Access to GP Services and NHS Dentistry

Debate between Wes Streeting and Meg Hillier

Tuesday 21st June 2022 Commons Chamber

[Wes Streeting]

My hon. Friend is absolutely right about the state of dentistry. It is not alliterative, but I suspect that my hon. Friend the Member for Hackney South and Shoreditch has similar points to make.

[Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

A constituent of mine told me that she had a terrible toothache, rang 111 and was assigned to an emergency dentist. The system worked, but does my hon. Friend agree that that that costs the taxpayer so much more money? My hon. Friend talks about overpromising and underdelivering, but with dentistry the Government have not even promised anything and they are underdelivering.

[Wes Streeting]

My hon. Friend knows exactly what she is talking about. Of course, there is no one better in this House to make the point about the waste of public money. That is the outrageous thing about all of this. People are paying more and getting less. Their taxes have been put up, justified in the name of the NHS, but the money is not being directed in the right way to deliver better care. In fact, the Government admit that even with the investment they are putting in, people will be waiting longer for care and that is a disgrace.

Support for Self-employed and Freelance Workers

Debate between Wes Streeting and Meg Hillier

Thursday 17th September 2020 Commons Chamber

[Wes Streeting]

My hon. Friend is absolutely right. She is second to none in championing that issue on behalf of the people of Luton.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

Although many groups are affected, I want to highlight those people on repeated short-term contracts. They do not fit into any category, but they have tax records. Surely, with a bit of imagination, people with a long-standing tax record could be helped.

[Wes Streeting]

My hon. Friend is absolutely right. There are practical ways through this. We do not pretend that it is not difficult, but the problems are not insurmountable if the Government would only show flexibility and willingness to listen. Millions of people’s hopes were crushed and their lives thrown into chaos and anxiety when they saw the ship was sailing and had left them behind.

I do not need to list the exclusions, but can we drop this idea once and for all that these are all super-wealthy people living it up on savings or shares? One of my constituents affected is a face painter and balloon artist. She has a simple job, which is to bring joy to children, and it is a job she loves doing, but it is a job she could not do when, like every other business, she went into lockdown and her business closed. Now, as she is trying to get her business back up and running, she finds the rule of six has once again crushed the party business. She is not super rich, she cannot do her job through no fault of her own and she has not had a penny of support since April.

We have heard other powerful examples, including from my hon. Friends the Member for Bristol East (Kerry McCarthy) and for Enfield, Southgate (Bambos Charalambous). There are so many examples we could give, but we have so little time and those people have even less time. “You will not face this alone”, the Chancellor said. Unfortunately, that was true in only one respect: they found each other. Through ExcludedUK, ForgottenLtd and other campaign groups, they have found a support network and managed to win a hearing in the huge cross-party support they have built in this House. So why is the Chancellor not listening? Why is he being so stubborn and inflexible? Why, even now, do Ministers refuse the basic request, which is just to meet and talk with people who are willing to come forward with ideas and practical solutions? The consequences of the Government’s failure to act are clear. Before the crisis began, around 15% of the workforce were self-employed. That figure has fallen sharply during this crisis. We heard powerful personal testimony on this from the hon. Members for Buckingham (Greg Smith) and for Warrington South (Andy Carter)—people who know what it means to take the plunge, take the risk and start a business.

We have heard powerful contributions on the arts and creative industries, not least from my hon. Friend the Member for Batley and Spen (Tracy Brabin), who knows how to build an audience. We have heard other brilliant speeches, too, from my hon. Friends the Members for Hammersmith (Andy Slaughter) and for Belfast South (Claire Hanna), from Conservative Members, such as the hon. Members for North East Bedfordshire (Richard Fuller), for Hastings and Rye (Sally-Ann Hart) and for Congleton (Fiona Bruce), and from right across the Back Benches, from SNP and Plaid Cymru Members.

People might think that theatre is frivolous and all about singing and dancing and having a good time, but there is an important economic issue here. There is a reason central London is empty: the theatres are closed. The live music sector contributed £4.5 billion to the UK economy in 2019. We also see in the figures that some of the sharpest falls have been in construction, professional, scientific and technical services, and administration and support services. The Resolution Foundation has highlighted the sharp fall in these people’s earnings.

Labour has repeatedly called on the Government to listen to the concerns of the excluded. The shadow Chancellor has written to the Chancellor four times in recent months to highlight problems and suggest solutions, and we are always willing to meet, if only the Government were not so stubborn and unwilling to listen. The Federation of Small Businesses—experts in this area—has repeatedly called for a rescue plan for those left out of Government support. It is right to argue that those whose businesses are often suffering through no fault of their own should not be left out of support. As my hon. Friend the Member for Brentford and Isleworth (Ruth Cadbury) underlined, the Government do not understand Britain’s self-employed. As a result, they have not valued them and because of that they have not provided them with the support they desperately need.

Before I was elected to this House, I spent just a year as a freelancer. It was one of the most terrifying professional experiences of my life—not knowing if I would get the next job, or if the invoice would be paid on time; worrying about things such as my cash flow, bills, my incomes, my outgoings. It is a stressful experience. I can speak for the self-employed and the excluded in my constituency—we have heard so many others speak for their constituents too—but none of us can truly understand what these people have been through this year, seeing other people receive support and themselves left behind.

Ways and Means

Debate between Wes Streeting and Meg Hillier

Ways and Means resolution: House of Commons
Wednesday 6th September 2017 Commons Chamber

[Wes Streeting]

There is no one here—even Conservative Members have given up defending the Government’s Ways and Means motions. We have the poor Minister, his Whip and his poor Parliamentary Private Secretary in the Chamber, but there we are. I thank everyone else for paying attention this afternoon. The serious point is that the Ways and Means motions do not actually address the fundamental structural weaknesses in our economy.

I will now draw heavily from today’s report by the Institute for Public Policy Research, which I commend to the House and which I hope people will read. The fact is that the UK has the most geographically unbalanced economy in Europe. Although I am proud to be a London and Essex MP, I understand why colleagues from other regions and nations of the UK want a more balanced approach to regional economic and infrastructure investment, which is in the interests not only of their constituents but of my constituents. If we are to build a stronger, more resilient, more prosperous and fairer economy, it has to be one that is fairly balanced across the UK.

As Conservative Members tell us, we have a high employment rate and unemployment has been kept low, which I acknowledge and welcome, but Ministers and Conservative Members must have some humility about the fact that the high employment rate has been accompanied by an increasingly insecure and casualised labour market. Fifteen per cent. of the workforce are now self-employed, and many of those self-employed people will be hit by the Ways and Means motions, particularly those relating to Making Tax Digital.

We welcome self-employment. I have been self-employed, and I admire people who pluck up the courage to take the plunge and the risk of starting their own business, but there are many people who are not self-employed in the conventional sense—the sense that is to be encouraged and welcomed—but are in enforced self-employment, driven either by businesses seeking to duck their employer responsibilities or, worse still, by a punitive welfare regime in which people seek to declare themselves as self-employed so that they do not lose their tax credits while they scramble to find a real job. That is not properly understood.

Of course, there is also an unequal distribution of economic wealth. Between 1979 and 2012, only 10% of overall income growth went to the bottom half of the income distribution; almost 40% went to the richest tenth of households. Small wonder that we see this outcry from significant parts of our population, concentrated in certain parts of the country in particular, who are not just angry about the injustice they feel but are completely aware that it is a genuine injustice. It is not just a feeling of resentment—an irrational emotional response—as they are being left behind.

Let us be honest about the fact that we have, as the IPPR says,

“both world-leading businesses and world-lagging productivity.”

We have a lower rate of investment than most of our major competitors, as I have already said. Yes, we have a trade surplus in services, but our overall current account deficit as a percentage of GDP is the largest of all the G7 countries. The extent of manufacturing in our economy should make Ministers blush.

In the past seven years, the Government have been far too reliant on monetary policy levers. They have been over-reliant on quantitative easing, over-reliant on extremely low interest rates and over-reliant on growth that is fuelled by record consumer spending and consumer debt. We are building a new debt crisis in this country—it is a consumer debt crisis, and it is here. All it will take is a marginal interest rate increase for people to be unable to service their debt, and they are barely able to service that as it is. There are real questions to be answered about irresponsible lending, and the Treasury Committee needs to examine that.

These structural weaknesses in our economy ought to be at the forefront of the motions, but they are not. That would be irresponsible in the best of times, but let us look at what we face down the track. We are going to see deeper globalisation, and a shift of economic power to the south and to the east, with a requirement on us to become far more competitive, particularly in seizing opportunities in the service economy. We face enormous and fundamental technological change. The rate of such change is now vastly outstripping the rate at which regulators, government and businesses are able to respond to it. I am not someone who sees the rise of the robots as the beginning of human serfdom in the age of the machine; as with globalisation, there are huge opportunities here to deal with enormous inequality and with big issues facing the planet, such as climate change. Automation presents huge possibilities, but let us learn the lesson from globalisation. This is not something that we can slow or stop; it is happening, and it is a process. We must make sure that this new industrial revolution, the fourth one, works in the interests of everyone, rather than a select few. Otherwise, we will end up back where we are with Brexit, which is the biggest risk facing our country.

When we think about what could happen in the next couple of years as the UK leaves the EU or comes crashing out, we see that the idea that these Ways and Means motions would make any bit of difference is fanciful—it is not serious. When we look at policy coming from the Treasury and the Department for Business, Energy and Industrial Strategy, we see that it is insufficient to meet the challenges of the time. Worse, it seems that far from pursuing policies that will address these big challenges, the Government are pursuing an approach that would make things even worse, relegating the economy to a second-order issue. As George Osborne said from the Government Back Benches after he left office as Chancellor, in a debate about our relationship with the EU,

“the Government have chosen…not to make the economy the priority”.—[Official Report, 1 February 2017; Vol. 620, c. 1034.]

Can you imagine that? Can you imagine a Government not making the economy the priority? As I have said throughout this debate, that would be inexcusable in the best of times, but it is absolutely outrageous in the worst of times.

In conclusion, I hope that the Government not only take on board the detailed critique that has been made of their Ways and Means motions, but reflect on the structural weaknesses in our economy, the challenges that lie ahead and how they can meet them. Let us think about the biggest political event this country has seen in post-war history: the decision to leave the EU. We know that the referendum was lost because of a coalition of voters. I accept that there were a lot of committed Eurosceptics who always wanted out come what may, but the referendum was won thanks to the votes of millions of people who simply felt left behind, who felt unheard and who wanted to send a clear message. They are the people who have been at the sharp end of globalisation; they are the victims of economic inequality and social injustice. When we campaigned in areas where people turned out in droves to vote leave and we told people they may be voting to make themselves poorer, time and again we heard the same reply: “Things cannot get worse than this.” The thing I fear more than anything else about the economic outlook in this Parliament is that things can, and indeed may well, get worse. It would be a tragedy if the very people whose voices cried out to demand change, and who expect that change, were once again the ones who bore the brunt of short-term economic thinking, and of a politics and economics that works in the interests of the privileged few.

I did my democratic duty in honouring the referendum by voting to trigger article 50. What I will not do during this Parliament is pretend that I think the right decision has been made or that the warnings we gave will not come to pass. It is my responsibility, and the responsibility of us all, to protect the interests of our nation and our constituents. If we want to deal with what we are seeing across western democracies—the consequences of people abandoning their faith in mainstream politics—and we want to see off that trend and process, the only way to change course is to change our country. There is no shortcut to achieving change. It has to be meaningful, serious and a lot better than the measures the Government have presented this afternoon.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

On a point of order, Madam Deputy Speaker. Following the point of order made by the right hon. Member for New Forest East (Dr Lewis) earlier today about the establishment of Select Committees, it has come to my attention that every party has a list of names of members of Select Committees. Will you and Mr Speaker use your good offices to encourage the Government to table a motion tonight with those names—if there are any gaps, they can be filled at a later time—so that the Committees of this House can scrutinise this Government as swiftly as possible, hopefully starting next Monday?

NHS in London

Debate between Wes Streeting and Meg Hillier

Thursday 24th March 2016 Westminster Hall

[Wes Streeting]

They may well be the judge, but I am standing down as a councillor in 2018. I was elected to Parliament while serving as a councillor, which is a good indication.

Seriously, the London Borough of Redbridge has the fourth lowest public health grant in London. Given the diversity of our population, and the pressures that that brings, it is a cause for concern. In that context, I was even more disappointed to find that the Government have cut our public health grant in-year. As a former cabinet member for health and wellbeing in Redbridge, and as the former chair of our health and wellbeing board, I know that we were already struggling to meet our statutory duties on public health, not least the new responsibilities we have been given, such as for health visiting, for which the allocation received from the Government was not sufficient. We managed to squeeze some extra funding out of the Government, but we are still struggling.

The reduction is disappointing, particularly in the context of London, where people’s healthcare needs and lifestyles are placing pressures on the NHS. Public health investment is an upfront investment in people’s lifestyles that will reduce NHS costs in the longer term, as well as improving people’s health and wellbeing. I cannot understand why, in that context, preventive budgets such as public health budgets are bearing the brunt of cuts. I hope Redbridge’s public health allocation in particular is something that the Department of Health will revisit.

I have talked about the financial challenge for local authorities, and I will now address the financial challenge facing the NHS and our local health economy. I was concerned, as everyone else was, to read David Laws’s revelation at the weekend that, far from the £8 billion that keeps being mentioned as the hole in the NHS budget, Simon Stevens actually identified a £30 billion hole, of which he said £15 billion could be found through efficiencies and improvements. My maths makes that a £15 billion hole in the NHS budget, and it is a source of concern that the £8 billion promised by the Conservatives at the last election is still not there. We have seen the Chancellor having to shuffle money around. Earlier, my hon. Friend the Member for Lewisham East (Heidi Alexander), the shadow Secretary of State for Health, talked about the reallocation from capital to revenue in terms of the health budget.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

The Public Accounts Committee recently considered the health budget following a National Audit Office report. There is a £22 billion gap, and one of the key drivers of that is the 4% efficiency savings year on year. Simon Stevens has himself acknowledged that that is too high and that 2% would be more reasonable. The head of NHS Improvement also acknowledged that it is a cause of acute hospitals’ deficits at the moment.

[Wes Streeting]

I am grateful to the Chair of the Public Accounts Committee for giving us that insight, which gives me even greater cause for concern about our local situation in Redbridge. The overall gap in funding for the NHS should be a concern to the whole country.

In my borough in particular, I am concerned by a report produced for NHS England by McKinsey & Company in, I believe, July 2014. The report has just been released by NHS England following a freedom of information request, and it identifies a Barking, Havering and Redbridge system gap of £128 million for commissioners and £260 million for providers. I am concerned by several things. One is that one way in which McKinsey identified that the BHR system will be able to address that gap is through acute reconfiguration of King George hospital, where the accident and emergency department is threatened with closure. I am deeply disappointed that, at a recent meeting of the Ilford North Conservatives attended by the hon. Member for Richmond Park (Zac Goldsmith) for his London mayoral campaign, the Conservatives once again stood up and said, “People should not worry about the accident and emergency department, because we always say it’s going to close and it never does.” The only reason why the accident and emergency department at King George hospital is still there is not because of a positive decision to keep it but because the NHS trust and the local health economy are in such a mess that it would not be clinically safe to close it at this time; the accident and emergency department is still very much at risk.