(3 years, 1 month 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.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is a pleasure to serve under your chairmanship, Mr Hollobone, and I thank the right hon. Member for Kingston and Surbiton (Ed Davey) for securing this important debate. I agree with everything he said about the plight of unpaid carers. We must increase and expand the carer’s allowance, properly fund respite breaks and recognise unpaid carers in legislation.
The situation for paid carers is equally dire. The Resolution Foundation found that between 2017 and 2019 more than half of care workers were paid well under the real living wage. Despite this, after a decade of cuts and Government underfunding of care, Salford has done its best to try to lift wages to a standard that carers can actually live on. Salford City Council and Salford clinical commissioning group, following a campaign by Salford City Unison, set aside funds to give care workers a significant wage increase and covid sick pay when isolating. This so-called Salford offer was offered to private care providers, but staggeringly, even when public money is made available, some companies have actually refused to take it if it means improving pay or terms and conditions for workers. What can the Minster suggest to address this?
Sadly, that is only one symptom of the structural problems that exist in care. As the Women’s Budget Group states,
“the structural problems with the sector…have arisen from allowing uncontrolled consolidation by private providers, including private equity.”
Salford City Unison further told me:
“We also see every day that even where we are able to secure contractual guarantees for workers, companies invest so little in back-office services that workers are regularly paid the wrong amount, get rotas at the last minute and find that the days they booked for leave are not recorded in the system and are therefore cancelled at short notice.”
I will read the Minster two quotes from care workers in Salford. Paul says:
“Private companies—and even so-called charities—only care about how much money they make. Not us workers or the people who need our care and support. We want more Government money for social care, but we’ve seen in Salford that loads of private companies would rather turn down public money offered by the council and the NHS, than use it to improve our wages or pay us when we’re off because of COVID.”
Diane, another care worker, says:
“I work in Homecare, often working 7am until 2pm, then back on at 4pm until 10:30pm and then back on at 7am the next day to do it all again. Bear in mind that means I have to get to my first call at 6:30am and don’t get home until 11pm. I am not the same carer when I work that many hours and that breaks my heart. When I ask for holidays, the company asks ‘Are they important? Do you need to be off that long?’ They tell you your days off have changed so that you have to cancel your appointments made in your own time. I am always being given extra calls. Once I actually covered 32 calls in one day. You cannot be a good carer when you are forced to work like that.”
That is not how we should treat those people we charge to look after the most precious people in our lives, is it? It is no way to run a care system. I hope that the Minster agrees that care workers must receive the pay and security they deserve; that unpaid carers must receive the allowances and respite they deserve; and ultimately that the Government must recognise care as a form of public social infrastructure and fund it as such.
(3 years, 3 months ago)
Commons ChamberThe red, amber and green lists reflect the risks that there are in other places around the world. The amber list means that people need to quarantine at home, the red list means that they need to quarantine in a hotel, and the green list means that we think it is safe to travel. My hon. Friend should get his passport out—he can get on a plane to Portugal or one of the other countries. The system allows for some careful foreign travel. However, my first duty is to protect the lives of people here in the UK, and the best way to do that right now is to make sure that we are cautious on international travel to protect the opening up here at home.
The Secretary of State will know that analysis of the data published by Public Health England shows that the spike in cases in Bolton so far is mostly confined to schoolchildren and young adults who are socially mobile and have not yet been vaccinated. There are valid concerns, therefore, that as lockdown eases today, it might lead to a rise in cases within unvaccinated cohorts across Salford, which borders Bolton. Can he confirm that he will act now to protect people in Salford by curbing any spread beyond surge hotspots and accelerating the vaccine roll-out programme in Salford not just for second doses, but for first doses for young, unvaccinated cohorts?
Yes, we are opening up vaccinations for those aged 37 tomorrow, and anybody in Salford who is in one of the eligible groups and has not been vaccinated should come forward. If you are in Salford and you were vaccinated more than eight weeks ago but have not yet had your second jab, please come forward. We now have a very good surveillance system in this country and we publish all the data from it so that we can all see the cases day by day. We can also see the impact on hospitalisations. I am glad to say that, thankfully, the almost inexorable link from cases through to hospitalisation and death that we saw in the past is now broken. The link is not completely severed, but it is much, much weaker because of the protection of the vaccine. Those are the things that people can do in Salford, and I look forward to working with the hon. Lady to get those messages out to everybody.
(3 years, 5 months ago)
Commons ChamberYes, my hon. Friend puts it characteristically well. It is very important to take all considerations into account when making decisions like these. Of course, the precautionary principle is important, but when there are such huge benefits to vaccination, over-precaution is a mistake. We have to take overall public health into account.
The Salford system has delivered the covid vaccine in an unprecedented way. Everyone from cohorts 1 to 9 has been invited at least once—some three or four times—and I understand that, even with the vaccine shortage and guaranteed second doses factored in, we will run out of people in cohorts 1 to 9 to give our current vaccine supply to. Will the Secretary of State authorise Salford to proceed to cohorts 10, 11 and 12 and begin to prioritise the vulnerable members in those age groups, so that we can maximise the doses we have?
No. What everybody in Salford and around the country needs to do is make sure that every last effort is made to reach every last person in groups 1 to 9, because they are the most vulnerable. Only in exceptional circumstances should people under the age of 50 who are not in groups 1 to 9 be invited for vaccination. The message is incredibly clear and I speak very directly to the whole team, including in Salford: please put all your efforts in the forthcoming weeks into delivering vaccines for groups 1 to 9.
(3 years, 7 months ago)
Commons ChamberI am grateful to my hon. Friend, who always asks very important practical questions. He is absolutely right to say that it has been challenging. Part of the challenge, which I think we have addressed today, is the amount of notice primary care networks and GPs have of a delivery. That will only get better as we stabilise deliveries to the warehouses and are then able to take them out into the primary care networks and hospitals. I will of course work with primary care networks and the whole of the NHS family to make sure our communications get better and better.
In Salford, we receive little or no notice that a delivery of the vaccine from the Government is due. Some batches have not turned up at all. When they do arrive, we act quickly. It was therefore staggering when, late last night, our clinical commissioning group was instructed to cancel 924 pre-existing second dose Pfizer appointments, with little time to book new appointments before the batch expires at midday on Wednesday. Will the Minister now allow local CCGs to plan and order their own vaccine batches? Can he assure those whose time before their second Pfizer dose has been elongated that they will be 70% to 90% protected for up to 12 weeks?
I shall take the hon. Lady’s questions in reverse. The four chief medical officers have looked at the issue of the up-to-12-week dosing and all agree that it is the right thing to do. I apologise to the people Salford for that cancellation, if that is what happened yesterday. We have touched on this, but part of the issue has been the lumpiness in the deliveries in the early days, which will begin to become much smoother. The NHS central team, with Brigadier Prosser and the 101 Logistic Brigade, are absolutely focused on making sure that we give as much notice as possible to primary care networks so that they can plan ahead, and that will only get better and better as we smooth out the delivery process from manufacturer into warehouse.
(3 years, 10 months ago)
Commons ChamberMadam Deputy Speaker,
“I am not confident, and nor is anybody confident, that the tier 3 proposals for the highest rates…would be enough to get on top of it.”
Those were the words last night of the chief medical officer, but sadly the Government knew this in September, when SAGE scientists advised the immediate introduction of a list of measures including a circuit breaker. In the following days, the Prime Minister went ahead with only the work-from-home U-turn and the 10 pm curfew. Now we know the truth. Last night, we saw that the SAGE minutes clearly stated that the curfew measure was likely to have a marginal impact, as it also seems the Government’s tiered approach will do.
Further, after the initial lockdown, any semblance of economic normality that would have kept the public safe was predicated on a comprehensive test, track and trace system, but with people still making vast round trips to get a test and risking their details being lost in an Excel spreadsheet never to be seen again, it is clear that we do not have a comprehensive testing system. And how can we forget Operation Moonshot? Salford was to be one of the pilot areas testing the Moonshot programme. However, my local council confirmed to me this morning that, some time ago now, it asked the Department of Health and Social Care to share the clinical validity data behind this new technology. To date, that query remains unanswered, and until this morning Salford City Council had been told to pause the programme. So can the Secretary confirm his current plans for the development of mass testing?
We all know what needs to be done. Any resumption of normal life depends on bringing the infection rate down, followed by robust test, trace and isolate systems, but for this to happen, we need clear direction from Government, and our businesses and workers need economic support to do what is required of them. So far, the Chancellor’s support still does not extend to the more than 3 million people who are excluded, and the watering down of economic support means that, even under tier 2, many businesses and workers across Greater Manchester will see a significant drop in income that they will not be able to sustain. So it seems we have a choice here: either we do not follow the science and instead impose the misery of prolonged tier 2 and tier 3 restrictions in many areas with little economic support, and cases and deaths will rise; or we follow the science and bring down transmission with a short national circuit breaker and a reform to test, track, trace and isolate. Frankly, the pandemic strategy so far has been akin to throwing a glass of water on a chip pan fire, and the Government need to change course today.
(3 years, 11 months ago)
Commons ChamberI have listened to the Secretary of State’s comments and the revocations that he has set out have been welcome, but they are cosmetic and they certainly do not go anywhere near restoring the safeguards that those suffering from mental health problems, disabled people and those in need of care deserve. As for his promise for parliamentary scrutiny, frankly, it is nothing more than a gentlemen’s agreement.
The Act in its current form allows clumsy and asymmetric authoritarianism. Powers to restrict mass gatherings might well have been necessary, but broad police powers under schedule 21 to detain potentially infectious people have led to unlawful prosecutions 100% of the time. Where were the extra powers—the resources to inspect or restrict unsafe workplaces or to requisition private lab space, healthcare or other facilities for mass testing? Where were the powers to take charge of food supply in the event of future lockdowns to avoid further panic buying and ensure that shielding and vulnerable people receive the food that they deserve?
The Government demand that their citizens give up their liberties and livelihoods in the pandemic, yet they do not stand beside them. The Secretary of State’s comments today certainly do not deal with the issues that many of our constituencies face, and some of us begin to worry that the Government’s confused and often contradictory public messaging is not mere incompetence, but a studied chaos, designed to blame ordinary people instead of taking democratic political responsibility for some of the worst pandemic management in the world. The Government are at real risk of squandering public sentiment and public good will, and, at the very least, they must set out to revoke the most insidious parts of this Act tonight.
(4 years, 3 months ago)
Commons ChamberThe consultation closed in October last year. We were hit by twin issues of purdah being imposed and now, obviously, our principal focus being on dealing with the coronavirus. We hope to respond to the consultation in the near future, but I am not currently in a position to give my hon. Friend an exact date.
Constant speculation on when schools will reopen and whether it is safe to do so is leaving many parents, pupils and staff anxious. Last week, it was reported that the Government were looking at best practice in other countries; this weekend, it was reported that the Government would reopen schools for year 6 pupils on 1 June; and last night, it was reported that there were discussions in Government about giving schools and multi-academy trusts the flexibility to decide for themselves, amid concerns that Ministers were coming under pressure to help to kick-start the economy. I am sure the Secretary of State will want to reassure parents, pupils and staff that their safety is the Government’s No. 1 priority, so will he clarify the basis on which the Government are making decisions on school and college opening, and when will he make the scientific advice supporting his strategy publicly available?
First, let me take this opportunity to congratulate the hon. Lady on her new appointment. I appreciate the time she has made available to speak with me, and I hope the regular briefings from officials that we are providing are of considerable assistance to her, as I think they were to her predecessor.
All SAGE advice is made public, and we will certainly do that. On the return of schools, I am sure the hon. Lady shares my desire for children to be given the opportunity to return to school when it is the right time to do so. The decision will be based on the scientific and medical advice that we receive. I assure her that we will take a phased approach to reopening schools, and we will always aim to give schools, parents and, critically, children maximum notice of when that will happen.
I thank the Secretary of State for his kind comments. He must understand that faith that children and staff are safe will be necessary to parents having the confidence to send their children to school, but nearly 1 million pupils in English schools are in classes of 31 or more—an increase of 28% since 2010—so there is understandable concern that social distancing will be difficult in schools. Everyone wants a return to vital education to support pupils and to stop the ever-widening attainment gap, but does the Secretary of State agree that first we need a national plan for social distancing and personal protective equipment, evidence of a sustained downward trend in cases, comprehensive access to testing for staff and pupils, a whole-school strategy for when cases emerge, and protection for the vulnerable? In the words of the National Education Union:
“Anything else will be a dereliction of duty from government”.
I think the hon. Lady would very much appreciate the fact that I take my responsibilities for the safety and the health of children who attend school as the absolute principal motivation for everything I do, as is the case for those who work in schools. I always welcome constructive dialogue with her, which is why we have made every effort to do so, about how best we can support children to be in schools. Let us not forget that the overwhelming majority of schools—over three quarters of them—are currently operating in a safe, considered and proper way, supporting the children of critical workers as well as those children who are most vulnerable in society. Every step we take is about making sure that we look after those who are the most important part of our society, and that is our children, but also about supporting those who work in educational settings.
(8 years, 3 months ago)
Commons ChamberI thank the hon. Gentleman for his intervention. Parliamentary questions have shown that the Department of Health failed to consult the Royal College of Midwives, the Royal College of Nursing and Unison before the policy was announced in the autumn statement last year. It is not just the Labour party that is worried about this, but the Royal College of Midwives, the Royal College of Nursing, the College of Podiatry, the Royal College of Speech and Language Therapists and the NHS Pay Review Body, as well as Members across the House. It is little surprise, then, that the result fails to understand the unique characteristics of the sector and the hard-working professionals that work in it. This is a process that has been driven by short-term financial savings at the cost of tackling the big questions of how we adequately fund our NHS for the decades to come.
What about the effect of this policy on the nurses and midwives of the future? At the centre of any policy on healthcare education must be the students themselves. In this case, they are diverse: older than most—the average age is 28—and overwhelmingly female. There are greater numbers from black and minority ethnic backgrounds. We should not forget that completing a degree necessitates 2,300 hours of clinical practice over three years. Any legislation that we need to design to encourage students in the future and to guarantee high-quality care for patients must recognise those types of people. They are people like Katie, a nurse in my constituency, who wrote to me about her concerns about the prospect of debt. She said:
“It is particularly worrying for mature students, many of whom have dependants, and it could deter them from joining the profession altogether. I can relate to this as three of my close colleagues are mature students and have stated on multiple occasions that, without the bursary, nursing school would not have been an option. Student nurses are not like other students: 50% of their time is spent on unpaid clinical placements in hospitals and in the community and there are simply not the same opportunities for part-time work as other students. I could not have completed this course without the bursary. Studying nursing requires participation in extra-curricular activities. This is in line with a recent national initiative: revalidation…Therefore, finding time for part-time work becomes very difficult, and many of my friends have been turned away from part-time jobs as our weekly schedules, working shifts and time for completing university work are often sporadic. The bursary covers my rent and without that I would not be able to support myself and nor would my family.”
We need to take such views on board when looking at a new policy.
Research from the House of Commons has shown that of the net savings made to the Treasury through measures taken by this Government since 2010, 86% will have come from women. Does my hon. Friend agree that these proposals are no different from those we have seen in the junior doctors’ contract dispute, and that they will adversely affect women rather than men?
My hon. Friend makes a very important point. It is important to remember that, and to think about how the prospect of paying off more than £100,000 worth of debt affects the calculation of a mature student looking to study a second time to become a mental health nurse. It is important to think about how a lone parent, who is hoping to become a midwife, might feel the pressure of £59,000 of repayments when considering the future of their family—that is the latest estimate of debt from the Royal College of Midwives.
It is important to wonder how a nursing student, taking part in a 48-week extended course, is expected to find part-time work to make their studies viable. Not only is the Government’s evidence base desperately weak, but research by the Higher Education Funding Council for England tells us that poorer students, lone parents and BME students—the demographics of many of the people attracted to nursing—are disproportionately dissuaded from applying to university by the prospect of large debts.
The policy fails on two fronts. The refusal to engage with experts in the field has led to a misguided policy that makes healthcare education the privilege of those who can afford decades of debt. It fails to ensure fair and equal access to healthcare education. Secondly, there is a real danger that this policy will fail to achieve its own aim of attracting future students. Everyone in health who knows about these issues will acknowledge the shortages of nurses, midwives and other health professionals, but moving the burden of payment to students is widely seen as a mistake. Deterring potential candidates by promising a lifetime of repayments immediately on graduation cannot be the answer.
I conclude by joining the calls of the Royal College of Midwives and the Royal College of Nursing for the Government to rethink the proposals and to scrap the NHS bursary. We need a thorough and inclusive consultation process so that those with experience of the system are able to contribute properly. I ask Ministers to ensure that future students at Manchester University’s School of Nursing, Midwifery and Social Work are not forced to bear the burden of a Government unwilling to listen. The Royal College of Nursing has said that the Government have not thought hard enough about the risks. Now is the time to do so.
(8 years, 7 months ago)
Commons ChamberBefore my hon. Friend the Member for Ilford North (Wes Streeting) leaves the Chamber, I would like to wish him a very happy birthday and congratulate him on his point of order.
I thank the Minister for attending what I have no doubt will be a lively and informative debate. It might be helpful if I first define what specific kind of transport I am focusing my comments on today. Adults with special educational needs often attend day centres or schools. Until recently, many councils have provided accessible transport to allow the most vulnerable to access these facilities, often by way of a bus or the provision of a driver plus an expert escort on board to ensure safety. That support is a vital service in many communities, providing independence for those with special needs and peace of mind for their parents and carers. It also provides a much-needed break for the unsung heroes of social care who struggle with the commitments of family life and work alongside caring for their loved ones.
Let me set a backdrop for the harrowing tale I am about to tell. In 2014 my local council, Salford City Council, was ordered by the Government to find £25 million of so-called savings in its budget. That was in addition to £97 million in spending cuts that it had already suffered since 2010. As an already efficient and well-respected council, it had already sought to find every possible means of saving money through genuine efficiency gains. It had fought for four years to find ways to save money or reduce spending here and there in order to ensure that all services for the most vulnerable residents across Salford were unaffected. By 2014 the council was way beyond being able to salami-slice budgets and, as a result, was forced to look at making real changes to a wide range of services. Our mayor, councillors and council officers were put in the agonising position of having to prioritise which types of care they provided and to determine who was the most vulnerable, instead of simply protecting all the vulnerable, as it had done before.
This year, £16.4 million has been taken out of Tameside council’s budget for adult social services, £11.1 million has been taken out of Oldham council’s budget for adult social services and a deficit of over £20 million has been forecast for Tameside general hospital. Cuts to front-line local services not only cost more in terms of the quality of life for the individuals affected, but cost us all more in the long run. Does my hon. Friend agree that these cuts are really short-sighted and damage not only our local services, but our NHS, which has to pick up the pieces afterwards?
I thank my hon. Friend for those helpful comments. I completely agree. As she will hear, Tameside is not alone in suffering such savage cuts.
Salford City Council had to face the difficult decision to cut the in-house provision of vulnerable adult transport for over 200 families across the city, amounting to a £500,000 cut in transport support for those with special needs. That was alongside the £400,000 that the Government’s cuts took from the provision of adult social care support to those with learning difficulties in the same year. I must add that prior to the cuts the transport service was rated excellent as a council service. It was not inefficient and there were no plans to cut it had the funding been available.
Commenting on the Government cuts at the time, our mayor, Ian Stewart, stated that
“this is not about efficiencies any more. These cuts will cause untold damage to the services we provide”.
Even in this desperate funding crisis, the council worked hard to make the best of a terrible financial situation. In partnership with the individuals affected and their carers, appropriate alternative arrangements were made. Transport was not ended for anyone until suitable alternative arrangements had been agreed. The good news is that a number of parents were generally happy with the council’s new arrangements, because they can individualise their journey times. That means that they are not spending significant amounts of time on transport, which previously resulted in some people arriving at the day centre in an agitated mood. The council is very much aware that the change is not universally popular, and it continues to work with any individuals who express concern. The fact remains, however, that it does not hold sufficient funding to provide an in-house passenger transport service as it was provided.
I have spoken at length to some of the families affected. I have heard their tales of despair and their worry about which other services that they rely on might be cut in future. I have listened to the mayor, our councillors and council officers, who have frankly lost faith in the Government’s commitment to provide a welfare system, which should be there to look after the vulnerable. In the wider context, for the 2014-15 financial year, a total of £4 million had to be cut from community health and social care, £2.4 million from public health, £4.7 million from support services, £5.6 million from education, and £4 million from environment and community safety. These are not “efficiency savings”—they are cuts to front-line services.
Perhaps in 2010 there were areas where genuine savings could be made with minimal knock-on effects on front-line services, but by the time £97 million has been taken from the budget, there is nothing left to cut but vital front-line services. Even the Prime Minister’s own council leader had to explain this principle to him following the now infamous letter in which he criticised his local council’s cuts to front-line services. By 2016-17, Salford City Council will have to make budget cuts of £188 million in order to balance its budget; £83 million of that sum alone is the amount by which the Government grant has been cut. That is a cut of over 43%, but in real terms the figure is much higher.
This is not just an issue for Salford City Council. Every council has faced vast reductions in funding from central Government, and my local council is not alone in having to cut transport for those with special educational needs. Countless numbers of local authorities have reduced or completely ceased to provide transport for vulnerable adults. It is rather tenuous, therefore, for the Government to argue that all these councils have made the choice to cut such an important service when they could instead have made efficiency savings in their back offices. These councils have no such choice any more.
When my constituents visited me about this issue, my first reaction was to try to locate funding elsewhere. What about the northern powerhouse, I thought, all that money that is supposedly being unlocked in the north—surely Salford’s vulnerable people deserve a piece of that? When I examined the detail I became even more disillusioned. We have often heard the Chancellor wax lyrical about his so-called devolution revolution, which he argues will enable areas such as Salford to raise and spend revenues locally, but he fails to acknowledge that councils in poorer areas have very limited revenue-raising capacities.
For instance, the policy to allow councils to set and retain their own business rates without the safeguard of a grant scheme has the potential to create severe inequalities among different areas of Britain. Indeed, the director of the National Institute of Economic and Social Research has said that while he agrees with the principle, it would be “inconceivable” not to keep a grant scheme. He stated:
“does this have the potential to disadvantage deprived areas and advantaged rich ones?..Absolutely!”
The Institute for Fiscal Studies has expressed concern that such a move would create winners and losers, with poorer areas seeing a fall in revenue. Let us not forget that we are already seeing disparities between local authority cuts. Between 2010 and 2015, Salford saw cuts of £210 per head, while authorities such as Epsom and Ewell saw only a £15 per head decrease. With local government funding being cut in terms of the grant by 56% by the end of this Parliament, it is frankly terrifying for Members like me whose local councils will see even more significant reductions in their spending power.
The same issue arises with regard to the social care precept, which would allow councils to raise council tax by 2% in order to fund social care. The president of the Association of Directors of Adult Social Services has warned:
“The Council Tax precept will raise least money in areas of greatest need which risks heightening inequality.”
My hon. Friend and parliamentary neighbour is making a great speech in support of our local council and about the difficulties it faces. On the social care precept, does she agree that a council such as ours, which has lost £15 million from its adult social care budget, will be able to raise, at most, only £1.5 million to £1.6 million? The gap is enormous. We no longer want to hear Ministers saying that they have put extra funding into social care, because, frankly, they have not.
My hon. Friend is right: councils in deprived areas will have the greatest social care needs, yet they will raise less than a third of what more affluent areas raise through this approach. I really fear that any revenue we raise across the city of Salford will barely touch the sides of the funding crisis in social care. Sadly, the Minister may be hoping to say that services such as in-house transport for vulnerable adults could be funded through a future increase in the social care precept, but that is not likely to be an option for Salford City Council. As I have outlined, councils in deprived areas have already been hit the hardest, and they will be hit worst again by the measures in the latest spending review.
The Government have had since 2010 to convince us that their argument for local government austerity is necessary. In that time, they have slashed the budgets available to councils for vulnerable adult transport and other essential services, while at the same time handing out tax breaks for millionaires, slashing inheritance tax and, despite their rhetoric, doing very little to crack down on tax avoidance. In fact, only in December we heard that five of the largest banks in the UK paid no corporation tax at all in 2014, despite making billions of pounds in profits.
The Prime Minister gave the game away in an interview on Monday morning, when he said that
“if you are a Conservative, you don’t believe in a big state”.
I fear that that is what these cuts are all about: rolling back the state and going back to a time when the vulnerable relied on the philanthropic donations of wealthy people with a conscience.
The cuts that have been inflicted on my city are clearly a political choice, not an economic necessity. My and my hon. Friend’s city is living in fear, with the sword of Damocles hanging over our heads, waiting for the next savage cut to drop.
I look forward to hearing the Minister’s comments and I hope he will be able to reassure me that my fears are unfounded. I also hope that as a result of this debate he will ensure that there is a much-needed boost to local government funding, in order to provide essential services such as the one I have outlined. I hope he amazes me with what he is about to say.
I will come on to the numbers for Salford. I rang Salford this morning to get the very latest numbers, and they make quite interesting listening.
Let me just set the scene on the settlement. In the context of the tough public sector finances, we listened to local government and took steps to protect social care services. In the spending review, we reflected that by introducing a 2% social care precept to the council tax for authorities with social care responsibilities. It is ring-fenced: it has to be spent on social care. The precept could mean up to £2 billion of additional funding for social care by 2019-20, which would be enough to support more than 50,000 people in care homes or 200,000 people in their own homes. In addition, we have secured a further £1.5 billion by 2019-20 through extra funding for the better care fund, which brings that funding to a total of £5.3 billion. Those resources are secure, and they are in the hands of local authorities.
Let me turn to transport for disabled people in Salford. Rightly in my view, the provision of social care and the question of how to meet local need are very much matters for the local authority, as I think hon. Members would agree. That is at the heart of this issue. I understand that Salford City Council has decided that the transport needs of people who require support to get to local day care and respite care services can best be met, in the patients’ interests, by closing the in-house passenger transport unit and providing suitable alternatives for individuals.
I also understand from the local authority that a significant number of parents and carers have commented on how much better the arrangements are because they can individualise journey times. Instead of having to wait and then sit on the council bus to get to services, going on very long routes, the vast majority of users are getting a much more personal and bespoke service. It means that the users of the service do not spend significant amounts of time on transport, which used to result in some of them arriving at a day centre or home upset, agitated, delayed and frustrated.
The council has worked hard to resolve the concerns that have been expressed by care users and their families. Having spoken to the council this morning, I understand that all have now accepted the new arrangements. Indeed, the director of adult social services at Salford City Council has told me that he considers the change to be
“a success both in terms of outcomes for individuals and in delivering a saving to the council budget.”
The Minister is quite right in what he says. The ability of my local authority to do more with less has been extremely amazing, but the fact remains that the review of special needs transport would not have occurred to this extent had the funding not been taken away. I do not dispute that it is right to review the service and the needs of individuals on an ongoing basis, but it should not have been done in such a forthright and extreme way. That would not have occurred had the funding not been taken away.
I am not sure what the question was. It is interesting that the hon. Lady is saying that the review was the right thing to do and the service has improved, but the rationale for doing it was wrong. I beg to differ. If the rationale that we have to deliver more for less leads good councils, in this case Salford, to find a better way to deliver services that uses less money and provides a better service, that is good. It is exactly what we want councils across the country to do.
For far too long, local government has been hidebound by receiving far too much of its funding from central Government. For me, as a localist, it is anathema that the majority of local government spending comes from central Government. That is why we have begun the process of seriously rebalancing the funding settlement by providing more powers and freedoms locally to raise money that can be spent on locally agreed priorities. The social care precept and the retention of business rates locally are powerful things for which many of us have campaigned for years.
If Salford uses the full social care precept flexibility that we have just provided, it could raise £7.6 million in 2019-20. That will be on top of Salford’s additional income from the better care fund of £10.5 million in 2019-20.
This is not about cuts. It is about a Labour council making prudent decisions that not only improve the way in which services for vulnerable people with disabilities are delivered, but do so in the most cost-effective way. The council’s prudence extends to its decision to nearly double its non-ring-fenced reserves from £29.7 million in 2010 to £56.5 million at the end of 2014-15. I will just say that again: the council doubled its reserves to £56.5 million over the course of the coalition Government.
I will take the question as being, what do I think about that statement? The hon. Lady is right that the funding ramps up, but she is not right in saying that it does not come on stream until 2020. Indeed, I have looked at the figures for Salford. The money that will go to Salford from the better care fund will be £1.1 million in 2017-18, £6.1 million in 2018-19 and £10.5 million in 2019-20. Similarly, the precept will rise over the course of this Parliament, depending on Salford’s decisions on raising it.
Salford’s reserves have gone from being £29.7 million in 2010 to £56.5 million. Those reserves are public money that is there to be used prudently. In this period when we are all having to make sure that our children do not inherit ever more debts, I do not think the fact that Salford City Council is having to dip into its reserves to ensure that it is able to provide services—which, remember, are costing less but delivering better quality—is the savage crisis that the hon. Lady referred to.
I invite the Minister to visit the city of Salford. He will see the extent of the damage that this Government have done to local authority services. It is not just social care that is experiencing a large funding gap. Salford is experiencing a large-scale regeneration and is coming out of its post-industrial decline, but all that is at risk. He made the fantastic comment that we have increased our reserves, but there is much more that needs to be done in Salford.
I would happily welcome the chance to debate more widely the economic regeneration of Salford, which I hugely welcome. Since the floods have been mentioned, may I extend my sympathy, and that of the Government, to those who have been affected? However, this debate is on transport for vulnerable adults and when I spoke to Salford Council this morning, it told me that all those affected—I believe there are 200 families—are happy with the new service and believe that it is providing a better service for vulnerable adults in Salford.
The hon. Lady has cleverly used the debate to make wider points about the Government’s approach to care, which is perfectly within her rights. I have tried to deal with them. She says that we are underfunding local government, but in the recent comprehensive spending review, local government made clear to central Government that it foresaw a shortage of £2.9 billion that it was worried would not be met. That is why we gave local government a funding settlement of £3.5 billion, to ensure that the shortage we were warned about was properly met. We went further and gave local government the right to raise up to what will equal £2 billion in 2020 to fund that care gap, and a four-year settlement so that it can plan ahead—one of the other key asks. We have put an extra £1.5 billion into the better care fund, which now totals £5.3 billion for the integration of health and care.
The plea may go up that that is not enough, but money does not grow on trees and we can only fund what we can from our strongly recovering economy. However, I do not believe that that fits the pattern of “savage cuts” described earlier. I merely repeat that if the picture that the hon. Lady painted about transport for vulnerable people in Salford were true, I would be very concerned. However, when I spoke to the Labour-run council, it told me that it believes it is delivering better services at a more efficient cost, and that all those in the families involved have settled and are happy with that. The council’s reserves are up substantially on where the Labour Government left them, to the extent that over the next one or two years, while the extra money that we have put in comes on stream, it will have those reserves that it built up during the coalition Government. I simply do not recognise the picture of savage cuts and austerity that the hon. Lady presents.
I am quite concerned about the Minister’s comments. I spoke to the council this week and received similar comments, including notification that large numbers of the families were happy with the new service—I outlined that in my speech. I also highlighted that the council was aware that some families are not happy with the amended service, and it continues to work with them to try to reach a sensible conclusion on the matter. That is why I have raised this issue in the Chamber today.
I am delighted that we close on a point of unanimity: we agree that Salford council is doing a good job and has managed well the issue of transport for vulnerable adults. I was merely dealing with the wider points that the hon. Lady sought to make about the Government’s more general approach to care, to which it is my duty to respond. I welcome the work that Salford council is doing to look after its most vulnerable citizens, and I hugely support it in that. The Government’s vision is to give councils more freedoms and funding to provide for local people in the way that they see fit; in that way, all councils can do what Salford has done and deliver more for less.
Question put and agreed to.
(8 years, 8 months ago)
Commons ChamberIn Salford and Eccles, we know only too well about the urgent need to provide better mental health services, but I want to focus specifically on children’s mental health services. As we have heard, a significant proportion of lifelong mental health problems start in the teenage years, yet only 6% of the mental health budget is spent on child and adolescent services. YoungMinds, a leading mental health charity, has confirmed that, due to local government cuts, 60% of local authorities have either cut or frozen their child and adolescent mental health services budget since 2010.
Research has shown that early intervention is of paramount importance, with one in 10 children encountering a mental health problem, which, without early intervention, is likely to become a more chronic problem in later life and thus a greater burden on the NHS. Early intervention is also key to ensuring that an issue does not escalate to the stage where hospitalisation is required. One in-patient bed costs a staggering £25,000 a month. It is perfectly clear that adequate investment in the lower tiers of CAMHS provision is not just a question of social conscience, but a matter of economic common sense.
I must also address the systems in place for ensuring that children who present with mental health issues receive the requisite help at the earliest opportunity. GPs play an incredibly important role in early intervention, as they are often the first point of contact for parents whose child is experiencing a mental health problem. GPs have, however, voiced the concern nationally that they are not sufficiently equipped to deal with children with mental health issues and their training does not prepare them adequately for such situations.
Time and again, I am made aware of cases in my constituency where a child did not present symptoms clearly enough to a GP, a referral was not made and the problem, which could have been dealt with relatively easily, escalated to the point where the child became seriously ill and required hospitalisation. Other barriers to referral include the body mass index limits in relation to eating disorders, which my hon. Friend the Member for Liverpool, Wavertree (Luciana Berger) highlighted earlier. What further support and guidance will the Government provide to GPs in order to address the issues?
The case for effective early intervention in Salford becomes even more convincing when we consider the shortage of in-patient beds in Greater Manchester. I have been working with a family in my constituency whose child desperately needed urgent treatment but who, due to the lack of available beds, was admitted to a general paediatric ward, where they waited for months until a child mental health bed became available. Although the staff on that ward were amazing and did all they could, the simple fact remained that this child was not on the correct ward and was therefore not receiving the psychiatric treatment that was immediately required.
Although I appreciate some of the measures that the Government have taken, I have serious concerns that they will barely begin to address the issues that I have raised today.