(3 days, 21 hours ago)
Commons ChamberI am grateful for the steps that my hon. Friend is taking to make representations on behalf of her local children’s hospice, both on the Floor of the House and outside the Chamber. I recognise the pressure she describes. We are determined to help hospices to overcome them.
Can the Secretary of State confirm what assessment has been made of the number of women waiting for endometriosis surgery across the United Kingdom? What has been done to reduce waiting lists?
As my hon. Friend the Minister for Secondary Care said, the wait for women with common conditions such as endometriosis is far too long. That is why we are taking steps to cut waiting times and stop the merry-go-round of repeat visits to the same clinician to get the same answer, until someone finally listens to what a woman has to say.
(2 weeks, 3 days ago)
Commons ChamberI am grateful for that intervention for two reasons. First, it gives me an opportunity to say to GPs, hospices and other parts of the health and care system that will be affected by employers’ national insurance contribution changes that I am well aware of the pressures, we have not made allocations for the year ahead, and I will take those representations seriously.
Secondly, it gives me a chance to ask the hon. Member and the Opposition: do they support the investment or not? Are they choosing to invest in the NHS or not? They are now confronted with the hard reality of opposition. Just as when we were in opposition we had to set out how much every single one of our policies would cost and how those would be funded, they have to do that now. If they oppose the investment, they have to tell us where they would make the cuts in the NHS. If they oppose the investment, they have to tell us where they would make the cuts in school budgets. Those are the choices that we have made, and we stand by those choices. The Opposition will have to set out their choices, too.
I was told that because the Conservatives had run up huge deficits in NHS finances, I would not be able to deliver the 40,000 extra appointments a week that we had promised. In fact, I was told that we would have to cut 20,000 appointments a week instead. The Chancellor and I were not prepared to see waiting lists rise further. She put the funding in, and an extra 40,000 patients will be treated by the NHS each week. That is the difference that a Labour Budget makes.
It would be churlish of anybody in the House not to welcome the £22 billion that has been allocated to the NHS. Everyone across this great United Kingdom of Great Britain and Northern Ireland will benefit from that.
A number of my GP surgeries have contacted me about their national insurance contributions, which they see as a catalyst to perhaps not being able to deliver what they want to do for their patients. I understand that the Labour party and Government are looking at that in a consensual way. Can the Secretary of State please give me the latest position so that I can go back to my GPs and tell them, “This has been looked at and there will be something coming”?
I am grateful for that intervention. It is of course for the devolved Administrations to decide how to use the Barnett consequentials that the generous uplift in funding provided by the Chancellor will provide. We make no bones about it: we had to make some difficult choices in the Budget to plug the £22 billion black hole that we inherited, to deliver on our promises and to ensure that we are fixing the foundations of our economy and our public services. We have asked businesses and some of the wealthiest to make a contribution. I say to people right across the House that they cannot welcome the investment at the same time as opposing the means to raise it. If they do, they have to explain how they would find the money.
(1 month, 2 weeks ago)
Commons ChamberI am grateful to the hon. Member for her intervention. I wish that this was a challenge only in her constituency; it is a challenge right across the country. As I said to the Royal College of GPs last week, it will take time to rebuild general practice, so that it is back where we want it to be. We would be delighted to hear more from her; I will ensure that my Department makes contact, and that a Minister is in touch about the challenge in her constituency.
I thank the Secretary of State for today’s debate. The whole House, and indeed the whole of the United Kingdom of Great Britain and Northern Ireland, wishes him well in bringing forward the changes that we wish to see. An issue that comes to my attention regularly is research and development. We hear in the press every day about new advances in treating diabetes, heart disease, cancer, Alzheimer’s, dementia and rare diseases. When we look at the bigger picture of the NHS, we see the big problems, but sometimes there are smaller issues. Will he reassure us that research and development will be encouraged?
I strongly agree. Although health is devolved, I look forward to working constructively and closely with Governments right across the United Kingdom of Great Britain and Northern Ireland, because every part of the health system in every part of the UK is going through challenges. We are determined to do that. [Interruption.] I think the hon. Member wants to come in again.
National Institute for Health and Care Excellence recommendations go from here to Northern Ireland, and then we endorse them; if we do not get them from here to start with, we cannot make people better. That is the point that I was trying to make.
The hon. Member’s point is taken.
The NHS stands at a fork in the road. There is a choice before us, and the parties represented in the House have different opinions on the best way forward. The first option is for the NHS to continue on its current path—to head down the road to ruin, on a mismanaged decline, with a status quo so poor that patients are forced to raid their savings to go private, and with the worst yet to come, because many Opposition Members believe that all patients should have to put their hands in their pockets when they fall ill. Reform UK has openly stated that it wants to change the funding model and replace it with an insurance-based system, and plenty in the Conservative party want to head in the same direction, chasing Reform UK down the hard-right rabbit hole.
(2 months, 1 week ago)
Commons ChamberI am delighted to see my hon. Friend in her place. She is absolutely right. I feel really sorry for NHS staff for what they have been put through over more than a decade of mismanagement and political incompetence, and we will work with them to clean up the mess. She establishes exactly the right test, which is whether we would want our loved ones to be treated in our local health and care services, and whether we would have confidence that, in every case, on every occasion and in every interaction, they would have access to the best-quality care. The truth is that we do not have that certainty, and too often it feels like chance. That is why we will always put the patient voice, the patient interest and the patient experience at the heart of our reform and modernisation programme.
I thank the Secretary of State for the honesty in his statement, and for his contact with the regional Minister responsible at the Northern Ireland Assembly. Those are the first actions of a Secretary of State who, I suggest, does not run away from issues but takes them head on. I congratulate him on that.
I appreciate the terminology used in the report, which outlines the seriousness of conditions in the NHS but also highlights the fact that the vital signs are still strong. Will the Secretary of State outline how he intends to address the fact that the NHS in devolved regions is in an arguably worse condition? Will he confirm that the review will incorporate Northern Ireland and will he ensure that the findings, new practices and standards will be in place for Northern Ireland, along with increased funding in a new funding formula?
I thank the hon. Gentleman for what he said; coming from him, that means a great deal to me. I reassure him that I am committed to working with Ministers in all devolved Administrations to improve health outcomes for everyone in every part of our United Kingdom. I know that the system is particularly pressed in Northern Ireland and I will do whatever I can, working with Ministers in Northern Ireland, to help that situation and create the rising tide that lifts all ships right across the UK.
(2 months, 2 weeks ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I am grateful to my hon. Friend for his question. We know that the NHS is broken, and is going through the worst crisis in history. We will shortly hear from the noble Lord Darzi about the outcome of his investigation into the true state of our national health service, but against that bleak backdrop of political failure are stories across the country of triumph against the odds, and of some outstanding public servants doing extraordinary things, showing what the future of our health and care services could look like with a Government on their side. I am pleased that such a Government is here—this Labour Government—and I would be delighted to hear more about my hon. Friend’s constituency.
I wish the Secretary of State all the best in his new role, and in the task that he has taken on. With great respect to my Conservative colleagues, the downfall of the Tory Government was due in part to the fact that people did not trust the background politics behind closed doors. I want the Government to succeed, as do most people in this House. Stability and direction are much needed, but that can happen only with openness, transparency and a desire to put nation before party. How can the Secretary of State assure us that this Government will do things differently, and that policy will be proposed by those with know-how, and passed with scrutiny in this place, not simply due to pressure from lobby groups?
I strongly agree with the hon. Member. In the short time that I have been in post, I have been delighted to have had virtual meetings with the current Northern Ireland Minister of Health, as well as with his predecessor, the hon. Member for South Antrim (Robin Swann), who now sits over there on the Opposition Benches—I am delighted to see him in his place.
Ministerial meetings attended by third parties are declared in our quarterly transparency publication. People will want to lobby and influence Government, and Members of Parliament, all the time. Members of Parliament regularly receive correspondence—let alone the deluge of advice that we receive in government. The important thing is that Ministers take decisions on the basis of the best possible advice available, that they weigh up carefully the evidence and arguments in a fair and proper way, and that advisers may advise but Ministers ultimately decide.
This Government are aware of the deep crisis in trust in our politics. That is why, on his very first day, the Prime Minister talked outside Downing Street about restoring Government to service. It is why it should be no surprise whatsoever that many people who have given outstanding public service to this country, such as my right honourable friend Alan Milburn—and the same is true of Patricia Hewitt, Alan Johnson, my noble Friend Lord Reed, the Mayor of Greater Manchester and many more—want to roll up their sleeves and help the Government. They can see the state that the Conservative party left our country in, and are willing once again to roll their sleeves up to get our country back on its feet, turn the situation around and ensure that everyone in our country can look forward to the future with optimism and hope after 14 years of abysmal failure.
(10 months, 2 weeks ago)
Commons ChamberI must make some progress.
Turning to other parts of the country, Keir Cozens, Labour’s candidate in Great Yarmouth, has been running a campaign on the state of dentistry in Great Yarmouth. He has heard heartbreaking stories of broken teeth left for months with people in pain, of children unable to be seen, of at least one person a day going to accident and emergency with dental issues, and of people performing DIY dentistry at home after buying kits from Amazon. No one should be doing that, but people are desperate. DIY dentistry does not work, and before you know it, people are back in A&E waiting for expensive emergency dental treatment. I have heard similar stories from Kevin Bonavia, Labour’s candidate in Stevenage. He tells me that people turning to DIY is shockingly common.
No one voted for this. None of the five Conservative Prime Ministers, the seven Conservative Chancellors or the eight Conservative Health Secretaries told the public that this was what the future held, but this is what they have done to dentistry. It is the way all our public services are going, and it is why the Conservative party cannot be allowed five more years to finish the job.
I thank the shadow Secretary of State for bringing this debate forward. The stats from the British Dental Association cannot be ignored. In its survey, 41% of practice owners and 38% of associate dentists said that they would like to leave NHS dentistry as soon as possible. This debate will resonate with many people out there. Does he agree with the chair of the Northern Ireland Dental Practice Committee that now is the time for the funding allocation to pay for a better contract and for training more dedicated dentists who will commit to the NHS, rather than private practice?
I agree with the hon. Gentleman about the urgency of the situation. There is a different path available to us. We can revive our public services and give our country back what we used to take for granted. Labour’s plan would take immediate steps to rescue NHS dentistry, with 700,000 more urgent appointments and the recruitment of new dentists in the areas most in need. We would also take the necessary steps to rebuild NHS dentistry over the long term, including reforming the dental contract and introducing supervised toothbrushing for three to five-year-olds in primary schools, so that poor oral health is prevented and demands on the service reduced.
In fact, some of my Labour colleagues are not even waiting for the general election to start making a difference. Labour’s candidate in Stroud, Simon Opher—himself a GP—has spearheaded a campaign working with local dentists and the integrated care board. From opposition, he has more than trebled the number of emergency appointments available each day across Gloucestershire, pioneered a new dental stabilisation scheme for people not known to a local practice, opening up more than 130 appointments a week, and introduced supervised toothbrushing in 14 local primary schools. If that is the difference Simon is making in opposition, imagine what he will be able to do as a Labour MP working with a Labour Government. That Government cannot come soon enough.
(1 year ago)
Commons ChamberThe Minister says, “Is that it?”. It is 700,000 more NHS dentistry appointments than her Government are providing. It is ridiculous. The extent to which Ministers continue to parrot these ridiculous lines is embarrassing. If they want to intervene, make my day. I am perfectly prepared to confront any Member with their own Government’s record. Of course, they do not want to defend the Government’s record; they have a hard enough time doing that on the doorstep.
Turning back to His Majesty’s Gracious Speech, there may not have been any Bills for the health service last week, but we did see the white flag being waved on the Prime Minister’s pledge to cut waiting lists. Hospitals received a letter telling them to cut the number of operations and appointments they are aiming to offer this year. At the same time, an extra funding pot was announced, so we are literally paying more and getting less. No wonder the NHS is in such a state. No wonder waiting lists have trebled since 2010. No wonder hundreds of thousands more patients are waiting for treatment today than when the Prime Minister first made his pledge.
I want to make a plea for those 10,000 young people with cystic fibrosis, who have to take multiple medications and endure daily physiotherapy, blood tests, X-rays, and hospital visits—waiting on many occasions—as part of their normal routine just to stay well. The shadow Secretary of State and the Labour Opposition have given a commitment to endeavour to do better for the NHS. Will he do better for those 10,000 young people who have cystic fibrosis?
I am very grateful to the hon. Member for his intervention. I am deeply concerned about the situation facing children with cystic fibrosis in particular, given that there is radically life-extending treatment available that offers the hope to those young people not just of longer, happier, healthier lives, but of reduced admissions to hospital. It is right that the National Institute for Health and Care Excellence makes those judgments in a rigorous way, looking at the evidence. I hope that it will be successful in bringing down the price of those drugs by negotiating with the pharmaceutical companies to make sure that we can get affordable drugs to families who desperately need them and are desperately anxious that the announcement they have read about means shorter lives for their children. No family should go through that agony, and I hope that a resolution can be found.
The Government and the previous Health Secretary got into the habit of stealing Labour’s policies—I say that not as a complaint, but as an invitation. It is clear that the Government do not have a plan to cut NHS waiting lists, but we do: £1.1 billion will be paid straight into the pockets of hard-pressed NHS staff to deliver 2 million more appointments a year at evenings and weekends, paid for by abolishing the non-dom tax status, because patients need treatment more than the wealthiest need a tax break—[Interruption.] Conservative Members groan when we mention charging non-doms their fair share, they groan when we talk about closing private equity loopholes and they groan when we talk about taxing private schools fairly. They did not groan when taxes went up on working people. They did not groan when benefits were cut for the poorest people.
We know who the Conservatives are in it for. They are in it for the few; we champion the interests of the many. That is the Labour difference. We believe strongly that people who live or work in Britain should pay their taxes here too. There is still time for the new Secretary of State to lobby the Chancellor ahead of the autumn statement. This genuinely is an oven-ready plan, unlike some of the plans we have heard from the Conservatives, and I encourage the new Secretary of State to nick it.
After 13 years, we have an NHS that gets to people too late. We have a hospital-based system geared towards late-stage diagnosis and treatment, which delivers poorer outcomes at greater cost. We have an analogue system in a digital age. We have a sickness service, not a health service, with too many lives hampered by preventable illness and too many lives lost to the biggest killers. It could not be clearer: the longer we give the Conservatives in power, the longer patients will wait. This was an empty King’s Speech from a Government who have run out of road, run out of steam and run out of ideas; a Conservative party too busy tearing itself apart to govern the country; a Prime Minister who cannot decide whether it is time for a change or to go back to year zero.
The future of the NHS after another five years of the Tories is emerging before our eyes: a two-tier health service, where those who can afford it go private, and those who cannot are left waiting behind—our NHS reduced to a poor service for poor people; our country viewed as the sick man of Europe. It does not have to be that way. The Prime Minister was right when he said,
“It’s time for a change”,
but only Labour can deliver it.
Labour has a different vision for our country in which no one fears ill health or old age; people have power, choice and control over their own health and care; the place people are born, or the wealth they are born into, does not determine how long they will live or how happy their lives will be; patients benefit from the brightest minds developing cutting-edge treatments and technology; and children born in Britain today become the healthiest generation that ever lived.
Only Labour has a plan to get the NHS back on its feet and make that vision a reality: a plan to cut waiting lists, delivering 2 million more appointments a year; a rescue plan for NHS dentistry, delivering 700,000 more appointments, recruiting dentists to the areas most in need, introducing toothbrushing for three to five-year-olds in schools and having an NHS dentist for all who need one; a plan to double the number of scanners so that patients are diagnosed earlier; a plan to recover our nation’s mental health from the damage of lockdowns; a plan to cut red tape that ties up GPs’ time, so that we can bring back the family doctor; a plan for the biggest expansion of NHS staff in history—a plan so good that the Government adopted it and gave us a head start; and a plan to reform the NHS to make it fit for the future. To those who say that that cannot be done and that things cannot be better, I say this: the last Labour Government delivered the shortest waiting times and the highest patient satisfaction in history. We did it before and we will do it again.
It is not a change of faces we need but a change of Government. It is time to call a general election and give the British people the choice: more of the same with the Conservatives or a fresh start with Labour. Call a general election now, so that Labour can give Britain its future back.
(1 year, 8 months ago)
Commons ChamberThere are a couple of challenges with that approach. First—I want to be clear about this—having international students come to study at UK universities is a wonderful thing. It is wonderful for British students who mix with cohorts drawn from across the world, and it is wonderful because they contribute to the cultural and intellectual life of our universities, and of the towns and cities in which they live while studying here. It is a wonderful thing because they often return to their countries with fond memories of Britain, which is an extension of our soft power and diplomatic influence. Those are all great reasons why we should cherish, embrace and welcome international students, and it is why I hope the Home Secretary does not win the argument inside Government to restrict further access to international students. Finally, I should say that international students also pay an enormous amount to come and study here in the UK, and they subsidise home students.
I want to be clear about how much I welcome international students, but it is an absurdity that people are coming to this country to study in medical schools that have no British students. It is an absurdity, when we have a chronic shortage of doctors, nurses, midwives and allied health professionals, that we see straight-A students from our own country being turned away, while university medical schools are being told they can only recruit international students. That is the depths of stupidity that this Government are plumbing.
I commend the shadow Minister for his thoughts. The poaching of junior doctors by Australia, for example, for better pay and working conditions, as opposed to fractured shift patterns here, is a major issue. It is not just about expanding the workforce, to which he has referred; it is also about having a careful and concerted campaign to retain staff here. Does he agree that has to be part of the thrust of this debate?
I wholeheartedly agree with the hon. Member. I will talk about this later in my speech, but it is why the Government have to resolve this pay dispute with existing NHS staff. The danger is not that they walk out for another day of strike action, but that they walk out of the NHS altogether for countries that treat them better. What an absurd position to be in. It is also absurd, by the way, that we still have doctors retiring early for no other reason than that the pensions rules create an active financial disincentive to work up to normal retirement age, as many of them would like to do. It is completely absurd.
(1 year, 11 months ago)
Commons ChamberMy hon. Friend is absolutely right. This is the tragedy of where we have got to on social care in particular. The Government have allocated half a billion pounds to alleviate pressure this winter, but not a penny of it has reached social care providers. Not a penny of it is currently being worked in action to try to deal with delayed discharges. I have no doubt whatsoever that one reason why it has taken so long from that commitment to getting money to the frontline is the constant churn of Ministers that we saw over the summer. The absolute circus that we saw in the Conservative party has had a direct impact on the competence of effective Government in this country. We now have ineffective Government, so even when the Government seek to do the right thing and allocate the resources, they cannot get the money out the door far enough because Ministers seem to change week in and week out.
I commend the shadow Secretary of State for what he is saying. When it comes to staffing issues, one thing should clearly be done. Does he agree that part of the reason why we rely so heavily on agency staff is because our NHS staff have migrated to agency working, where there is less pressure, so the Government should spend less money on agency workers and give our NHS staff greater support and appropriate pay so that they can stay in the NHS?
I strongly agree with the hon. Gentleman. I will come shortly to talk about industrial action, but this should be at the heart of the Secretary of State’s thinking. The demands from staff trade unions, whether on pay, terms and conditions or the wider pay machinery, should be seen not just as a negotiation with staff unions but as a retention issue. We are losing staff faster than we can recruit them in some places—especially in areas such as midwifery—and if we lose the staff that we have, even Labour’s plans to undertake the biggest recruitment in the NHS’s history would not be as effective as they would be if we kept staff in the service today. That is why I urge the Secretary of State to treat those NHS staff with respect, get their representatives around the table, and negotiate a solution.
I am aware that the situation in the NHS in Northern Ireland is the worst that we see throughout the United Kingdom. The shadow Secretary of State for Northern Ireland, my hon. Friend the Member for Hove (Peter Kyle), visited NHS services in Northern Ireland only recently. I have no doubt that we need to get effective governance back up and running again in Northern Ireland as well. I urge the Government to discharge their responsibilities in that area, too. Certainly, when Labour was last in government, I do not remember Labour Prime Ministers taking such a complacent, lackadaisical or indeed absent approach to the governance of Northern Ireland. I hope that we can see a breakthrough of the deadlock so that the people of Northern Ireland get the Government they deserve in Stormont, as well as the United Kingdom getting the Government it deserves here in Westminster.
Waiting lists were already at a record 4.5 million before the pandemic. Ambulances were taking longer than is safe to reach patients in an emergency before the pandemic. Patients were waiting longer than four hours in A&E before the pandemic. The 18-week guarantee for elective treatment had not been met for four years before the pandemic, and more patients have waited longer than two months to start their cancer treatment every year since 2010. From the moment the Conservatives entered power, things began to deteriorate. It is not just that the Conservatives did not fix the roof while the sun was shining; they blew off the roof and ripped up the floorboards, and then they wonder why the storm did so much damage.
(2 years, 5 months ago)
Commons ChamberIt is not just about GPs and surgeries; it is about dental access as well. In my constituency and across the whole of the United Kingdom of Great Britain and Northern Ireland, dentists are prepared to take private care and monthly care, but they will not take NHS patients. As poverty levels and prices rise, dentistry is at the end of the queue. Does the hon. Gentleman agree that dentistry is at crisis point and that Government intervention is absolutely critical?
The hon. Gentleman is right to describe the state of dentistry and I will be getting my teeth into that issue very shortly.
[Hon. Members: “Groan!”] It had to happen at some point. I had to get it in at some point. Let me touch on the other issue he mentions, which is about inequality and inequality of access.
The system in primary care is entirely unequal. Some areas have twice as many doctors as other parts of the country, with as many as 2,800 patients fighting over one family doctor. Patient safety is being put at risk. Last week, the BBC revealed the scale of the crisis in GP surgeries with its investigation into Operose Health. Patients who can get an appointment are seen by less qualified staff, standing in for GPs without supervision. Patient referrals and test results were left unread for up to six months: private profit placed above patient safety. When the Health Secretary was asked about that last week, he said:
“we expect local commissioners to take action.”—[Official Report, 14 June 2022; Vol. 716, c. 140.]
Well, it is not good enough to sit back and wait for others to act. Is an investigation happening? Can he tell us? If not, why on earth has he not launched one? [Interruption.] The Under-Secretary of State for Health and Social Care, the hon. Member for Lewes (Maria Caulfield), from a sedentary position, talks about the last Labour Government. When are the Conservatives going to wake up to the fact that they have been in government for 12 years? Twelve years! It is remarkable. Twelve years they have been in government.
(2 years, 7 months ago)
Commons ChamberMy hon. Friend is absolutely right and she will know of our party’s ambitious commitments, outlined by my hon. Friend the Member for Tooting (Dr Allin-Khan), to ensure that patients receive guaranteed mental health treatment within a month. That would be revolutionary. It will require investment and require recruiting the people we need to help provide that care, but this country is living through a mental health crisis on top of everything else. This has been a deeply difficult two years for our country during the pandemic. Many people bear not just the physical scars and ongoing physical health consequences of long covid, but the grief, the loss and the injury to their mental health and wellbeing caused by this deadly pandemic. Many of those people who are suffering mental health crises are the very people who are still turning up for their shifts in the hospitals, still turning up for their shifts in the GP surgeries, and still turning up at work to help care for others even though they are in need of care themselves.
Lords amendment 29 does not commit the Government to hire thousands more doctors and nurses, although they should. It does not commit to new funding for the NHS, although it desperately needs that. It does not even commit the Government to finally publish the workforce strategy the NHS is crying out for, despite the fact that the NHS has not had a comprehensive workforce strategy since the Labour Government’s plan was published in 2003. All we are talking about today is an independent review of how many doctors, nurses and other staff the NHS needs for the future. That is not just a view put across by Labour Members: it is supported by many Members right across the House, including the Chair of the Health and Social Care Committee, the right hon. Member for South West Surrey, who is a former Health Secretary. It is not the first time that he has helped to unite the sector, although I remember the days when it was sometimes united in opposition to, rather than in support of, his proposals.
I will say this, actually: when the right hon. Member for South West Surrey took over as Chair of the Health and Social Care Committee, I was really nervous about the prospect of a former Health Secretary effectively marking his own homework, but on this issue, he has shown a degree of honest reflection and has genuinely contributed his experience to the debate about the future of health and social care in this country. Not only has he been honest about where he fell short, and where other Conservative Ministers may have fallen short, but he is determined to make sure that we improve the quality of the health and social care debate in this House. I very much welcome his contribution to the debate about the NHS workforce challenge.
The shadow Minister is always kind in giving way. I want to back up his comments about the right hon. Member for South West Surrey (Jeremy Hunt). On Lords amendment 29, does the shadow Minister acknowledge that Macmillan Cancer Support said that it needs an additional 3,371 cancer nurse specialists? That would double the nurses by 2030, and it gives us a reason why we need to support Lords amendment 29 and why workforce safety is critical.
The hon. Gentleman is absolutely right. If I am honest, I suspect that the Minister and the Secretary of State for Health and Social Care also agree that Lords amendment 29 is needed. I suspect the truth is that they are not the ones blocking it. They are in a Treasury-imposed straitjacket from the Chancellor, preventing them from doing what they know to be necessary for the NHS, because the Treasury would rather stick its head in the sand and not acknowledge the scale of the challenge or the reality of the cost. It hopes that ignorance is bliss and that we can carry on as we are, and perhaps nobody will notice—even the 6 million people on NHS waiting lists.
(4 years, 4 months ago)
Commons ChamberThe Economic Secretary to the Treasury said that it is cheap. I am not sure that a seat at a Conservative party fundraiser is particularly cheap, and it is certainly a price too high for lobbying the Government, but there we are.
Let me turn now to the comments made by Torsten Bell, the chief executive of the Resolution Foundation. He said that the £2 billion kick-start scheme is “a very welcome return” to the approach of the future jobs fund, but he notes that creating those opportunities will be a huge delivery challenge. He says that it will need loads of these jobs to be created by local authorities, and he is right. The success or failure of the kick-start programme will depend on the strength of local government to help deliver it, so it is time for the Government to put their money where their mouth is and fund local government properly.
The shadow Minister is right about the role for local government and the important role that it plays. My local council of Ards and North Down has a very clear economic plan. With low rates and with the highly skilled employment that we have, the opportunities are very clearly there. All we need is that investment. I know that the Government have given so much on the Barnett consequentials and that is really important, but it is also important that we have strategy that works for both the Northern Ireland Assembly and for here as well.
The hon. Gentleman makes a really important point. Of course, the devolved Administrations can provide their own policy responses, but we know that decisions taken here on public spending have a direct impact on their ability to respond accordingly, too.
We have said throughout this crisis that we would not criticise for criticism sake, and beyond the kick-start future jobs fund announced today, we welcome the attempt to make sure that the furlough scheme gets people back to work, instead of making them redundant through the jobs retention bonus. We are glad that the Chancellor included provision to get people into training and apprenticeships in his statement, and we welcome the additional resources provided to the Department for Work and Pensions to help get people back into work. In so far as they can, we hope that the cut in VAT and the limited “eat out to help out” scheme will be of some assistance to our tourism and hospitality industries, but this falls far short of what we called for and what was promised. We were promised a new deal, but the Chancellor’s big announcement was a meal deal. The Chancellor said that we cannot have endless extensions to the job retention scheme, which was echoed by the Chief Secretary, and that we cannot allow furloughing to go on forever. We agree. We have never argued otherwise. This straw man argument does a real disservice to the concerns coming from those employers and industries that face the biggest and longest hit as a result of covid-19.
(8 years, 4 months ago)
Commons ChamberMy hon. Friend is absolutely right to highlight the ongoing challenges. I will begin by talking about the history of the Sri Lankan civil war, but it is important to remember this afternoon that there are ongoing issues, such as human rights abuses, that need to be taken seriously by the international community and this House.
The hon. Gentleman is most gracious in giving way—I did ask his permission beforehand. We should not forget the other human rights abuses that are happening in Sri Lanka. The National Christian Evangelical Alliance of Sri Lanka has documented an estimated 450 incidents against Christian minorities since 2009. Since 2015, 130 incidents of intimidation, discrimination and violence against Christians have been recorded, and a campaign to close churches continues to this very day. Although the war has ended, does the hon. Gentleman agree that we need assurances from the UK Government and the Minister that they will do everything in their power to ensure that Sri Lanka moves further towards religious freedom for all, not away from it?
The hon. Gentleman is a long-standing champion in this House of highlighting the persecution of Christians and demanding, quite rightly, that the issue gets greater Government focus and attention. Although a smaller religious minority in Sri Lanka, the Christian population is there none the less and also faces human rights abuses that must be recognised, tackled and dealt with effectively.
The Sri Lankan civil war ended in May 2009 and lasted some 26 years. It was primarily between the LTTE—the Tamil Tigers—and the Sri Lankan Government army. It is estimated that up to 100,000 people were killed during the course of the bloody conflict. In 2009, the then Foreign Secretary, David Miliband, described the brutality in the north of the country as a “war without witness”. Since the conclusion of the civil war, so much of that witness testimony has come forward. In my constituency surgery, I have been horrified by the descriptions of what people have suffered, and I have met constituents who bear not only the mental scars, but the physical scars of that conflict. Serious allegations of human rights abuses have been made by both sides of the conflict, including allegations of murder, sexual violence, torture, disappearances, the use of civilians as human shields and the use of child soldiers. Mines were used in the conflict, although many have been removed since the war ended. Many of the people at the top of Sri Lankan society—Ministers, military leaders, and figures in the judiciary and in wider civil society—are suspected of being complicit in many of the atrocities that took place.
(8 years, 11 months ago)
Commons ChamberI am grateful for this opportunity to lead my first Adjournment debate on the serious issue of finance for student nurses and midwives.
I have a long-standing interest in the issues. I spent much of my career outside this place working for a number of charities to widen access to higher education and to tackle broader educational disadvantage. As deputy leader and cabinet member for health and wellbeing in the London borough of Redbridge, I became acutely aware of the challenges facing frontline staff and managers in both of the NHS trusts that serve my constituents in Ilford North. I am also a proud supporter of Unison and draw Members’ attention to my declaration of interests. I am grateful to Unison, the National Union of Students, of which I am a former president, and many other organisations for their assistance in drawing together the evidence for this evening’s debate.
With just a few lines in the autumn statement, the Chancellor announced the biggest shake-up in the funding of nursing, midwifery and allied health subjects since the Health Services and Public Health Act 1968. By scrapping student bursaries and charging them tuition fees, the Chancellor is passing on the full cost of training to these essential frontline staff for the first time. The scale and potential consequences of his decisions merit further parliamentary scrutiny and public debate, and I hope that tonight will provide the first of many opportunities for that debate to take place.
Nursing and midwifery students currently pay no tuition fees for their studies and receive a non-means-tested grant of up to £1,000 and a means-tested bursary of up to £3,191 to help with the costs of living while they study and train. That is significant because students on both courses are required to work throughout their degrees in clinical practice, where they are subject to the full 24-hour care cycle. They work evenings, nights and weekends. Many will spend 60% of their degree doing that, with nurses required to work at least 2,300 hours across their degree. Even with the current levels of financial support in place, many struggle to make ends meet. Their courses are longer, their holidays are shorter and their placements are demanding. Those who do paid work outside their course can end up working more than 60 hours a week as a result, and they should not be expected to do so.
There has been a public outcry at the planned loss of the NHS bursary, but the Government’s plans go even further. Nursing and midwifery students will not only lose their grant and bursaries for maintenance; they will be expected to take out loans to pay for their tuition fees for the first time. These changes will burden students with eye-watering debts of at least £51,600, which they will begin to pay back as soon as they graduate, because nurses currently earn a starting salary just above the repayment threshold, which, shamefully, is now to be frozen at £21,000. As a result, nurses will on average take a pay cut of £900 a year to meet their debt repayments. That is no way for Ministers to treat the people who form the backbone of the NHS.
Given that the Government see fit to charge students for the cost of their tuition, will the Minister confirm whether he intends to pay student midwives and nurses for the hours they have to put into staffing our hospitals? If a private sector company tried to get workers to work long shifts and to pay for the privilege of working those long shifts while training, they would rightly be condemned. We should be no less outraged by what Ministers propose for nurses and midwives.
The impact of the changes will be felt beyond nurses and midwives; physiotherapists, occupational therapists, dieticians, chiropodists, podiatrists, radiographers, paramedics, prosthetists and other allied health professionals stand to lose out. We are not talking about the highest-paid people in this land; this assault on the living standards of key public sector workers is rightly causing outrage among NHS staff and members of the public who cherish the work they do on our behalf.
Given the scale and significance of the reforms, it is outrageous that the Government chose to sneak them out in the autumn statement. The Chancellor’s statement made an oblique reference to replacing
“direct funding with loans for new students”.—[Official Report, 25 November 2015; Vol. 602, c. 1363.]
The policy decision on page 126 of the Blue Book merely says:
“Students studying nursing, midwifery and allied health subjects from September 2017 will be moved on to the standard student support system, with the details subject to consultation.”
As the Government have placed so little information in the public domain so far and higher education institutions and potential applicants are already turning their minds to the 2017 admissions round, I hope that the Minister can shed some light on the details this evening. Will he confirm that the Government will consult on the principle of the policy changes, not merely on their implementation? What is the full timetable for the decision from consultation through to implementation?
What analysis have the Government conducted of students in receipt of NHS bursaries for tuition and maintenance costs? Will they publish an equality impact assessment for the proposals? What research have the Government conducted into the financial hardship facing existing nursery and midwifery students and students of allied health subjects?
Why do the Government think it is fair that students from the most deprived backgrounds should have their grants taken away while some of the wealthiest people in our society receive tax cuts? How much of this debt do the Government expect to write off because those indebted by these reforms are unable to repay them in full?
Which Department will meet the cost of servicing the RAB—resource accounting and budgeting—charge for the student loan debt: the Department of Health or the Department for Business, Innovation and Skills? What are the Barnett consequentials for health education budgets in Northern Ireland, Scotland and Wales, where different arrangements are in place?
I thank the hon. Gentleman for bringing this issue before the House. I understand that 56,000 students on the mainland, including Scotland and Wales, may be in debt as a result of this change. In Northern Ireland, the Health Minister has committed himself to continuing the bursary. We are doing that in Northern Ireland; perhaps the rest of the United Kingdom should do the same.