Prevention of Ill Health: Government Vision
Debbie Abrahams Excerpts(5 years, 6 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Matt Hancock
I am working with the Department for Transport. Transport Ministers feel very strongly about this question. The document details some of the things that we are going to do, but I am sure that there are a lot more.
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
May I suggest that the Secretary of State has a look at the report, “Fair Society, Health Lives”, by Professor Sir Michael Marmot, particularly at his recommendation about a minimum income for healthy living? With this in mind, what assessment has the Secretary of State made of the impact of universal credit and cuts to that scheme on poverty and healthy life expectancy?
Matt Hancock
I have of course looked at that report. It is important, and it is important that we get the answers to it right.
Budget Resolutions
Debbie Abrahams Excerpts(5 years, 6 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Matt Hancock
It is true that the Labour party in office has always left unemployment higher than it found it; it is true that, while Labour left the deficit higher, we are bringing it down; and it is true that inequality, too, is coming down. Page 8 of the distributional analysis shows that, contrary to what we heard in that paean of gloom from the shadow Chancellor, the biggest rises in full-time employee gross weekly real earnings over the last three years have been among the 10% least well paid in our country. That is what this Conservative Government are doing—delivering for everybody in our country.
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
On inequalities, does the Secretary of State recognise that life expectancy is stalling under his Government? In some regions it is getting worse. For women, it is getting worse. Perhaps he can answer the question he could not answer last week—why, for the first time in 100 years, do four babies in 1,000 not reach their first birthday?
Matt Hancock
As the hon. Lady knows, life expectancy is increasing, and we are forecast to see an increasing number of people live to a good old age. Indeed, the number of people aged 75 and over is set to double in the next 30 years. That is a brilliant achievement, which is in part down to the hard work of our NHS. Cancer survival rates are at a record high, strokes are down by a third and deaths from heart failure are down by a quarter. Of course, those successes have brought new challenges. The biggest health challenge we face is that people are living longer, often with multiple chronic conditions. The money is only one part of the plan to safeguard the NHS and ensure it is fit for the 21st century. The Budget delivers the funding, and later this year we will deliver the plan for how we will set the NHS fair for the future.
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
I should like to highlight some of the facts and figures that the Chancellor missed yesterday before I move on to discuss some of the taxation and public spending measures. First, a record 8 million working people are now living in poverty. There are also 4 million children living in poverty, two thirds of whom are in working families. That number is going in the wrong direction. There are also 4 million sick and disabled people living in poverty—twice the number of non-disabled people. Our life expectancy is flatlining, and for women it is actually going backwards, but what do this Government do? They increase the state pension age. We also know that infant mortality has increased for the first time in 100 years, and that four in 1,000 babies will not reach their first birthday, compared with 2.8 per 1,000 in Europe.
Many epidemiologists have linked this reversal of the generations of health improvement with the austerity that this Government have wrought on the country as a whole and on people on the lowest incomes in particular. Resolution Foundation analysis published today and yesterday’s Budget book show that people on the lowest incomes will be hit disproportionately hard. The Government have not reduced inequalities. Have Ministers assessed the Budget’s impact on life expectancy? Will it continue to flatline, will it get worse or will it increase? I doubt they are able to say it is on the road to recovery.
On tax, I am pleased that small businesses, particularly those on the high street, will have their business rates reduced—that has been a particular issue for a number of my constituents—but what will that mean for councils’ revenue, and how will they be recompensed? My council has lost nearly half its budget from central Government. The digital services tax sounds great, but the OBR says it will affect around 30 tech giants, which will pay about £15 million each. How will that address the fundamental issue that, for example, in 2016, Google paid £36.4 million in corporation tax on declared UK sales of £1 billion, whereas according to its US accounts those sales were £6 billion?
On public spending, the Chancellor confirmed that the NHS would be given much-needed cash. That is welcome, but a range of think-tanks, from the King’s Fund to the Nuffield Trust, say it actually needs £30 billion by 2020. Again, the additional £2 billion for mental health crisis is welcome, but what about emphasising prevention? What about assessing the Government’s own policies on sanctions, work capability assessments and the personal independence payment process, which make the mental health of many claimants worse?
The £1 billion for social care is important, but it does not address the £2.5 billion funding gap since 2010 and does not help the 1.2 million people who need care but cannot get it. I worry that after the publication of the social care Green Paper, which is being consulted on, a new funding regime involving a social care insurance scheme will be announced. That would have disastrous implications for the NHS, as we see closer integration between the NHS and social care.
I could go on about the derisory figures for education and the fact that my local police force and our emergency services will receive nothing substantial, but I want to talk about homelessness, which is rising but was not mentioned in the Budget. We see rough sleepers on our streets in towns and cities up and down the country, but we hear nothing about the families who live in temporary accommodation or people who sofa-surf, as they are not deemed as having priority need for housing. That is the Government’s biggest shame. It epitomises their neglect of too many citizens and reflects not just their failure to ensure that enough houses are built for us all, with social and affordable homes as part of the mix, but their ill-thought-out social security policies, such as universal credit.
Universal credit has been a disaster from start to finish, and it has now been revealed to be driving homelessness. One shelter says UC is the reason why a third of its residents are in it. UC tenants of the housing association First Choice Homes in Oldham are in more than £2.5 million of rent arrears. Research suggests that nearly one in five people in Oldham struggles to pay a social rent. UC is part of that problem. Policy in Practice estimates that the changes to UC announced in the Budget will not have a significant effect. It says 345,000 more households will still be worse off and 29,000 will be no better off. Disabled people will still be worse off. People in employment will see some improvements, but self-employed people will see none at all.
Karin Smyth
My hon. Friend is a well-known expert in this area, which she has spoken up about many times. Does she agree that the Government’s inability to look at people in the round—particularly at their mental ill health, their disability, their poverty and their lack of access to work—drives some of the problems she highlights, including those with universal credit?
Debbie Abrahams
My hon. Friend hits the nail on the head. The human misery caused by such an inhumane policy cannot be underestimated.
L contacted my office recently after her UC was suddenly stopped because her son, B, has severe learning difficulties and L, who is the main carer, did not realise that he would have to make a separate claim once he had reached his 19th birthday. When the money stopped, L had nothing—she did not know why it had stopped and nobody contacted her. It was an absolute disaster for her, and she said:
“At times I just want to end it all…it’s just so hard and I get no support or respite.”
L is a candidate for the new mental health crisis fund that the Government have set out—a product of their universal credit policy. On top of this, the investment in UC does not offset other cuts to social security, with welfare spending set to fall in the next couple of years.
Most worrying are the cuts affecting disabled people, which have not been addressed in the Budget. In fact, according to the OBR, disabled people will be worse off. As the United Nations said last year, this Government are presiding over a “human catastrophe”. The Equality and Human Rights Commission estimates that families with a disabled adult and a disabled child will have lost 13% of their income—£5,500 a year—by 2022. This is on top of colossal cuts across other Departments. What about their help from the Chancellor? What about their bright future?
We have done a lot—the former Labour Government did a huge amount to improve life expectancy, and to lift disabled people and children out of poverty—but we need to do more. The inequalities in our society are getting worse, not better. These inequalities are socially reproduced, so they can be changed, and that should give us all hope. But political will is needed to tackle them, and I am afraid that this Government just do not have it in them.
Oral Answers to Questions
Debbie Abrahams Excerpts(5 years, 6 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Mr Speaker
As in the health service under successive Governments of both colours, demand exceeds supply and we cannot carry on indefinitely, but let us hear a few more questions.
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
Last week, the Royal College of Paediatrics and Child Health revealed that there has been an increase in infant mortality for the first time in 100 years. Four in every 1,000 babies will not reach their first birthday, compared with 2.8 in every 1,000 babies in Europe. This was warned against as an effect of austerity. What assessment has the Health Secretary done on the effects of next week’s Budget on child health and the longevity of our children?
Matt Hancock
I saw that report and we are analysing it. Last week was Baby Loss Awareness Week, and I am glad that there is more awareness of the issue now than there was previously. It is a very important issue that we are looking at right across the board.
Social Care Funding
Debbie Abrahams Excerpts(5 years, 7 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Barbara Keeley (Worsley and Eccles South) (Lab)
I beg to move,
That this House notes that eight years of Government cuts to council budges have resulted in a social care funding crisis; further notes that 1.4 million older people have unmet social care needs; notes that Government grant funding for local services is set to be cut by a further £1.3 billion in 2019-20, further exacerbating the crisis; recognises with concern the increasing funding gap for social care; further recognises that proposals from the Government to invest £240 million will not close that gap; and calls on the Government to close the funding gap for social care this year and for the rest of the Parliament.
In October 2016, the Prime Minister told this House that her Government would provide a long-term sustainable system for social care that gives people reassurance. Then the Conservative manifesto said:
“Where others have failed to lead, we will act.”
But the Government have failed utterly to act and people in need of care have paid the price of that inaction. It is approaching a year since the Government promised they would deliver a Green Paper, yet it is still nowhere to be seen months after the planned publication date originally scheduled for summer. Since then, we have seen a further £1 billion cut from social care because of the cuts the Government have made to the budgets of the councils that deliver it, with disastrous consequences for the social care system.
The Prime Minister has not heeded her own warnings about failing to act. During last year’s election campaign, she said that
“the social care system will collapse unless we do something about it. We could try and pretend the problem isn’t there and hope it will go away, but it won’t. It will grow each year.”
That is exactly what has happened. The problem has not gone away and it has grown in the past year.
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
Does my hon. Friend agree that in addition to the immediate injection of £2.5 billion funding for social care, with 20% of the poorest local authority areas losing nearly £280 million in the past year compared with 20% of the most affluent local authorities gaining £55 million, we also need to address the issue in relation to the deprivation grant funding allocation?
Barbara Keeley
We do need to address that. Things have come to a pretty serious pass.
Matt Hancock
As I said, progress has been made. There has been a reduction of 17% in the number of in-patients—down from 2,875 in March 2015 to 2,375 on the latest figures—but I would fully acknowledge that there is more to do and I am determined to see that happen.
Our population is ageing. More people are living longer and, as a society, we must address the challenge that that creates for social care. To put that into context, over the next 25 years, the number of people aged 75 and over is set to double and the number of people aged 85 will rise by more still. Of course, this is good news. It is down in part to the hard work of our NHS. Cancer survival rates are at a record high and strokes are down by a third, but with such successes come new challenges. For instance, we are seeing a rise in dementia and in age-related conditions, with 70% of people in residential care homes now suffering with dementia.
Debbie Abrahams
Will the Secretary of State agree to support a dedicated dementia fund, as proposed by the Alzheimer’s Society, to recognise the inequity given the additional care costs that such people would be paying?
Matt Hancock
I have seen that proposal from the Alzheimer’s Society and we are looking at it now. At the same time, we are working on both the Green Paper for the future of social care, which will come before the end of the year, and the long-term plan for the future of the NHS. The interaction between the two is important.
NHS Long-Term Plan
Debbie Abrahams Excerpts(5 years, 11 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Mr Hunt
My hon. Friend is right to raise that question, because under the Barnett consequentials, for every £1 per head additional for the NHS in England, there will be £1 per head available for the NHS in Scotland. The Scottish National party has chosen to invest only 84p of every £1, which is why people in Scotland are 30% more likely to wait too long for their elective care in Scotland. That is a choice made by the SNP in Scotland and I hope that it will do it differently this time.
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
I welcome any additional funding because, let us face it, it is not just the NHS that is in deep crisis, but social care, too. However, as others have said, it is still not enough—3.5% was the minimum that was needed to see actual improvements. What assessment has the Secretary of State done to gauge what the improvements will be in the next 12 months? What financial scenarios is the Chancellor considering, and will the Secretary of State commit to stop tendering health services to the private sector, which is a waste of money for the public?
Mr Hunt
It is really extraordinary that on a day that we have announced a £20 billion annual rise in the NHS budget—you could not get a bigger commitment from a Government to state-funded healthcare—Labour is still running off down the rabbit hole of privatisation. If it is any reassurance to the hon. Lady, last year the proportion of NHS services contracted to the private sector went up by the enormous amount of zero.
NHS Outsourcing and Privatisation
Debbie Abrahams Excerpts(5 years, 11 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
I rise to speak as a former public health consultant and the chair of a primary care trust.
I want to start by recalling a conversation I had with Brenda Rustidge, a constituent of mine. She was born in the 1930s, and she described to me what it was like living in a pre-NHS world. Her father, who had just been demobbed after the war, was unemployed. She had a number of brothers and sisters, and they used to have to hide under the window when the doctor’s secretary called round on a Friday night to collect the money. She described the real fear and shame that she felt as a result. Of course, all that changed nearly 70 years ago when the NHS was created. Brenda and her family have thrived because of that.
This debate is not about scaremongering. It is about raising awareness of the real concerns not just of political parties but of clinicians, academics and experts across the country and across the world about what privatisation means. Okay, it is on a small scale, but in terms of spending it has increased from about 2.8% in 2006 to over 7.5%—over 10% if we include not just private providers but all non-NHS providers.
I want to reflect on a point made by my hon. Friend the Member for Stockton South (Dr Williams): we have within the NHS a system that provides universal, comprehensive and free healthcare. That is something we should be very, very proud of. We are seeing that being eroded. For example, private providers of knee and hip replacements exclude certain people. They do not want the complex cases because they are too time-consuming and costly. I take issue with the point that the right hon. Member for Mid Sussex (Sir Nicholas Soames) made, because it does entirely matter who provides the care that we get. There is a slow and steady erosion of the NHS as the sole provider.
In 2014, I conducted an inquiry into the international evidence on the effect of privatisation, marketisation and competition across different health systems. We commissioned a review of reviews, which is the strongest type of evidence, on the impact on health services, particularly looking at equity and quality. It was submitted to peer reviews and accepted in peer-reviewed journals subsequently, and it showed clearly and conclusively that health equity worsens in terms of not only access to healthcare but health outcomes.
It also revealed that there is no compelling evidence that competition, privatisation or marketisation improves healthcare quality. In fact, there is some evidence that it actually impedes quality, increasing hospitalisation rates and mortality rates. Of course, that was the key argument and the sole reason that the Government put forward for the Health and Social Care Act 2012.
The report found a whole host of other issues. I am sure that Members will go to my website to read about that. The transactional cost was one example—
Social Care
Debbie Abrahams Excerpts(6 years ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
Let us get back to the present day, because that is what we are debating. Disabled people of working age make up more than half of adult social care users. Given that the UN condemned the Government’s breaches of the convention on the rights of persons with disabilities, particularly article 19 on independent living, what does the Minister estimate to be the impact on independent living for disabled people of the cuts to social care?
Caroline Dinenage
If the hon. Lady will bear with me, I will come on to discuss that, but there will be a separate, parallel workstream on working-age adults, who account for over half of the spending—
The Parliamentary Under-Secretary of State for Health (Jackie Doyle-Price)
I should open with a thank you to those Members who have made some very thoughtful contributions to today’s debate. We recognise the challenge we face, and the hon. Member for Central Ayrshire (Dr Whitford) put it most strongly when she said that it is the result of something very positive: that we are all living longer. That requires some serious strategic thought about how we fund social care. It is in that spirit that we are rising to the challenge.
Both Opposition Front Benchers, the hon. Members for Worsley and Eccles South (Barbara Keeley) and for Denton and Reddish (Andrew Gwynne), expressed their dissatisfaction with the speed with which we are pursuing these reforms, but it is important that we get it right and that we take people with us. With that in mind, we have put together an advisory group to work with on the reforms. The whole sector is co-operating with us and actively contributing to the debate, because it more than anyone recognises the need to fix this and get the solutions right. I make no apologies for the fact that we are where we are now, but we are well down the track with the process. In the spirit of cross-party consensus that I have heard a lot about this afternoon, I will not get into some of the partisan points that have been made, but I want to set the context of where we are with the debate. When we introduce the Green Paper, I hope it will be received in the spirit of the comments that we have heard from most hon. Members today.
Debbie Abrahams
The Minister who opened the debate was unable to respond to my question, so I will repeat it to this Minister. What assessment have the Government made of the impact of social care cuts on the ability of disabled people to live independently, and will she apologise to those disabled people for what the UN has described as this Government’s “grave and systematic violations” against disabled people?
Jackie Doyle-Price
To be frank with the hon. Lady, one of our priorities is to make sure that disabled people can live independently for longer. That is very much a central part of our approach and we are making more money available for it. [Interruption.] She can sit and smile, but that informs our approach.
I should also like to associate myself with the comments made by a large number of colleagues in paying tribute to the hard-working, committed people who make up our social care workforce and to the informal carers who play such a vital part in our health and social care system. Central to the points made by the hon. Members for Stretford and Urmston (Kate Green) and for Keighley (John Grogan) is that we all collectively need to send a clear message that the work that those people do is valued. We are working with Skills for Care to put more value on this as a profession. People who work in the care sector do so because they are personally motivated and money actually matters less to them. We ought to give them a clear message that we really appreciate all the efforts that they make.
Many Members have raised the issue of funding cuts to council budgets. That subject obviously informed the comments from the hon. Member for Denton and Reddish just now. I will not run away from the fact that there have been challenges for councils in recent times— [Interruption.] Opposition Members mention cuts, but the bottom line is that we can only spend what we collect from taxpayers. That is the reality of the situation. I will be first in the queue to pay tribute to those councils that have stepped up to the challenge, coped well with the reductions and worked hard to become efficient. They have shown real innovation in rising to the challenge.