marie Rimmer Excerpts(1 year, 5 months ago)
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Ms Marie Rimmer (St Helens South and Whiston) (Lab)
Suicide is a tragedy: it is a tragedy for the person, their loved ones and their community. As we have heard in the debate, suicide affects people of all ages. However, I am going to focus on one group: men. For men under 50, suicide is the biggest killer—not cancer, not other physical illnesses, but suicide. Mental health matters so much and it should be on a par with physical health. The NHS is there to look after and care for us all. That is the basic principle it was founded on. With suicide being such a big killer, it is only right that more effort and resources go into treating poor mental health.
Each suicide cracks an irreparable hole in the lives of loved ones. They often ask themselves, “Could I have done more? How did I not spot any signs?” or even, “Did I contribute towards it?” This would not be the case for physical illness; instead they would rely on professional healthcare. That is why the same resources need to be in place to treat poor mental health. Yet instead this Government have scrapped their 10-year mental health plan, displaying yet again that they are not interested in long-term planning. If it does not give them an instant headline, it seems the Government lose interest.
Of course, society has a role to play. For too long, men struggling or even displaying emotion are told to “man up,” “stop being a wimp,” or even, more cruelly, to “grow a pair.” Those words may seem harmless at the time, but in reality they are dangerous and cause tremendous harm. No one knows what is going on in somebody else’s head. That again reinforces why a national strategy is so important, not only to offer better and more accessible mental health care but to help to shift societal attitudes. We all have a role to play. How we conduct ourselves towards others is very important. In everyday life, we have an impact on every person we come into contact with. Pre-emptive mental health care is a must. That is why Labour’s plan to prioritise mental health care in an open access hub is so important.
Businesses and employers also have a role to play. They have a duty to their employees’ mental health. Modern workplaces should have accessible mental first aid in the way that they have physical first aid. For any strategy to combat suicide to be successful, it needs to be a priority of national Government. We need professional mental health support requirements for employers and a plan to change attitudes in society, not just a plan to swat the flies with. We need a plan that is resourced and put into practice.
We should make it easier for men to talk at work, in the pub and, most importantly, with professionals. Labour’s plan to recruit thousands of mental health staff would put us on the right path of caring for our men. The Government need to and should do more to solve that crisis, and our Labour Government will resolve it.
Future of the NHS
Marie Rimmer Excerpts(1 year, 9 months ago)
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Jeremy Corbyn (Islington North) (Ind)
I thank the hon. Member for Jarrow (Kate Osborne) for initiating a debate that enables us to discuss the real philosophy behind the national health service.
When Aneurin Bevan piloted the original NHS legislation through the House, he was inspired by the way in which those in the community of Tredegar supported each other. In many ways, our NHS owes as much to the mining community in south Wales as it does to anyone else, in the sense that that was a community providing for each and every person, irrespective of their ability to pay but absolutely cognisant of their needs. That, surely, has to be the principle behind the national health service. There has been a little bit of rewriting of history today; just for the record, the Conservative party opposed the foundation of the NHS in 1947. It is on the record. It is in Hansard. No one can rewrite that.
We must also recognise that on his mission to establish the NHS, Nye Bevan was forced to make a number of compromises, the biggest of which was over the GP contract idea. The then BMA, which has thankfully mended its ways and is now very much part and parcel of the trade union movement within the NHS, opposed the NHS and threatened not to take part in it at all, hence the contractual arrangement that GPs have. In a sense, it is that contractual arrangement that is a fundamental problem within the NHS, and it affects not just GPs, but many others as well. There has been a discussion about dentistry today. Surely, many other countries do not have this problem; they see a doctor as an important part of the health service, as we all do, and therefore we should employ them on a salary to be a doctor within the NHS. There are a small number of places around the country that have salaried GPs. I had one such practice in my constituency and it worked absolutely fine, until this Government interfered and handed it over to an American healthcare company, which, fortunately, has now been sent on its way, and the practice is now out for tender once again.
The original provision of the NHS was total healthcare, including preventive healthcare, such as optical treatment and dentistry. That was taken out of the NHS only two years later, and the prescription charges came in at the same time. As many have said today, we need to look at dental costs. Even within the NHS, they are so huge for many of our constituents that they either suffer the pain or borrow huge amounts of money to get private dentistry just to be able to get through the pain barrier that comes from not being able to get treatment. That is not acceptable. It is actually very expensive not just for the individual, but for our health service as a whole. We need to think a bit more about revisiting the totality of our national health service.
The undermining of the NHS went on for quite a long time. It reached its zenith, if you like, with the Health and Social Care Act 2012, which was piloted through by the coalition Government. That built on previous internal market ideas and specifically encouraged the contracting out of services, which are making a great deal of money through pharmacies in hospitals, through private finance initiatives in hospital and through a whole lot of other things. Money is being taken out of healthcare and handed over as private profit, which is why I intervened on the former Health and Social Care Secretary on this issue.
If we run the health service on the basis of internal markets and profitability, a massive bureaucracy is required to manage that internal market. That means that we end up with many managers working out who will get a contract to do which bit, rather than making the objective the totality of the hospital, the care system, the care service and whatever else it happens to be. We should be looking to more public ownership and intervention in the NHS, not less, and we should not be handing services over to private contractors.
It is not sensible to have a private contractor—say, Virgin Health—running a pharmacy within a hospital. That pharmacy should be part and parcel of the service of the hospital, where all are working for the same employer.
Ms Marie Rimmer (St Helens South and Whiston) (Lab)
I agree entirely with the sentiments expressed by my right hon. Friend. However, does he accept that, when we do not have the supply of workers to meet the needs at the time, we should bring in more nurses and doctors from abroad? We should do that while we assess the numbers that we need to train. Once we have trained more people, we can stop bringing in the staff from abroad. The same applies to contractors and the private sector now. What is not known widely is that many GP practices are private companies—they are not part of the national health service. Where that is not happening, we should be recruiting more GPs.
Jeremy Corbyn
I agree that the issue of recruitment is crucial, which means that the issue of training is crucial. However, we have relied for a very long time, and we still do, on many medical professionals coming from other countries, making their homes here and making an incredible contribution to all of our lives. We should thank them, thank the Windrush generation and thank that generation of Irish nurses and others who came to this country to work in and run our NHS. My hon. Friend is right: when there is a shortage or a crisis, we need to reach out to somebody else—perhaps a private contractor—to help deal with it. I can see that happening in an emergency situation, but it has now become part and parcel of the NHS.
Most Members of this House grew up with the idea that the GP was the local person in a local practice. That GP might or might not have been in an NHS-owned building, but they were part of the NHS. We now have major American companies owning a large number of GP practices and providing that service. When I warned, during the 2019 election campaign, that the Government were in secret negotiations with the USA to allow American healthcare companies to enter our health market—as they deftly termed it—I was told that this was some kind of Russian plot that I was regurgitating. It was nothing of the kind. It was a dodgy deal done by this Government to bring in those private healthcare contractors who are making a great deal of money out of our NHS. What we need is public ownership of our NHS. I absolutely agree with the intervention of my hon. Friend the Member for St Helens South and Whiston (Ms Rimmer).
I think everybody would accept that the NHS performed brilliantly during covid. However, what the former Secretary of State did not say was that he managed to make a lot of monumentally ineffective contracts with Serco and others that made a huge amount of money out of track and trace—out of our NHS budget. Those places that used local public health services for track and trace had a much better outcome. We should recognise that the need to invest in local public health services for preventive measures such as track and trace, as well as for many other preventive health measures, is very important, because, as others I am sure will agree, that ends up reducing the overall costs.
A central part of my contribution today is about the care services in this country. Everybody knows that quite a large number of people in NHS beds cannot leave hospital because the care service is simply not sufficient and cannot accommodate them. That means that they are stuck in the worst possible situation. They are in a very expensive NHS hospital bed, where they do not want to be, and are in danger of picking up or passing on an infection while they are there. They want to be in a care facility, but there is not one available for them. That is a monumental waste of money and resources, and it is also very cruel on the individuals concerned. We have all met such patients in hospital.
There was a 15% reduction in care beds between 2012 and 2020. Now, 84% of our care services are owned and run by the private sector. There have been debates in this House for as long as I can remember about the inadequacy of social care, the need to invest more money in social care, and the need to provide for real social care.
Social care is a fear that stalks many families. It is the fear that an older relative—a parent, or whoever—will develop dementia or any other condition, and need social care as a result. The amount of money that they would have to pay into the private care system terrifies people. To avoid that cost, who pays? Usually it is women in families who give up jobs, careers, and their life to care for somebody. It is not that they do not love their relative—they do love them—but their whole lives are turned around by the needs of care. We must grasp this nettle.
If in 1948, with all the post-war problems of investment, public austerity and so on, we were bold enough to develop a national health service, surely to goodness by 2021 we can be bold enough to develop a national care service, which takes away the fear for so many people of the enormous costs of healthcare—healthcare that at the moment is largely provided by the private sector on low wages and in sometimes not very adequate conditions. I think we need to revisit that. An interesting report produced by Unison on social care makes five recommendations, and I will quote the first:
“Remove the profit motive from the care sector. This would involve transitioning to either a national care service or a mix of not-for-profit provider types. If coupled with sufficient Government funding that meets the true cost of care provisions (something which is currently not in place), it would offer a number of benefits including greater financial accountability, value for public money, and likely greater attention to achieving quality care rather than generating a return for investors.”
People are making a great deal of money out of those with social care needs. I think we need to turn that around and ensure it is a public investment.
Our NHS was founded and put forward by very brave people, and it is something we should value and preserve. I think of the people who campaigned for many years on the national health service, but it has problems within it. It has the care problem that I have mentioned, and the inadequacy of mental health provision has been mentioned by a number of colleagues. Some years ago we mounted a huge campaign in my constituency to prevent Whittington Hospital from closing its A&E department. We were successful. The local papers, the community—everybody—got behind the campaign, and the A&E department is open and treats more than 90,000 patients a year. At the end of the campaign we held a celebration rally, and the main organiser of the campaign, Shirley Franklin, said, “Would you all have been here if it had been a mental health unit to be closed, or would you have stayed away?” I think we all know the answer to that. Mental health is seen as something separate and different that we simply do not want to talk about. We must invest in it fully.
This debate is about investing and extending, and thanking those who have gone before us. Some weeks ago I learned with great sadness that the late Alice Mahon died on Christmas day. I will be attending her funeral the week after next. She was a fantastic worker in the NHS, an auxiliary nurse, and I remember her like it was yesterday, standing up in this Chamber and challenging Ministers, be they Tory or Labour: “What are you doing to defend the principle of an NHS that is free at the point of need?” We can learn from the inspiration of wonderful people like the late, great Alice Mahon.
Ms Marie Rimmer (St Helens South and Whiston) (Lab)
I congratulate my hon. Friend the Member for Jarrow (Kate Osborne) on securing this debate and on her strong and informative opening. I also commend my hon. Friend the Member for Bolton South East (Yasmin Qureshi) for her detailed explanation of dentistry. I am acutely aware of the issue but I could not go into all that detail, so I thank her sincerely for that.
Our NHS is not a faceless organisation; it is hundreds of thousands of dedicated workers who look after us. Their commitment is being exploited. Our NHS is the people who work in it, and they need to be, and should be, valued and treasured. This Government should be ashamed of the way the people in our NHS are being exploited. After years of Conservative-led Governments, our national health service is reaching breaking point. We have heard from many Members today about the problems with waiting lists, ambulance times, GP appointments and dental health. We need a national assessment of need, and some kind of national inquiry to get down to how we meet that need.
Things need to change, and change quickly, and I have two points that largely read into issues with GPs and hospitals, although our health service is much bigger. There must be a commitment to look at social care, which must be considered and addressed. Without that, we will never get hospitals right, because most of the beds that are taken up—I hate to say that—but could be freed up, are as a result of problems with social care. We must ensure that the funding we give for social care goes to the funded body.
The relationship between GP surgeries and patients needs to be addressed. We have heard about how many members of the public are illiterate, and they do not have confidence when they go to a surgery to argue their point. I have a case at the moment that is driving me around the bend. It involves a simple admin error—any of us could make an error, so I am not criticising anyone—and it has caused such anxiety to my constituent that I am receiving texts minute by minute. The bureaucracy involved between a GP surgery and a consultant to get something right is unreal. The relationships and training within GP surgeries need to be addressed.
There has been an absolute failure to adopt a long-term plan to recruit doctors, nurses and social care workers—social care needs to be treated as a profession, rather than simply going into a house to provide a bit of care. The crisis has been allowed to reach such a stage that a long-term plan is not enough. Urgent action is needed to tackle the lack of doctors and nurses. There is now no option other than to make it easier for the NHS to recruit doctors and nurses from abroad. There are 130,000 vacancies across the health and care sectors, and there is not enough time to train sufficient people to plug the gap. I respect the quality of the nurses and doctors we recruit from abroad, so I am not doing them down; we have to bring them in because we do not have what we need. We are having to use the private sector to fill the gap, but we should be thinking about our long-term needs. We should be recruiting and training people so that we do not have to keep recruiting from abroad.
The Government have failed to outline anything like a long-term plan for the health service. We need home-grown doctors, nurses and carers, and we need to think about what else we can do. We have lost so many surgeries. Why does the NHS not employ GPs? One of our surgeries in St Helens is run by the NHS. The Government have failed to offer more training places for doctors and nurses, and they have failed to prepare our NHS for the future. The current crisis is putting a spotlight on the issue, which results from more than a decade of failure to adopt a long-term approach to staffing. Instead of adopting such an approach, each Health Secretary and Prime Minister has wanted to put their own short-term stamp on the NHS. We have had so many Prime Ministers and Health Secretaries in the past couple of years, and each has wanted to put their own stamp on the NHS. Our NHS is too important for that. It is too important not to have a long-term plan for recruitment and retention.
Labour will train 10,000 new nurses every year, and it will double medical school places. Training and recruiting staff is only half the story; the other important half is retention. NHS staff are leaving in droves, and morale is at an all-time low. We would not be able to handle another covid strain, as our NHS is not what it was three years ago because it has been drained and exploited. It is at its lowest ebb.
Keeping well-trained and experienced is staff is vital to delivering a good service to the public. We need to respect their skill and commitment. It costs a lot more to recruit and train new staff than it costs to keep existing staff. For more than a year, the Government clapped nurses on the doorstep, but they refused to give even the 2.5% increase that was already in the Budget, and now they will not sort out a third pay settlement.
If we want our NHS to care for us, we need to care for our NHS. The Government have lost the confidence of our NHS heroes, and that needs to change. Our NHS needs rescuing, and only Labour will do that. I think it is simple. The Government say they have a long-term plan, but Labour will deliver a long-term plan to save the NHS by plugging the staffing shortage with more training places, greater recruitment and better retention. That will give patients the service they deserve, a service for which we will always be thankful.
Oral Answers to Questions
Marie Rimmer Excerpts(2 years, 5 months ago)
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Maria Caulfield
My hon. Friend is right: there is a perverse disincentive in the current contract in that under the UDA dentists are not paid in relation to the level of activity or work they have to do for an appointment. That is the nub of the problem and we are in discussions with the British Dental Association right now; it is reviewing our proposals and we hope to have news very soon.
Ms Marie Rimmer (St Helens South and Whiston) (Lab)
People with dementia deserve to be treated with dignity and respect. There are ways to enable those living with dementia to lead the lives they want. This is what the all-party group on dementia inquiry is currently investigating. Will the Secretary of State commit to attending the all-party group’s inquiry—
Mr Speaker
Order. Sorry, but that is not relevant to the question, which is about dentistry.
Mr Speaker
I cannot jump questions; this question is about dentistry so I now call the shadow Minister, Feryal Clark.
Sajid Javid
First, I will ensure the hon. Lady gets the meeting she requests. She will know that NHS GP services all have to meet the same requirements, the same regulations and the same standards across the country. Where patients are not getting that care and those standards are not being met, we expect local commissioners to take action.
Ms Marie Rimmer (St Helens South and Whiston) (Lab)
The Minister for Care and Mental Health (Gillian Keegan)
It is crucial that the health and social care workforce have the necessary skills to provide high- quality care for those living with dementia. As announced in the White Paper, we will invest £500 million in training, and we will work with social care staff to co-produce a knowledge and skills framework to include the dementia training standards framework. Later this year, we will set out our plans on dementia for England for the next 10 years, which will include plans for dementia training.
Ms Rimmer
People with dementia deserve to be treated with dignity and respect. There are ways to enable people living with dementia to live the lives they want to lead and that is what the inquiry by the all-party parliamentary group on dementia is investigating right now. Will the Secretary of State commit to attending the APPG’s inquiry report launch in September to hear how that can be achieved? Most importantly, will he commit to taking on board its recommendations? Families of people with dementia feel they are neglected and not getting the attention they need. I urge him to attend the launch of the report.
Gillian Keegan
I completely agree with the hon. Lady that we, of course, must treat all those living with dementia—and all those caring for people with dementia, which is a lot of people in the country—with respect and do everything we can to support them. That is why we will, as I say, be setting out our plans for dementia in England for the next 10 years and why the Secretary of State mentioned dementia in a speech very recently. I will personally commit to attending the APPG. I am very happy to work with her on this issue to understand what more we could be doing and what more we can do to inform the 10-year plan for dementia in England.
Public Health
Marie Rimmer Excerpts(2 years, 11 months ago)
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Wes Streeting
That is such an important point, and I am grateful to my hon. Friend for making it. There is a reassurance I would like to offer her and a call to action that I would like to issue to the Government. The reassurance is that there were concerns about what would happen to the social care workforce, which very much influenced Labour’s position on that statutory instrument at the time, but we did not see the collapse in the social care workforce that was warned of and there was lots of evidence that there was a positive impact on take-up.
I say to the Secretary of State and his team that if they are asking the health and social care workforce to do their duty as professionals, the Government must show greater respect to their professional voice and experience—on pay, conditions and workload. It is often said that the NHS runs on goodwill, so I would like to see the Government showing greater goodwill in return and engaging with the royal colleges and staff trade unions, not just on the plan for vaccine roll-out to their members, but on the debate about the future of our health and social care systems and the big workforce challenge.
On vaccinations, there is still precious time to do the work on persuasion. I have met the trade unions in recent days, including a great meeting with Unison yesterday—I should declare that I am a member of Unison. Unison had some really helpful advice and practical feedback about the kind of conversations with occupational health that are making a big impact in giving staff the confidence to choose to take the vaccine well ahead of the deadline. Of course we would much rather persuasion than compulsion.
Ms Marie Rimmer (St Helens South and Whiston) (Lab)
In St Helens, 99% of care home staff are vaccinated, and at Whiston Hospital, the best one in the country, 91% have had the first vaccine, 89% the second vaccine and 64% the booster. That has all been done with persuasion, not with the threat of the sack. These people are in a vocation. It is not just a job to them; they believe in the patients. We must not get to the stage where we are threatening people. The GPs have even been involved in persuading the care home staff. Everyone has been involved for some considerable time and that is the way to do it—
Madam Deputy Speaker (Dame Eleanor Laing)
Order. Let me just make this clear: more than 40 people wish to speak this afternoon and if people make interventions, it is simply not fair on those at the end of the list who will be trying to speak later on. The hon. Lady is only one of many. The shadow Secretary of State is being very fair, as was the Secretary of State, in answering all the questions, but I must ask people to be reasonable.
Rachael Maskell
I am grateful to my hon. Friend for making that intervention and he makes a point I wanted to make myself. The Government’s estimate on that in their impact assessment is 123,000, and even in the best-case scenario 62,000 will lose their jobs, which the NHS simply cannot afford.
Ms Rimmer
I apologise. I know my hon. Friend knows about care and health workers so she knows how dedicated they are; they have a vocation. Does my hon. Friend agree that the Government can and should stop going too far? Let us not break the trust between patient and worker and between Government. Let us go down the route, which has been proven to work, of persuasion and education, and ask them and work with them to distil the fear.
Rachael Maskell
I thank my hon. Friend, who represents her constituents so well. There is an alternative path and we can take it today. We know that the Prime Minister is allowing people to go to pubs and clubs unmasked, while he is sacking NHS staff who are wearing full PPE and testing. Some 93% of NHS staff are vaccinated; figures from the Office for National Statistics show that 4% of people are vaccine-hesitant, which rises to 21% among minoritised communities. As 22.1% of NHS staff are from minoritised communities, the regulations will target black workers. In fact, 26.8% of workers of mixed race are not vaccinated; that is in the Government’s impact assessment, which also gives the figures for black workers. The regulations therefore indirectly discriminate against black workers.
Unvaccinated staff are frightened. On Friday, I spoke to someone in my constituency who has worked for the NHS for 16 years. Her father had a vaccine. His heart stopped. Miraculously, NHS workers brought him back to life; he is now in a critical condition. She is frightened. She tests; she wears PPE; she has sacrificed everything. She will be sacked.
I want all NHS and care staff to have vaccine counselling and education with a qualified practitioner who holds the right competencies so that concerns can be explored, not with line managers, who just do not have the competencies. I want everyone to be vaccinated—I cannot stress that enough—but I want to win the trust of staff, not push them further away, as the Government’s approach will. In York, where we have focused on those trusted conversations, we have seen 99% of our social care staff vaccinated. It just shows what works and what makes the difference.
We do not want to push people further away. We want to bring them in, win their trust and win their confidence, because we will have to ask more from our health and care staff as things get harder—we certainly will if there are fewer people to deliver the service. Let us do what works—enforcement never does. The regulations are vaccine-illiterate.
If 123,000 people lose their job in the midst of a health and care crisis, it will be catastrophic, not least as people are starting to hand in their notice now. Why go through another tough winter of trauma when we do not have to? The regulations will make it worse. We know that two vaccines, or even three, will reduce transmission of the virus, so get your jabs! But they will not stop transmission, so let us move to better PPE, FFP3 masks, daily testing and better biosecurity. Rather than pushing the regulations today, I urge the Government to go away and come back to the House with a plan for us to vote on in January. That is good governance and the way forward.
As a trade unionist, I am not prepared to be complicit in the sacking of our NHS and care staff. Trade unionists fight for working people; we are never complicit in writing their P45. As a trade unionist, I came to this place to fight for working people. I therefore urge that we change course and put staff and the care that they have for their patients first.
Health and Care Bill
Marie Rimmer ExcerptsTuesday 23rd November 2021
(2 years, 12 months ago)
Commons ChamberRead Full debate Health and Care Act 2022 View all Health and Care Act 2022 Debates Read Hansard Text Watch Debate Read Debate Ministerial Extracts Amendment Paper: Consideration of Bill Amendments as at 23 November 2021 - (23 Nov 2021)
Madam Deputy Speaker (Dame Rosie Winterton)
In order to try to get as many people in as possible, I am going to put on a three-minute time limit.
Ms Marie Rimmer (St Helens South and Whiston) (Lab)
Forced organ harvesting in China is one of the worst crimes against humanity of the 21st century. That is why I wish to speak to new clauses 24 and 25 in my name. It is a crime that no British citizens should be taking part in, and a crime that humanity has a duty to stop. New clause 24 aims to put a dent in the forced organ harvesting trade. It would prohibit UK citizens from receiving a transplant abroad without the clear consent of the donor. The forced organ trade is a big money business. The organs of a young healthy adult are worth in the region of half to three quarters of a million US dollars. That is money that people would, and do, kill for.
China started with political prisoners, with the religious Falun Gong group being the main source. Now it has moved on to Uyghur Muslims, some Christians and other minority groups. Evidence was heard at the China and Uyghur tribunals that mass DNA testing is taking place in the internment camps in Xinjiang, enough to compile a Uyghur organ database and bank ready for withdrawals on demand. The world might believe that China had an ethnical organ donation system based on the World Health Organisation’s assessment, yet that assessment from the WHO is based on a country’s self-assessment—in this case by the Chinese Communist party. It is a barbaric practice, and every democracy in the world should be looking at what it can do to stop it.
I am grateful to Members from every party across this House for supporting my new clause. It will not stop the trade, but it will show that we in Britain are doing our part and helping to influence other countries to do the same. I thank my hon. Friend the Member for Nottingham North (Alex Norris) for raising these new clauses in Committee. The Minister sympathised, but expressed certain concerns. He was worried that countries could have a deemed consent system in which everyone was automatically a donor. Deemed consent is acceptable only if people can opt out. Under a new provision, the Secretary of State will assess the deemed consent of each country. The Minister was also concerned that the recipient of an organ could face criminal consequences. It is the duty of a Government to ensure that people are aware of what is a crime, and supporting or funding a crime against humanity must be illegal.
New clause 25 would make imported cadavers require the same consent as bodies sourced from within the UK. The Minister claimed that a revised code of practice covered this, but a code of practice is not law. Surely the sanctity and dignity of the human body demand the power of legislation. I call on the House and this Government to step up and do their part to stop this crime against humanity.
Robin Millar (Aberconwy) (Con)
I rise to speak to new clauses 60 and 61 in my name. Simply, they would put patients first. I am thankful to my right hon. Friend the Member for West Suffolk (Matt Hancock) for his comments on new clause 60, but as I do not seek to press it to a Division, I will mention no more of it now.
On new clause 61, let me simply say this: good data is needed for good services. Good data allows professionals and planners to assign resources and guide interventions where they are needed most. Good data allows patients to make informed decisions about where to be treated, or where to live. Good data allows politicians to be held to account when services fail. Therefore, new clause 61, at its simplest, is about collecting and comparing data. It would standardise the publication of a set of UK-wide NHS data and ensure the interoperability of that data.
In Wales, unfortunately, Welsh reporting standards mean that waiting list statistics are not available for most procedures. Before the pandemic, it took a journalistic investigation in north Wales to highlight that patients were waiting for more than two years for hip operations. Constituents now report that they are being told that they face a two-year wait just for a first out-patient clinical appointment. That is distressing and disappointing, and it is simply because data is not available.
We must ask the question, if for want of a nail, the shoe was lost, what are we losing for the want of good data? If the Government are to bring digital transformation into the heart of the NHS, the Minister must know that that heart can only be animated when good data courses through its veins.
In the months I have worked with colleagues on new clause 61, we have heard overwhelming support from patients—they agree. Healthcare professionals, IT experts and administrators have told us that they agree. In fact, I do not believe that the clause would divide the House, in compassion or common sense. I accept, however, that there is a challenge in delivering it and I know that the Government are exploring ways to address that.
I note the Minister’s comments at the start of the debate about close working with the devolved Administrations, and I welcome that.
UK Rare Diseases Framework
Marie Rimmer Excerpts(3 years, 8 months ago)
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Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Ms Marie Rimmer (St Helens South and Whiston) (Lab) [V]
It is a pleasure to serve under your chairmanship, Mrs Miller. I pay tribute to my hon. Friend the Member for Blaydon (Liz Twist).
PKU is a disease that leaves people unable to break down protein. It can lead to severe brain damage. Kuvan is a life-changing drug that can help people cope with PKU. NICE’s decision to offer Kuvan only to patients up to the age of 18 is wrong. There is no miraculous cure for PKU when patients turn 18.
The transition to adulthood is a tough time already; 18-year-olds are moving away from school and often away from parental support, whether attending university, beginning an apprenticeship or starting a career. It is a difficult time. NICE’s decision strips young people of a life-changing drug when they are at their most vulnerable. Giving patients Kuvan and then taking it away turns an 18th birthday into a day of dread. Never mind the joy of a Greggs sausage roll, PKU patients cannot even grab a healthy salad or a vegetarian sandwich. The disease requires an exacting regulation of food intake.
I met Liam, a 20-year-old constituent who has PKU. The first thing that struck me was Liam’s mother bringing him bags of special ingredients. Careful planning is essential. Everything is homemade and all the ingredients have to be measured out, for Liam’s safety. Preparing the food is a full-time job. Liam has never had Kuvan and is in his second year at university studying policing. He is planned and worked hard to contribute to society, but he fears that without Kuvan this would not happen. There are hundreds like Liam who want to make a positive contribution. I asked him for his thoughts on the decision. He said:
“The overwhelming feeling right now is one of betrayal. We have spent 12 years fighting for this drug, seeing it within our sights, our hopes finally rising at the prospect of receiving such a life changing drug, only to have it snatched from us.”
I ask BioMarin and the Government to put people like Liam at the forefront of their decision making. People are being denied the quality of life that is possible and that they deserve.
Covid-19 Update
Marie Rimmer Excerpts(3 years, 8 months ago)
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Matt Hancock
I am very grateful to my hon. Friend for asking that question because we have seen, in a minority of areas, a small increase in the number of cases and that does include Kirklees. We have seen this in just under one in five local authority areas. My message to everybody in Kirklees is that this is not over yet. We have a road map out but it is not a road map for Government alone; it is a road map for all of us to walk down together. That means following the rules, and that means, for now, staying at home, but by doing that, we can all then move on the dates that are set out, and instead of “not before” dates they will become the dates that we can make the next step. But it is on all of us, and so I would urge everybody to continue. I know it has been a difficult winter and the sun is starting to shine a bit brighter, but we must all stick at this. We can see the way out and I hope that we can get there together.
Ms Marie Rimmer (St Helens South and Whiston) (Lab) [V]
Over 3,000 clinically vulnerable people in cohort 6 are going to have their vaccinations cancelled in St Helens at the end of this week, unless the required supplies are delivered by Thursday lunchtime. The vaccine site is serving four primary care networks, yet the national supply team is only recognising and supplying one network. The mutual aid gathered to cover this shortfall in the past is no longer available. Will the Secretary of State please urgently intervene to address this misunderstanding so that no vaccinations are cancelled?