Oral Answers to Questions

Paul Uppal Excerpts

Tuesday 24th February 2015 Commons Chamber

[Mr Speaker]

Order. The question was about Chester, so there was no particular reason to talk about Wales.

[Paul Uppal (Wolverhampton South West) (Con)]

5. What assessment he has made of the implications for his policies of the most recent rates of cancer survival.

[Mark Menzies (Fylde) (Con)]

6. What assessment he has made of the implications for his policies of the most recent rates of cancer survival.

[The Secretary of State for Health (Mr Jeremy Hunt)]

This Government inherited the worst cancer survival rates in western Europe and, as we have just heard, we have invested a record £450 million in improving early diagnosis, which means that record numbers of people are being tested and record numbers of people are being treated.

[Paul Uppal]

I thank the Secretary of State for his response. Last year, I met cancer patients and carers with the aim of looking at how we can improve cancer survival rates so that they are among the best in western Europe. The main observation was that early diagnosis is key. Does my right hon. Friend agree that it is absolutely crucial that we support GPs to find and identify the early signs and symptoms of cancer so that we can improve survival rates?

[Mr Hunt]

That is absolutely right. What is said by everyone who has been wrestling with this problem about why our survival rates are not as good as we want them to be is that early diagnosis and access to the latest drugs are the two critical things. My hon. Friend will be pleased that 9,000 people in his region have accessed the cancer drugs fund and that, in his constituency, 300 more people every year are now being treated for cancer than was the case four years ago.

A and E (Major Incidents)

Paul Uppal Excerpts

Wednesday 7th January 2015 Commons Chamber

[Mr Hunt]

I was talking to a doctor at Plymouth last night and I recognise that there are real pressures there and staff are working very hard. The long-term solution is to back the non-party political plan that the NHS itself has put together under the leadership of Simon Stevens—the “Five Year Forward View”. We made the big call in our autumn statement to find £2 billion, which is what he said the NHS needed next year, and I hope Labour will support that. Then we can have the kind of consensus that the hon. Lady asked for.

[Paul Uppal (Wolverhampton South West) (Con)]

In 2003, a dozen years almost to the day, I accompanied my grandmother to A and E. We arrived at 8 o’clock in the morning. She was not allocated a bed until 9.30 that evening. May I impress upon my right hon. Friend that money alone is not the issue? It is important that we push ahead with the long-term plan and do not adopt a short-term opportunistic approach.

[Mr Hunt]

My hon. Friend is right. It is important to say that lots of people in the NHS have been asked in the past few days on the media what the issues are, and they have not been saying that it is about money. They have been saying that it is about reforming the structures. That is why, as well as the money that is available for this winter, we need to look at the plans that we can put in place to improve access to GPs, to improve the co-ordination between the health and the social care systems, to deal with issues that prevent people from going to hospital in the first place. That is what this Government want to do.

NHS

Paul Uppal Excerpts

Wednesday 5th February 2014 Commons Chamber

[Andy Burnham]

I think the hon. Gentleman is referring to Hinchingbrooke, the contract for which, he will recall, was signed under his Government. If he comes to the House, he should at least have the decency to get his facts straight. A procurement exercise began under the NHS preferred provider policy that I introduced, but he will find that his Government changed that to any qualified provider, and then appointed Circle health, whose shareholders also happen to be major donors to the Conservative party, to run the hospital.

The Government are spending millions of pounds on competition advice under the regime introduced by the 2012 Act. Since last April, CCGs, have spent £5 million on external competition legal advice. How can that be justifiable at a time when we have a shortage of A and E doctors? Around the world, we see that competition not only costs more, not less, than a planned system such as the NHS, but results in more fragmentation. It will never be an answer to the pressures in A and E. We need an approach where clinicians can collaborate and develop integrated solutions to relieve pressure. How can we possibly achieve integrated care when there are several different providers, each providing a different part of the same patient pathway?

The A and E crisis will be permanent, unless the Government accept its root causes and remove the barriers to its solution. The answer is in the motion before the House. The House can vote to reverse the competition policy introduced by the Government in the 2012 Act and to remove the market madness now holding back the NHS, and it could all be done because it would be consistent with the coalition agreement. The simple fact is that nobody voted for the NHS to be broken up in this way. Who gave this Prime Minister and Government permission to put the NHS up for sale? Nobody. They said there would be no top-down reorganisation. In the fullness of time, “No top-down reorganisation of the NHS” will be to this Prime Minister what, “No rise in tuition fees” is to the Deputy Prime Minister.

The choice on the NHS in 2015 is becoming clear: it can stay on the fast track to fragmentation or it can return to its values of putting integration over fragmentation, collaboration over competition, and people before profits. That is what the Opposition believe in. Let us have that debate so that we can save our NHS for future generations.

[Paul Uppal (Wolverhampton South West) (Con)]

On a point of order, Madam Deputy Speaker. In response to yesterday’s sensitive statement on Sri Harmandir Sahib, the shadow Foreign Secretary, the right hon. Member for Paisley and Renfrewshire South (Mr Alexander), made a point about documents pertaining to Lady Thatcher not being released. In fact, they were released back in January. I would appreciate your guidance, Madam Deputy Speaker, as this is a very sensitive matter, and I would hate to see it politicised.

[Madam Deputy Speaker (Dawn Primarolo)]

I am grateful to the hon. Gentleman for notice of his point of order, but this is a matter for the right hon. Member for Paisley and Renfrewshire South (Mr Alexander), whom I understand he notified of his intention to raise it in the Chamber. It is not a point of order for the Chair, but he has got his concerns on the record, and I think he will have to leave it at that for today.

Oral Answers to Questions

Paul Uppal Excerpts

Tuesday 16th April 2013 Commons Chamber

[Mr Hunt]

The statistic that the right hon. Gentleman will not give the House is that for the year as a whole, which ended last March, the Government hit our A and E target. Furthermore, he still will not tell the House about the disaster that is happening in Labour-controlled Wales, where the A and E target has not been hit since 2009. He still refuses to condemn what is happening there. There is a lot of pressure on A and E, because 1 million more people are using A and E every year, compared with just two years ago. What are the root causes? They are poor primary care alternatives that date directly to the disastrous GP contract negotiated by his Government, since when more than 4 million additional people have been using A and E every year, social care and hospital sectors that are not joined up—Labour had 13 years to sort that out but did nothing—and problems in recruitment that have been made a great deal worse by his disastrous decision to implement the working time directive. It is time he sorted out his own issues before trying to criticise the Government for sorting them out.

[Paul Uppal (Wolverhampton South West) (Con)]

T2. The all-party group on men’s health, of which I am vice-chairman, has assisted in research that seems to show that men’s poor sexual health is often symptomatic of more serious problems, such as type 2 diabetes and cardiovascular disease. Will my hon. Friend assure me that all robust measures are being put in place to ensure that that is not overlooked and that men do not die unnecessarily because that situation is taken for granted?

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

I completely agree with everything my hon. Friend has said, and the sexual health document we published in March relates specifically to those matters. Men are not very good at going to see their GP, a nurse or another health professional when they fear that they might need some sort of assistance. It is beholden on all men to follow the lead of women.

Health and Social Care Bill

Paul Uppal Excerpts

Tuesday 13th March 2012 Commons Chamber

[Mr Lansley]

So now we know, Mr Deputy Speaker. It is sheer invention. There is nothing in the Bill that creates a free-for-all. There is nothing in it that creates a market of that kind. The Bill means competition for quality, not price. It gives patients choice—and the Labour party’s manifesto was in favour of giving patients choice. Competition is not being introduced to the NHS by the Bill; it is being channelled in the interests of patients to support quality throughout the NHS.

The Opposition talk about privatisation. As I said to my right hon. Friend the Member for Bermondsey and Old Southwark (Simon Hughes), there is nothing in the Bill that allows any privatisation of NHS services. There is nothing in it that promotes such a privatisation.

The left-leaning papers talk about privatisation at Hinchingbrooke hospital because Circle is an independent mutual organisation. That is interesting, because the process for the franchising out of the management of Hinchingbrooke was started by the right hon. Gentleman when he was Secretary of State. So there we are: the only secret Tory plan that Labour can find turns out to be a Labour plan.

[Paul Uppal (Wolverhampton South West) (Con)]

The real issue in the debate is between long-termism and short-termism. Is not the reality that the Labour Government went aggressively down the route towards private finance initiatives, burdening so many of our foundation trust hospitals with debt that was unnecessary?

[Mr Lansley]

My hon. Friend makes an important point. When Labour Members talk about the private sector in the NHS, they leave out of account the fact that not only did they give the private sector a sweetheart deal to get it into the independent sector treatment centres, but they have left us with 102 hospitals that were built by the private sector and £67 billion of debt to the NHS. They wandered around the country saying, “Look how we’re spending all your money to build all these new hospitals,” but they did not spend the money to build the new hospitals. They have left the NHS to have to deal with it now, which is why I am having to support hospitals that have unsustainable private finance initiative debt that the right hon. Member for Leigh and his colleagues did not deal with.

What do we have? We have policies that the right hon. Gentleman disowns, and we have nothing to replace them with. We have political opportunism, distortions dressed up as arguments, and a shameful campaign to scare people about a Bill that, in reality, is about strengthening the NHS for the benefit of patients.

Of course, if we want to see what Labour would do, we only have to look at the situation in Wales. I have to hand a Wales Audit Office bar chart; I shall hold it up so Opposition Members can see it. One bar shows rising real-terms expenditure on the NHS in England, and the blue bar shows rising real-terms expenditure on the NHS in Scotland, while the green bar shows the rate for Northern Ireland, where the rise is lower. Another bar, however, shows a very large real-terms cut in NHS spending in Labour-run Wales. Labour in Wales did not just agree with the right hon. Gentleman that it would be “irresponsible” to increase NHS spending; Labour in Wales went further, and cut spending.

In order to see the result of that, we must look at performance. In England, 91% of patients are seen and treated within 18 weeks, compared with just 68% in Wales. In England, only 1.4% of patients waited over six weeks for diagnostic tests; in Wales, 29% waited over six weeks. In Wales, Labour says it wants to insulate the NHS against reform. It ought to adopt it, however, because all that is happening in Wales is that the Labour party is, once again, putting politics before patients.

It is patients who should be at the heart of the NHS —patients and those who care for them. This Bill is simply the support to a far more important set of changes, which make shared decision-making with patients the norm across the NHS, which bring clinical leadership to the forefront of the design and delivery of health and care services, which make local government central to planning for health and care, which strengthen the patient voice, and under which the NHS is open about the results we achieve and how to improve those results so we genuinely match the best in the world. We will continue to work with the royal colleges, and others with an interest in the future of the NHS, to implement our plans, so that we provide the best possible care for patients. The right hon. Gentleman’s motion and speech gave no credit to the NHS for what it is achieving, but I will.

We are proud of the services we deliver for patients: the lowest ever number of patients waiting over six months for treatment—[Interruption.] Labour Members do not like to listen to this, but it is the reality. Average time spent waiting for treatment is lower than at the last election. The number of patients waiting over a year for treatment has more than halved since the election. MRSA and C. difficile are at their lowest ever levels. There are more diagnostic tests—up by 300,000 over a year. There is more planned care, and there are fewer unplanned emergency admissions to hospital. Some 11,800 patients have benefited from the cancer drugs fund, and 990,000 more people have had access to NHS dentistry, while mixed-sex accommodation is down by 95%.

--- Later in debate ---

[Priti Patel]

No, at my constituents, actually. The Bill will bring much-needed front-line NHS resources to my constituency.

We have heard the shadow Secretary of State recycle the same speech from the Dispatch Box like a broken record stuck in the 1970s. The Opposition have nothing sincere to say and, as in every other debate on the Bill, my right hon. Friend the Secretary of State has rebutted all their opportunistic smears and given a robust account of the Bill and the benefits that it will bring. He has also ensured that the NHS budget is being increased.

Opposition Members would have done well to engage constructively on the Bill, instead of spending the past two years siding with the smear campaigns run by the left and its trade union paymasters that seek to misinform the public, play with their emotions and frighten them. In particular, we hear the Opposition complain about the involvement of the private sector in delivering health care, but it is this Government who are getting to grips with the spiralling private finance initiative costs that are crippling many NHS trusts in England, for which the Labour Government were entirely to blame.

I find it astonishing that the shadow Secretary of State can come to the Dispatch Box, week in and week out, and bleat on about the private sector without having the courtesy to accept that his Labour Government blew hundreds of millions of pounds of taxpayers’ cash on paying private providers for treatments that they failed to carry out. [Interruption.] Opposition Members should put away their synthetic anger for a moment and accept that, thanks to the Bill, expensive private sector pay-offs will be a thing of the past. When they were in government, they were enriching the private sector and creating an army of fat-cat NHS managers while failing to support patient care.

[Paul Uppal]

Opposition Members often try to portray us as callous and uncaring about the NHS, but is not reform absolutely essential if we want an NHS that is free at the point of delivery for our children and grandchildren?

[Priti Patel]

My hon. Friend is absolutely right. I mentioned front-line patient care in all our constituencies. This is about ensuring that resource goes to the front line, and that it is taken away from the back office, the bureaucracy and the managers.

Labour’s opposition to the Bill is shallow. Every time we have these debates—[Interruption.] We have had 13 years of Labour. Witham was once a Labour town, but my constituents have all woken up to the fact that, under Labour, there was no resource going to the front line of the NHS. Now, we are working across the parties to ensure that the Bill goes through Parliament, so that we can bring that much-needed front-line care to my constituents in Witham town. Labour’s opposition to the Bill is completely shallow, and every time we have this debate, its arguments are exposed as being ever more synthetic and opportunistic, with little connection to reality. The hon. Member for Bethnal Green and Bow (Rushanara Ali) talked about Labour’s commitment to the NHS. Just as history shows that Nye Bevan introduced the legislation to establish the NHS, it will show that this Secretary of State, through the Bill, has saved it for the patients who rely on it.

Breast Implants

Paul Uppal Excerpts

Wednesday 11th January 2012 Commons Chamber

[Mr Lansley]

I cannot tell the hon. Lady how many clinics the CQC will visit, but it will be a sample of providers, not all of them. As she may know from the material we published last Friday, there were 93 private providers. The operations were heavily concentrated in that a lot of them were carried out by a small proportion of providers, but about 87 other small providers, or even single-handed providers, are involved and accessing data from all of them will be difficult. I also recognise that, as the hon. Member for Edinburgh East (Sheila Gilmore) said, some may not be in business any longer, or there may be surgeons who have retired.

[Paul Uppal (Wolverhampton South West) (Con)]

I also thank the Secretary of State for making the statement. Following on from a vein of questioning that has already been explored, will he elaborate on the point about the Government pursuing firms to recover costs and explain what mechanisms are available to the Secretary of State to recover costs?

[Mr Lansley]

I will do so to an extent. It depends on the nature of the legal contract between a woman and her private provider. I hope that in many cases the legal obligations derived under that contract or under sale of goods and services legislation will clearly mean that the woman will get redress from her private providers or her insurers. If the NHS becomes involved, there may be compensation through the injury costs recovery scheme, so if the NHS incurs costs, we can go on to seek to recover them.

Organ Donation

Paul Uppal Excerpts

Wednesday 9th November 2011 Westminster Hall

[Paul Uppal (Wolverhampton South West) (Con)]

It is an honour to serve under your stewardship, Mr Davies. We have half an hour in which to debate this issue, and I will try to be brief, because a number of hon. Members have told me that they may wish to intervene, and my hon. Friend the Member for Montgomeryshire (Glyn Davies) has said that he would like to speak in the debate. I have always found his contributions, whether here or in the House, valuable and I am sure that he will only enhance the debate, and give his personal perspective and the view from Wales.

Organ donation sounds far removed from most people’s lives. They have never considered it, or believe that it is something to consider later in life or when they are in need. We all know people who are waiting for donations and people who have received them. Perhaps the thought makes us uncomfortable, because it forces us to confront the reality of life and death, but we must not ignore the fact that more than 7,500 people are on a waiting list for a donor organ. Whatever the reasons and whatever the causes, profound changes in medicine have provided the ability to save people from illnesses with donated organs, but we are still grappling with a shortage of donors.

Although there are people on waiting lists, things are getting better. Since 2007-08, there has been a 26% increase in the number of people who have agreed to be organ donors after their death, and today there are 18 million donors on the NHS organ donor register, but we must hope for more. With many groups that work tirelessly to ensure that one day the waiting list will be short, I want to raise awareness throughout the country, and to change people’s perception so that being a registered donor will become the cultural norm.

I am here today because I do not believe that those improvements have gone far enough. I am worried that the target to increase the number of people who become organ donors after their death by 50% in 2012-13 will not be met unless the Government take urgent action. I am particularly worried that not enough progress has been made to increase organ donation in black and minority ethnic communities. People of black and minority ethnic origin are three to four times more likely to need an organ transplant, but are significantly under-represented on the NHS organ donor register. When asked, 75% of families of potential donors from BME communities refused to give consent for their loved one to become an organ donor. That must not continue. As a member of the BME community, as well as representing a seat with a large BME population, I know that we must continue to work hard to maintain a dialogue within those communities, and start to break down some of the stigma that organ donation may hold.

[Mr Marcus Jones (Nuneaton) (Con)]

I congratulate my hon. Friend on securing this extremely important debate. My constituency has a BME community that is centred around one ward—Abbey—where life expectancy is 17 years lower than other parts of Warwickshire. I am sure that my constituents in that ward will be heartened to hear my hon. Friend’s comments, but does he agree that we need to raise the profile of these important issues, particularly organ donation and transplantation, as well as diabetes and so on, in those communities to try to deal with those health inequalities?

[Paul Uppal]

My hon. Friend makes a valuable point. I know how hard he works with the BME community in his constituency, and he is a champion of such issues. I have been heartened by most of my colleagues, who have shown a wide and passionate interest in specific concerns involving the BME community. He is right to highlight the issue.

[Guy Opperman (Hexham) (Con)]

I congratulate my hon. Friend on securing this debate. It is great that he is standing up for such an important issue, and for the BME community. The issue affects all hon. Members, whether their constituencies are urban, or rural like mine. I declare an interest in that I once thought I needed a kidney donation because I tore my left kidney in half at Stratford when I was a jockey. That was due to poor jockeyship, and a good doctor saved me. My question is simple. Does my hon. Friend believe that GPs could play a greater role in the community in stimulating more organ donation?

[Paul Uppal]

My hon. Friend makes an important point. This is a difficult issue, and the nub of the problem is that clinicians and individuals in our communities often find it difficult to talk about the matter and to face reality. I see no reason why it would be harmful if GPs spoke openly and candidly about it to people who attend their surgeries. They could highlight the matter, and spread the broader message among the broader populace about how vital the need is.

[Mike Weatherley (Hove) (Con)]

I congratulate my hon. Friend on securing this debate. Does he recognise the work of those calling for an opt-out system of organ donation, which includes national campaigns such as the British Heart Foundation, as well as local campaigners, including Valerie Paynter, who underwent a kidney transplant 20 years ago, which saved her life? Her story is very moving. Will my hon. Friend encourage hon. Members to sign my recently tabled early-day motion, although I appreciate that he does not sign them?

[Paul Uppal]

My hon. Friend is correct: I do not sign early-day motions. On the opt-out, we have made some progress, and we should continue on that route, but increase the pace. I have seen some of the research from various task forces. Some work in 2008 suggested that there was no substantive evidence that going down that route would increase organ donation. That is probably a matter for debate another time, but my personal opinion is that we must deal with it sequentially. Let us get to 2013, then see where we are.

[Paul Flynn (Newport West) (Lab)]

If anyone is in any doubt about the desperate suffering at the moment, they should look at the evidence from my constituent, Matthew Lammas, and his family, who came to the House and talked about their six months of agony while he waited for an organ to become available. There were calls in the middle of the night, and drives of sometimes hundreds of miles with disappointment after disappointment. He came near to death, but finally and happily, he was given the heart that he needed, and he is surviving. Anyone who believes that the issue can be pushed aside should read about that family’s terrible suffering because of the lack of organs. For those who did not attend the meeting, the story is available on my blog. Unfortunately, another constituent died due to lack of an organ.

[Paul Uppal]

I thank the hon. Gentleman for his intervention. No one in the Chamber would in any way, shape or form underestimate the suffering of those who need a transplant. I am a trustee of a Sikh temple, and I have been approached specifically about the matter and people’s real concern about it. I have felt the pain that many families feel. We may leave the main thrust of the debate today, but I am sure that we will revisit the issue. I accept completely what the hon. Gentleman says, but for the time being we must go along the path of sequential progress.

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

I congratulate my hon. Friend on securing this debate. He highlighted very well the fact that organ donation in urban areas is much lower than in more rural areas. That is partly due to population churn, but also because, as he rightly highlights, it is difficult to persuade people in black and ethnic minority communities to come forward and agree to organ donation. There are some cultural barriers to organ donation. How can we break down those barriers and focus on what really matters—ensuring that people have a chance of life?

[Paul Uppal]

I thank my hon. Friend for his intervention. As I said, I am a trustee of a Sikh temple, and I think it is important that we continue to spread that message in mosques, gurdwaras, mundas and temples in any shape or form. It needs to be consensual. It is about breaking down stigmas and prejudices that may be out there in certain communities. I would be very much in favour of anything that does that, and I have personally done that in my own constituency.

[Jason McCartney (Colne Valley) (Con)]

I thank my hon. Friend for his generosity in giving way. Many colleagues are here for this passionate debate, so perhaps next time we should have a full hour and a half for such an important issue.

We have heard the statistics. In my part of the world, Yorkshire and Humber, 581 people are waiting for an organ transplant, and 41 have died while waiting in the period 2010-11. I received a letter yesterday from a young lad aged 11, Matthew Taylor from Salendine Nook high school, which is doing a project on organ donations and the opt-in, opt-out processes. Will my hon. Friend join me in congratulating Salendine high school on engaging with young people and thinking about the processes? We can debate having a soft opt-in or opt-out process, but it is great that schools are engaging young people to think about organ donation.

[Paul Uppal]

I absolutely agree. My hon. Friend makes a good point. It is important that we raise the issue. That is the function of today’s debate. I am sure that the Minister will respond to that as well. I want to allow time for my hon. Friend the Member for Montgomeryshire to make a speech, so I will try to be brief. I will practise the skill of cutting down a speech to a few minutes.

I am concerned that leadership on organ donation and transplantation might be lost and that that will jeopardise the improvements that have been made since 2008. The national clinical director for transplantation, who was overseeing the implementation of the Organ Donation Taskforce recommendations, has now retired and I understand that his post is not due to be replaced. The Organ Donation Taskforce programme delivery board, which supported him in that role, has been disbanded. There is clearly a risk that in the absence of clear leadership, the improvements to date may be lost. Will the Minister tell us who is driving the agenda on organ donation and transplantation in the Department of Health, and whether the Department remains committed to the 50% increase in donors from 2007-08? What additional steps does he plan to take to ensure that that is achieved?

There is also the question of the goalposts being moved slightly further away when we reach 2013. I am sure the Minister is aware that there is no strategy for organ donation and transplantation beyond 2013, by which point all the Organ Donation Taskforce recommendations should be implemented. Will the Department of Health produce a strategy to ensure that the number of organ donors and transplants continue to increase after that date?

Organ donation is a gift, and that fact should be the focus of all policies involving donation, but it would be remiss to ignore those who have given. In previous years, the Government have recognised the incredible gift that organ donors have given by welcoming their families to a reception in Downing street. I would wholeheartedly support a continuation of that tradition. We are having a reception here at the House in December. It will be hosted by the hon. Member for Derby North (Chris Williamson) in his role as chair of the all-party group on organ donation, and we would welcome the Minister’s attendance. I am sure he would enjoy meeting the families and thanking them for what they have done for others.

There are big goals in place for 2013. We are all committed to working so that we have more than 20 million people on the official donor register. As people elected to serve our constituents, we can do no more than set a good example in our own communities, so I will take a moment to encourage all MPs to ensure that they are registered organ donors. We would all like to leave a legacy, and there can be no better one than that of saving a life.

Reform of Social Care

Paul Uppal Excerpts

Monday 4th July 2011 Commons Chamber

[Mr Lansley]

My hon. Friend is absolutely right. The children’s hospice movement has done immensely good work over the years. I am aware of that in my own constituency through the work of East Anglia’s Children’s Hospices, and I am sure many Members also completely understand. That movement’s work has been done in circumstances in which a very small proportion of the resources for children’s hospices comes from state sources. The palliative care funding review addresses both adult’s and children’s end-of-life care and palliative care and identifies per-patient funding for children as well as adults, and it therefore offers children’s hospices precisely the same kind of security in the future as adult hospices.

[Paul Uppal (Wolverhampton South West) (Con)]

Does my right hon. Friend agree that the Dilnot report goes some way to addressing the long-standing issue that for many years the current system has been punitive to those who have been prudent and frugal in planning for their old age?

[Mr Lansley]

Yes I do, and one of the essential reasons why the Dilnot commission was rightly established is that there are many people who have worked hard, saved and accumulated assets and expected to be able to enjoy them in their older age or to pass them on to their families, but who instead found that all those assets were destroyed as a result of the sheer chance event of, for example, long-term disability or dementia. That is a tragic situation, and as Andrew Dilnot well puts it, if people have a health care need and are seriously ill the NHS will look after them, and if their house burns down or they have a car crash there is insurance for that, but here we have a potential catastrophe in people’s lives for which the state will not provide and nobody else is willing or able to offer them that similar kind of protection. It is therefore vital that we take forward the Dilnot recommendations in the way we are proposing.