Oral Answers to Questions

Toby Perkins Excerpts

Tuesday 10th March 2020 Commons Chamber

[Helen Whately]

I am well aware of concerns about the surcharge. Many overseas nurses coming to work in the NHS do not have to pay the surcharge, as it is covered by their employer.

[Mr Toby Perkins (Chesterfield) (Lab)]

The phrase “brightest and best”, when it appears in immigration talk, is obviously subjective and deliberately vague. What the private sector and local authorities want to know is: under the new Government system, will they be able to get people to come in who want to provide care—people we are desperate for?

[Helen Whately]

For the NHS, we have the NHS visa and a clear route to come to work in the health sector. For social care, there is a job to be done by employers, to make sure that working in social care is an attractive job that is well paid. I also recognise that there is a role for Government and for all of us in Parliament, to come together and support changes to how we fund social care. We need to fix the social care system for the future.

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[Matt Hancock]

My hon. Friend is quite right to raise this—it is true that that the NHS has had to rise to address the scandal over mesh. There is a lot of work still to be done.

[Mr Toby Perkins (Chesterfield) (Lab)]

T3. The Secretary of State is absolutely right to say that we need to take advantage of all the medical evidence. In the light of that, is it not deeply damaging for the Prime Minister to go on morning television and start musing on the idea that we might have a theory of letting coronavirus have its bounce out and see how it goes? Does that not absolutely fly in the face of the efforts that the Secretary of State is making? Can he clarify that that is not the policy of this Government and tell us what the hell the Prime Minister was talking about?

[Matt Hancock]

No, the hon. Gentleman is wrong to raise this issue in this way. It was addressed in the House yesterday actually—the Prime Minister was explaining that that is not Government policy.

Health Inequalities

Toby Perkins Excerpts

Wednesday 4th March 2020 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

I beg to move,

That this House notes the publication of Health Equity in England: The Marmot Review 10 Years On; is concerned by its findings that since 2010 improvements to life expectancy have stalled for the first time in more than 100 years and declined for the poorest women in society, that the health gap between wealthy and deprived areas has grown, and that the amount of time people spend in poor health has increased across England; agrees with the review that these avoidable health inequalities have been exacerbated by cuts to public spending and can be reduced with the right policies; and calls on the Government to end austerity, invest in public health, implement the recommendations of the review, publish public health allocations for this April as a matter of urgency, and bring forward a world-leading health inequalities strategy to take action on the social determinants of health.

A former Health Secretary, Frank Dobson, whom we sadly lost towards the end of last year, said:

“Inequality in health is the worst inequality of all. There is no more serious inequality than knowing that you’ll die sooner because you’re badly off.”

He was absolutely right. Poverty and deprivation mean that people become ill quicker and die sooner. The current Health Secretary—I understand why he cannot be here for this debate; I do not criticise him for that, given what is going on, and we welcome the Under-Secretary of State, the hon. Member for Bury St Edmunds (Jo Churchill), to the Chamber—said, when we last debated health inequalities, that

“extending healthy life expectancies is a central goal of the Government, and we will move heaven and earth to make it happen.”—[Official Report, 14 May 2019; Vol. 660, c. 153.]

Well, last week the respected academic, Sir Michael Marmot, gave us his assessment of the Government’s attempts to move heaven and earth to narrow those inequalities and extend healthy life expectancy.

[Mr Toby Perkins (Chesterfield) (Lab)]

I absolutely congratulate my hon. Friend on bringing this crucial issue to the Chamber. The health inequalities that we have seen in our communities are bad enough, and the additional inequalities regarding access to GP appointments are even worse, but we are also seeing cuts in local government funding hitting the most deprived areas and adding to those inequalities we are already aware of.

[Jonathan Ashworth]

My hon. Friend makes that point very well. Not only are there inequalities in health outcomes, but inequalities are opening up in access to health services.

I said that I understood why the Secretary of State cannot be here, but he has now joined his colleagues on the Front Bench. I will state, just for the record so that he can be reassured, that I did not criticise him for not being here—I said that I entirely understood why he could not be here. But he is always welcome to listen to my pearls of wisdom, of course.

Michael Marmot’s analysis was shocking, and his conclusions devastating. Let me remind the House of what Professor Marmot found: for the first time in more than 100 years, life expectancy has essentially flattened overall since 2010, and has actually declined for women in the poorest areas of England. In last week’s Opposition day debate, the Health Secretary told Opposition Members that we must debate these issues based on the facts. In fairness, he said that there were life expectancy differences between, for example, Blackpool and Buckingham. [Interruption.] Indeed—gulfs. The Secretary of State made that point. If I may say so, however, I do not believe that he was as clear as he could have been in presenting the full picture for the benefit of Members. When we look at the figures, we see that for more than 100 years, life expectancy has been increasing by about one year every four years. More recently, from 2001 to 2010, the increase was 0.3 years for each calendar year for men and 0.23 years for women. Between 2011 and 2018, the average rate of increase was 0.07 years for males and 0.04 years for women. By any standards, that is a truly dramatic lowering in the rate of improvement in life expectancy between 2011 and 2018.

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[Jo Churchill]

The hon. Gentleman makes a good point, but it typifies the problems we deal with, because air pollution is the responsibility of the Department for Environment, Food and Rural Affairs, the Department for Transport and the Department of Health and Social Care. They all have a role to play, and we must ensure we take account of that—it is important that we think about all these different challenges. Helping people to live longer healthier lives while narrowing the gap between the richest and the poorest needs action, a point made by the hon. Member for Coventry South (Zarah Sultana).

[Mr Perkins]

Will the Minister give way?

[Jo Churchill]

If the hon. Gentleman will just bear with me and let me make a little more progress, I will come back to him.

Going forward, I am clear that we must integrate good health into decisions on housing, transport, education, welfare and the economy, because we know that preventing ill health, both physical and mental, is about more than just access to our health services.

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[Jo Churchill]

I will come on to that point in a few minutes, if my right hon. Friend will bear with me.

[Mr Perkins]

The Minister is right that this is a very complicated issue and that health inequalities have existed for a considerable amount of time. On the research she refers to, will she tell us whether local government cuts, which have been greater in the poorest areas, with a significant reduction in health education and prevention work, were mentioned as factors for why this continues to be such a major problem?

[Jo Churchill]

The problems we are dealing with are complex across the piece, which is why we have held the public health budget at the same level this year so that we can start to deliver on them. It is important that local people have local ownership over the issues and challenges in their area, because one size will not fit all.

Social Care

Toby Perkins Excerpts

Tuesday 25th February 2020 Commons Chamber

[Barbara Keeley]

I thank the hon. Gentleman for making that point; he does make it on every occasion that we debate this subject, so I congratulate him on doing so again. However, the person he needs to be directing his comments about cross-party talks to is sitting on the Government Front Bench. I am hopeful that the Secretary of State is going to tell us what he is going to do about cross-party talks, because those 15-minute visits are really not good enough.

[Mr Toby Perkins (Chesterfield) (Lab)]

I agree entirely about the need for cross-party consensus on this issue, but there can be no consensus until there is an acknowledgement of what has caused the care crisis—the underfunding of the health service and cuts to local government budgets, which have had an impact on A&Es, GPs and other services. Until there is an acknowledgement of what caused the situation, there can be no consensus towards a solution.

[Barbara Keeley]

My hon. Friend is right. I will come to the causes, because it is important to mention them.

The 15-minute care visit reduces the giving of care by care staff to a series of physical tasks, rather than the staff being able to see a person with their own interests, desires and opinions. It really strips them of the time to do the job they want to do. I pay tribute to all care staff, who go above and beyond in their jobs to improve the lives of the people they support. Without them, our social care system would not work, but they do not get the pay and recognition that they deserve.

Care staff, who provide essential practical and emotional support to some of the most vulnerable people in society, are among the most poorly paid workers. The average hourly pay for care staff is below the rate paid in most UK supermarkets. On average, care staff are paid less than cleaners and healthcare assistants in the NHS, and this has led to a vacancy rate of 122,000 care jobs and a turnover rate of 33%. Now the Government are planning to make the situation worse by turning away people who want to come to this country to work in social care. One in seven care workers is from outside the UK, but the average care worker earns £10,000 a year less than the Government’s immigration salary threshold, so will the Secretary of State tell us just how he thinks he is going to be able to fill the large number of vacancies in the social care workforce?

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[Mr Toby Perkins (Chesterfield) (Lab)]

It is a great pleasure to follow the right hon. Member for Ashford (Damian Green). I found myself agreeing with many of the priorities that he set out; that gives us some hope about cross-party consensus.

I wish to talk about three things: first, the proposal by Derbyshire County Council to close the Spinney care home in Brimington in my constituency and six other homes throughout Derbyshire; secondly, the wider implications of Government funding decisions over the past 10 years; and finally, the role of carers and the impact of councils’ use of private sector agencies to reduce council budgets on the quality of care provided.

First, the Spinney is a care home built in 1974 and run by Derbyshire County Council. Up until the Conservatives took over in 2017, it had been rated good by the CQC and was full; since 2017, the council has stopped taking new residents, and gradually numbers have fallen as residents have passed away. All the residents and their families to whom I have spoken speak warmly of the quality and culture of care provided by the Spinney and oppose the council’s call for closure. In the past two years, five of the rooms in the Spinney have been fitted with en suite bathrooms—the lack of en suite facilities being one of the reasons given for the closure—but none of those rooms has been used. Now, Derbyshire County Council says it will close the home and allow the residents to live more independently.

The comments from residents make it clear what they feel. One said:

“I have no relations, no family, the carers and staff are my family…I want to live the rest of my days here it has all come crashing down around me”.

Another said:

“People will not get more than 10 minutes three times a day”

if they leave and go independent. They went on to say that

“this doesn’t stop people roaming the streets and the police having to bring them back.”

A family member said:

“My mum lived independently till she was 96 years of age. We all rallied round to look after her, but she was only safe once she was here at the Spinney.”

There are many, many more stories.

I note that the county council had a £5.7 million underspend last year in its social care budget, so I roundly condemn it for its decision, and I hope that it listens to reason when the consultation finishes and that it agrees to improve the Spinney rather than to let it close.

More broadly, we all know that the money available to councils for social care has been savagely cut during the nine years of austerity. Indeed, at the very time when our ageing population were demanding an increase in care spending, the Government were cutting £5 billion from council budgets for care. The money that the Prime Minister has promised, welcome as it is, is simply one step back up the mountain.

The failure to provide care for some of our most vulnerable citizens is not just morally repugnant and does not just shame us as a society, it is also economically illiterate. Failure to care for people in residential or domestic settings and leaving them to fend for themselves means that they end up in A&E. It means that they end up being treated more expensively in our hospital system. The 148 people who were left in hospital beds in Derbyshire because there was no care package available for them were costing us more than they should have done as a result of cost savings. Cuts in care are not only barbaric, but economically crazy too.

There is no way that a Government who have reduced council spending by 50% in real terms over 10 years can be anything but complicit in the care crisis that faces us, but providing ring-fenced money for care alone will not be the step required to make this right. There must be a whole-system approach that addresses the many causes of the crisis in care. Those causes include the inadequate number of GP appointments available, particularly in more deprived areas; the crisis in the recruitment of GPs, nurses and carers; and the casual and unprofessional way that carers are recruited, trained and employed, which means that workers at McDonald’s are given greater job security and better rates of pay than someone who plays a crucial role in the health of the most vulnerable citizens in our society. There is also the crisis in A&E, which sweeps up the greater share of the NHS budget. That crisis is then exacerbated by people taking up hospital beds when they could be at home receiving care, and so the vicious cycle continues.

Finally, I would like to touch on the issue of how carers are employed. Council budgets are a part of this equation, but, in truth, councils were outsourcing these services long before council budgets were shrunk. It should never be said that people who provide care on behalf of private companies—or, in many cases, those companies themselves—have any less capacity to care or any less empathy for their customers than people who do it in the public sector. However, many councils are signing tenders that can only lead to the provision of inadequate care.

Hillcare Group, a nursing care home provider in my constituency, wrote to me recently to say that the funding provided by Derbyshire County Council was £150 per resident per week less than in other local authority areas, and that ends up having an impact on the care that is provided. I have an idea: when councils set tenders, they should be setting a rate of pay at the time they use private companies. The reason for using private companies is not just about saving budget, but about that company providing care in a better way. It is not just a way of undercutting the wages of unionised council staff. If rates of pay across the sector were set by the councils, we would not find council contracts being provided by private companies in such an inadequate way.

This is a multifaceted and real problem. Residents and families of the Spinney are just the latest victims of our failure to take this matter seriously. I hope that it will be solved, because our older people desperately need it to be.

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[Helen Whately]

I have already visited two care homes since becoming Minister for Care, and I want to visit many more. I hope I will be able to take up my hon. Friend’s invitation and see that good work for myself.

I pay tribute to my predecessor as Minister for Care, my hon. Friend the Member for Gosport (Caroline Dinenage). I hear that she was visiting a hospice on reshuffle day—her actions illustrate the enormous commitment and compassion she brought to this role. I sincerely hope to follow in her footsteps.

I also thank all the hon. Members who have spoken today. Social care is important to many thousands of our constituents, and their interest and input are incredibly valuable.

[Mr Perkins]

I welcome the Minister to her post, and I welcome what she says about carers. Would it not be wonderful if, rather than just giving them her warm words, support and admiration, she were able to join a cross-party campaign to see that carers get paid more than burger flippers in McDonald’s so that we actually start recognising them with the same prestige as nurses and the same earnings as people in our health service?

[Helen Whately]

I thank the hon. Gentleman for his suggestion. It is almost as if he has seen my notes.

One thing I particularly welcome is the number of hon. Members on both sides of the House who spoke about the importance of careworkers, who provide such important care.

My hon. Friend the Member for Peterborough (Paul Bristow) mentioned that both his parents were nurses in the care sector. He drew on his knowledge of care and rightly said that the profession should be held in higher esteem and that, just as we hugely value NHS staff, we should hugely value careworkers. The hon. Members for Warrington North (Charlotte Nichols), for Blaydon (Liz Twist), for Dulwich and West Norwood (Helen Hayes), for Putney (Fleur Anderson) and for Liverpool, Wavertree (Paula Barker) and my hon. Friend the Member for Bury North (James Daly) spoke along the same lines, and I could not agree more.

Not long after I became the Member of Parliament for Faversham and Mid Kent, I joined a careworker, Kim, on her daily round. By the time I met her at 7.30 am, she had already started washing her first client. By lunch time, she had washed, dressed, fed, medicated and chatted with six or seven men and women. Some of them were grateful and some of them, quite honestly, were not grateful, but they were all utterly reliant on her care. That experience really brought home to me the skill, knowledge and compassion of our social care workers. For those who need help, there are amazing carers with hearts of gold, like Kim.

Our care system depends on an extraordinary workforce of capable and compassionate carers, but we need more people to choose care as a career. That means changing the perception of being a care worker. As a society, we must truly recognise the importance of the work. We must make sure that more people realise the range of jobs in care and the opportunities for progression. The Government are currently investing in an adult social care recruitment campaign with the strapline “When you care, every day makes a difference”. We are working with Skills for Care to support workforce development and there is funding for a workforce development fund. That is really important, but we know that we must go further in making sure that we truly value the important work that the care sector does and to make sure that the care profession attracts the workforce that we need and gives them the opportunities to lead a truly fulfilling career.

Several Members rightly talked about unpaid carers, who also provide so much vital care. We fully recognise the value of that work and know the importance of support for those people who do so much caring. That is one reason why the Government will introduce a statutory right to leave from work for one week a year for the 5 million people who juggle work alongside being an unpaid carer.

My hon. Friend the Member for Bury North talked about quality of care, and it was really important to hear that mentioned as part of the debate. He spoke about how good care is in his constituency, and he is absolutely right that we should talk about how good care is throughout England. Some 84% of adult social care providers are currently rated good or outstanding by the CQC. Let us recognise the high quality of care.

My hon. Friend also spoke about the importance of integration—of the NHS, local authorities and care providers working together—as did my right hon. Friend the Member for Ashford (Damian Green), who is knowledgeable on this subject. The interplay between the NHS and social care is critical. The better care fund and the improved better care fund are a success story in respect of enabling more co-operation between the systems. It is crucial that we continue to build on that success so that our care system meets the needs of the individual, not just of the system.

My hon. Friend the Member for Watford (Dean Russell) made some excellent points about how, paradoxically, we can use technology to help to achieve more human and more personal care for a more cohesive and effective care system.

Both my hon. Friend the Member for Thurrock (Jackie Doyle-Price) and the shadow Minister for Care, the hon. Member for Worsley and Eccles South (Barbara Keeley), mentioned those with learning disabilities and autism who are being cared for in in-patient settings. I am new to this job, but I absolutely appreciate the importance of making sure that we do better in this regard. People should be cared for in the best place for their needs. At the end of last month, the number of those in in-patient settings had been reduced by 24% compared with 2015—

Health and Social Care

Toby Perkins Excerpts

Wednesday 29th January 2020 Ministerial Corrections

The following is an extract from Questions to the Secretary of State for Health and Social Care on 28 January 2020.

[Mr Perkins]

I do not know whether the Minister is aware, but we have a winter every year. We have had one for the past 71 years, and yet these are the worst A&E waiting times in history, and they are the culmination of the policies that his party has followed for the past nine years: the cuts in social care, the number of GPs driven out of practices, and this Government’s failure on prevention. All of that has led us to the worst A&E waiting times in history, and the Minister’s answer does not start to look at the failure that he has delivered.

[Edward Argar]

Well, as I pointed out to the hon. Gentleman—he may not have heard this—demand in A&E has significantly increased this winter. He asks about GPs. I am sure he fully supports our clear commitment to 50 million more GP appointments and 6,000 more GPs. I am sure he also welcomes, in his own constituency, the £19 million investment by this Government in 2017 in a new urgent treatment centre, which will serve his constituents and is due to start work this summer.

[Official Report, 28 January 2020, Vol. 670, c. 664.]

Letter of correction from the Minister for Health, the hon. Member for Charnwood (Edward Argar):

An error has been identified in the response I gave to the hon. Member for Chesterfield (Mr Perkins).

The correct response should have been:

Oral Answers to Questions

Toby Perkins Excerpts

Tuesday 28th January 2020 Commons Chamber

[Ms Dorries]

Baroness Cumberlege’s review is examining what happened in the case of Primodos and will determine what further action is required. Ministers will consider any recommendations very carefully. We do not have a date for the publication of the review, but it will be very soon. Perhaps we can continue the conversation then.

[Mr Toby Perkins (Chesterfield) (Lab)]

14. What recent assessment he has made of the reasons for the increase in A&E waiting times.

[Imran Hussain (Bradford East) (Lab)]

19. What recent assessment he has made of performance against waiting time targets for A&E services throughout England.

[The Minister for Health (Edward Argar)]

Winter is the most challenging time of year for our NHS, when cold weather and an increase in flu cases place additional pressures on the service. As ever, the NHS staff have done an amazing job this winter, and the NHS has seen a significant increase in demand, with 1 million more patients attending A&E in 2019. The December figures, when compared with those in 2018, show a 6.5% increase on attendance at A&E.

[Mr Perkins]

I do not know whether the Minister is aware, but we have a winter every year. We have had one for the past 71 years, and yet these are the worst A&E waiting times in history, and they are the culmination of the policies that his party has followed for the past nine years: the cuts in social care, the number of GPs driven out of practices, and this Government’s failure on prevention. All of that has led us to the worst A&E waiting times in history, and the Minister’s answer does not start to look at the failure that he has delivered.

[Edward Argar]

Well, as I pointed out to the hon. Gentleman—he may not have heard this—demand in A&E has significantly increased this winter. He asks about GPs. I am sure he fully supports our clear commitment to 50 million more GP appointments and 6,000 more GPs. I am sure he also welcomes, in his own constituency, the £19 million investment by this Government in 2017 in a new urgent treatment centre, which will serve his constituents and is due to start work this summer.[Official Report, 29 January 2020, Vol. 670, c. 6MC.]

NHS Long-Term Plan: Implementation

Toby Perkins Excerpts

Monday 1st July 2019 Commons Chamber

[Matt Hancock]

Yes, it will in all circumstances. This is a firm commitment, supported right across this House and right across our party, and it will be delivered. There is absolutely no question about that.

[Toby Perkins (Chesterfield) (Lab)]

We know that areas of greater deprivation have greater health needs than other areas. Will the Secretary of State tell us what more there is in the long-term plan specifically about increasing the resources for GP practices that serve areas of greater deprivation? They have longer waiting times and greater vacancy lists and we need specific action to support those practices.

[Matt Hancock]

Making sure that we have the right allocations for CCGs across the country that reflect the needs of the local population is a very important responsibility for NHS England—as the commissioner of those services—to make sure that the money follows need. After all, the principle of the NHS is that it is available to everybody according to need, not ability to pay.

Oral Answers to Questions

Toby Perkins Excerpts

Tuesday 19th February 2019 Commons Chamber

[Matt Hancock]

My hon. Friend is absolutely right: the £20,000 bonus is an important part of the solution, but so is having more GPs, and the fact that we have a record number of people going into GP training at the moment is great news that Members in all parts of this House should welcome.

[Toby Perkins (Chesterfield) (Lab)]

T7. A huge number of GP surgeries are struggling to recruit, and meanwhile lots of locums are making a lot more money being locums than working on permanent GP contracts. Will the Secretary of State consider offering his state-backed indemnity to those who commit to being on a permanent contract with a GP surgery?

[Matt Hancock]

Of course the nature of being in a GP practice is changing. For a long time practices, which are essentially private businesses, also had the benefit of rising property prices that brought additional income on top of their income from the NHS. That is no longer the case because property is so expensive, so many people are changing the way that GPs are employed, so they are directly employed rather than through practices. That move is happening, but it is just one of the many changes we are seeing to try to make sure that being a GP is sustainable, and clearly things are starting to improve because a record number of people are choosing to become GPs.

Oral Answers to Questions

Toby Perkins Excerpts

Tuesday 15th January 2019 Commons Chamber

[Toby Perkins (Chesterfield) (Lab)]

4. What recent assessment he has made of the effectiveness of primary care in diagnosing fibromyalgia; and if he will make a statement.

[The Minister for Care (Caroline Dinenage)]

Diagnosing fibromyalgia can be difficult because there is no specific diagnostic test and symptoms can vary. A range of support exists to help GPs, including an e-learning course developed by the Royal College of General Practitioners and Versus Arthritis, and a medical guide on diagnosis and treatment developed by Fibromyalgia Action UK.

[Toby Perkins]

I am grateful to the Minister for that answer. I just hot-footed it here from Westminster Hall, where an excellent debate on fibromyalgia took place this morning. We heard a huge amount of evidence about people who suffer with fibromyalgia having waited more than a year to be diagnosed and having received treatments irrelevant to their condition. Clearly, diagnosis is not working at the moment. What more can the Minister tell us about investment in research to improve diagnosis and to try to get better outcomes for fibromyalgia sufferers?

[Caroline Dinenage]

I feel that my colleague the Secretary of State has set the bar for compliments to Members this morning. On that basis, I congratulate the hon. Gentleman on his Westminster Hall debate, which raised a key issue. The Department’s National Institute for Health Research welcomes funding applications for research into any aspect of human health, including fibromyalgia. Its support for that research over the past five years includes £1.8 million funding for research projects and £0.6 million funding for clinical trials through the clinical research network.

Oral Answers to Questions

Toby Perkins Excerpts

Tuesday 23rd October 2018 Commons Chamber

[Steve Brine]

We are continuing to review the advice from our expert advisory groups on safe levels of folate intake, but, continuing our tradition of announcing things to the House first, I want to inform the House today that we are going to issue a public consultation, as of now, on adding folic acid to flour.

[Toby Perkins (Chesterfield) (Lab)]

The service from the East Midlands Ambulance Service NHS Trust has been a considerable disappointment for many of my constituents in recent months. When I met them about the service, they told me that on a huge number of occasions they have ambulances sat waiting outside accident and emergency departments, rather than getting to the next call. What more can the Government do to make sure we get these A&Es cleared?

[Stephen Barclay]

The hon. Gentleman is right to say that we need to improve those handovers. We have improvement programmes in place at 11 hospital sites in the east midlands, alongside which we are making a £4.9 million investment in 37 new ambulances. Part of this is also about the length of stay and addressing the pathway.

Derbyshire CCGs’ Finances

Toby Perkins Excerpts

Tuesday 4th September 2018 Westminster Hall

[Ruth George (High Peak) (Lab)]

I beg to move,

That this House has considered Derbyshire clinical commissioning groups’ finances.

It does not give me great pleasure to raise this matter of great importance: the finances of our local health services and the clinical commissioning groups in Derbyshire. Two months ago—ironically on the 70th anniversary of the NHS—all the voluntary sector organisations in Derbyshire were shocked to receive letters stating that their funding from the clinical commissioning groups was to be cut. Our voluntary services provide much-needed support to thousands of frail, elderly and disabled people across Derbyshire, including support when they come home from hospital, befriending services, respite care, overnight stays and community transport.

Thousands of volunteers give their time to help vulnerable people, often in very rural areas where no other services are available, to live independently and stay well. They provide a constant check on those people’s physical and mental wellbeing. I thank all the volunteers across Derbyshire and the services that support them in helping people. They help older people to manage on their own, reducing the calls on GPs, visits to accident and emergency, and stays in hospitals or care homes for a fraction of the cost of those services. For example, the night-sitting service in High Peak provides emergency and respite care overnight—for example, when a carer is ill or to prevent a patient who would otherwise have to go into hospital from being admitted.

[Toby Perkins (Chesterfield) (Lab)]

I congratulate my hon. Friend on securing this important debate. Does she agree that, alongside the financial consequences of their cheaper cost, many voluntary organisations, such as Age Concern, which I saw last week, keep old people well and prevent them from having to use health services by providing services such as the befriending service in Chesterfield?

[Ruth George]

Absolutely. Age Concern and other voluntary services work fantastically well with thousands of older people.

Last year, the night-sitting service supported 93 people with more than 2,000 hours of care at a cost of just £34,000. That works out at just £369 per person for an average of three nights’ support each. Just one of those nights in a hospital would have cost the CCG more than that.

The CCG says that the county council provides an alternative service, and it may do on paper, but as we have a drastic shortage of social carers, like so many other places, no other help is available. The voluntary sector provides friendly, personalised, local care for far less than any other service could. For example, New Mills and District Volunteer Centre told me that it supports 550 mostly elderly, widowed and disabled clients for an average cost, between the staff and the volunteers, of just £2.26 an hour. If just two of those 550 clients have to go into a care home as a result of losing the volunteer services—in practice, it is likely to be many times that—the cut will cost more than has been saved.

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[Stephen Barclay]

I was just about to come on to the voluntary sector, because that is where the hon. Lady’s speech started, but in her remarks she talked about the four CCGs coming together as part of the “efficiencies of scale”—her precise phrase—so I shall come back to the voluntary sector later.

[Toby Perkins]

I am probably in the position of largely agreeing with the Minister. I remember that, back in 2010, we had the Derbyshire primary care trust, but then the Lansley reforms came in, broke up the PCT and turned it into five different organisations in North Derbyshire. Can he imagine how galling it is for us to hear that those organisations, which went from a very strong financial position back in 2010, are now in utter financial chaos, so the Government are going to undo the Lansley reforms and to get those economies of scale that we were telling them about back in 2010?

[Stephen Barclay]

There seems to be a slight contradiction in the hon. Gentleman’s argument. He is arguing that, on the one hand, the financial position was strong in 2016—I remind him simply that the Lansley reforms were in 2012—and, on the other hand, that the issue is with the Lansley reforms.

[Toby Perkins]

May I make a point of clarification, because the Minister is misquoting me? I said that the financial position was strong in 2010, not in 2016.