(1 year ago)
Commons ChamberMy right hon. Friend is right: it is a systemic problem. It does not just affect Britain or the health service. Indeed, I think that numbers for those years for the health service were about 25%—so huge, huge numbers. I bring this back to the reality of the individual. If we delay diagnosis and treatment, we sentence people to death. It is as harsh as that.
I would like us dramatically to increase the amount of diagnostic capacity we have. If we look at OECD numbers on CT scans, I think we are third from worst. This is why I say it is not a single Government problem—we do not get to be third from worst in one term; it happened over the course of the whole 30 years. On MRI scans, we are the worst in the OECD. How on earth a country such as ours gets to that position is astonishing.
The right hon. Gentleman is making some interesting points, and the total amount of Whitehall day-to-day spending on health is phenomenal. On the point about scanners, I am afraid that lies directly at the door of his Government—well, I am not afraid; it does. The lack of capital investment in the big bits of kit has led to deterioration and lack of availability. Such investment would have saved money, and been better for the patient and better generally for the health of the nation.
I agree with the hon. Lady on the saving money element, and I will come back to that in a second. The truth is that this Government have poured more money into the health service than anybody ever predicted, and more money than they intended over time, but decisions within the health service—I come back to management rather than money—led to some of those decisions. The hon. Lady is dead right that it is a waste of money not to do the diagnosis. I am talking about MRI and CT scans, blood tests, and all the other things that help us get ahead of the disease.
I talked to Randox, one of the diagnostic companies, which is based in Northern Ireland, and asked about this issue. It has technology that it says will reduce a seven-day analysis of blood samples, for example, to 30 minutes. My view is that we should break clear of the ideology and look dramatically to increase the amount of scans and diagnostic procedures—when I say “dramatically”, I mean a multiple of what we currently do—and we should use the private sector to do it. I know that causes a bridling and a backing off, but the only way we can do this fast enough is to do that. That would save about £3 billion and reduce waiting lists for millions of people. Most importantly of all, it would save thousands of lives. If there were one thing I would do within healthcare, that would be it; there would be other things, but that would be that.
(3 years, 8 months ago)
Commons ChamberI welcome parts of this Budget because if it works, it will prop up the system for a bit longer, but I am worried that we have seen announcements about the extension of furlough, for example, at a point at which many workers will have already been hit by decisions taken by employers who were worried that such an announcement would not be made today.
The country is crying out for change. It is in debt and there is an uncertain future for many individuals and businesses. Brexit, which I do not think I heard mentioned in the Chancellor’s speech, is hitting businesses and individual consumers very hard and proving costly to the economy, certainly in the short term. The bit that was missing from the Budget is the vision for a country that should be supporting people into decent, affordable homes; that should be properly tackling net zero, on which I will touch in more detail; and that should have a plan for social care, the sector that was abandoned in the early stages of covid.
We should also be tackling the challenging issues in respect of different employment statuses that have caused so much difficulty for so many. In my constituency is represented everything from zero-hours contracts to IR35, self-employment, people employed for tax purposes and people on short-term contracts. Covid has had different impacts on different groups of people.
The Chancellor said he will do whatever it takes but, structurally, the inequalities remain. The poorest get a welcome prop-up with the extension of the uplift to universal credit, but only to September. I am not sure that I can see—I am sure the Chancellor would agree that he does not have a crystal ball—what will suddenly change in September that will mean that people do not need the extra £20 a week.
Structurally, there are real issues. A few figures have been announced today on green initiatives—I have not had a chance to go through the detail in the Red Book—but there is no clear plan. We have targets on net zero and other environmental targets, including on things such as electric or net zero cars, yet there are not enough milestones along the way to the targets, which are coming upon us really fast. I will look in detail at the little bits of money announced today, as my Committee, the Public Accounts Committee, is examining issues relating to the green economy in a series of inquiries.
I welcome the fact that there is finally a bit more support for some of the self-employed people in my constituency—we need to see the detail on that—but it is a whole year late. Like many Members, I have constituents who have lived for a year without a penny of income and did not qualify for universal credit, and sometimes they were in exactly the same position as somebody else who lost their job only a day later. Lives have been put on hold and future plans shredded, and there is no prospect of work for many people in many sectors for many months.
I welcome investment in Her Majesty’s Revenue and Customs and the Department for Work and Pensions to look at fraud and error. These are small amounts. But it was this very Government who pushed bounce back loans through, as the National Audit Office has said, with very little regard to risk. A slight delay of 24 or 48 hours would have put less risk on the taxpayer for the guarantee on those loans. With regard to some of the furlough schemes, at the early stages it was right to get this out the door, as my Committee has acknowledged, but later, more safety mechanisms could have been put in place. That money is good money chasing bad, in many respects. The risk appetite was high.
The hon. Lady mentions the risk in bounce back loans. Her Committee—our Committee—has done sterling service over the years on the whole question of tax evasion and the investigation of that. Does she have anything to say to the Chancellor about that, because it is a very large, lucrative area that the Government could pay attention to?
I have hopes for some of the £100 million that HMRC has been given. In fact, having scanned the Red Book, I see that other money is being added to HMRC. As a Committee—as the right hon. Gentleman, a former Chair of the Committee, will know—we are very keen for HMRC to get money because with every £1 it gets for compliance it brings back a lot more to the Exchequer. We need to look closely at this because there is a challenge in the tax system—for example, as regards high street businesses versus online businesses. It is a complex matter and no one should imagine that there is a simple solution; I know he does not think it is simple. It is something we need to continue to engage with.
On housing, once again we have seen a focus on fuelling demand, not increasing supply. The Chancellor seems to have got off the hook on leasehold issues for constituents of mine, and those around the country, who had dangerous cladding by taking the announcement from the Ministry of Housing, Communities and Local Government last week as though that is the matter closed.
(6 years, 6 months ago)
Commons ChamberOne of the key players in discussing and settling the EU financial settlement is the European Court of Auditors. As a member state, we have Phil Wynn Owen as our representative, but as it stands, he is set to leave the European Court of Auditors come 29 March 2019. Will the Secretary of State add to his negotiating list the need to make sure we have a full British representative on the European Court of Auditors during the transition period?
All of the implementation period issues are currently under discussion. I am not sure, frankly, that we will put the hon. Lady’s proposal at the top of the priority list, but we certainly aim to cover issues such as audit in the joint committee.
(7 years, 2 months ago)
Commons ChamberI should declare that my husband is a dual Irish-British national, which gives me a particular interest in the relationship we have after Brexit with our largest trading partner in the EU. The Secretary of State talked about “significant, concrete progress” in this vital area. Yet when I was in Ireland this summer, commentators universally were saying what Fintan O’Toole from The Irish Times said:
“behind all of these delightful reassurances, there is sweet”—
here I paraphrase—“nothing”. Will the Secretary of State please detail what that “significant, concrete progress” is, or are his descriptions of this magic border just a whim?
The biggest single issue that came up at the previous negotiating round in July was concern by the European Union that our intention to continue with the common travel area would impinge on the rights of European citizens. We managed to achieve an understanding on its part that that was not the case and that the CTA was therefore well worth preserving. We currently have technical work ongoing on north-south arrangements. We will, of course, have to wait on the outcome elsewhere for things like the Irish energy market and so on, but they are all very much front and centre in our negotiation. The Northern Ireland-Ireland border is very important, but the other very important thing in respect of Ireland is, as the hon. Lady says, its sales and trade with us—a billion a week. But there are also its sales to the continent which tend to come through Britain and require a common transport area too. We are working on all those things.
(11 years, 4 months ago)
Commons ChamberMy hon. Friend makes a good point that I will return to later. He is exactly right—this is one of the likely unintended consequences of what is being proposed in the consultation.
In their efforts to cut legal costs overall, the Government are overlooking a far bigger cause of waste in the system than legal aid, namely the sheer inefficiency of the Crown Prosecution Service. In 2011-12, more than 123,000 prosecutions failed after charge because either no evidence was presented or the case was eventually dropped. The cost to the service, the courts and aborted defences was measured in tens of millions of pounds, not to mention the stress faced by people who were, presumably, innocent.
If the hon. Lady will forgive, I am very tight on time. I will give way if I can a little later.
That does not tell the whole story, however. Time and again, we see trials delayed and extended by CPS incompetence. In my part of the world alone, the newspapers are littered with cases of lawyers not turning up, evidence not being presented and cases being adjourned again and again. I suspect we all have constituency cases just like that. This happens right across the country. We should not pretend that the legal aid system is a model of efficiency, but when it comes to finding savings and better, effective justice across the whole system, we should look first at the CPS itself before we let the axe fall again on legal aid.
I am yet to be convinced—this addresses the point made by my hon. Friend the Member for Esher and Walton (Mr Raab)—by Government assurances that the quality of legal aid providers will be guaranteed by a state body. This debate comes barely a week after the Care Quality Commission scandal. That demonstrates how difficult it is to guarantee the quality of complex intellectual services, which, of course, justice is. We should notice that even where the state has direct control—namely, the CPS and the Serious Fraud Office—it cannot guarantee quality there either. A judge in a recent murder case described the CPS lawyer as “completely inadequate”. The judge said that the lawyer cited old law, did not understand the current law, fell out with the prosecution team, and then simply did not show up on the following Monday. As a result, the trial had to be held six months later. If we cannot guarantee our own system and our own service, how are we going to guarantee 400 private operators around the country?