(4 years, 5 months ago)
Commons ChamberI agree with what my hon. Friend has said—and not just the first bit—but I repeat what I said in my statement. I want to be clear that, where people absolutely cannot work from home, they can still go to work. Indeed, it is important that they do so to keep the country running.
That is the nub of the confusion, because I am hearing reports from constituents and from elsewhere in the city that, for example, workers in call centres for outbound sales calls—which will undoubtedly be disruptive to those self-isolating at home who receive them—are being asked to come in and work in cramped conditions, which we know exist in such places. Should those employers not be taking advantage of the Government’s furlough scheme, so that their employees do not have to come into work? Is it not the case that no employee should be punished for doing the right thing and following the Government advice to stay at home?
That sort of activity can technically be done from home and, where work cannot be done from home, employers should be following the guidelines to keep people more than 2 metres apart.
(4 years, 5 months ago)
Commons ChamberI commend the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) for his comments, and thank him for the measured tone in which he delivered them. It has been noticeable over the last few days that things have been a bit more calm and sensible here even when we have disagreed politically; perhaps we could keep that going after the public health crisis has passed.
I noted that the right hon. Gentleman could not resist having a wee dig at the Scottish National party Government for not having done up his bit of trunk road yet. Obviously I cannot speak for the Scottish Government, whose spending decisions are made in the Scottish Parliament, but I have had a quick look at the Scottish Parliament’s website, and I have the contact details of the MSP for Dumfriesshire, which I can pass on to the right hon. Gentleman later. He is some chap by the name of Oliver Mundell. [Laughter.] I do not know whether he is still holding surgeries, but I can probably find his phone number for the right hon. Gentleman.
I am pleased to be able to speak on behalf of the SNP today. Our position is a bit different from those of many other parties, in that we will be keeping out of many of the detailed discussions about which health trusts and local authorities receive funding, because we have a devolved national Parliament to make those decisions on our behalf. As the previous three speakers made clear, although today’s debate is about the funding of public services, we cannot ignore the rapidly changing public health challenge that faces all four nations in the United Kingdom—and, now, the majority of nations in the world.
The statement that will be made later by the Secretary of State for Health and Social Care will be the right occasion for detailed questioning about the Government’s approach to those health challenges, but I want to consider some of the significant, and even potentially fundamental, changes that the economy will undergo as a result of them. The right hon. Member for Dumfriesshire, Clydesdale and Tweeddale—the former Secretary of State for Scotland—commented on the permanent change that the foot and mouth outbreak made to the economy of rural Scotland 20 years ago. This is much bigger, and its impact on the economy throughout these islands will be much bigger, and will probably be permanent.
My hon. Friends who spoke in last week’s debates will have specified which of the Government’s emergency actions we fully support—and there are a great many of them—as well as some instances in which we would like to see more being done, and a few in which we think that the action is simply going in the wrong direction. I hope that, at all times, the discussion of those matters can be kept as civilised and as temperate as it has been over the last few days. The situation has changed significantly since my colleagues made those comments on Wednesday and Thursday last week, and it has changed significantly since the Chancellor’s Budget speech. It is vital for the Government’s response to those changes to be not only sufficiently robust, but sufficiently flexible.
I am encouraged by the degree of co-operation on the part of the UK Government—through Cobra, for example—in agreeing on our combined and shared response to the public health issues, and I hope that we can see a similar degree of proper engagement when it comes to how to deal with the economic challenges. It must be said that, on those matters, the UK Government have not always engaged positively and constructively with the devolved nations in the past.
Let me give just one apparently small example of the way in which the coronavirus outbreak is already affecting my constituency. Like many other constituencies—perhaps most—we are blessed with a huge number of brilliant, independently owned cafés and restaurants. “Restaurants” sounds quite grand, but I am talking about places that can hold, at the most, 20 or 30 people who come in for a plate of soup and a bacon roll for their lunch. Their collective contribution to my communities and to all our communities, not just economically but socially, is impossible to measure. Several of them have changed hands recently or have been established for less than a year, while others have been on the go for decades. Obviously, I am not privy to any of their individual financial affairs, but I doubt that any of them would survive for two, three or four months without any customers—if that is how some people are interpreting Government advice, that is what those businesses would have to put up with. Clearly, it is not as bad as that, but it is an indication of the fact that those small businesses will need some severe Government intervention, and some of them will need it very soon indeed. I am happy to support them as much as I can.
There are various examples of that happening. The Hug and Pint, a fantastic little venue on Great Western Road in Glasgow North, has had to announce that it is going to close tomorrow. It has set up a crowdfunding campaign, as have various enterprises on the folk music scene in Scotland. Will my hon. Friend commend those initiatives to try to encourage business? People would have been going there in other circumstances for a pint anyway, so perhaps they can spare that money to help some of those small businesses through the most difficult period.
My hon. Friend makes a valid point. That is sometimes an indication of how important many of these businesses are in their local communities. Neighbours do not just see them as a business and they will support them. The difficulty is that, if neighbours, customers and clients lose their jobs and suddenly find that they have to get by on a wholly inadequate social security system, they will not be able to afford to put £4 or £5 over the bar in the local community-owned pub, whether or not they get a couple of pints in return.
I support many of these businesses as best I can—some of them are very co-operative, allowing me to hold advice surgeries on their premises—but if I do what a lot of colleagues are doing and begin to cancel surgeries, and if I do not go to the local coffee shop and sit for an hour or so talking to people, no one else will do that. By making that decision—I understand why people want me to make it—I might well be hastening the time when many of these valuable businesses can no longer continue. If they close temporarily now, some of them will not reopen.
It is not just cafés, catering and hospitality businesses—the same goes for locally owned hairdressers, bakers, craft shops, one or two-person printers and many other businesses. Independent retail businesses may be small individually, but cumulatively, they represent the financial wellbeing of a vast number of people on these islands, many of whom stand to lose not just their job and livelihood but the very home in which they live. For many of these establishments—I am thinking especially of small bed-and-breakfast businesses and guesthouses—their business is their house. Many others have mortgaged their house to finance the business. They stand to lose everything apart from the clothes they stand up in if things go wrong, and they will need help quickly.
I welcome the emergency measures that the Chancellor announced last week, but I do not think that they go far enough. I fear that a great many small and valued businesses in my constituency, and in all our constituencies, will close and never reopen. At the other end of the scale, we have heard severe warnings from some of the biggest and most iconic transport operators in the UK and elsewhere. British Airways, for example, has warned that its survival is not guaranteed if it gets it wrong.
This morning, my journey to Edinburgh airport was the quietest that I can remember in five years as an MP; I do not come down on the train all the time. The car park where I usually struggle to find a space was deserted—you could have played five-a-side football without bumping into a car. The flight on which I often struggle to get a seat was 30% full. That is not sustainable. What I prefer to do when it is realistic is come down on the train. If I had done that, I would have seen another drop in business, although I do not know whether it is as big. Train operators are struggling as well.
Hotel bookings in London and many other places have crashed. Comparing prices on hotel websites with what they were three or four weeks ago, I see they are a half or a quarter the price, or even less. Those businesses cannot survive that, and there are tens of thousands—perhaps hundreds of thousands—of jobs at stake. It is not about bailing out the billionaires who own those high-profile businesses. It is about protecting the rights of tens of thousands of workers whose livelihoods are on the line.
Despite the torrent of platitudes from the Government, and despite the welcome measures announced last week, many of those hundreds of thousands of people face being thrown on to the mercy of a social security system that was utterly unfit for purpose before this crisis, and will be even more unfit to deal with the challenges that it will face. While the changes that have been announced are welcome, we need a lot more, and we are going to need them an awful lot quicker.
Detailed spending plans for Government Departments are going to be published, but there are worrying indications that the Budget is stretching public finances to the absolute limit. Page 5 of the report from the Office for Budget Responsibility says that public sector debt is likely to increase by £125 billion in four years’ time. That is assuming 20% of the promised capital spend does not happen. We cannot rely on economic growth to make the debt less painful to repay in five or 10 years’ time than it would be now, because Brexit is going to slow our economic growth by at least 4%, even if we get a good deal. The OBR commented that
“Public finances are more vulnerable to adverse inflation and interest rate surprises than they were”.
It strikes me that the fundamental problem of the Blair-Brown Government was that, in effect, we had a Chancellor of the Exchequer who by instinct was a Keynesian but who tried to do Thatcherite economics, and it failed. Now we have a Government packed full of Thatcherites and they are having a wee shot at Keynesianism, and I do not think that will work either.
As my hon. Friends have highlighted, the OBR also warns us that its
“forecast assumes an orderly move to a new trading arrangement”,
first with the European Union and then with the rest of the world. Given that the minds of the UK Government and of all our current and potential trading partners are, quite understandably, fully occupied by covid-19 and will be until after the June 2020 deadline by which the Government say they need to have at least the basics of a trade agreement in place, surely the Government will now finally admit that enshrining the end of the transition period—December 2020—in law was an act of criminal recklessness. They might not have known what crisis was going to happen in the intervening period, but it did not take a genius to work out that something might go wrong.
Although the Government announcements on public spending have been welcomed in many quarters, and rightly so, if we look at the hard facts behind those announcements, we find that the long-term sustainability of our public services is, if anything, less secure after the Budget than it was before. That is not helped by an illogical and immoral approach to immigration, which will contribute to a 0.3% drop in GDP over four years. Ludicrously, that immigration, or rather anti-immigration, policy takes more money out of the public purse, because even the lower-paid migrant workers—the ones the current Secretary of State for Scotland was so shamefully contemptuous of last week, accusing them of coming here to work on low wages just to take advantage of our benefits and our services—pay three times as much in taxes as they take in benefits. So by deliberately stopping them coming here, by deliberately stopping them earning and paying their taxes, the UK Government are deliberately creating an additional black hole of £1 billion to £1.5 billion in our public finances.
Today, I heard the head of Scottish Care, who represents Scotland’s private sector care providers—and yes, I have issues relating to some of the private care providers in Scotland—say how moved he was by so many workers in the sector offering to move away from their families and become residents in care homes or hospitals for several weeks, just to make sure that the people they care for do not lose out if several members of staff have to phone in sick. They are the very workers whom the Government regard as burdens on our public services. As for the idea that hard-working, low-paid NHS workers should have to pay an extra flat-rate tax of £624 a head just for the privilege of continuing to work in our NHS, I cannot describe it in language that you would allow, Mr Deputy Speaker, because there is no parliamentary language robust enough to properly describe the sheer immorality of that proposal.
The Government will want to make a big noise about the new capital spending they announced—as I said, we will see when it actually happens—but we need to remember the very low baseline they are starting from. The National Education Union has pointed out that, in England, 3,731 schools need immediate repair and a further 9,972 will need significant work within two years at most, but the Treasury figures in the Red Book show that the Department for Education’s capital budget next year will be £100 million less than it is this year. How is that going to help? In contrast, the Scottish Government have replaced or substantially upgraded 928 schools since the Scottish National party came to power, and I am delighted that two thirds of all pupils attending secondary school in my constituency do so in schools that are less than seven years old. In Scotland, teacher numbers have increased for the fourth year in a row—[Interruption.] I hear muttering from the usual suspects on the Tory Benches. In Scotland, there are 7,485 teachers per 100,000 pupils; in England, the equivalent figure is 5,545.
I want to look at what the Government’s priorities appear to be. Working-age benefits are going up by 1.7%. If that was 1.7% on top of a similar increase every year for the past five or six years, it would not be too bad, but it is 1.7% on top of nothing for far too long. How can we defend a 1.7% increase in working-age benefits when MPs are getting 3%? I will not defend that to my constituents and I defy anyone in here to try to defend it to theirs. Perhaps one emergency step the Government need to take is temporarily to put Parliament back in charge of MPs’ pay rises and have this place unanimously agree that we are not taking a pay rise this year unless it is going to be at least matched by that for the lowest-paid workers in our society.
The new financial year starts in 16 days’ time. The Scottish Government, if they are lucky perhaps, have only just had confirmation of the full Barnett consequentials of this Budget—I am not convinced they have even got that yet. When we look at the potential impacts on the devolved finances of the covid-19 emergency, and we try to disentangle what additional funding is coming to the Scottish Government and what additional funding is not additional at all, as it has already been announced, it becomes quite difficult. I suggest to the Minister that this indicates that the current financial settlement—the fiscal settlement between the UK Government and the devolved Governments—needs to be completely revised, because it simply does not give the Scottish Government the flexibility they need to respond to this crisis in the same way as the UK Government need to be able to respond.
I saw a comment recently that pointed out that it is sad that it has taken a public emergency and a public crisis to force the Government to do some of the things they should have been doing previously. Even now, in responding to a public crisis, they have not acknowledged the tens of millions of private crises that have been going on in these islands in the past few years under this Administration. Far too many people are still living in poverty and that number will increase significantly as a result of the coronavirus crisis. It is essential that the Government look at their spending and taxation plans, initially to make sure that as many as possible of those whose domestic finances are severely disrupted by this crisis are back on their feet financially as soon as possible. The Government then have to acknowledge that we are starting from a position where far too many people on these islands are living in poverty or close to it, and that for that to happen in the fifth, sixth or seventh biggest economy in the world, depending who you believe, is utterly shameful. For any Government to be presiding over those levels of poverty 10 years after coming into office is something they cannot be proud about.
(4 years, 6 months ago)
Commons ChamberIt was always the final point, and it is very much the final point.
The other area that is essential for capacity is the social care system. My hon. Friend the Member for Ruislip, Northwood and Pinner (David Simmonds) talked about how money can be wasted. One of the biggest wastes of money is that we pay for people to be in hospital beds, which cost three times as much as care home beds, because we do not have the capacity in the social care system. It is very important that we encourage people to save for the future and protect people against losing their homes, but if we want to see a change in the NHS in the next five years it is fundamental that we increase the ability of local authorities to deliver adult social care to people who cannot afford it. At the moment, they do not have enough to do that, and we must put that right.
Finally, here we are, in the English Parliament after all these years. Isn’t it great? The Mace is down, the signs are up, and the dream of David Cameron has finally been realised. For the first time since 1707, English Members of Parliament will get to vote on English legislation to the active exclusion of the rest of us. I wonder if the Minister could have even dreamed, when he and I were but lowly Back-Bench members of the Procedure Committee back in 2015 and scrutinising the EVEL processes, that this is where we would end up today.
On 19 September 2014 David Cameron promised, in response to the independence referendum in Scotland, that we would have English votes for English laws. Three general elections, two Prime Ministers and countless Leaders of the House later, here it is in all its glory. I wonder, given the responses and speeches that we have heard today, whether anyone on the Government Benches really understands what is going on. We are debating clauses and amendments to a Bill that has been certified as being only relevant to England, but as the amendment themselves demonstrate, and as we have heard in speeches, it will have implications for health spending policy across the whole of the United Kingdom—and very serious issues, too—for mental health, for the construction of hospitals, and for the difference between capital and revenue spending on the NHS.
I wonder whether, like me, my hon. Friend feels that this English Parliament is actually pretty similar to the usual Westminster Parliament that we do all our business in. Does he agree that the English votes for English laws procedure has been about the most divisive, disruptive and useless procedure ever put into this House? It makes distinctions between classes of Members of Parliament in this House, and what we are doing today is disallowing us to vote on issues that are vital to the Scottish health service. Does he agree that it is a disgrace, and that it must go?
Yes; I absolutely agree. My hon. Friend is right: I barely noticed the difference as this place magically transformed itself into the Legislative Grand Committee (England). Incidentally, I do not know whether he remembers, from his time here, whether the Scottish Grand Committee was ever permitted to meet in the Chamber of the House of Commons. I fear it was not, so quite why the English Grand Committee enjoys that privilege and does not have to meet elsewhere in the building or elsewhere in England is kind of beyond me. But my hon. Friend is right that those of us from seats in Scotland and Wales and Northern Ireland are, for the first time, being actively excluded from the opportunity to vote on amendments.
The right hon. Member for Alyn and Deeside (Mark Tami) may also have been a member of the Procedure Committee back in the day; I certainly seem to remember points about the cross-border hospitals being raised. He has constituents in Wales who use hospitals in England that will be affected by this legislation, and he is unable to vote on or amend those provisions.
My hon. Friend’s secondment to the English Parliament is going rather well so far, although it is rather similar to the UK one. Does it not distil the ridiculousness of the EVEL procedure that we have before us a Bill that clearly impacts on the funding of the NHS in Scotland, as the former Secretary of State mentioned, and yet the Government have put the Chair in the invidious position of deciding on the issues that we can or cannot vote on, instead of our making that decision about the issues that are important to our constituents?
My hon. Friend is absolutely right; and we raised those points five years ago, when the EVEL process was being introduced.
I have never been a member of the Procedure Committee. The Countess of Chester, which is a foundation hospital, has trustees who are elected from Wales. They are elected and can take part in decision making, but as an elected representative in this place, I cannot, apparently.
There we go. We have now had as many Welsh and Scottish Members contributing from the Floor, as Members from elsewhere in the United Kingdom. These points were raised back in the day, on the Procedure Committee, even if it was not the hon. Gentleman who gave that evidence.
This morning, the Prime Minister turned up at the Science Museum in London to launch a conference that is taking place in Glasgow. That probably tells us all we need to know about the Government’s concept of how the United Kingdom works. Four days after the UK leaves the European Union, and the Tory Government choose to display their love for the precious Union on these islands by creating two classes of Member in the House of Commons—those who can amend legislation and those who cannot. Well, as the Chair of the Health Committee asked us to say, “Thank you.” Thank you so much, because the polls are showing that support for independence in Scotland has reached 52% and growing, and that support will not go away. Constituents in Scotland will be watching today’s proceedings, wanting to know why their Members of Parliament are not allowed to vote on amendments that could increase health spending, not just here in England but throughout the United Kingdom.
Labour’s new clause 5 rightly calls for the Government to analyse the effect of inflation on the figures set out in the Bill.
Does my hon. Friend agree that, as I mentioned earlier, the fact that inflation could make these cash rises meaningless makes it very difficult for the Scottish Government to predict what Barnett consequentials they can count on in 2023 and 2024, so it should be committed to in real terms, not just cash terms?
Yes; my hon. Friend is absolutely right, and we would be very happy to support new clause 5 if the procedures of the House allowed us to. It is absolutely crucial to what the Bill is trying to achieve.
We know it is a showpiece Bill anyway, but the Government are getting a showpiece English Parliament out of it as well. Of course, the terms of the money resolution are so restrictive that amendments intended to amend the figures in the Bill are completely out of order. The Labour party tried that—that point was raised by more than one Opposition Member at Second Reading, and I am not sure that Ministers could answer it.
Labour’s amendment 3 prevents capital funding from being transferred to revenue streams. That is hugely important as well, because any increases in the revenue funding—the figures on the face of the Bill—have to come from new money. Otherwise, the whole thing is pointless: it is just shuffling things around. It is new money that would give rise to Barnett consequentials, and that is where our interest comes in.
New clause 4, on performance targets, makes exactly the same point, and we support that as well. That is also relevant to us.
It is often cast up here that the Government in Scotland are not spending all the Barnett consequentials on health, but they do. The problem is that although the Government here keep talking about the rise they are giving to the NHS, there are cuts to public health and social care, and there have been cuts to education and training. In Scotland, we still take the whole responsibility of a health Department seriously.
My hon. Friend is absolutely right on that. The Scottish National party has always pledged—we have done this throughout our time in government—that any Barnett consequentials that arise from health spending in England get passed to the NHS in Scotland. Any time the figures set out in this Bill increase, those Barnett consequentials would be expected to fall to the Scottish block grant, so it is well within the interests of Members from Scotland, Wales and Northern Ireland to seek to amend this Bill. Our own unselectable suggestions that appear on the amendment paper require analysis of what would happen if health spending per capita in England and Wales was raised to the level in Scotland. That was part of our manifesto commitment; by raising health spending in England, we would also raise spending across the United Kingdom. But here and now, on the Floor of the House of Commons, in the UK Parliament, that idea cannot be tested, voted on or even, technically, discussed.
Does my hon. Friend agree that “per capita” is a much more informative way of describing spending, because demand is increasingly rapidly, with an ageing population that is not ageing healthily, and just talking about the headline numbers does not show whether the amount provided for each person is sufficient to provide their services?
I thank my hon. Friend for that. The contributions she is making demonstrate precisely why Members from Scotland should have been allowed to participate fully in this stage of the Bill and the whole process.
If the official Opposition choose to press any of their amendments this afternoon, we will seek to express our views, on behalf of our constituents, by walking through the Lobby. We will walk past the signs that say, “England only” and if the Tellers from the Government Whips team choose not to count us, that will be their decision. Of course they will also have to discount any of their own colleagues from Scotland and Wales who deliberately or accidentally end up in the Lobby; perhaps that is also an argument for getting rid of this ridiculous voting Lobby system, but I appreciate that that is for another day.
The Government could have avoided this situation, by allowing proper time for a Report stage, where Members from Scotland and elsewhere could move amendments. They could have committed the Bill upstairs to a Public Bill Committee, but they chose to convene an English Parliament here in the Chamber of the House of Commons, which is supposed to represent the whole of the UK.
My hon. Friend has taken over the EVEL mantle with great aplomb. I understand that the “England only” signs are already in the Lobby, and this in the UK Parliament of Great Britain and Northern Ireland! What does that say to people from Scotland? What does it say, given that this Bill determines so much of our health spending in Scotland? Surely the days of EVEL have to come to an end. We cannot go on like this. This is the Parliament for everybody across the United Kingdom; it is not their Parliament to squat in.
It really does not feel like that at the moment, does it? Hear no EVEL, see no EVEL, speak no EVEL should be the mantra, because my hon. Friend is right; this might not be the last time.
I am grateful to my hon. Friend for allowing me to speak in the English Parliament for the first time. Does he agree that one way to get around this whole EVEL conundrum is simply for the English Parliament to be made officially an English Parliament and then we can all have our own national Parliaments in our own countries?
Order. I am sure colleagues will appreciate that it is important that we actually talk about the Bill.
I wholeheartedly agree, Dame Rosie. I have addressed the amendments that we have an interest in, and I am contextualising why they are relevant to our constituents, but points are being extremely well made by my colleagues. There is a simple solution to this, which we in the SNP have been promoting for 84 years, since 1934: Scotland can become an independent country and England can have the Parliament that it wants. As my hon. Friend the Member for Airdrie and Shotts (Neil Gray) says, with the greatest respect for the Speaker, it should not be for the Chair or for the Government to decide what does and does not apply to Members from different parts of the UK. My job and that of my colleagues is to look at each measure before this House and determine for ourselves whether it is relevant to our constituents and act accordingly. Today, we are being actively prevented from doing that. There are amendments and new clauses on the amendment paper that we deem to be of interest to people in Scotland, which would take forward commitments in our manifesto, but we will not be able to vote for them. That is not a precious Union. That is not a partnership of equals. That is not leading instead of leaving. It is not something that is going to be sustainable for much longer, and 52% of people in Scotland seem inclined to agree.
I rise to speak to new clause 9, tabled in my name and those of the hon. Member for Central Ayrshire (Dr Whitford) and my hon. Friend the Member for Broxbourne (Sir Charles Walker). I am pleased that Scotland will have its say, at least with regard to this new clause.
Conceptually, the Bill will absolutely do the right thing, because for long-term decision making we need some clarity as to how much money there will be. As I said on Second Reading, my concern is about whether or not the figures are right, and at that point I proposed a formula that would enable the figures to be flexed to properly determine the need and whether the figure would to be sufficient to meet it.
New clause 9 deals specifically with the issue of mental health. There is agreement among all parties that it is crucial that we get mental health right. It is crucial that it is properly respected and properly resourced. Members from all parties have talked about and supported parity of esteem between physical health and mental health. It might be useful—this is not in the new clause, but we are talking about the issue more broadly—if at some point the Government could give some clarity on, if not a formal definition of, what parity of esteem means.
I am grateful to my east midlands colleague, my hon. Friend the Member for North East Derbyshire (Lee Rowley), for that excellent speech. He made some important points, particularly about outputs, the specific healthcare that is needed and the support required throughout the NHS.
I am grateful for this opportunity to speak to amendments 1, 2 and 3. The funding in the Bill will be administered by NHS England. The Bill guarantees long-term funding to implement the NHS long-term plan. It commits the Government to a £33.9 billion increase for the NHS by 2023-24, bringing the total spend to £148.5 billion. It also provides certainty through a double-lock agreement that places a legal duty on the Secretary of State and the Treasury to uphold this level of funding as a minimum over the next four years.
We are putting our money where our mouth is. Our manifesto clearly stated that
“within the first three months of our new term, we will enshrine in law our fully funded, long-term NHS plan”.
Since our success in December, we have consistently put forward and agreed steps to meet the commitments in our manifesto. We are delivering on the promises that we have made.
One of the most important aspects of the NHS long-term plan is its approach to mental health. It is crucial that people have access to mental health services where and when they need them. I, therefore, welcome the fact that the plan commits to ensuring that mental health receives a growing share of the NHS budget, which will be worth at least a further £2.3 billion a year in real terms by 2023-24. This will enable further service expansion and faster access to community and crisis mental health services for adults and particularly for children and young people.
Given that many people living with mental health issues may need to access health services more often, the NHS long term plan also allows for better and more consistent working between all parts of health care and voluntary elements of the sector. As we have seen in west Leicestershire, for example, primary care networks have formed, grouping GPs and other partners together to the benefit of their patients.
As NHS England sets out, primary care networks build on the core of current primary care services and enable greater provision of proactive, personalised, co-ordinated and more integrated health and social care. Clinicians describe this as a change from reactively providing appointments to proactively caring for the people and the communities that they serve.
Linking this local working together with the benefit and knowledge of vanguard projects from across the country and giving experienced local trust leaders, who have a deep understanding of the physical and mental health needs of their local area, the freedom to make appropriate funding decisions will improve the overall experience of the patient and provide better health and lifestyle outcomes. That is to be welcomed and celebrated, and I ask my fellow colleagues to support the Bill and reject the amendments today.
On a point of order, Dame Eleanor. I notice that it is now 5.10 pm and that the Minister is about to get to his feet. If the knife falls at 5.30 pm, while the Minister is still speaking, or a Division is under way, can you confirm that that means there will be no Report stage, and no chance for the SNP amendments to be tabled or voted on?
The hon. Gentleman is absolutely right in regard to the procedure. If we finish this part of the procedure before 5.29 pm, there will be a very short time for the next part of the procedure. If this part of the consideration of the Bill goes to 5.29 pm, there will indeed be no time for the Report and consideration stage. That is correct, as is normal in any Bill, but I am grateful to him for pointing it out so clearly.
On a point of order, Dame Eleanor. I think that we should mark this moment. This is the busiest that the English Parliament has been since 1707. I have never seen so many people so keen to take part.
I am interested in the numbers that have just been read out, Madam Deputy Speaker, because 163 for the Ayes seems very low to me. Just by means of a headcount, I counted a significant number more than that. In fact, according to my calculations, at least 46 Members from Scotland, Wales and Northern Ireland were in the Lobby just now. Can you tell me whether the number that was read out in the House accurately records the number of Members of Parliament who wished to express their view on the amendment?
I am grateful to the hon. Gentleman for expressing his concerns in such an articulate fashion, and I note the words that he has used. I can confirm to him that, although his count of the number of Members who wished to express their view might well be correct, the numbers that I have announced to the House and on which I will rely from the Chair constitute the number of Members who have a right to vote on this matter. As the hon. Gentleman knows, under the procedures set out in Standing Order 83W—with which he, if not the rest of the House, must of course be familiar—Members who do not represent constituencies geographically situated in England do not have a right to vote in these particular Divisions.
There are no amendments on consideration.
On a point of order, Madam Deputy Speaker. It is great to be back in the United Kingdom Parliament—just like magic! I congratulate you on your skilful chairing of the English Parliament from the lower Chair over the last three hours. You have just announced that there are no amendments to be considered on Report as none had been tabled because the knife fell more than an hour ago. Could you confirm that that is correct? I notice that the selection list says:
“Mr Speaker has provisionally selected…New Clauses…as long as the 3 hour time limit has not expired: NC6 [SNP] + NC7 [SNP].”
For the record, can we confirm that the effect of all this has been that amendments tabled by Members of the Scottish National party have not been debated tonight and could not been divided on because the Government did not provide enough time, or Members took up so much time in the meeting of the English Parliament—the Legislative Grand Committee—that they have effectively denied the rights of SNP Members to table amendments to a Bill that directly affects our constituents?
The hon. Gentleman’s analysis is not wrong. The knife has fallen. The House voted some days ago to provide three hours, or four hours in total, for consideration of this Bill, and it is indeed the case that because those four hours have passed, there is no time for debate on consideration and Report—that is absolutely correct. There is also no time for debate on Third Reading.
As to whether the Government did not provide sufficient time, or Members of this House took up all the time in the early part of the proceedings, that is not a matter for me to judge; I have merely facilitated it. Members might have decided not to speak for very long at the beginning. If so, the hon. Gentleman and his colleagues would have had the opportunity to discuss the matters that they had tabled. I thank him for his further points.
Does the Minister intend to move a consent motion in the Legislative Grand Committee?
I remind hon. Members, although I do not think there is any need for reminding at this stage, that if there is a Division, only Members representing constituencies in England may vote.
On a point of order, Dame Eleanor. We are back in the English Parliament again and the absurdity of this procedure is now being laid bare. [Interruption.] I am delighted that Conservative Members are groaning because several of them voted for it when it was introduced way back in 2015. They did not have to—it was a choice. I am not trying to beat the record of my hon. Friend the Member for Perth and North Perthshire (Pete Wishart), who has spoken in the Legislative Grand Committee for England more times than any other Member of this House over the past four years, but can we just confirm again that, as you said, if Scottish Members, for whatever reason, were to object to the consent motion, you would not even be able to hear their voices —it is as if we are invisible?
It is not as if any hon. Member of this House is ever invisible or, indeed, inaudible, but merely, once again, following Standing Order No. 83W, which this House resolved to put into the Standing Orders of the House.
(4 years, 7 months ago)
Commons ChamberI want to finish this section, Madam Deputy Speaker. The crucial thing in this Bill is the certainty: the Bill provides everyone in the NHS with the certainty to work better together to make long-term decisions, get the best possible value for money, increase the productivity of the NHS and improve how the health system is organised and delivered. That is not just tied to what has been done in the past, but is driven by a clear view of what the NHS needs to do in future, exactly as my hon. Friend the Member for South Dorset (Richard Drax) said.
If the Secretary of State is so proud that these figures represent a floor and not a maximum, why have the Government tabled such a restrictive money resolution? It means that it will be impossible for Members to table their own suggestions about higher amounts—bringing UK health spending in line with per capita spend in Scotland, for example, despite the fact that the Bill is subject to the English votes procedure.
Having spent 33 years as a surgeon at the very sharp end of the NHS, I welcome the multi-year funding because it should allow better planning, but it does come after a decade of drought. Between 2010 and 2015, the average annual uplift was 1.1%. Between 2015 and 2018, it was only 2%. That means that over that period of eight years—during a time of inflation, and particularly rising demand with an ageing population—the NHS in England faced a real-terms cut, which is why quoting the spend per head is actually more realistic and more accurate. Scotland spends £136 a head more on health, which is why the Secretary of State is forever claiming that Barnett consequentials are not passed on in Scotland. Every penny of resource consequentials are passed on, but here is a little explanation of percentages: if the starting amount is bigger, the same amount will be a smaller percentage. We have explained this before, but we keep hearing this nonsense. In actual fact, if the Scottish Government used the same per capita spend on health as the UK Government does for England, Scotland would be £740 million worse off.
I have raised with the Minister the concern about the cap that the Government have put on the spending figures through the use of the money resolution, but the whole Bill is going to be committed to the English Legislative Grand Committee, so Members from Scotland are not going to be able to table amendments to pursue exactly such points with the Government. We are not going to be able to inquire, as other Members from the rest of the UK will be able to do, table probing amendments or question the impact of the Government’s spending. Does my hon. Friend agree that that really undermines the point of this being a sovereign UK Parliament?
The whole issue of English votes for English laws applying to Bills that have direct Barnett consequentials for the three devolved Governments is obviously complete nonsense, and certainly makes all devolved MPs second class.
The Government are committed to £33.9 billion a year in cash terms by 2024. As has already been pointed out, that is actually just the same £20 billion that was promised in 2018. It is not extra, new money. It is not on top of the £20 billion. It is the same amount. It has been described as a 3.4% increase in real terms, but the Health Foundation has already suggested that, due to inflation, it is actually only 3.3%, and the Institute for Fiscal Studies predicts that it will be only 3.1%. The key problem of making a commitment in cash terms is that if inflation rises post Brexit—by which I mean at the end of 2020—as is likely, the commitment would simply wither on the vine. It should be front-loaded because the urgent need is now, and it should be in real terms; otherwise, talking about 2024 in cash terms is actually just pie in the sky. The three main health think-tanks and the British Medical Association think that 4% is required to restore the service to the performance that is expected. More than that would be required for service redesign, to match the shopping list we heard the Secretary of State recite.
I am glad that the Secretary of State has moved away from talking about apps. The idea that people are going to rub a mobile phone over their tummy to diagnose appendicitis is for the birds. People need doctors. Healthcare is delivered by people, and the idea that an app on our phones can replace that is just nonsense. However, I was glad to hear the Secretary of State talking about internal IT in the NHS in England because, frankly, it has fallen behind since the Care.data scandal. There is a lot that could be done IT-wise to utilise the existing workforce in a much better way. In Scotland, radiologists can view any X-ray anywhere in Scotland through the picture archiving and communications system. We have electronic prescribing, which is not only efficient, but a patient safety issue because doctors cannot prescribe a drug to which the patient is allergic. These are things that should be focused on, rather than gimmicky apps on mobile phones. Again, this is just money focused on the NHS revenue funding.
The NHS long-term plan, exactly like the 2015 five-year forward plan—we are seeing a bit of a theme here—was predicated on game-changing investment in both public health and social care. The public health grant for local authorities that is currently proposed is only expected to rise by 1%. That means a significant real-terms cut, on the back of £850 million of cuts that have already happened, resulting in a reduction in smoking cessation, sexual health and addiction services. That does not make sense, as even the Secretary of State admits that prevention is better than cure.
(5 years, 3 months ago)
Commons ChamberI congratulate the right hon. Member for Hemel Hempstead (Sir Mike Penning) and the hon. Member for Gower (Tonia Antoniazzi) on securing this debate, and I thank the Backbench Business Committee for managing to schedule it so that we have enough time for a reflective, open and consensual debate—[Interruption.] So far! I am really looking forward to hearing what the Minister has to say in response.
We are debating an issue whose time has come. The individual cases have come together into a campaign that shows where the consensus is beginning to lie. I want to reflect a bit on that, and to speak, as many others have done, about an individual constituency case. I also want to think a bit more about the consequences of the wider campaign.
At the beginning of the debate, some Members, including the right hon. Member for Hemel Hempstead and the hon. Member for Reigate (Crispin Blunt), talked about the growth of the campaign and of public awareness of this issue. Campaigns such as these can often start with what seem to be quite isolated cases. An individual comes to one of our surgeries and the Member then has the incentive to raise the issue here in the House, after which others join in, saying, “I’ve had that as well.” Then we get the urgent questions and the Back-Bench debates, and the issue becomes much more live and mainstream. Members of the public are encouraged to come forward to their MPs with their individual cases, and the broader public are encouraged to support the overall issues. We have seen this in a number of areas. I am reminded of the WASPI campaign—although that is a completely different situation—because of the way in which it snowballed as people came forward to their individual MPs with their local cases and it built into a positive campaign from there.
The policy environment on medicinal cannabis is ripe for change. We have heard today about the knowledge and experience in other countries as the different kinds of cannabis medicines have been rolled out effectively. In fact, we have heard about that happening here as well, because those people who can afford private prescriptions are feeling the benefit of these medicines. However, it is incredibly frustrating for those who, for whatever reason, cannot access the right kind of medicine privately. The whole point of the NHS is that treatment should be available free at the point of need, and that it should be blind to people’s individual financial circumstances. The progress that the Government have made has to a certain extent been welcome, but the hope that was provided when the reclassifications and the provision for prescriptions from individual doctors were announced has now been dashed.
In the spirit of this cross-party consensus, I say to the hon. Gentleman that this is not a dig. This matter is devolved in Scotland, Wales and Northern Ireland. These medicines have been prescribed privately in Northern Ireland. Progress was made there. Scotland could do this; we could do it; and Wales could do it. I know that discussions are going on within the Department, but we must not take this in isolation. This must happen across the United Kingdom. I passionately agree with devolution, but no child should suffer because one area is devolved and people are playing catch-up with the other parts of the United Kingdom.
That is fair enough, and I want to maintain the tone of consensus in the debate. The licensing and classification of drugs remains a reserved issue, and the right hon. Gentleman is right to say that the Governments have to work and move forward together. The Scottish Government have indicated their willingness to do this, and we have to make sure that we move on. Frankly, in Scotland, we are always happy to take on more responsibilities and further devolution and, if we do not see the progress that is being sought, perhaps that is what we should do.
I want to speak about a specific constituency case that I have raised in the Chamber once or twice before. My constituents Laura Murray and John Ahern came to see me for the first time in November 2017, a few months after their beautiful daughter Bláthnaid was born. She has been diagnosed with Aicardi syndrome. With only around 4,000 cases worldwide, it is incredibly rare, but the symptoms are similar to those described by others and include frequent seizures and possible visual impairment. The treatment is limited, and the medicines that she has been prescribed are incredibly powerful, coming with their own debilitating side effects. The hon. Member for Gower made a powerful point about how much money the NHS has been spending—I appreciate that some of this is devolved—on providing emergency treatment and last-minute access to expensive drugs when the parents are keen to try an alternative.
Laura and John wrote to the Secretary of State for Health and Social Care to describe the situation, saying that Bláthnaid
“suffers multiple seizures every day and night which cause her extreme distress. They cause her to scream in pain, cry tears and become highly distressed, which is very distressing for her and us as parents and for her family to witness.
Bláthnaid has been hospitalised due to the severity of her seizures, and whenever she is ill her seizures increase, and she ends up in hospital. This is no way to live for Bláthnaid, to continually suffer and have no quality of life.”
Sadly, we hear about too many similar cases. Bláthnaid’s parents are looking for access to full-extract medical cannabis and will otherwise be at their wits’ end. The situation is particularly galling because, as the wee girl gets older and becomes more aware of what is happening, things become even more frustrating and painful.
I have written to the Health Secretary, the Home Secretary and the Scottish Government’s Cabinet Secretary for Health and Sport. I want to work with people at every level. I will meet with Ministers, with the GMC and with the local health board—whoever I have to meet—to try to secure progress for this individual case, but it should not have to come to that. Almost every Member who has spoken has raised a constituency case or another specific case, which demonstrates that the overall regime has to change. Doctors having to take personal responsibility is a hurdle in several cases. I know that there is provision for second opinions on this side of the border and I want to discover how that can work in Scotland.
I hope that future decisions do not have to come down to individual interventions and that we can have a more permissive atmosphere. I appreciate the point about devolved and reserved matters, but I was a little disappointed simply to be batted to the Scottish Government by the ministerial correspondence unit after raising the issue on the Floor of the House and after including the personal testimony from my constituents. I hope for a little more engagement from the Department of Health and Social Care down here.
It is interesting that the broader campaign is called “End Our Pain” because this does go beyond any one individual case. Dozens of constituents have been in touch in support of the campaign, because they see the benefit to themselves, their families and their friends. They see the benefit to wider society, and they have been moved by the different stories told throughout the campaign. “End Our Pain” refers not just to physical pain or the symptoms that any one individual is experiencing, but the frustration, the delays and the uncertainty. It means the pain of knowing that others are suffering unnecessarily and the pain of knowing that the solution is out there—if they could only get their hands on it.
As I have said, medical cannabis is an idea whose time has come. Public support is there. The evidence from other countries is there. The individual evidence based on when people have been able to access medical cannabis in the United Kingdom is there as well. The Scottish Government stand ready to play their part. I hope that the United Kingdom Government will also take this opportunity to act.
(5 years, 3 months ago)
Westminster HallWestminster 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.
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In some respects, it is nice to have a slightly relaxed atmosphere in Westminster Hall, because that gives us the opportunity to consider issues in detail. I congratulate the hon. Member for Congleton (Fiona Bruce) on securing the debate. It is a happy coincidence of the calendar that Marriage Week and Mental Health Awareness Week have fallen on the same dates, because that allows us to consider how marriage and mental health relate to each other. We should also note the general importance of awareness weeks and the work of the organisations that support them, because they give us an opportunity to raise issues in the House and press the Government on their commitments.
I congratulate the Marriage Foundation on promoting Marriage Week, which I believe has been marked for the past 22 years—not quite as long as the hon. Member for Strangford (Jim Shannon) has been married, but not far off. I also congratulate the Mental Health Foundation, which has worked on mental health issues for more than 70 years. I am actually wearing a tie with the mental health tartan, which was developed by Support in Mind Scotland as a colourful way to promote mental health awareness and understanding.
As we have heard, Marriage Week is all about the ingredients of positive and healthy relationships, which are at the heart of a successful and vibrant society. Families and relationships bring meaning and purpose to people’s lives, and they come in all shapes and sizes, as the hon. Member for South West Bedfordshire (Andrew Selous) said. Governments have a responsibility to support them by providing good-quality public services and fair work practices to ensure that people can live healthy and fruitful lives. When people feel supported by such services and by a positive sense of community, relationships can flourish. That is an ambition of all Governments, no matter what their political character may be or in which part of the United Kingdom they may operate.
It is right to stress that not all marriages are happy or end as happily as they began. It is important to have services and support in place to help those partnerships to move forward as positively as possible. In Scotland, a lot of support is provided to national family support organisations, such as Relationships Scotland and The Spark. As the hon. Gentleman also said, that importance is particularly true in making sure that the support is there for children, whether that is mental health support or mediation.
As the hon. Member for Strangford said, people present at our surgeries and we, as Members of Parliament, have an individual responsibility to signpost people to the right organisations and to be aware of the range of support services available nationally and in our communities.
Marriages come in all shapes and sizes, and Scotland was of course the first country in the United Kingdom to consult on same-sex marriage and subsequently to legalise it, through the Marriage and Civil Partnerships (Scotland) Act 2014. That has been a cause of great celebration, including among close friends of mine.
Not every marriage, however, is made through free choice. That is why we must also recognise the importance of having robust legislation in place to protect against the appalling practice of forced marriage and to ensure that marriage is not a misery or a trap. The Scottish Government introduced forced marriage protection orders to protect people from being forced to marry, or who were already in a forced marriage. In September 2014, that protection was extended to protect those at risk and to make forcing someone into a marriage a criminal offence in Scotland.
By coincidence, there was a particularly high-profile exponent of marriage in the news last week. The First Minister of Scotland, Nicola Sturgeon, gave an interview to her local station, Sunny Govan Radio. She was asked what had surprised her in recent years, and she said her marriage had surprised her:
“I had always been a bit of a feminist and never really considered marriage as an option. When Peter and I decided to get married, it was immediate how much more strong and stable I felt knowing that I had him at my back. His support and the support of my mum and dad give me the resilience and strength to keep going every day and doing my best.”
I hope those are words of encouragement to everyone who is considering marriage. Nobody is an island. None of us politicians is an island. We all have colleagues who have experienced difficulties and intimidation. When you are the one person in a room standing up speaking, that is difficult for any one of us. For most of us, it is the knowledge of the strong relationships in the background, whether marriage or other forms of partnership, or friends and family, that provides that support network that we rely on.
That point links to the importance of Mental Health Awareness Week. The First Minister went on to speak about some of the challenges and stresses that come with life in the public eye, particularly her experience of imposter syndrome. When asked if she ever feels like an imposter, she said:
“Like many women in senior positions, yes I absolutely do. However, I think it gives women a bit of humility too and reminds you that you have to work hard for what you need to achieve. It keeps you grounded. Do I deserve this? Could I do better? It makes you more accountable for your own work.”
That level of self-awareness and her willingness to speak out should be an encouragement for everyone in public life and beyond. It is important to use such opportunities to raise awareness of the issues.
The main focus for Mental Health Awareness Week this year is body image—a subject that has become topical in the last few days with the issues that led to the cancellation of “The Jeremy Kyle Show” and questions about “Love Island” and other reality TV programmes. Sometimes, frankly, this job can feel like a bit of a reality TV programme, though it is less likely to be slated for immediate cancellation. Using the opportunity of awareness weeks to turn the debate on social media around and to try to detoxify online culture is hugely important. We must support people who champion body positivity online and make sure that people who are struggling with those kinds of issue, especially young people, interact with social media content in a healthy way and avoid falling into mental spirals.
The Scottish Government have made several announcements to try to support that this week. They are setting up an advisory group on healthy body image, which will include members from youth, third sector and equalities groups, to identify steps that can improve support for young people and advice for relevant professionals. That will build on a package of measures to improve young people’s mental health, including £90,000 in funding to provide advice on the healthy use of social media and screen time, and a review of evidence on the effects of screen use on sleep and its implications for mental health.
We will continue to drive that forward and, again, I hope there will be lessons that the Governments can learn from each other. The hon. Member for South West Bedfordshire spoke about how such issues can be championed in Government. The Scottish Government have a dedicated ministerial post for mental health. The occupant, Clare Haughey, was herself a mental health nurse and brings significant personal experience to the post. The desire to see mental health issues mainstreamed across the NHS and other support organisations runs right across the national strategy.
Like other hon. Members, I see fantastic examples in my own constituency. The members at Flourish House, part of the global Clubhouse Network, presented me with this tie the last time I met them. They wanted to engage with me on different aspects of how Government and public policy affect people with mental health issues, particularly on questions around welfare reform, but also other aspects of social care and the health services. Flourish House does a fantastic job in reducing social isolation and providing different kinds of activity and engagement for its members. Similarly, the Coach House Trust provides a particular focus on employability and skills. It has been doing so for more than 20 years and has an annual open day that is a highlight of the summer calendar. We are always spoilt for choice with the arts and crafts available for sale that have been produced by their members over the years.
I also pay tribute to a group called Differabled, which was founded by parents in my constituency to provide support for other parents and carers of children and young adults with a range of additional support and mental health needs. I met them during the 2017 election campaign and it was an incredibly powerful experience. The way that organisation has developed is incredibly impressive, and I continue to support it.
The Glasgow Riding for the Disabled Association helps to promote the mental health benefits of physical activity and physical exercise in different ways. It was the beneficiary of the Christmas card competition that I ran in my constituency last year. Last year and the year before, the winners of the competition came from two of the schools that provide support to children with additional needs and mental health issues. East Park in Maryhill has been supporting young people since 1874, and Alexander Houston was a worthy winner of last year’s competition. Abercorn Secondary School, which is supported by the local authority, provides a fantastic supportive environment, and Jack Slavin’s Christmas castle featured on my card in 2017. Kelbourne Park Primary School, in North Kelvinside in my constituency, supports younger age groups in a wonderfully nurturing environment. I use this opportunity to offer them my full support.
There has been a fair degree of consensus in this debate, particularly on the importance of stability in relationships for good mental health, and the benefits that that has for wider society in promoting social justice and tackling poverty, and the many different things that, in our different capacities, we all came into politics to try to achieve. There is a challenge to the Governments in the United Kingdom and the devolved nations to ensure that adequate funding is in place for the different services and that the appropriate legislative frameworks are in place to support families and the various organisations that work with them.
I hope the Chamber will indulge me, because on 1 June, during the recess, I will be attending a wedding of two very good friends of mine, Emma and Adam. I have known Adam Sutherland since we were very young. Of course, people are a bit older when they get married these days, so their chances of being married for quite as long as the parents of the hon. Member for Strangford probably depend on a variety of factors, but the strength of their relationship will be a solid foundation for many long years of happiness, and I hope the Chamber will join me in wishing them all the best.
(5 years, 4 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
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Order. It is in the interest of the hon. Member for Cumbernauld, Kilsyth and Kirkintilloch East (Stuart C. McDonald) that I call his Chief Whip before him.
The expectations of too many families have been raised by the Government’s previous announcements. It really is time that they get a move on. I will write to the Secretary of State about my young constituent who has Aicardi syndrome. Her parents firmly believe that medical cannabis would help her symptoms and seizures. What steps is he taking to ensure that those kinds of rare syndromes are taken into account at trial stage?
(5 years, 5 months ago)
Commons ChamberI am sure that the right hon. Member for Chesham and Amersham (Dame Cheryl Gillan) would have been very proud of all the contributions to the debate today, and I hope that the hon. Member for Bexhill and Battle (Huw Merriman) will send her our best wishes.
On a point of order, Madam Deputy Speaker. Can you advise me, first, how we can get on the record that over 1 million people have now signed the petition calling for the revocation of article 50 as the best way to stop the Brexit madness that seems to be engulfing the country, and secondly, whether you have had any indication from the Leader of the House—she said this morning that if it got to 17.5 million signatures, she would start to consider it seriously, so only 16.5 million more are now needed—that she is planning to make a statement to the House?
I thank the hon. Gentleman for his point of order. I have not received any indication from the Leader of the House that she intends to come here today. He will know that, under the e-petitions system, the Petitions Committee will consider any petition that receives more than 100,000 signatures for a debate. It is a matter for that Committee when such a debate is scheduled. I am sure it will be looking at this petition in due course, and I am also sure there will be ample opportunities in the coming days for the hon. Gentleman to make his views known. In the meantime, those on the Treasury Bench will have heard his request.
(5 years, 8 months ago)
Commons ChamberAs chair of the all-party group on HIV and AIDS, may I first offer a whole hearted tribute to the bravery, courage and example of my hon. Friend the Member for Brighton, Kemptown (Lloyd Russell-Moyle)? He has not only shared with us his own very personal experiences in such a clear and honest way that will have an impact in this country and globally; he has also—I would expect nothing less from him—not shied away from the fact that HIV is political. He has mentioned many of the issues still faced by those living with HIV in this country and around the globe, including stigma, discrimination and a lack of access to services. If any message goes out from here today, it should be that we need to continue the fight and end this by 2030, and we can end it. After the example that my hon. Friend has shown today, I am all the more confident that we will do so.
I also pay tribute to my hon. Friend on behalf of other vice-chairs who wanted to be here but could not—Baroness Barker, Lord Black, and my hon. Friend the Member for Stockton South (Dr Williams)—and who are incredibly proud of what he has done today.
As my hon. Friend said, the situation has dramatically transformed since the first World Aids Day 30 years ago. I remember coming to these issues while working in the international development sector for World Vision, Oxfam and others, and I look back at some of the horrific statistics, particularly on young people orphaned or made vulnerable, on those living with HIV and on those dying from AIDS. We saw this as an unreachable mountain that could not be overcome. The progress that has been made over the past 15 years is remarkable, but we must not have a slipping back in that progress.
I would like to express, on my own behalf and that of my SNP colleagues who cannot be here, our commendation for the incredibly powerful and moving testimony that the hon. Member for Brighton, Kemptown (Lloyd Russell-Moyle) has given. The hon. Member for Cardiff South and Penarth (Stephen Doughty) is absolutely correct that that speech will be heard not just here, and not just across this country, but around the world. It provides an opportunity to tackle the stigma that is still associated with HIV in so many parts of the world and that prevents people seeking the treatment, or even the diagnosis, that they need, despite all the opportunities and all the funding that is provided. There has to be a change of mindset as well. So we are thoroughly behind what we are hearing today.
I thank the hon. Gentleman for his intervention and completely agree with what he has said.
As my hon. Friend said, access to antiretroviral treatments has revolutionised both treatment and prevention. That has enabled many HIV-positive people to achieve viral suppression where the level of HIV in the blood is so low that it is undetectable and, crucially—we have to emphasise this—untransmittable to others. U=U—undetectable equals untransmittable—is one of the messages that must ring loud and clear from his speech and from this House. It has transformed the medical understanding of HIV from a fatal and emergency disease to one that is chronic and manageable, and where people can live long, happy, healthy lives.
But we must recognise the challenges that exist, particularly internationally, among the world’s 36.9 million people living with HIV. That is still a huge figure. One in four remain unaware of their HIV status. Among those who have tested HIV-positive, 21% globally do not have access to treatment and, of those who have access to antiretroviral treatment, 19% have not yet achieved viral suppression.
I want to turn briefly to some of the key challenges that we face in the UK, which my hon. Friend laid out. Forty-one per cent. of people are still diagnosed late and one in eight people living with HIV do not know their status. In October, we held an event here where we heard from a lady who preferred not to use her real name who had been diagnosed with HIV in her late 50s. She had been left with lifelong physical complications and, tragically, suffered a mental health breakdown because of the extreme stress caused by the diagnosis, the lack of support, the fear, the stigma and the discrimination that she thought she would experience. Holding back tears, she told that room full of strangers that she had been unable to share her HIV status with her friends or family. That shows the courage of the example set by my hon. Friend today. Unfortunately, there are still many people out there, including many I know, who would not have the confidence to do this or even to share their status in private circumstances. We have to turn that around and end the stigma and discrimination.
I absolutely endorse what my hon. Friend said about PrEP. It is simply extraordinary that we are still waiting for the English NHS to make this routinely available. People have told me this week that they want to access PrEP and cannot do so. That simply cannot be the right way forward, from a purely public health point of view, from a rights point of view, and from a cost point of view. In all respects, it is wrong. I hope that the Minister can give us some positive news on that and that we will see the progress that we have seen in the other nations. I pay tribute, as my hon. Friend did, to our Labour Health Secretary in Wales who has shown quite a lot of political and practical leadership, as a Minister, on this issue.
I was disappointed when we had the Department of Health and Social Care prevention strategy last month. there is much in there for us all to agree with, while it failed to mention sexual health at all. That was a huge disappointment because there is a huge amount in the strategy that very much applies to the agenda that we have been talking about today. I hope that the Minister can explain what the Department is going to do to ensure sexual health and HIV prevention are at the heart of that prevention strategy for the NHS overall. I also emphasise what my hon. Friend said about demand for sexual health services rising and the challenges facing particular communities, whether the BME community, the LGBT community, young people, sex workers or injecting drug users. Sometimes we shy away from talking about unfashionable and difficult topics in this House, but we need to have honest and frank conversations if we are going to end HIV and AIDS in this country.
Globally, there are still 15 million people who are not accessing treatment because of inadequate health systems and funding, discriminatory laws, stigma and discrimination, and colonial-era laws that ensure that people do not get the treatment they need. The UK needs to lead the way in ending HIV stigma for good and supporting these programmes through the work of the Department for International Development.
I pay tribute to the Minister of State, Department for International Development, the right hon. Member for North East Bedfordshire (Alistair Burt), who announced at the AIDS conference in Amsterdam an increase in funding for the Robert Carr Fund, for which so many of us have campaigned, and support for civil society organisations to support key populations.
It was inspiring yesterday to hear from not only a young female AIDS activist from Zimbabwe called Audrey, but two former Presidents—the former President of Botswana, Festus Mogae, and the former President of Mozambique, Joaquim Chissano. President Mogae spoke to us in a way that I did not expect. He spoke about all the things that we know we need to do to tackle HIV, but he stood up as a former African leader and said, “We need to address the needs of the LGBT population, the needs of the trans population, the needs of sex workers and the needs of injecting drug users.” That sent an incredibly strong signal to leaders across Africa and the world that we must talk about these issues and take action on them, and I hope the UK will continue to provide that crucial support.
I pay tribute again to my hon. Friend the Member for Brighton, Kemptown for his courage and bravery and the message that it sends. I hope the Minister will have some hopeful words for us about the situation in the UK. I want to end by thanking all the organisations that do so much to support our APPG’s work, including the Terrence Higgins Trust, the National AIDS Trust, the International HIV/AIDS Alliance, STOPAIDS, Youth Stop AIDS, the British Association for Sexual Health and HIV and so many more. I thank all the organisations that are active in our communities and, I am sorry to say, are filling the gaps left by cuts to provision. They are out there making the case, supporting people living with HIV and taking us all down the road to ending this epidemic by 2030.
(6 years, 1 month ago)
Commons ChamberWe now have more professionally qualified clinical staff working in the NHS: over 41,000 more since 2010, including over 14,000 more doctors and over 13,000 more nurses on our wards.
It is interesting that the hon. Gentleman asks that question, because it is worth looking at some of the facts. Over the five years to 2017 health spending increased by 20% in England but by only 14% in Scotland. As a consequence, people are 30% more likely to wait 18 weeks for treatment in Scotland than in England, and the increase in the number of nurses and doctors in England has been higher than in Scotland. Perhaps the SNP should look at how we have been performing in the NHS in England and learn from that.
In that case, perhaps the Secretary of State will join the Royal College of Nursing in welcoming the action by the Scottish Government to enshrine safe staffing levels and ratios in law. Given that there are over 36,000 vacant nursing posts in the NHS in England, when will he follow the Scottish Government’s lead and bring forward legislation on safe staffing levels?
I have seen what has happened, and maybe the reason why the SNP has had to do that is that in England we have increased the medical workforce faster than in Scotland. When the performances improve in the Scottish NHS, we in England will start to take lessons, but until then I will concentrate on making sure we get the very best NHS right across the country.
The hon. Lady is absolutely right to raise this issue. Prevention is a key aspect of the new Secretary of State’s focus as the Department moves forward. NHS England will support all CCGs that are in special measures to return to financial balance. It also provides a bespoke package of support, along with a higher level of monitoring and oversight, to ensure that the money is always spent wisely.
We have proposed £20 billion more funding for the NHS to guarantee its future, and I am looking forward to working with everyone in the NHS and the social care system on a long-term plan to ensure that that money is well spent. Today, we have published for the House the 2018-19 pay settlement for doctors and dentists. It represents the highest pay settlement since 2008. I regard it as a first step and look forward to a wider conversation on pay and improvements to help to make the NHS the best employer in the world.
Will the Secretary of State update the House on the progress of Baroness Cumberlege’s review of the use of mesh implants? Will he confirm whether the inquiry will liaise with the Scottish Government and whether it will hold any evidence sessions in Scotland? There are plenty of women, including some in my constituency, who had operations in England but now live in Scotland. Their voices must be heard in the inquiry.
Yes, the hon. Gentleman is absolutely right. We published information on this issue just last week. We absolutely will consult the Scottish Government and all interested stakeholders. It is a very important matter to get right.