Local Government and Social Care Funding

Debate between Peter Bottomley and Andrew Gwynne

Wednesday 24th April 2019 Commons Chamber

[Andrew Gwynne (Denton and Reddish) (Lab)]

I beg to move,

That this House notes that despite the Prime Minister announcing that austerity is over, local authorities’ spending power per household is on course to fall by an average of 23 per cent by 2020, and that nine of the 10 most deprived council areas in this country have seen reductions that are almost three times the average of any other council under this Government; recognises that this has resulted in social care budgets in England losing £7 billion; further notes that at the last General Election Labour committed to a fully costed plan to invest an additional £8 billion in social care over this Parliament; and calls on the Government to ensure that local authorities and social care are properly and sustainably funded.

If I may, I seek the indulgence of the House to briefly place on record, as shadow Communities Secretary, my utter shock and revulsion at the recent terrorist atrocities, both in Northern Ireland and in Sri Lanka, over the Easter break. We send our condolences to the families affected and to their communities. Coming so soon after the terrible events in Christchurch, New Zealand, just before Easter, they serve as a bleak reminder of how fragile our human rights and freedoms are, and how we must redouble our efforts in this place and outside to hold our communities together.

[Sir Peter Bottomley (Worthing West) (Con)]

The whole House will be grateful for the way the hon. Gentleman has introduced the debate and for those sentiments. Does he agree that people do such things for publicity and public reaction, and that we should take care to ensure that our publicity and our public reaction confronts and confounds their aims, so that what they do will be in vain, even though it has taken a terrible toll on those directly affected?

[Andrew Gwynne]

The hon. Gentleman is absolutely right. We should stand firm against terrorist atrocities wherever they are perpetrated. We should stand strong as a community, both in the United Kingdom and in the global community, against such acts of terror. We should call them out wherever they take place.

I welcome the opportunity to raise the important matter of local government funding in an Opposition day debate, especially considering how scarce the opportunities are for the Opposition to raise matters in such debates. I pay tribute to the shadow Leader of the House, my hon. Friend the Member for Walsall South (Valerie Vaz), whose dogged pursuit of that issue has allowed us to debate this important matter today.

In this place our discussion has been dominated by Brexit, but across the country our local councils, and the local services people rely on, are straining at the seams. I pay tribute to councillors of all political persuasions and none for the work they do in serving their communities. I pay tribute to the council officers and dedicated public servants who deliver neighbourhood and care services on the frontline. Years of uncertainty and unfair funding have created a quiet crisis that is now impossible to ignore. Under this Government, the facts speak for themselves: local authorities have faced a reduction to core funding of nearly £16 billion since 2010. That means that councils will have lost 60p out of every £1 that the previous Labour Government provided to spend on local services.

When the Prime Minister entered Downing Street, she promised to build a country that works for everyone, and she then promised an end to austerity. As her time in office probably comes to an end, we are able to reflect on both of those promises. Like in many areas of her leadership, I am sure we will all find that in both those areas she has been sorely lacking.

NHS Patient Data

Debate between Peter Bottomley and Andrew Gwynne

Thursday 27th February 2014 Westminster Hall

[Andrew Gwynne]

It certainly is a two-horse race in my constituency; do not let the Liberals tell you otherwise. The point is that it is very easy for someone to miss the leaflet about care.data even if they received it. I received it and I read it, but I think that is probably the neurosis of politicians; when a leaflet comes through the door, we automatically think that our opponents have started the general election 16 months early.

Many of my neighbours, who I assume must have received the leaflet, claim that they did not. Likewise, we can easily skip the adverts on TV. In my home, we have Sky Plus, that wonderful technology that allows us to press fast forward as soon as the advert break starts and skip all the adverts. Conventional methods now fail to penetrate with the vast majority of the general public. We probably need to implement a more personalised approach to make the public aware of the scheme, of the benefits, of the implications and of their individual rights.

Incredibly, we have heard stories of people who want to opt out of the system and have had to make an appointment with their already overburdened GPs to do so. I do not think that that is necessarily the right approach. GPs are already struggling to use their time to deliver good quality general practice and primary care services, and perhaps an easier way to allow people to opt out using a variety of methods should be explored. As the Minister will be aware, the chief executives of Mencap, Sense, the Royal National Institute of Blind People, the National Autistic Society and Action on Hearing Loss have written to the Secretary of State expressing concerns that information about care.data is not being communicated in an accessible way to disabled people, who are consequently being deprived of the opportunity to make an informed choice about the future of their medical records.

We want care.data to work, and it is in everyone’s interests that it does, but—this is where the pause is welcome—the Government need to get a grip before the aims of the project are lost on a suspicious public anxious about what care.data is for and how their personal data will be used. That risks compromising a project that I think we all recognise to be vital. The proposal by the hon. Member for Mid Norfolk for the Government to establish a working group of campaigners and opponents—their inclusion is important—to try to resolve the differences is a sensible way forward. Consensus is the key here.

The Government must understand that the data do not belong to them or to the NHS, but to each of us individually. That should be the starting premise. The combined data that the NHS holds about me are mine and no one else’s, and that should be enshrined. Only then will the Government be able to make the case that inappropriate use of the data could never be sanctioned.

Let us be honest—if the data are mine and they are recognised to be so, that is empowering for me as an individual and a patient. “No decision about me, without me” has been the mantra of Ministers of all political parties in the Department for some years, but how about “no information about me, without me” as the next guiding principle? Our most intimate details are wrapped up in this system. The Government will be able to shore up public and institutional support only when they have convinced the public that the data will not and cannot be abused, and when they have been honest about the potential risks.

The data are owned by the patient, and all parts of the NHS must be their legal custodian. Rights and proper responsibilities must go together—the legal responsibility to use data for necessary purposes, and only for necessary purposes, with proper safeguards in place and, to agree with my hon. Friend the Member for Leeds East, tougher sanctions to underpin them. We need to convey to the public the laudable intention behind the proposals, because even professional trust in the programme is so low that a poll for the Medical Protection Society found that 80% of family doctors believed that the system could undermine public confidence in the principle of medical confidentiality.

[Sir Peter Bottomley]

I often try to look at the questions that people are asked. I am not absolutely certain that doctors were asked, “On balance, would you recommend that people stay in to contribute their information for the benefit of all?”

[Andrew Gwynne]

I entirely take the hon. Gentleman’s point, but if we are to reintroduce the element of public confidence, enshrining proper rights and responsibilities will start to build that sense of trust. As the hon. Member for Mid Norfolk suggested, it is consensus that will get us where we want and need to be.

One example of the problems that can arise lies in recent media reports, which we have heard about again in this debate, including those about the Institute and Faculty of Actuaries, which obtained at least 13 years of hospital data equating to 47 million patients. Often, media reports are not quite what they seem, but the damage is, sadly, done as a consequence. I would hate for the benefits of information sharing within the NHS, and of drawing out anonymised data sets from that system for beneficial medical research, to be jeopardised by incorrect assumptions made from media reports. There would be rightful public revulsion if identifiable or cross-identifiable information were to fall into the hands of insurers and other private interests that do not have the public good in mind, but such reports are potentially damaging to public confidence in care.data, which is already quite low.

That is why we welcome the Government’s decision to pause the scheme. I hope that they will use the opportunity wisely to reflect on how better to engage with the public about the real benefits that we have discussed in this debate, and to revolutionise patients’ rights: make the data theirs; make the NHS their custodian; put in real safeguards and, importantly, proper penalties; and have rights with responsibilities and whole-person information for the age of whole-person care. That would be genuinely transformational.

I reiterate to the Minister that we are happy to support the measures in the House, but as it stands, we fear that the security regime is woefully inadequate. There is still time to save it, and we on the Labour Front Bench have offered the Secretary of State for Health our full support if he can come up with an offer that satisfies everyone. On Tuesday, those points were put to the Health Secretary at Health questions by my right hon. Friend the Member for Leigh (Andy Burnham), the shadow Health Secretary. Maybe the desire for consensus and a way forward is sometimes lost in the theatre of the Chamber of the House of Commons, so I repeat those points to the Minister in this debate, which has been much more consensual and informative than it would ever be on the Floor of the House during Health questions. I sincerely hope that she will respond to them positively.

There are five key protections that Labour wants to introduce. First, we want tougher penalties for any misuse of data; my hon. Friend the Member for Leeds East made that point far more eloquently than I. We also want to keep the requirement for the Secretary of State to sign off on any new application to access the data, which the Government are seeking to remove in the Care Bill. Accountability to the Secretary of State, to Parliament and to us as Members of Parliament on behalf of our constituents is a fundamental requirement that would start to satisfy the need for oversight.

We want and need full transparency for all organisations granted access to the data, so there is full openness about who has access and what data they have. We need a proper targeted and personalised awareness campaign for people with a learning disability, autism or sensory impairments, so we think that GPs should be issued with clear guidance to ensure that all of their patients are informed. We want easier opt-out arrangements than those possible at present. If the Secretary of State is happy to ensure that the new provisions are in place, we are happy to lend our support to make it happen.

In closing, I should say that confidentiality has always had a tense relationship with scientific progress when it comes to clinical research, but it is only right that information is made available outside the NHS in a completely anonymised form. The hon. Member for Mid Norfolk is quite right about clinical data: their potential is enormous, they can revolutionise systems and processes and they can get to the heart of problems in certain areas far sooner. It is hugely empowering for future patients to get away not just from the silo mentalities of the structures of our health and social care system—all parties want to do that—but from the silo mentality about data that exists in parts of the health and social care system: whole-person care and whole-person information.

I commend the hon. Member for Mid Norfolk for his work on this hugely important issue and congratulate him on securing this important debate, on the summit in Parliament earlier today and on the work that he is doing alongside patients for data. Hopefully, we can get some movement on this from the Government, so that we end up with a scheme with the appropriate safeguards. I look forward to the Minister’s response.