Oral Answers to Questions

Paul Blomfield Excerpts

Tuesday 24th February 2015 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

This issue came up in a debate on cystic fibrosis last year and I am very happy to look at it again. I looked at it subsequent to that debate, in response to an inquiry from, I think, the hon. Member for Colchester (Sir Bob Russell), but I am happy to look at it again and get back to my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton).

[Paul Blomfield (Sheffield Central) (Lab)]

T8. When I asked the Minister last June what guarantees he would give to GP practices at risk because of the withdrawal of the minimum practice income guarantee, I was told that NHS England would ensure threatened practices “get to the right place.”—[Official Report, 10 June 2014; Vol. 582, c. 400.]Over the past seven months, those discussions have not alleviated the threat to two highly regarded practices in my constituency that face closure. Will the Minister agree to meet me and representatives of the practices to discuss what is really happening, and to consider what can be done to save them?

[Dr Poulter]

I am very happy to meet the hon. Gentleman, but he will be aware that the move away from the historical funding formula towards a per head or capitation formula is a move in the right direction. If there are certain local concerns, I am very happy to meet him to discuss them.

National Health Service

Paul Blomfield Excerpts

Wednesday 21st January 2015 Commons Chamber

[Andy Burnham]

I have said that the market was let in too far, and, as Health Secretary in 2009, I changed policy away from what was a version of “any willing” or “any qualified” provider to “NHS preferred provider” and I stand by that. I agree with the hon. Lady that the market is simply not the answer to 21st-century health and care. When the Prime Minister stood at the Dispatch Box about an hour or so ago and said no privatisation on his watch, he was not being straight with the public. Services across the country are being put out to open tender and then transferred to the private sector. That is the Government’s record and the people of this country know it.

[Paul Blomfield (Sheffield Central) (Lab)]

Does my right hon. Friend agree that it says everything about this Government’s attitude to the NHS that general practices that serve the most needy and vulnerable patients, like Devonshire Green and Hanover medical centres in my constituency, are under threat because of the withdrawal of the minimum practice income guarantee introduced by Labour? Does he agree that the Government should immediately stop the phased withdrawal of funding and review their decision to end MPIG?

[Andy Burnham]

I said earlier that there had been cuts to the GP budget, and that is one of the implications of those cuts. The Government have developed a plan to phase out the guarantee that secures practices in some of the more deprived communities. In east London there have been campaigns against practice closures; I know there are similar concerns in Sheffield. That process should be reviewed and if necessary stopped, because no practice should close as a result of any of those changes. That is the commitment I give to my hon. Friend today.

Care Workers

Paul Blomfield Excerpts

Wednesday 5th November 2014 Westminster Hall

[Paul Blomfield (Sheffield Central) (Lab)]

It is a pleasure to participate in this debate with you in the Chair, Mr Robertson. I join others in commending my right hon. Friend the Member for Oxford East (Mr Smith) not only on securing the debate, but on an incredibly powerful opening contribution.

During the conference recess, I carried out a community consultation. I spoke to about 1,800 constituents in 61 meetings over three weeks. The dominant issue that came out of that consultation was low pay and abusive payment practices, particularly from those who told me some fairly horrendous stories about working in the care sector, and particularly about zero-hours contracts and non-payment of travel time. I accept my right hon. Friend’s point that for some people, zero-hours contracts work, but there are too many abusive zero-hours contracts. I thought that I understood the issues: peoples’ uncertainty about what hours they would work from week to week, and the difficulties of navigating the benefit system on low pay. However, people told me stories of getting a phone call on a Sunday night and being told, “Get on the bus. Travel across the city. We have work for you tomorrow morning at 8 o’clock”, only to arrive and be told, “Sorry, there is no work available”, or, “If you would like to hang around till 2 o’clock this afternoon, we might have some work for you.” We really have to address that sort of abusive employment practice.

Another care worker told me of her experience of non-payment for travelling time. She will get one job on one side of the city, a second on the other side, and a third a considerable distance away again. Paid the minimum wage for contact time, she is in effect working eight hours but being paid for four or five—a really abusive practice that we must address.

[Mr Anderson]

Let me advise my hon. Friend that at a recent meeting with Unison members who work in the care sector, one of them made the point that she worked 27 hours a month travelling between jobs. That was 27 hours a month for which she should have been paid, but was not. That is a disgrace.

[Paul Blomfield]

I thank my hon. Friend for his intervention. He is absolutely right: it is a disgrace. However, last week on Radio 4’s “Today” programme, I heard a care commissioner and a care provider debating the issue and accepting almost as the norm—indeed, for too many people it is the norm—that travel time is not paid for. That was so accepted in the discussion that I had to check with the House of Commons Library that it is in fact an illegal practice. However, it is accepted across the sector by commissioners and providers. People doing some of the most important work in our society, as my right hon. Friend the Member for Oxford East pointed out, are denied the dignity of being paid even the minimum wage, and it is tough enough to make ends meet from month to month on the minimum wage.

The arguments about the impact on care standards, the increase in hospital admissions because carers are spending less time with people, and the impact on staff turnover are well rehearsed, but we need to get to the bottom line. It is simply wrong that people are being paid an amount that contravenes the law, and too many people are accepting that. Allowing these practices to continue makes a mockery of having a national minimum wage.

Yesterday was the day in 2014 on which women in full-time work in effect stopped being paid—I am referring to women’s wages as a proportion of men’s wages—because of the gender pay gap, which is widening under this Government. Is it any wonder that that gap is widening when abuses such as these in the care sector, in which most workers are female, are just allowed to continue? I use the word “allowed” carefully, because it is not that the Government do not know about the abuses. The Minister’s right hon. Friend the Secretary of State for Business, Innovation and Skills said:

“The problem with domiciliary care is that there is almost certainly an avoidance by companies to pay the minimum wage, and that overlaps with the problem of zero-hours contracts. We recognise that there are some very specific problems for workers in that sector.”—[Official Report, 26 June 2014; Vol. 583, c. 447.]

HMRC, too, knows that that is happening, because an investigation of care providers between 2011 and 2013 found that 50% or half of care providers investigated were guilty of non-compliance with the national minimum wage, yet what are the Government doing to tackle the exploitation of predominantly female carers looking after our frail, vulnerable and disabled relatives? According to the Public Accounts Committee in July 2014, “seemingly little” has been done. I am inclined to agree and, given the nodding heads on both sides of the Chamber, colleagues agree, too.

Having found a 50% non-compliance rate, HMRC has stopped carrying out proactive investigations into minimum wage compliance in the care sector. I hope that the Minister will explain that decision for us today and, more importantly, will commit to talking to colleagues across Government about reversing it, because it is simply not acceptable for the Government to say that they are concerned about this issue but remove the resources for addressing it.

In the same vein, given the overlap between non-payment of the minimum wage and the problem of zero-hours contracts, will the Minister look to give bodies such as trade unions and law centres a formal, third-party role, so that reports of national minimum wage breaches can be treated as formal complaints? I ask that because we know that part of the reason for the incredibly low level of reporting of abuses—there were just 11 complaints to the pay and work rights telephone helpline in 2011-12 from home care workers—is the precarious position in which care workers on zero-hours contracts find themselves. If they put their head above the parapet, they will find themselves with no work next month, so I would also like to hear from the Minister what the Government are doing to promote the pay and work rights helpline for those who do feel confident enough to use it.

Will the Minister assure us that when workers do complain, they will be paid what they are owed? I ask that because written answers to my hon. Friend the Member for Stockton North (Alex Cunningham) suggest that the Government are not in a position to say either way. I therefore urge the Minister to talk to colleagues about collecting the data, because how else will we know the success of HMRC’s intervention?

Care workers do one of the most important jobs in society. They look after those whom we are concerned about most—the most vulnerable—and whom we love the most, and they deserve better.

Oral Answers to Questions

Paul Blomfield Excerpts

Tuesday 10th June 2014 Commons Chamber

[Paul Blomfield (Sheffield Central) (Lab)]

11. What assessment he has made of the potential effect on health outcomes of phasing out minimum practice income guarantee funding from GP practices in England.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

The minimum practice income guarantee payment is unfair because practices serving very similar populations are paid very different amounts per patient. The payments are being phased out over a seven-year period to allow practices time to adjust. The money released by doing this will be reinvested in the basic payments made to all general medical services practices, which are based on numbers of patients and key determinants of practice workload, such as the age and health needs of patients.

[Paul Blomfield]

The minimum practice income guarantee was introduced to meet the specific needs of specific practices. Those needs have not changed. NHS England has drawn up a list of 100 practices across the country that will be threatened by its withdrawal. Five are in Sheffield and two are in my constituency. Will the Minister give a guarantee that no practice will close as a result of the withdrawal of the minimum practice income guarantee, and will he provide the funding to achieve that?

[Dr Poulter]

The point is this: the funding system set up by the previous Government was based on historical funding and did not necessarily recognise the needs of patients. One practice might have been paid more for historical reasons than another practice next door that might have been treating more patients. That was unfair; we have changed it. NHS England is working at local level with practices that are, for whatever reason, in financial difficulties to make sure that it can help them get to the right place.

Oral Answers to Questions

Paul Blomfield Excerpts

Tuesday 1st April 2014 Commons Chamber

[Andy McDonald (Middlesbrough) (Lab)]

8. What progress has been made on achieving parity of esteem between physical and mental health.

[Paul Blomfield (Sheffield Central) (Lab)]

12. What progress has been made on achieving parity of esteem between physical and mental health.

[Mr Andy Slaughter (Hammersmith) (Lab)]

15. What progress has been made on achieving parity of esteem between physical and mental health.

--- Later in debate ---

[Norman Lamb]

It is because I really care about parity of esteem that I described the decision by NHS England as flawed. It cannot be justified. It is not based on evidence. I am pleased to say that since then the former chief executive, David Nicholson, has written to all his area teams to make it very clear that in their commissioning plans and clinical commissioning groups, and in determining contracts with mental health providers, they must apply the principle of parity of esteem. Let us wait to see what emerges from that, but any reduction in funding for mental health this year would be unacceptable.

[Paul Blomfield]

We know that spending on mental health fell for the first time in a decade in the first year in which this Government were in power. Unfortunately, the Department no longer collects or publishes that data, but Sheffield Mind has expressed its concerns about cuts in the two subsequent years despite referrals rising dramatically. Will the Minister assure the House that he will in future publish figures on spending levels and that mental health services will not be subject to a fourth year of cuts?

[Norman Lamb]

We want to make sure that there is complete transparency in the availability of data and to ensure that in future it will be possible to draw those comparisons. I suspect that there is agreement across the House that mental health must not lose out. In the last decade, when the NHS was financially squeezed mental health lost out, as the Health Committee confirmed. It has happened again this time, but I am absolutely determined that we will change the levers to ensure that mental health gets its fair deal. I am delighted to confirm today that we are ending the exclusion of mental health patients from the legal right of choice. It is extraordinary to me that when the Labour Government introduced a legal right of choice in the NHS, they inexplicably left out mental health patients. We are ending that today.

Health and Social Care

Paul Blomfield Excerpts

Monday 13th May 2013 Commons Chamber

[Paul Blomfield (Sheffield Central) (Lab)]

It is a delight to follow the hon. Member for South West Devon (Mr Streeter). I might not have agreed with everything he said, but he was right to point out that away from this place people’s concern is about economic growth. Sadly, the Queen’s Speech does not adequately address that concern.

Some of the less thoughtful contributions have demonstrated just how deeply divided this Government are—not between parties, but within the main party of government. The Prime Minister is unable to command the support of his own party. When he makes a decision, it is often the wrong one, putting party squabbles before national interest.

Just for one moment, let us imagine the scene in Washington today. The Prime Minister is there to seek the ear of the President on the EU-US trade deal, which is hugely important to this country and worth £10 billion a year. As the President received his pre-meeting briefing, I wonder what his advisers would have been saying: “Don’t waste time on this Prime Minister, Mr President. He has only two years left. He can’t even command the support of his own party. His Cabinet members are speaking out against him as they jostle for succession, and he has even told members of his own Government that they can vote against him on the Government’s programme. We will have to talk to the people who count in Government—ignore this one.” As Barack Obama raises his eyebrows in incredulity, British influence disappears out of the window because of the weakness of this Prime Minister.

That situation is also demonstrated in the Queen’s Speech, and as much by what is not included in it as by what is. When the Prime Minister makes a decision, too often he buckles under pressure from the wrong people, backing powerful vested interests against those of ordinary people. As a number of my colleagues and a number of Government Members have done, I want to highlight the absence of the promised legislation for standardised cigarette packaging, which sacrifices the health of our children in favour of the profits of the big tobacco companies.

Back in February, the Prime Minister talked clearly about introducing legislation for standardised packaging. The papers reported that

“Ministers are convinced that the ban is necessary to take the next step to reduce smoking in the UK.”

Those reports were confirmed by a senior Whitehall source, who said:

“We are going to follow what they have done in Australia.”

The source correctly went on to say:

“The evidence suggests it is going to deter young smokers. There is going to be legislation”.

That was what we were all expecting, although perhaps some of us were surprised that the Government had actually got it right on this issue and were putting people first—that was, until just a few days ago. I do not know whether they were under the influence of Lynton Crosby—bear it in mind that he earned considerable sums of money from the tobacco lobby, and that he failed to win the argument against standardised packaging in Australia before bringing his toxic approach to politics here—or perhaps they were just running frightened from the UK Independence party’s opposition to public health measures against smoking.

[Mr Leech]

I note that the hon. Gentleman does not mention the intervention of the unions and their support for retaining the existing system of packaging. Would he like to condemn the position that the unions have taken on standardised packaging?

[Paul Blomfield]

My understanding is that the majority of unions would support standardised packaging. I deeply regret the fact that the tobacco giants use some individual trade unionists as de facto lobbyists.

The Government surrendered to the tobacco giants. What message does that send to the country? This Government are prepared to see people die and, as the hon. Member for Mid Derbyshire (Pauline Latham) said, die horribly, and in their hundreds of thousands, to prop up the profits of the tobacco industry. There are no industries like the tobacco industry—the more cigarettes it sells, the more money it makes and the more people die.

Since science confirmed the link between smoking and lung cancer, the tobacco industry has opposed every single measure to reduce smoking. We all know that smoking is the largest preventable cause of cancer; it is responsible for four out of every 10 cancer deaths. According to Cancer Research UK, tobacco is responsible for 100,000 deaths in the UK every year. We have made huge strides with the measures that have already been taken against smoking, but as we have encouraged people to stop smoking, the tobacco giants have been building their market among young people. A report from Cancer Research UK in March showed that the number of children smoking had risen by 50,000 in just one year.

[Frank Dobson]

Let me demonstrate the absolutely vile morality—if I can combine those two words—of the tobacco industry. When it was discovered that nicotine was addictive, the industry increased the proportion of nicotine in cigarettes to make them more addictive. People like that should not be listened to; they should be shown the door.

[Paul Blomfield]

I agree with my right hon. Friend: the tobacco industry should not be listened to. However, it finds no end of ways to seek to defeat the arguments of public health lobbies against smoking, and indeed to encourage the wider use of cigarettes.

Shockingly, in the last year for which figures are available about 207,000 children aged between 11 and 15 started smoking. The vile way—to use my right hon. Friend’s word—in which the tobacco giants operate means that that is a direct result of the industry’s marketing strategies, which are as sophisticated as they are cynical. Flavoured cigarettes have been introduced, and not only menthol, but chocolate and fruit flavours. Some cigarettes are targeted at young women. Even the Daily Mail pointed out, in condemning that move, that those cigarettes seek to

“make smoking look elegant, sexy and classy”.

Alternatively, as British American Tobacco’s Hinesh Patel said, almost acknowledging the company’s strategy:

“We’ve taken a creative approach to respond to the female under-30 demand for a smaller, slimmer, less masculine cigarette…a contemporary product in a new accessible size.”

In that context, packaging is crucial. A Saatchi & Saatchi marketeer said this of British American Tobacco’s Vogue package:

“The cigarettes look like something found behind a glitzy counter at Selfridges....trying to capitalise on a woman’s desire to feel beautiful to sell their cigarettes.”

The Government public health Minister, the hon. Member for Broxtowe (Anna Soubry), is not present, but she has made her views on this subject clear. In April, she said before a House of Lords Select Committee:

“We know that the package itself plays an important part in the process of young people and their decision to buy a packet and to smoke cigarettes.”

All the experts back standardised packaging, and until a few days ago we thought the Government did, too. The public back that as well, with 63% in favour and only 16% against, according to recent polling. This Government are getting it wrong again. They are showing again that they are out of touch with people and they are on the wrong side of the argument, and I urge them to think again.

Heart Surgery (Leeds)

Paul Blomfield Excerpts

Monday 15th April 2013 Commons Chamber

[Mr Hunt]

Absolutely.

[Paul Blomfield (Sheffield Central) (Lab)]

We have seen an extraordinary sequence of events that have unnecessarily tarnished the reputation of what the Secretary of State described as a fine hospital, and caused enormous anxiety to families across Yorkshire and the wider region. Does the Secretary of State not agree therefore that we need a full inquiry into how the decision was taken?

[Mr Hunt]

I think the most important thing is properly to establish the truth of the data and then to make sure that any lessons learned from that are reflected in decisions made about the Safe and Sustainable Review, so that the influence of mortality data on any decisions in Safe and Sustainable is based on proper analysis of those data. That is certainly something we will learn from.

Oral Answers to Questions

Paul Blomfield Excerpts

Tuesday 26th February 2013 Commons Chamber

[Mr Hunt]

I congratulate my hon. Friend on his campaigning. No sooner do we agree to the inclusion of one indicator in relation to early cancer diagnosis than he finds another that should also be included.

I will certainly consider the issue that my hon. Friend has raised, but I think that there is a broader question about the role of GPs. They should see themselves as being in the front line when it comes to early diagnosis of not just people who walk through the doors of their surgeries, but people in their communities who are at high risk. That is a much more fundamental change that we need to think about.

[Paul Blomfield (Sheffield Central) (Lab)]

14. What was the change in the level of spending in real terms on adult mental health services in 2011-12.

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

It is the responsibility of local commissioners to ensure that resources are used effectively to meet the needs of their local populations. According to the national survey of investment in adult mental health services for 2011-12, cash investment rose between 2010-11, but real-terms investment fell by 1%.

[Paul Blomfield]

I will meet Sheffield Mind on Friday, and one of the issues we will be talking about is the impact of that fall in spending on crisis care. Mind’s research shows that crisis care teams are often under-resourced and overstretched, with four in 10 trusts having staffing levels below the Department’s own guidelines of 14 staff to 25 service users. Does the Minister think that is acceptable, and if not, what is he going to do about it?

[Norman Lamb]

The Government inherited an institutional bias against mental health in the NHS. [Interruption.] It is absolutely true; when the 18-week target was introduced, nothing was available for those suffering with mental health problems. Mental health patients did not benefit from choice that was introduced elsewhere in the NHS. I completely agree with the hon. Gentleman about the importance of crisis services, and the first NHS mandate has required the Commissioning Board to do work on the availability of mental health services and to ensure that we can introduce access standards so that mental health service users and patients benefit from the same rights as those with physical health problems.

--- Later in debate ---

[Mr Jeremy Hunt]

I am happy to confirm to my hon. Friend that we intend to take some profound steps in this area, because we have a national health service, not an international health service. We have to ask whether it is appropriate for us to be giving free health care to short-term visitors, to students, to people on temporary visas. We will be saying more about that issue shortly.

[Paul Blomfield (Sheffield Central) (Lab)]

T6. On 13 March 2012, the former Secretary of State said of the Health and Social Care Bill:“There is absolutely nothing in the Bill that promotes or permits the transfer of NHS activities to the private sector.”—[Official Report, 13 March 2012; Vol. 542, c. 169.]However, the new NHS competition regulations break those promises by creating a requirement for almost all commissioning to be carried out through competitive markets, forcing privatisation through the back door, regardless of local will. Will the Secretary of State agree to make the regulations subject to a full debate and vote of both Houses?

[Mr Jeremy Hunt]

If the hon. Gentleman had listened to my previous answer, he would have heard that the regulations are consistent with the procurement guidelines that his own Government sent out to PCTs. It is not our job to be a champion for the private sector or the NHS sector; we want to be there to do the best job for patients. That is the purpose of the regulations.

Oral Answers to Questions

Paul Blomfield Excerpts

Tuesday 15th January 2013 Commons Chamber

[Mr Hunt]

That is a very important point. Every year we screen about 3.5 million women for cervical cancer and we think we save about 4,500 lives, but we could save many more. Our “Be Clear on Cancer” campaign is highlighting the four clear symptoms people need to watch out for: unexplained bleeding, weight loss, pain, and lumps.

[Paul Blomfield (Sheffield Central) (Lab)]

T3. The Minister of State earlier failed to answer the key question on midwife numbers, so I wonder whether the Secretary of State could take it on. Before the last election, the Prime Minister made a firm pledge to increase the number of midwives by 3,000. Will the Secretary of State tell the House whether that pledge will be honoured or discarded along with all the other promises on the NHS?

[Mr Hunt]

The number is up by 800 already, but as the Labour Front-Bench team knows, it takes some time to train midwives. I say to the hon. Gentleman that none of the investment in additional midwives would be possible if we had a real-terms cut in the NHS budget, which is what his Front-Bench team wants.

Oral Answers to Questions

Paul Blomfield Excerpts

Tuesday 12th June 2012 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Anne Milton)]

Yes, and may I commend my hon. Friend on the work he has done in this area? In the reformed NHS, infertility treatment services will be commissioned by clinical commissioning groups, with the NHS Commissioning Board providing oversight and support. That will include the provision of resources and tools to enable CCGs to collaborate to commission infertility services. We will continue to expect those commissioning infertility treatment services to be fully aware of the importance of having regard to the National Institute for Health and Clinical Excellence fertility guidelines.

[Paul Blomfield (Sheffield Central) (Lab)]

T2. Speaking on 24 April, the Secretary of State indicated that the NHS distribution formula should no longer take account of deprivation. That would have cost Sheffield £73 million a year and benefited Surrey by £400 million. His ministerial colleague, the Minister of State, the right hon. Member for Chelmsford (Mr Burns), seems to have denied that that is the case. Will the Secretary of State therefore confirm that this is the Government’s latest U-turn?

[Mr Lansley]

No, I will do no such thing, because the premise of the hon. Gentleman’s question is completely wrong. I never said any such thing. What I made perfectly clear is that, as has been the case in the past, age will continue to be the principal determinant of health need, and therefore, by extension, that age will be the largest factor in determining the allocation of resources to the NHS. That was true under the last Government; it will continue to be true under this one.