Baby Loss Awareness Week

Diana Johnson Excerpts

Tuesday 10th October 2017 Commons Chamber

[Diana Johnson (Kingston upon Hull North) (Lab)]

I am very grateful to be called to speak in this debate. I took part in the debate last year and was very moved by the contributions. I am pleased that we have such excellent speakers again today. I wish to pay tribute to the all-party group for the wonderful work that it has done, and to say to the Government that their record of making improvements and investing in this area is to be applauded.

I am having to stand here again because I wish to speak about my constituents, Mike and Tina Trowhill. Members may remember that I spoke about them last year. Many years ago, they lost their little boy, William, who was then cremated. They were told that there were no ashes, but 20 years later they found that there had been ashes and that they had been scattered without the family’s knowledge. Mike and Tina started to ask questions, and it became clear that they were not the only family that this had happened to. It now appears that there are about 70 families in the Hull area who share their experience. The ashes of those babies may have been left on the shelves of the funeral director’s offices. There was one instance of a baby being cremated, with no indication of an undertaker being used. Nobody seems to know quite how that happened.

When this all came to light, I went to see the council, because I knew that there had been similar instances in Shrewsbury and Scotland and that there had been inquiries about what had happened in those areas. It was on 27 March 2015 that I went to the council with Mike and Tina and we asked whether we could have an inquiry into what had happened to these 70-odd families. It took three and a half months for the council to say that no, it was not willing to do that. I felt that there was an injustice here and that these families needed to know what had happened to their babies’ ashes.

In February 2016, I went to see the right hon. Member for Surrey Heath (Michael Gove), who, at that time, was Secretary of State for Justice. He wrote a letter to Hull City Council, which said:

“My fellow Secretaries of State at the Department of Health and the Department for Communities and Local Government have agreed with me that there is a need for an historic investigation into the practices relating to infant cremations in the Hull area, and we have today jointly written to the Chief Executive of Hull City Council asking him to commission this. We have suggested that the Hull investigation should have terms of reference similar to those of the Emstrey inquiry.”

I was very grateful to the right hon. Gentleman for that. He met my constituents and was incredibly compassionate and understanding. It is really important to see a politician showing such kindness. However, unfortunately, Hull City Council said that it did not need to hold that inquiry and there was a change in Justice Secretary. Without any reference to me, Tina or any of the other families, the Ministry of Justice decided not to pursue the issue with Hull City Council. It accepted that Hull had done everything it needed to do and that everything was fine. I was not told that. I only found it out because the council told me that it was no longer considering holding an inquiry. I was livid and, as Members can imagine, my constituent was completely dismayed. She has now formed a group with the other families called Action for Ashes in Hull.

The families were absolutely dismayed, as their hope of getting the answer to what had happened was snatched away from them. However, the new Justice Secretary did write to Hull City Council, suggesting that it might like to meet the Action for Ashes group. The council refused to do that, saying that it was not willing to meet the group, but that it would meet me, Tina and one other parent. We had that meeting on 24 March 2017. I specifically asked for the full investigation that it said it had carried out to be published so that we could see what it had actually done. That took four months. On 25 July, my constituent Tina was given 27 minutes’ notice that the report was about to be published and given to the press. It was not sent to any of the other parents who were in the group.

A 22-page internal report was produced by Hull City Council, but so many questions still needed answering—questions, as I said at the outset, about why babies’ ashes were left on the shelves of funeral directors and why families were told there were no ashes in the first instance. None of that was properly addressed, and there was no investigation into the role the NHS had played or into the independent funeral directors who had been involved. The report also looked at just 2% of the cremations that had been carried out in the area, whereas, in Shropshire, the Emstrey inquiry looked at 100%—it combed through all the records. In Hull, the report looked only at the families who had come forward and self-identified.

A year on from the last time I raised this issue in Parliament, Hull City Council still believes it has done everything it needs to do, despite families saying they still have not got the answers they need. I still do not understand why, in Shrewsbury and Scotland, an inquiry was appropriate, but one is not appropriate for the people I represent. There have never been clear answers and explanations about what happened. One Conservative Member made the point that there seems to be a fear that this will turn into a legal dispute and that there will be an opportunity for compensation. That is not what these families want; they just want to know what happened, why they were told things that were not true, and who knew what when. It is that basic information that they are still seeking.

I hope very much that come next year—I hope there will be a debate again, because this is an important issue, which we need to discuss each year—I do not have to come here and say, “I am still fighting to get a local authority to display the kindness and compassion this group of people truly deserves.” I am staggered that I am still having to fight this case, because it is absolutely obvious that an internal investigation is not sufficient. What we need is to have some fresh air in this case and to have someone independent come in, look at all the records and ask the families about what happened. That seems to me the best way forward, the kindest way forward and the way we will actually get justice and truth for these families finally.

Contaminated Blood

Diana Johnson Excerpts

Thursday 20th July 2017 Commons Chamber

[Diana Johnson (Kingston upon Hull North) (Lab)]

(Urgent Question): To ask the Secretary of State for Health if he will make a statement on the responsibility for establishing an inquiry into the contaminated blood scandal.

[The Parliamentary Under-Secretary of State for Health (Jackie Doyle-Price)]

I begin by adding my personal apology to those who have previously spoken in this House about the tragedy of contaminated blood, and by reiterating that the Government recognise the terrible impact contaminated blood has had on many thousands of lives.

The Government recognise that previous inquiries into the events that led to thousands of people being infected with HIV and/or hepatitis C through NHS-supplied blood or blood products did not go far enough. That is why, on Tuesday 11 July 2017, the Prime Minister committed to establishing a further inquiry so that the causes of this tragedy can be fully understood.

Once established, we want the inquiry to be fully independent. Before it is established, however, there is a need to define its scope and format so that terms of reference may be set by the relevant Secretary of State. Given the tragedy’s impact on so many lives, it is vital that we get this right and that we get it right from the start. I am aware of the concerns that have been raised this week by those affected, by campaign groups and by Members of this House. Indeed, I spoke to the hon. Member for Kingston upon Hull North (Diana Johnson) on Tuesday about this very issue.

I reassure the House that the Government have as yet made no final decisions on the scope and format of an inquiry, or on its leadership. I have newly taken on this policy area, and I am keen to make sure that all those affected are given an opportunity to give us their thoughts and opinions. I understand it is normal practice for public inquiries to be sponsored by the relevant Department. However, we are keen to listen to the concerns that have been raised and ensure that they are addressed, which is why we are in discussions with the Cabinet Office and colleagues across Government to ensure that this inquiry does its job, and does it well, under appropriate leadership.

That is why an early consultative meeting was scheduled for today, hosted at the Cabinet Office, and the Secretary of State and Ministers hope to understand further the important views of those affected on the shape and establishment of an inquiry. This is the first of several meetings that the Government would like to offer over the coming weeks. I strongly encourage anyone affected to give us their views. Our door is open to anyone who wants to discuss the inquiry or raise any concerns they may have.

It is important to note that, whatever arrangements are agreed for this independent inquiry, safeguards will be put in place to ensure independence—for instance, by ensuring that the secretary to the inquiry has never worked at the Department of Health or any of its agencies. I reiterate that we are absolutely committed to a thorough and transparent inquiry, and we want to establish the best format and remit. That is why we want to hear as many opinions as possible, and we will work with those affected and Members of this House to do so.

[Mr Speaker]

Order. I am grateful to the Minister for the clarity of what she has just said. I should emphasise that this is not an occasion for a general debate on the contaminated blood scandal. We have had that on many occasions, and I have also granted urgent questions previously to the hon. Member for Kingston upon Hull North (Diana Johnson) on this matter. The issue is very specifically the locus, the responsibility and possibly, at a stretch, the scope. If Members can tailor their questions accordingly, it would be greatly appreciated.

[Diana Johnson]

Thank you for granting this urgent question, Mr Speaker.

Although I welcome last week’s announcement of an inquiry into the contaminated blood scandal, the vast majority of people affected by this scandal, their families, campaign groups and legal representatives, plus many cross-party parliamentarians, are, like me, dismayed to see the Department of Health leading on the establishment of this inquiry. The Department of Health, an implicated party at the heart of so much that has gone wrong over the past 45 years, must have no role in how this inquiry is established—in my view, it is akin to asking South Yorkshire police to lead an inquiry into the Hillsborough disaster. I regret that the Government have not been able to understand that putting the Department of Health in charge at this time immediately undermines their excellent decision to call a public inquiry last week. In consequence, contaminated blood campaigners boycotted a meeting organised by the Department of Health at 10 am today in protest. Another Department must surely now take over the responsibility for consulting on the remit of this inquiry.

I am pleased that the Government acknowledge the overwhelming and unanimous opposition to the Department of Health consulting on the inquiry, including from more than 250 campaigners and 10 campaign groups, the Haemophilia Society, and the law firms Collins Law and Leigh Day, which together represent 716 claimants. Nevertheless, the Minister needs to address two questions urgently. Why, on Tuesday 18 July, did the Department of Health call a meeting for 10 am today, with just two days’ notice, in central London, and at a time that is most difficult, inconvenient and expensive for people affected to attend? When I spoke to the Minister, she told me that the Government plan to update the House by September and get the inquiry up and running as soon as possible. That had not been made clear to campaigners or MPs, and I wondered why.

I still believe that the case is even more pressing for another Department to take over the work of establishing this inquiry now. That Department must then have a true and meaningful consultation with everyone affected, so that they can be fully involved and have confidence in this public inquiry.

[Jackie Doyle-Price]

As I mentioned, no firm view has been taken as to which Department will run the inquiry, but as the Minister with responsibility for this area the House would consider it amiss if I were not having meetings and discussions with those affected about the inquiry’s remit. When the Minister of State, my hon. Friend the Member for Ludlow (Mr Dunne), made the statement to the House about the inquiry, we made it clear that we wanted to progress as soon as possible. The Secretary of State called this meeting because we want to hear directly from the victims about what they want from the inquiry. We are very much in listening mode. A decision has not yet been taken as to which Department will run the inquiry but ultimately, as a Minister, I am accountable to Parliament for what happens in the Department of Health in those areas for which I have responsibility, and I want to be leading from the front, having those discussions.

Contaminated Blood

Diana Johnson Excerpts

Tuesday 11th July 2017 Commons Chamber

[Diana Johnson (Kingston upon Hull North) (Lab)]

I beg to move,

That this House has considered the need for an independent public inquiry into the contaminated blood scandal.

May I first thank you, Mr Speaker, for allowing this emergency debate? This is the first such debate on the contaminated blood scandal, and it arises, as you know, after further evidence of criminal actions was produced by the right hon. Andy Burnham and after a joint letter calling for a Hillsborough-style inquiry from all six non-Government Westminster party leaders. After the announcement this lunchtime from Downing Street of a full inquiry into the scandal, emergency debates may become an even more popular route to get the Government to listen and act.

In the light of the announcement, I want to acknowledge all the people who have been involved in getting us to this point. I will start by thanking my constituent Glenn Wilkinson for his persistence and dogged determination when he came to see me in 2010 to tell me his story. I have kept him at the centre of whatever I have attempted to do on this issue. I also thank the many individuals and campaign groups who have fought for years to get to this point: the Manor House group, the Contaminated Blood Campaign, and Tainted Blood. I thank the Haemophilia Society, in particular Liz Carroll, its chief executive, and Jefferson Courtney, the policy and public affairs manager. Over 2,400 individuals have tragically lost their lives. They are not here to see this announcement, but their voices live on through their family members, who have never given up fighting for them. The campaign, which has run for many years, has at times had the great benefit of brilliant investigative journalists, including Caroline Wheeler of The Sunday Times, who was formerly a correspondent on the Hull Daily Mail, and the many researchers and journalists who worked on the BBC “Panorama” documentary on the disaster from just a few months ago. I know that the Daily Mail is not a favourite of yours, Mr Speaker, but it also ran a good story on its front page last week.

I thank the 111 parliamentarians who are members of the all-party parliamentary group on haemophilia and contaminated blood, particularly my co-chair the hon. Member for Worthing West (Sir Peter Bottomley), the previous chair Jason McCartney, who is no longer a Member, Margaret Ritchie and Mark Durkan, who are also no longer Members but were vocal in the campaign, and of course the right hon. Andy Burnham, who set out clearly in his valedictory speech why this was unfinished business and why we needed a public inquiry. Finally, I thank the late right hon. Paul Goggins, who was a huge inspiration in this cause.

[Ian Austin (Dudley North) (Lab)]

My hon. Friend is completely right to thank all those people, but there is one person missing from that list: herself. The whole House should thank her for her tireless work over the past seven years on this absolutely brilliant campaign. This shows how Parliament should work: a constituent raised the issue with her; she campaigned on it non-stop; she was not fobbed off; she pursued it doggedly; and she has played a huge role in bringing us to this point. Last night, I had a load of emails from constituents who have been affected by this scandal, and I want to say how grateful they are to my hon. Friend for the work that she has done.

[Diana Johnson]

I am grateful to my hon. Friend for those comments, but this is down to the combined effort of so many people over so many years.

[Stephen Doughty (Cardiff South and Penarth) (Lab/Co-op)]

I pay tribute to my hon. Friend, who has been dogged in her determination and in not giving up. My constituent David Thomas came to see me in similar circumstances, as many constituents have done with Members on both sides of the House, but if he had not done so I would not even have been aware of the scandal, let alone of the need to deal with it so fully. Will my hon. Friend join me in paying tribute to the national and regional groups, such as Haemophilia Wales, who have done so much to stand up for those affected in particular locations? Their work has highlighted that this was a legacy issue from the UK Department of Health and that complications relating to the devolved status of health services across the UK need to be addressed in the inquiry.

[Diana Johnson]

My hon. Friend makes that point well.

I want to comment on how we handle disasters and on the best way forward for a Hillsborough-style inquiry established by the Government.

[Norman Lamb (North Norfolk) (LD)]

I add my congratulations to the hon. Lady on her brilliant leadership on this issue. While the announcement is incredibly welcome news, does she agree that there is an urgency here, because the people who continue to suffer need help now? There is a danger of the process going on for years and leaving them still waiting for support.

[Diana Johnson]

The right hon. Gentleman makes an important point. The timetabling of any inquiry needs to be set out clearly, and I hope that the Minister may be able to help us with that.

[Mr Jim Cunningham (Coventry South) (Lab)]

I am grateful to my hon. Friend for giving way on that point, and I congratulate her and Andy Burnham, because this issue has been going on for a very long time. Has she had any indication from No. 10 Downing Street about the form of the inquiry? Some of my constituents have similar problems to her constituents, so can she give us any clarification?

[Diana Johnson]

Just like every other Member, I have only seen what is out in the media, and I understand that there will be a consultation on the form of the inquiry. I am sure that the Minister will be able to help us in his contribution.

[Sir Oliver Heald (North East Hertfordshire) (Con)]

I join in the tributes to the hon. Lady and the all-party group, of which I have been a member, because this is an example of how Parliament can work well. There is a family in Letchworth who said to me:

“As a family, we have suffered years of misery because of this scandal.”

Does the hon. Lady agree that it is right to consult the victims and their families on the form of the inquiry?

--- Later in debate ---

[Diana Johnson]

Absolutely. The right hon. and learned Gentleman makes a good point and I will come on to that.

I do not need to remind the House of the damage that public disasters do to all those who are affected, as we know from the Hillsborough tragedy in 1989 and, more recently, the appalling fire at Grenfell Tower. Every public disaster of this kind is different: their causes differ; the victims suffer in different ways; and the measures necessary to support those affected, and their families, also differ. However, every victim has a fundamental right to one thing: answers. They deserve to be told what went wrong, why it went wrong, and who is responsible for what happened. The story of the injustice they have suffered needs to be set out and told to the wider public. Their voices need to be heard. Apologies, compensation and other forms of support are essential, but if their right to answers is not also satisfied, they will be denied true and meaningful justice.

[Mark Tami (Alyn and Deeside) (Lab)]

My hon. Friend is making a powerful case, and I thank her for all her work. As she said at the beginning, many, many victims have died. Their families are still here and are still grieving, and they need answers as much as the victims.

[Diana Johnson]

My hon. Friend is absolutely right. This tragedy has taken the life of more than 2,400 people with haemophilia, infected mainly through blood factor concentrates. Many others, without bleeding disorders, infected through blood transfusions and other means have also lost their lives. Thousands more have been left devastated. The survivors have been left to live with a combination of HIV, hepatitis C and a range of other viruses.

My constituent Glen Wilkinson is one such individual. He has haemophilia and was infected with hepatitis C when he was just 19 during a routine tooth operation. Glen is one of thousands of people who have fallen victim to the worst treatment disaster in the history of our NHS, and one of the worst peacetime disasters ever to take place in this country. Indeed, each of the 15 or so non-terrorist related public disasters I have looked at—ranging from the Bradford City stadium fire in 1985 to the Clapham Junction crash in 1988, the Marchioness disaster and, of course, Hillsborough—was a tragic event, and I do not wish to detract from the magnitude of those events, but the House should note that all those disasters led to a public inquiry.

Hon. Members and their affected constituents are entitled to ask why the same has not happened with contaminated blood. Had more than 2,400 people died over the course of one day or one year, it would be inconceivable for any Government to refuse calls for a public inquiry, yet the devastation caused by the contaminated blood scandal has been spread not over days or years but over several decades.

We must also bear in mind the profound effect this scandal has had on one community, those with bleeding disorders, many of whom were provided with contaminated blood factor concentrates sourced from profit-making American firms. Virtually everyone who had haemophilia at the time has been infected.

Hon. Members will appreciate that the impact can be devastating when friends and close-knit communities are hit by a collective tragedy. Consider, for example, the Treloar school for disabled children, a special school with a large number of pupils with haemophilia: 72 of its pupils have died because of this scandal. Many were forced to be silent to the suffering, either for fear of the stigma of having HIV, hepatitis C or other viruses, or because they were not even aware that they had those conditions. Important though that distinction is, it does not excuse the fact that successive Governments of all colours have sidestepped the issue for too long.

Internationally, an investigation saw the imprisonment of the former head of France’s blood transfusion service and his deputy, and a former French Health Minister was found guilty of manslaughter. In Japan, three company executives were imprisoned and an official was convicted on negligence charges. In the United States, the private companies involved in this tragedy paid out millions in out-of-court settlements across the world.

But nothing of that kind has happened in the UK. In 1991, in response to the threat of court cases, the Government set up an ex gratia payments scheme. There was no implication of liability, no use of the word “compensation” and waivers renouncing the individual’s right to the take further legal action had to be signed before they could obtain small sums of money.

[Mrs Anne Main (St Albans) (Con)]

A constituent, who does not wish to be named, wants us to include the remit of the Skipton Fund in this review. She, and many others, feel that the remit was wrongly drawn up, and that she and others have been denied the justice they should have had.

[Diana Johnson]

The hon. Lady makes an important point.

[Chris Ruane (Vale of Clwyd) (Lab)]

I congratulate my hon. Friend on her work on this issue. I welcome the fact that there will be a public inquiry, eventually and at last. Does she agree that that public inquiry should address why the UK was the last country in the western world to introduce a test for hepatitis C, why vital documents were destroyed by the Department of Health and why the UK took 13 years to be self-sufficient in blood products, when it took Ireland only five years?

[Diana Johnson]

Those are important questions for any inquiry to address.

On today’s announcement, the Westminster leaders’ joint letter of 7 July provided a blueprint for how such an inquiry should be conducted. First, as with Hillsborough, there should be a commitment to secure full public disclosure of details related to this tragedy, through a process managed by the affected community. There should be a mechanism to ensure all public bodies involved in the scandal are compelled to give oral and written evidence to the inquiry. There need to be assurances that the inquiry will cover the role of American firms in providing blood factor concentrates to people with haemophilia. There should also be an investigation not just of the run-up to the scandal but of its aftermath. Finally, the inquiry has to address the allegations of criminal conduct. As I said earlier, I hope the Minister will also be able to help us with a timetable for the inquiry, as those affected have waited so long to get to this point.

[Chris Stephens (Glasgow South West) (SNP)]

I pay tribute to the hon. Lady’s chairpersonship of the all-party parliamentary group. My constituent Cathy Young is grateful to her and to other MPs, because those affected would have given up if not for Members of Parliament pursuing this issue. Cathy Young now has access to her husband’s health records, which she describes as a fairy tale. Does the hon. Lady agree that those affected by this scandal, if they have not already done so, should get, and have a look at, their family health records?

[Diana Johnson]

The hon. Gentleman makes an important point, and I certainly agree.

[Jim McMahon (Oldham West and Royton) (Lab/Co-op)]

I pay tribute to the hon. Lady for her outstanding leadership on this important issue. My constituent Alex Smith has been affected by contaminated blood. A great deal has been said about the Government response and the potential criminal cover-up, but there is also the immoral way in which the victims have been treated and the payments they receive. Many are living in absolute destitution and poverty as a result of Government penny-pinching, which should form part of the review.

[Diana Johnson]

My hon. Friend is correct. We need to look carefully at the support that has been provided for this group, and at what should be provided in the future.

[Jo Stevens (Cardiff Central) (Lab)]

I add my thanks, on behalf of my constituent Haydn Lewis and his family. Haydn and his brother have died, and other members of their family have been affected. Does my hon. Friend agree that we should learn from the lessons of the thalidomide inquiry and compensation fund to ensure that we do not repeat the mistakes that were made on thalidomide?

[Diana Johnson]

That is an excellent point, and it needs to be considered.

[Hywel Williams (Arfon) (PC)]

Will the hon. Lady give way?

[Diana Johnson]

I will give way one last time.

[Hywel Williams]

I am grateful to the hon. Lady for giving way. I pay tribute to her on behalf of my constituent Jane Jones, whose family have had to deal with great privation for many years because of the scandal. In a written answer to the Welsh Assembly on 27 March there was confirmation that the payments continue to be made on an ex gratia basis, but with no liability being accepted. The answer was in Welsh, but it confirms that the payment of £10,000 to a partner or widow continues on an ex gratia basis.

[Diana Johnson]

That goes to the heart of it. There has never been any finding of liability, which has resulted in very low payments being made on a support basis, rather than on a compensatory basis.

I strongly believe, and I think the majority of the APPG believe, that a Hillsborough-style inquiry is the best way forward in this case, putting those affected at the heart of whatever is created and set up. They should be given the opportunity to have an input into the terms of reference. They should be able to look at people being considered as the chairperson or panel members of the inquiry, which has to have the support and confidence of all those affected. That is why the Hillsborough inquiry seemed to work effectively. In the case of Hillsborough, this was known as “Families First”, and I hope that approach might be able to continue in this inquiry as it is set up. All those affected need to be treated with the utmost respect and reverence, and to be fully consulted; any information that becomes available should first go to them.

In the remaining few minutes, I wish to talk about the four questions that I think the inquiry needs to look at. Andy Burnham set out in his speech why an inquiry was necessary, and of course he was one of two former Health Secretaries, the other being Lord Owen, who had raised serious concerns about the scandal. We know that the “Panorama” programme and the Daily Mail article followed. Given what Andy Burnham said and all the developments in the past few months, serious questions still need to be addressed by a public inquiry. First, why did the Government not act sooner to protect blood supplies once the risks became known? And why were we so reliant on American commercial products for haemophilia patients?

The UK was not self-sufficient in blood supplies, so profit-making American companies played a considerable role in supplying factor concentrates to haemophilia patients. That blood was sourced from much riskier patients, including prison inmates, who were much more likely to have infections and had a financial incentive to be less than honest about their risks of infection. The dangers of American products were discussed in public not from the 1990s, nor the 1980s, but from 1970. As the Daily Mail reported last week, files now suggest that at least as early as 1980 officials had even put an estimate on the number of haemophilia patients being infected from these products with what we now know to be hepatitis C. They put the figure at 50 a year, yet it was not until 1986 that they took any action to address that.

If the whole of the UK had been self-sufficient in blood supplies, fewer haemophilia patients would have been infected. We know that, because Scotland had higher levels of self-sufficiency than England. As the BBC “Panorama” programme outlined, that meant that haemophiliacs in England were twice as likely to be infected with HIV as those in Scotland. Even in the mid-1980s, when the dangers of hepatitis C and HIV became known, it appears we could have acted sooner to remove risky blood products. And when the United States started screening its commercial products from March 1983, we carried on using non-screened American supplies that we had purchased before then; how can that possibly be justified?

My second question for the inquiry is: why were patients kept in the dark and not told of the risks once they became known? There are many aspects to this controversy that I know other hon. Members may wish to touch on, but I want to draw the House’s attention to developments in 1983, in the midst of the AIDS epidemic, when there was still uncertainty over whether AIDS was a blood-borne disease.

In November 1983, the then Health Minister, the right hon. and learned Member for Rushcliffe (Mr Clarke), told Parliament that there was

“no conclusive evidence that…AIDS is transmitted by blood products.”—[Official Report, 14 November 1983; Vol. 48, c. 327-8W.]

Yet earlier that same year his Department was preparing internal documents that said the opposite: in August 1983, that same Department was telling practising homosexuals and drug users not to give blood because of the risk of transmitting AIDS; in the summer of 1983, the Department was preparing a blood donor leaflet that said AIDS was “almost certainly” transmitted by blood and blood products; in July 1983, the UK Haemophilia Centre Doctors’ Organisation said that young children with haemophilia should receive a less risky form of blood product due to the dangers of AIDS; and between March and May 1983, the Scottish National Blood Transfusion Service prepared a leaflet for blood donors, which included “haemophiliacs” and “recipients of blood transfusion” on a list of people who could get AIDS, and asked those same individuals not to give blood. Of course, the Scottish Penrose inquiry itself acknowledged that in adopting its position in November 1983, the then Government relied on

“a highly nuanced use of language.”

My third question is: why were some people tested for viruses without their knowledge and only told of the results many years later? There are many such cases of this happening, but I will make reference to just one: Jonathan Evans first tested positive for HIV in 1984 yet was not told of this until seven months later, in mid-1985. That posed a huge health risk to his wider family, and the history of this scandal is full of cases of spouses infecting each other. Tragically, the virus took his life. His son, Jason, was just four years old when his father died. He is still campaigning for justice for his father, and he has been instrumental in generating recent news coverage in the Daily Mail article and elsewhere.

Fourthly, there are allegations of a criminal cover-up, on an industrial scale, from the highest ranks of government downwards. At every stage of this scandal, there are concerns that officials knew more than they were letting on. Almost everyone affected by the scandal has encountered issues with lost medical records. Others have recovered their files, only to find that any mention of the connection with contaminated blood has been removed. Some individuals today are unable to access financial support via the Skipton Fund because of what has happened to their medical records. These cases of lost records also extend to the highest level of government. During the Archer inquiry, Lord Owen requested his departmental papers from the time when he was a Health Minister in the 1970s. He was told they had been destroyed

“under the 10-year rule”,

even though there is no evidence of the existence of such a rule.

Finally, when people were forced to sign waivers in 1991, as I mentioned earlier in my speech, they were asked to commit to bringing no further hepatitis C litigation as well as HIV litigation. These individuals did not yet know they had hepatitis C, as the disease has a long incubation period. It seems that the inescapable conclusion is that departmental officials knew more than they were willing to disclose.

In conclusion, earlier this week the Prime Minister expressed her intention to work more with other party leaders to act in the best interests of this country. She has shown a laudable commitment to that with respect to other public disasters, including the child abuse inquiry and the Hillsborough disaster. Alongside the many thousands of people who have campaigned for justice for so long, I want to personally thank her for showing that same commitment with respect to the contaminated blood tragedy.

There are still questions to be answered on the detail of an inquiry. In welcoming this announcement, we must also be mindful of those who will never see its results: the more than 2,400 people who have tragically lost their lives. Many never even knew of the true scale of the scandal that was impacting on them. Those infected, and their families, will be waiting anxiously to know that the Prime Minister’s announcement will truly give them the justice they have so long been denied. But today the Prime Minister has earned a place in history as someone who has listened to an issue that her predecessors had ignored, and put party politics aside in the name of giving people the answers that are their basic right. For that, she has my gratitude.

[Several hon. Members rose—]

--- Later in debate ---

[Mr Dunne]

I shall make a little progress, then endeavour to answer that.

My right hon. Friend the Secretary of State and Ministers at the Department of Health will meet those affected and their families so that we can discuss the issues and understand their preferences directly about the style, scope and duration of the inquiry.

[Diana Johnson]

I am grateful for what the Minister is saying, but can he give a time estimate of when the meetings will take place? My experience of the Department of Health is that, on this issue, deadlines are not met and things have to be dragged on to the Floor of the House to get Ministers to respond. Is there a set timetable for when a decision will be made and those meetings held?

[Mr Dunne]

The hon. Lady, who has taken an active lead in encouraging inquiries, will want to make sure that we get it right. We will take the time that is necessary to consult colleagues and interested groups. Our intention is to be able to come back to the House as soon as practicable—I anticipate in the autumn.

--- Later in debate ---

[Diana Johnson]

It is delightful to see you in your new place in the Chamber, Madam Deputy Speaker. I congratulate my hon. Friend the Member for Oxford East (Anneliese Dodds) on her maiden speech. That was an excellent start, and I am sure she will have a very long career in the House of Commons.

We have heard some really important and excellent contributions. I think we were all moved by the contribution from my hon. Friend the Member for Newport East (Jessica Morden) when she talked about Colin Smith—a little boy who received contaminated blood products when he was quite tiny, and who eventually died of AIDS and hepatitis C. That reminded us all that this is about boys and girls, husbands and wives, and brothers and sisters who have been affected by this scandal.

[Nick Smith (Blaenau Gwent) (Lab)]

Does my hon. Friend agree that these blood products should have been withdrawn as soon as the risks involved in their use became clear?

[Diana Johnson]

That is a good point, and I hope the inquiry will be able to get to grips with it.

I am really pleased we have had this announcement today from the Government, but I gently say to the Minister that we will not be going away on this: parliamentarians on both sides of the House will be following carefully how the consultation takes place and who is consulted, and making sure that there is a good, timely timetable, that there is legal support for those who need help with representation, and that there are regular updates to Parliament.

I want to finish with a quote from a person who has just emailed me and says that this is

“just the end of the beginning and still a long way to go before truth, justice and holding to account are achieved”.

We will now be watching very carefully what the Government do next.

Question put and agreed to.

Resolved,

That this House has considered the need for an independent public inquiry into the contaminated blood scandal.

Adult Social Care Funding

Diana Johnson Excerpts

Thursday 6th July 2017 Commons Chamber

[Steve Brine]

Yes. This is no different from the conversation that we are having about the funding of every other public service. It is very easy to take to the streets with placards saying “Spend more!” Indeed, I think the Leader of the Opposition spent the national debt several times over just in his response to the Queen’s Speech. This is why we need a proper debate and a consultation on long-term funding. Ultimately, it could come out of general taxation, but we have to have a debate as a country on how much we can afford to do while funding all the other public services. I have not noticed us being short of requests to increase funding in other areas as well. We have to have that honest debate as a country.

[Diana Johnson (Kingston upon Hull North) (Lab)]

If we are going to have that honest debate, the Minister, whom I welcome to his place, has to accept that the decisions of his Government have fuelled the social care crisis. My council, the third most deprived in the country, has had the 17th highest cuts to its budget, including having £40 million taken out of social care by 2020. The social care precept that the Minister has introduced does not raise the amount of money in my area that it could in wealthier areas. Will he please accept some political responsibility for the mess we are in?

[Steve Brine]

Of course Governments of all colours have delivered us to the place where we are at this very moment, but have this Government put more money into the social care system? Yes. Did we provide more money in the Budget this year? Yes. Are we allowing councils to raise more money? Yes. As I said earlier, we spend more on long-term care as a share of GDP than other industrialised countries, including Germany and Canada and the massive economy of the United States.

Contaminated Blood

Diana Johnson Excerpts

Tuesday 25th April 2017 Commons Chamber

[Andy Burnham (Leigh) (Lab)]

Through you, Madam Deputy Speaker, may I thank Mr Speaker for giving me this opportunity to make what will be my last speech in this House? I make it on the subject of contaminated blood for a simple reason: knowing what I know, and what I believe to be true, I would not be able to live with myself if I left here without putting it on the official record. I will be honest: this is a speech made with a sense of guilt in that all of us here are collectively culpable of failing to act on evidence that is there before us if only we cared to look and, by extent, failing thousands of our fellow citizens who are the victims of perhaps the greatest untold injustice in the history of this country.

First, let me explain the genesis of my speech. Last year, the chair of the all-party group on contaminated blood, my hon. Friend the Member for Kingston upon Hull North (Diana Johnson), who has done absolutely outstanding work on behalf of those who have continued to struggle for truth and justice, invited me to a meeting to discuss where next for the campaign. There was a raising of expectations in the last Parliament—I am talking about a lot of goodwill on both sides of the House and a sense that people wanted to do something to help. That continued in the early part of this Parliament, with a sense building that something was going to be done. However, following those expectations, victims now feel that they have been led up to the top of the hill only to be let down once again.

Although I do not doubt the sincerity of the former Prime Minister’s apology at his last PMQs, the Government’s failure to back it with substantial action has left people feeling in the wilderness all over again. To try to find a way forward for them, my hon. Friend asked me to speak to the all-party group about whether my experience on the Hillsborough campaign might provide some insights that would help those still campaigning today, after all these years, for justice for those who have suffered from contaminated blood.

When I focused on that question, I had something of a penny-drop moment—this was when I was preparing to speak to the group. The more I thought about it, the more the parallels between the contaminated blood scandal and Hillsborough became clear. Obviously, both relate to the 1980s and both resulted from appalling negligence by public bodies, but there is also the fact that both have been subject to an orchestrated campaign to prevent the truth being told. It is that failure to give the victims the truth that compounds the injustice and the suffering.

Here is what I think is the crux of the problem. Contaminated blood has always been viewed through a financial prism. That suits the Government. It keeps the victims in a position of subservience, forced to beg for scraps of help from the various funds that have been set up. By the way, let me make it clear that I am talking about not just this particular Government—although I am talking about this Government—but all Governments. To the extent that the public know anything much about this scandal, there is a vague sense that it is an argument about money. In my view, it is in the Government’s interests to keep it there; they want to keep it there. Why is that? Just as with Hillsborough, if the great British public knew the real story here, there would be such a wave of public support for the victims that demands for full and fair compensation simply would not be able to be resisted by the Government. That is the experience of Hillsborough. When the truth was told, such was the huge groundswell of popular support that there had to be action. Perhaps that is why the Government do not want the truth to be told—they know that there would be little place for them to go in answering those calls.

I have brought this debate to the House today to try to break through that impasse. I want to refocus everybody on giving victims what they have never had—the truth. From what I know, this scandal amounts to a criminal cover-up on an industrial scale. I will present direct evidence to support that claim. There are hundreds of victims of this scandal who can point to evidence of crucial pages missing from their medical notes. Of course, the authorities have an excuse in these cases. They can always say, “Human error—they were lost. When we moved offices, the box got misplaced.” As implausible as that excuse is, they get away with it because how can we prove otherwise? But I want to focus on a small number of specific cases that reveal deliberate, provable acts of cover-up.

[Diana Johnson (Kingston upon Hull North) (Lab)]

I pay tribute to my right hon. Friend’s outstanding work on the Hillsborough inquiry and what he achieved there. Obviously there is still more to do. On behalf of the all-party group, I am so grateful that my right hon. Friend was willing to share his experiences with us in relation to contaminated blood.

I want to raise a point about Lord Owen’s request for documents, when he was the Health Minister in the 1970s. He was told then by officials that those documents had all been destroyed. The Archer inquiry, which I am sure my right hon. Friend will refer to, found no reason why that should have happened. I know he is going to talk about specific cases of documents being lost or doctored in some way. From what happened to a Government Minister, and given this idea of an industrial scale cover-up, does my right hon. Friend think that what happened with the individuals he is about to describe and with Lord Owen just shows how deep-seated this cover-up is?

[Andy Burnham]

My hon. Friend has put her finger on the point. With Hillsborough, when we finally got to match up documents held at a local level with those held at the national level, the full picture began to emerge. It is my contention that exactly the same would emerge here. The direct examples of a cover-up that I am about to give, relating to individual cases, would then be put together with what we know about documents held—or, indeed, not held, which itself implies wrongdoing—at a national level. In the end, it is the putting together of that picture that gives people the truth and allows them to understand how this happened. I will come directly to that point later.

I will focus on three cases. I highlight them not because they are the only ones I have seen or been sent, but because I have met or spoken directly to the individuals concerned, have a high degree of confidence in the facts and believe that these cases are representative of many more. The first case is of a gentleman who does not want to be named. I will call him Stuart, but I do have his full details.

[Andy Burnham]

The hon. Gentleman is absolutely correct. There is a stigma related to HIV and hepatitis. People do not want to talk about it openly. Although I have drawn a parallel with Hillsborough—the hon. Gentleman was outstanding in his support for me on that issue—there are many differences, and one major difference is that, with Hillsborough, the event happened on one day, and everybody was watching it and can remember where they were when the pictures came through. This scandal was a silent one, which affected people in all parts of the country and all walks of life—not people from a similar place. These people were spread about and unable to organise in the same way the Hillsborough campaigners were. That is another reason why they have not been able to move things forward, and the reason the hon. Gentleman gave is true, too.

When Stuart was six years old, he was sent by Maidstone hospital to the Lewisham and Oxford haemophilia centres to have tests to see whether he had haemophilia. When he was seven, they wrote back and said that all the tests were normal and that he did not have a bleeding problem. When he was eight, he attended Maidstone hospital with a swollen knee—nothing more. It was not life threatening, and he had no bleeding problem associated with it.

Then, with no warning to Stuart or his parents, Maidstone hospital treated him with 12 transfusions of contaminated blood products over three days. According to his medical records later, that should not have happened. Then, in 1986, the hospital, unbeknownst to Stuart, carried out an HIV and a hepatitis B test on him. He was never tested for hepatitis C, even though his records show that a test was available at the time. He was not tested in 1989 or called back as other tests became available. He has all his medical records, but one thing is missing: the batch numbers for the contaminated blood products.

Stuart was eventually told he had a hepatitis C infection in—listen to this, Madam Deputy Speaker—January 2013. He was also told that it was too late for him to pursue a court case, despite the fact that legal experts said that what had happened to him was negligent and he firmly believes there has been a cover-up.

Let me move on to the case of a woman called Nicola Enstone-Jones. She wrote:

“As a female with haemophilia diagnosed in the ‘70s. From the age of 9 my parents spent years trying to find out what happened to me after receiving Factor VIII, this was in 1980…Dr’s denying anything was wrong with me, referring to me as having psychological problems, as there was nothing wrong with the treatment they gave.”

She says that that was not unusual for haemophiliacs growing up then. She goes on:

“It was when I was 24”—

24!—

“in 1995 that I asked a nurse if I’d ever been tested for Hepatitis C, as my mum had seen on the news about Haemophiliacs being diagnosed and dying from this new strain of Hepatitis, and all the signs and symptoms listed was me.

The nurse laughed at me and said ‘you won’t have that’; then came back with my medical notes and informed me I was positive to Hepatitis C from a test…done in 1991. A test I knew nothing about... like a true haemophiliac and after spending years of searching for answers I had suddenly found out why I had suffered health problems since childhood.”

However, it was only later, when Nicola was able to access her medical notes, that she found an entry for 1990, which she has drawn to my attention, and I have it in my hand. The notes say: “Discussed hepatitis C”. Nicola has told me directly that that never happened—it was never discussed with her in 1990. She found out for the first time in 1995.

This story actually gets quite a lot worse. Let me read out what Nicola goes on to say:

“Little did I know almost 19 years later I would be at a police station reporting what I”

believe

“to be a criminal act and a form of abuse on my own child, once again…Dr’s performing tests”

without consent,

“another well-known”

practice

“which Haemophiliacs are sadly used to.

I had found out in 2013 that my 9 year old haemophilic son had been tested for HIV and hepatitis’s and no doubt a whole host of other viruses and pathogens, just like I had been when I was younger. Given my daughter has a bleeding disorder too, there is no doubt in my mind she will have been tested...I found this out third hand, by chance in a letter which was another professional”

asking

“if my son needed treatment abroad. The letter stated ‘This 9 year old haemophilic has a factor VIII level of 10% and…has been tested for HIV and hepatitis…which he is negative to.’”

She had never been told about this or given consent for her son to be tested. She says:

“Surely this isn’t right, in this day and age”.

In my view, it is a criminal act to test a child without a parent’s knowledge.

Let me come on to the third case, which, in my view, is the most troubling of them all. It relates to a gentleman called Kenneth David Bullock—Ken Bullock. Ken was a very high-ranking civil engineer who worked around the world. In his later career, he spent time advising what was then called the Overseas Development Agency. He was a haemophiliac. Sadly, Ken died in 1998—a very traumatic death, unfortunately. Let me read from the letter that his widow, Hazel Bullock, sent to me a few weeks ago:

“I am so relieved to hear you are still committed to an active”

inquiry into

“the contaminated blood tragedy…Between the 15th November, 1983 and the 3rd December, 1983, my husband stopped being a Haemophiliac patient who had been infected with NonA-NonB type Hepatitis to being a clinical alcoholic…This accusation continued and escalated during the next fifteen years completely unknown to him, he was refused a liver transplant in 1998 and left to die still unaware of these appalling accusations. He did not drink alcohol.”

Mrs Bullock has examined her late husband’s medical notes in detail. Again, I have them here in my possession today. An entry in his notes from February 1983 says, “Acute Hepatitis”. Another from March says:

“NonA NonB Hepatitis which he probably obtained from Cryo-precipitate”—

the recognised treatment at the time. Again in 1983, the notes say:

“In view of his exposure to blood products a diagnosis of NonA NonB was made.”

However, it would seem at that point that all mention of blood products was to be stopped, very suddenly. Mrs Bullock says:

“They were never again to be found anywhere in my husband’s notes. From the 15th December, 1983 all the hospital records refer only to alcoholic damage to the liver. I have in my possession full copies of all the following notes.”

In December 1983, the notes say, “alcohol could be considered”; in 1994,

“likes a few beers at week-ends”;

in 1995, “alcohol related hepatic dysfunction”; in 1995 again, “clinical alcoholism”; and in 1996, “chronic high alcohol consumption.” In 1998, the year that Mr Bullock died, they say, “alcoholic cirrhosis.”

Mrs Bullock concludes her letter:

“My husband died on the 3rd October, 1998. At no time during this 15 years should alcohol have been mentioned. My husband’s rare and occasional glass of wine was minimal. He never drank beer or spirits. Alcohol was never a part of our lives and he had his last glass of wine on 18th June 1995, my 60th birthday. My husband died completely unaware of these accusations that have shocked family, friends and colleagues alike.”

Just as the evidence of amended police statements provided the thread that we eventually pulled to unravel the Hillsborough cover-up, so I believe the evidence that I have just provided must now become the trigger for a wider inquiry into establishing the truth about contaminated blood. There is a very disturbing echo of Hillsborough—is there not?—in what I have just said. People who were the victims of negligence by the state were suddenly the victims of smears perpetrated by those working on behalf of public bodies, particularly smears related to alcohol, suggesting that the disease that afflicted Mr Bullock’s liver was self-inflicted. That reminds me, of course, of the front-page newspaper stories that appeared straight after Hillsborough that alleged that Liverpool fans were drunk. It is a time-honoured tactic—is it not?—to deflect the blame from where it should be over to somewhere else.

It is of course possible that in each of the cases that I have mentioned the hospitals and clinicians concerned were acting on an individual basis to prevent their negligent practices from being known. I have to say, however, that I doubt that that was the case. My suspicion, as I said a moment ago to my hon. Friend the Member for Kingston upon Hull North, is that there are documents held at a national level, either by the Government or by regulatory or professional bodies, that point to a more systematic effort to suppress the truth.

I actually have two documents in my possession—this will save the Minister and the Government time if they want to suggest that there are no such documents—and I want to put them on the official record. The first is a letter sent in January 1975 by Stanford University’s medical centre to the Blood Products Laboratory, which was the UK Government’s wholly owned blood products operation. The letter goes to great lengths warning about the risk of the new factor VIII products that were coming on to the market. The gentleman who wrote it, Mr Allen, said of one particular product that the

“source of blood is 100 percent from Skid-Row derelicts”.

He was writing to warn the British Government about the blood products that were being used.

The second document is from the Oxford Haemophilia Centre and it was sent in January 1982 to all haemophilia centre directors in England. It says of the new products coming on to the market:

“Although initial production batches may have been tested for infectivity by injecting them into chimpanzees it is unlikely that the manufacturers will be able to guarantee this form of quality control for all future batches. It is therefore very important to find out by studies in human beings to what extent the infectivity of the various concentrates has been reduced. The most clear cut way of doing this is by administering those concentrates to patients requiring treatment who have not been previously exposed to large pool concentrates.”

In other words, it is saying: let us find out whether there is “infectivity”—to use its word—in the products by using patients as guinea pigs, without regard for the consequences. That is proof, in my view, of negligence of a very serious kind.

That brings me to the point that my hon. Friend the Member for Kingston upon Hull North raised earlier. When we read the warning from the Americans in 1975 about blood products being derived from blood that had been taken off convicts on skid row and the letter some seven years later in which the Oxford Haemophilia Centre stated that it was necessary to push on with trials—to find out whether the products were infectious by giving them to patients—we soon start to see that there was something here that needed to be hidden.

In addition, we must consider the fact that all the papers belonging to a Health Minister were, as I understand it, comprehensively destroyed under something called the 10-year rule. I have been a Minister, and I have never heard of the 10-year rule. Have you, Madam Deputy Speaker? It is a new one on me. A Minister’s papers were destroyed without his consent. To me, that sounds alarm bells and suggests that something is seriously amiss.

[Diana Johnson]

Was my right hon. Friend shocked, as I was, to learn that in November 1983, the then Health Secretary told Parliament:

“There is no conclusive evidence that acquired immune deficiency syndrome (AIDS) is transmitted by blood products”?—[Official Report, 14 November 1983; Vol. 48, c. 328W.]

Only months earlier, however, the Department had been preparing a document that stated that AIDS was almost certainly transmitted in such a way, and the Advisory Committee on Dangerous Pathogens had also told of strong circumstantial evidence that the disease was blood-borne. It seems as though there were real issues about what people and Parliament were being told. Ministers must never mislead Parliament, yet clearly the information that was being given to Parliament at the time was not correct.

--- Later in debate ---

[Nicola Blackwood]

That is why I was speaking about Penrose. The final report from the inquiry was published as recently as March 2015 and includes an appendix that lists witnesses and many of the most significant statements and reports that the inquiry considered. Although the Department of Health was not called to provide witnesses to the Penrose inquiry, it co-operated fully with Lord Penrose’s requests for documentary evidence, and the departmental evidence that Lord Penrose used is referenced in his final report. Lord Penrose published the report of his public inquiry into infections acquired in Scotland on 25 March 2015. Nothing was withheld. Any redacted documents provided to the inquiry were redacted in line with both standard practice to protect personal information and current freedom of information requirements.

[Diana Johnson]

I really do not think it is acceptable to rely on Penrose. The inquiry could not compel witnesses to give evidence if they were outside Scotland, because of the jurisdictional issues, so it seems that there was not a complete picture in Penrose either, despite the picture of full disclosure that the Minister is trying to paint.

[Nicola Blackwood]

Of course, that was only part of the picture, because further documents have been disclosed. The Department has published all relevant information that it holds on blood safety, in line with the Freedom of Information Act 2000. All papers that are available for the period between 1970 and 1985, amounting to more than 5,500 documents, have been published on the Department of Health website, as the Prime Minister said in her letter to the right hon. Gentleman. In addition, more than 200 files of documents covering the period between 1986 and 1995 are available to the public through the National Archives. Of course, papers from more than 30 years ago are already a matter of public record.

We are also aware of six documents among those published on the Department’s website that are currently being withheld under the Freedom of Information Act, either on the grounds that they contain only personal information and nothing relevant to the issue of blood safety, or on the grounds that they hold legally privileged material that still has the potential for future litigation. A further 206 files containing documents covering the period between 1986 and 1995 have been published on the National Archives website and are available to the public. We cannot provide a figure for the number of individual documents that have been withheld from those files, but if documents have been withheld, the files will hold an indication of that which will be visible to the public. Files that contain only some information that is unsuitable for publication will have been redacted.

Oral Answers to Questions

Diana Johnson Excerpts

Tuesday 21st March 2017 Commons Chamber

[Nicola Blackwood]

Frist, let me pay tribute to my hon. Friend for his leadership of the APPG on rare diseases. I am sure he will join me in feeling proud that the UK is a recognised leader in research, treatment and care for rare diseases in particular. We are at the forefront of the genomics revolution. He is right that the UK strategy for rare diseases needs to be translated into an implementation plan, and that is one of my personal commitments.

[Diana Johnson (Kingston upon Hull North) (Lab)]

T5. Will the Secretary of State explain why my area of Hull, with its in-built health inequalities and poorer health outcomes, is getting just £13 million out of the additional money for social care set out in the Budget, while the local authority area that the Secretary of State represents in Surrey is getting £21 million-worth of additional support?

[Mr Hunt]

The formula is based on the better care fund formula, which is based on the spending power of local authorities. Let me tell the hon. Lady that, over the next year, that improved better care fund is going up by 35%, and Surrey’s allocation is going up by only 5%.

CQC: NHS Deaths Review

Diana Johnson Excerpts

Tuesday 13th December 2016 Commons Chamber

[Mr Hunt]

I am happy to look personally at the case that my hon. Friend talks about. I think he speaks for all patients and families who have suffered tragedies when he says that the only thing people want is for lessons to be learned. A more challenging issue is that staff sometimes do not feel empowered to speak out in such situations, and they worry about the consequences. A number of trusts have an outstanding learning culture that is really supportive of staff, but that is not the case everywhere. One of the big lessons from today is that we must work out how to spread that positive culture across the NHS.

[Diana Johnson (Kingston upon Hull North) (Lab)]

On 10 December last year, I asked:

“Is the Secretary of State satisfied that families seeking truth and justice for their loved ones are having to rely on pro bono lawyers for advice and representation, and on crowdsourcing to get legal advice?”

He said:

“It should never come down to lawyers.”—[Official Report, 10 December 2015; Vol. 603, c. 1147.]

Sadly, we all know that, on occasion, it will come down to lawyers getting involved. Will any of the recommendations from the CQC cover such eventualities?

[Mr Hunt]

It is a difficult one, because access to lawyers is a matter for the Ministry of Justice. I am not trying to duck the issue, but my responsibility, in what we are trying to do today, is to try to make sure that families do not feel as though they need to go to lawyers, because the NHS is open and transparent enough. With the values of people in the NHS, I think that ought to be achievable. I am happy to look at the case that she raises, and to bring it up with my colleague the Lord Chancellor.

Social Care Funding

Diana Johnson Excerpts

Monday 12th December 2016 Commons Chamber

[David Mowat]

In terms of council tax increases, this is not about the local government settlement that has already been announced. The additional better care fund will start to deliver more money from next April, and will deliver more money after that. During the course of this Parliament, there will be a 5% increase, in real terms, in money spent on adult social care.

[Diana Johnson (Kingston upon Hull North) (Lab)]

I hear what the Minister says about the better care fund, but that obviously applies from next April. How is it fair that this year the area I represent—the 19th most disadvantaged constituency in the country—will be able to raise only half of what an area like Kingston upon Thames can raise? We can raise about £5; it can raise about £10. How can that be fair for social care?

[David Mowat]

This year, 42% of councils are increasing their adult social care funding in real terms. The discrepancy caused by the precept is addressed by the way in which we allocate the additional better care fund component and the formula that is used for that.

Contaminated Blood and Blood Products

Diana Johnson Excerpts

Thursday 24th November 2016 Commons Chamber

[Diana Johnson (Kingston upon Hull North) (Lab)]

I beg to move,

That this House notes the Government’s recent announcement on the reform of the support schemes for people affected by contaminated blood and blood products; recognises that the contaminated blood scandal was one of the biggest treatment disasters in the history of the NHS; believes that those people affected should have a reasonable standard of living and not just be removed from poverty; is concerned that bereaved partners of people who died with HIV/AIDS and those reliant on regular top-up payments will be worse off; is concerned that the new payments for people infected with Hepatitis C are not commensurate with the pain and suffering caused; notes that people who were infected with other viruses, those who did not reach the chronic stage of Hepatitis C and bereaved parents are not mentioned in this announcement; and calls on the Government to use the funds from the sale of Plasma Resources UK to bring forward revised proposals that are properly funded and which provide appropriate support to all affected people.

I thank Members of the Backbench Business Committee, who, since the Committee was established, have always been very generous in recognising the importance of this issue to many of our constituents. This is the third Backbench Business debate that we have had on the subject.

It is more than 45 years since the first people were infected with HIV, hepatitis C and other viruses from NHS-supplied blood products. Their lives, and those of their families, were changed forever by this tragedy. The contaminated blood scandal is now rightly recognised as a grave injustice—the worst treatment disaster in the history of our country’s health service—but those affected are still waiting for a proper financial settlement that recognises the full effect that the scandal has had on them and on their families. This group of people have campaigned for far too many years for justice, at the same time as dealing with illness and disability.

The current financial support for those affected is simply not fit for purpose. That stark fact was laid bare in the inquiry of the all-party group on haemophilia and contaminated blood in January 2015. This quote is on the first page of our report:

“You can’t give us back our health. But you can give us back our dignity. This tortured road has been too long for many of us. But for the rest of us, please let this be the final road to closure.”

Thankfully, we all now agree that the current support arrangements cannot continue, and that we need to create a scheme that gives this community back their dignity.

I welcome the efforts made by the former Prime Minister when he was in office. I welcome the Under-Secretary of State for Health, the hon. Member for Oxford West and Abingdon (Nicola Blackwood), to her new post and I welcome Lord Prior of Brampton to his new position. I was happy to meet him last week, alongside other APPG members, to discuss the new support arrangements.

Although we are all agreed on the need for a reformed scheme, I cannot agree with the Department of Health that its proposed settlement is sufficient. The purpose of this debate is to highlight the aspects of the new support scheme that will not provide the support that these people need, following the hasty announcement made by the former Prime Minister as he left office in July 2016.

In my speech, I want to stress five key issues that the Department of Health urgently needs to address. The first issue concerns the differences between the country schemes in Wales, Scotland and Northern Ireland. We need to know what support people in all four countries of the United Kingdom will get. While Scotland and England have set out their own separate support schemes, in Wales and especially in Northern Ireland people desperately need some certainty about the help they will receive.

[Ms Margaret Ritchie (South Down) (SDLP)]

I thank my hon. Friend for securing this debate along with other right hon. and hon. Members. I have been in touch with the Minister for Health in Northern Ireland and there has been no progress on this matter. I and other hon. Members from Northern Ireland have constituents who have suffered from the ill effects of contaminated blood for over 45 years.

[Diana Johnson]

It is very worrying to hear that there has not been any progress on what is happening in Northern Ireland, so the Minister needs to explain to the House what work is going on.

[Andy Slaughter (Hammersmith) (Lab)]

I congratulate my hon. Friend on being one of the leaders of this campaign. It is clear that the Scottish scheme is more generous than the one in England. Does she agree that at the very least the Government should ensure parity, and in particular that nobody should be worse off under the new scheme than they were under the old scheme?

[Diana Johnson]

My hon. Friend makes that point very well. Later I will compare and contrast the Scottish scheme, which is more generous.

[Chris Stephens (Glasgow South West) (SNP)]

The difference between the two schemes is important because hon. Members representing constituencies across the UK may have one constituent getting compensation under the English scheme and another getting compensation under the Scottish scheme, involving, as is currently the case, different amounts of money and different levels of compensation.

[Diana Johnson]

Yes; the hon. Gentleman makes a very important point. One of the unintended consequences of devolution is that we are ending up with such a mishmash of schemes, and that is of concern for the people affected.

[Nadhim Zahawi (Stratford-on-Avon) (Con)]

One of my constituents, Mr M, makes exactly that point: it is unfair that the Scottish settlement is so different from the settlement for him in Stratford-on-Avon. Most importantly, one of my constituents, who is in the Public Gallery, wants to remind the House that there are fewer than 300 primary beneficiaries left, and it is vital that they are not forgotten.

[Diana Johnson]

Absolutely. That is a very important point. I will come on to the primary beneficiaries in a while, but I will now make some progress.

My first concern was about the different schemes that are available. The second issue, which is also important, is that we know the five existing trusts will be amalgamated into a single body to administer the scheme at some point in 2017. I am deeply troubled by the fact that the administration of the new body looks likely to be done by a profit-making private company. I know that Atos and Capita have attended meetings with Department of Health officials about the new contract. Formal tender submissions will be due soon, with a decision on the contractor set to be made in 2017. No Health Minister has had the courtesy to tell the all-party group of these plans, nor were the beneficiaries asked for their views about this in the survey done in January. Even the Department’s response to the survey, which was published in July, made absolutely no mention of such a prospect. Alongside hon. Members on both sides of the House, I cannot support proposals to contract out provision to Atos or Capita.

Let me remind the House how many in this community were infected in the first place. Many contracted HIV and hepatitis C from American blood products supplied by profit-making private companies. The United States, unlike the UK, has always allowed the commercial purchase of blood products, and those products were often donated by people who desperately needed money and were willing to be less than honest about their chances of infection. This is the reason why so many in the affected community harbour such distrust of private companies.

[Ian Austin (Dudley North) (Lab)]

I want to place on the record that I have been contacted by constituents in Dudley who have told me how grateful they are to my hon. Friend for the lead she has given and for the campaigning she has done on this issue. One constituent has written to me about allegations of impropriety in relation to doctors being encouraged by pharmaceutical companies to use plasma concentrates instead of cryoprecipitate in blood transfusions. Does she agree with my constituents that that should be investigated?

[Diana Johnson]

I am very happy to agree with my hon. Friend. That should certainly be investigated.

I return to people’s concerns about the use of private companies. We know that, over the past six years, there has been a huge sense of mistrust of the disability assessment regime operated by Atos before it walked away from its contract with the Department for Work and Pensions. If there is one thing that could fatally undermine progress towards a better support scheme, it is the plan that the new scheme be administered by a private company. I strongly urge the Government to look again at that plan and show empathy for the people affected.

[Catherine West (Hornsey and Wood Green) (Lab)]

I congratulate my hon. Friend on her dogged and tireless work on this issue. Does she agree that there is a big issue of trust here, in relation not just to the potential new providers but to what happened previously? Some survivors and families who survive victims who have passed away believe that senior health professionals knew about the contamination but decided to continue with their interventions for cost reasons.

[Diana Johnson]

Yes. One point I will come to later is the need for some form of inquiry.

To continue my point about why who runs the scheme is so important, a big criticism of the new scheme is the continuation of discretionary payments. Department of Health officials are still not listening to the concerns raised about that. The APPG inquiry uncovered huge issues with the highly conditional and poorly managed discretionary support scheme. One respondent told us:

“The whole system seems designed to make you feel like a beggar”.

I also believe that the trust’s current administrators have not fought hard enough for their beneficiaries, which legally they could have done. Instead, they saw their role as dispassionate managers and conduits to the Department of Health. They left the affected community alone to fight for themselves. If the new support scheme ends up being managed by Atos or Capita it will do nothing to address those fundamental issues, and could even make the situation much worse, adding insult to injury. I call on the Minister to do the right thing and announce that she will scrap plans for a private profit-making scheme administrator, and will replace the current scheme with a more beneficiary run and focused organisation that has no profit motive.

Will the Minister set out exactly what kind of discretionary support the new scheme will provide? It remains unclear whether any or all of the current support will continue. That contrasts starkly with the Scottish scheme, where the financial review group agreed that no one should receive less financial support under the new scheme. Will the Government urgently provide the same guarantee and publish full details of any obligations that the new scheme administrators will be subject to?

There are also issues with the current welfare benefits reassessment regime that many people are having to go through—for example, moving from disability living allowance on to the personal independence payment. Those issues need to be addressed urgently, so that individuals can be passported straightaway on to new benefits. I hope the Minister will agree that that is a sensible way forward for the people affected.

My third concern relates to the families of those affected, who need better support under the scheme. Under the new English proposals, widows and widowers will continue to be eligible for discretionary support—whatever that means; I have raised my concerns about that already—on top of a new £10,000 lump sum, provided their loved ones died at least partially as a result of contracting HIV or hepatitis C. However, many clinicians have already told me that that could mean many people are excluded from assistance simply because their partner’s death certificate does not include mention of HIV or hepatitis C, sometimes at the family’s request. The new proposals could also still be considerably less generous than the support that some widows already receive, because there is a huge question mark hanging over what discretionary help they will get under the reformed scheme.

[Tim Farron (Westmorland and Lonsdale) (LD)]

I am grateful to the hon. Lady for leading this debate. Many people around the country are hugely grateful to her, me included. Two of my constituents—Mike Dorricott and Neil Howson—sadly passed away as a consequence of contaminated blood and the diseases that they contracted. Their loved ones have exactly the concern that the hon. Lady indicated: that the dependence on potential discretionary payments is insufficient. The fact that the one-off payment is not backed up by the generosity, regularity and dependability of an annual payment means that such people often have to give up work, lose the ability to have a pension of their own and find themselves in immense hardship.

[Diana Johnson]

That leads me to my next point, which is on the Scottish proposals. As we have heard, they offer a better settlement, particularly for the bereaved, who are guaranteed 75% of their partner’s previous entitlement in addition to continued access to the Scottish discretionary scheme. That gives them much-needed security in a way that the proposed English scheme does not. I ask the Minister to look again at adopting the Scottish model and at providing more guarantees on non-discretionary support for widows and widowers.

My fourth point is about support for primary beneficiaries, which was raised in an intervention. The APPG asks the Government to look again at some groups of primary beneficiaries who need better support than is proposed under the English scheme. I received an email this morning from someone who contracted hepatitis B through contaminated blood products. Under the scheme, they are not eligible for any help, but they have obviously suffered and are suffering still. I hope that the Minister is willing to look at a very small group of people who are not covered.

The APPG believes that if more assistance were provided in the form of non-discretionary, ongoing payments, it would reduce the need for discretionary support and allay a great deal of our constituents’ worries. I urge the Department of Health to consider the contrast with the support announced in the Scottish scheme and whether more non-discretionary, ongoing payments could be made.

[Rebecca Pow (Taunton Deane) (Con)]

I applaud the hon. Lady for bringing the debate to the House. Although I recognise that the new payments scheme is an improvement, I want to speak up for one of my constituents, who does not want to be named. He is among the 256 out of the 1,250 haemophiliacs who were infected with multiple viruses—those who were co-infected. Their lives have been devastated—absolutely blighted—and they feel that they are not being fairly treated under the new arrangement. Will she expand on whether we can help those people a little bit more?

[Diana Johnson]

I will come on to the ways in which I think the funding that the Government have put together could be used more effectively to assist more people who have been affected by receiving contaminated blood, including the hon. Lady’s constituent.

I will talk a little about the overall funding of the new scheme. There is much that the Government could do to improve the scheme without any additional cost to the public purse. Even if the Scottish proposals, particularly those for widows and primary beneficiaries, were adopted in England, they would fall within the budget that has been allocated for every year save 2016-17. That is set out in an analysis conducted by the Haemophilia Society, which was presented to the Department of Health at last week’s meeting. I hope officials will consider that carefully.

Any need for additional funding could easily be met from two identifiable sources. I think the £230 million from the sale of our 80% stake in Plasma Resources UK should be made available, as should any reserves left in the accounts of the three discretionary charities when they are closed in 2017. Further, I ask the Minister to promise that any money that is not spent on beneficiaries in each year will be rolled over to support beneficiaries in the next year. At last week’s meeting at the Department of Health, it appeared from what officials told us that any unspent money would have to be given back to the Treasury. That would be a gross act of betrayal towards those affected.

In conclusion, unless the Department of Health accepts that its new scheme still has substantial issues that need to be addressed, the new support scheme will not command the full confidence of the people it needs to satisfy. Indeed, in some crucial respects it will be worse than the system it replaces.

The APPG still believes that people should have the option of a lump sum payment as part of any new scheme, to give them the opportunity to decide for themselves what is best for them—either a regular payment or a one-off lump sum payment.

[Andy Slaughter]

My hon. Friend is making an excellent speech. Why cannot lump sum payments be an alternative to regular payments? Why must the Government be grudging on these matters? This and previous Governments owe these people a huge debt of obligation. This should be a properly funded scheme and we should have a proper investigation to get to the truth of this terrible scandal, which is a stain on our country.

[Diana Johnson]

My hon. Friend puts the point very well. The APPG and the right hon. Member for North East Bedfordshire (Alistair Burt) have spoken to people about what they want from the revised scheme, and they have said they want the option of a lump sum payment, if that would be better for them than regular payments. It is important that we give people the ability to make those decisions for themselves.

As my hon. Friend the Member for Hammersmith (Andy Slaughter) just alluded to, the APPG still believes that we need a Hillsborough-style panel inquiry to allow people to tell their stories and to say what happened to them and how it affected them.

[Mr George Howarth (Knowsley) (Lab)]

Will my hon. Friend give way?

[Diana Johnson]

I am happy to give way to my right hon. Friend, who has great knowledge on this point.

[Mr Howarth]

I am grateful to my hon. Friend, who is making a very powerful case, as she always does, and I congratulate her on the way she is doing it. She is right about the potential of a Hillsborough-style inquiry—I note that the Prime Minister is a great fan of that process, and has said so previously—but we need to take care that such an inquiry does not put all the important and urgent issues she has raised into the shade while the process takes place. The two things need to be separate.

[Diana Johnson]

I agree with my right hon. Friend, who makes his point very well. We need to make sure that any new support scheme moves quickly. We need to get on with this. The previous Prime Minister, when he apologised on behalf of the nation 18 months ago, also allocated £25 million, but none of that has been spent yet, as I understand it. We need to make sure that a scheme is introduced as quickly as possible, although obviously with our concerns having being addressed. But absolutely the two things can run in parallel, and a Hillsborough-style panel inquiry would give people the opportunity of a truth and reconciliation inquiry. I still think it a key requirement if there is to be any real sense of justice and closure.

[Catherine West]

Families who have suffered a loss following this terrible scandal have expressed a desire to get hold of certain documents and to find out what happened and who knew what. They really just want a sense of justice.

[Diana Johnson]

I will now conclude. I know that in later speeches hon. Members will want to raise the deeply moving stories of their constituents. It is those stories that have led me to campaign on this issue over many years, and I am always mindful of the struggles faced by my constituent Glen Wilkinson. Glen was diagnosed with hepatitis C after a routine tooth operation in the 1980s, when he was just 19. He has had to live with the virus all his life and is still waiting for proper recognition of how it has affected him. I hope that the Minister and the Government will now work to ensure that Glen and others can live the rest of their lives in dignity.

[Several hon. Members rose—]

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Nicola Blackwood)]

I congratulate the hon. Member for Kingston upon Hull North (Diana Johnson) and all the members of the all-party parliamentary group on haemophilia and contaminated blood on helping to secure this debate, and I thank the Backbench Business Committee for providing time for it. It has been a highly informed, very personal and moving debate, but it has also been non-partisan. I thank all Members from across the House for the constructive way in which they have approached the debate.

I would like to begin by formally adding my personal apology to all those who have been affected by these tragic circumstances and the impact that this has had on so many families. I thank all colleagues’ constituents for their bravery in allowing their personal circumstances to be shared in the House today. It brings this debate to exactly where it should be, reminding us all what we are trying to achieve through the process. The importance of that cannot be overstated. I wish I could refer to all the constituents who were mentioned today. I listed them, but that would take most of the debating time that we have today, so I say thank you to all those who allowed their stories to be told. That is exactly why the Government are introducing the reforms we have been debating today to existing support schemes, alongside a commitment within this spending review period of up to £125 million until 2020-21 for those affected, which will more than double the annual spend over the next five years.

At the beginning, however, we should be up front in recognising that nothing can make up for the suffering and loss these families have experienced, and no financial support can change what has happened to them. However, I hope all of those here today will recognise that the support provided is significantly more than any previous Administration have provided, and recognise how seriously the Government take this issue. I would like to join colleagues in paying tribute to the previous Prime Minister and to my predecessor, my hon. Friend the Member for Battersea (Jane Ellison), for all their work on the issue. I reiterate their statement that the aim of this support scheme is that no one will be worse off.

It is, as many colleagues have said, time for our reforms to bring an end to the tortured road that far too many of those affected have been down. It is time for a more comprehensive and accessible scheme that gives those affected their dignity back. However, as I hope is clear from the debate, not all the details are yet resolved. I hope to answer as many questions as I can today, but I am certain that the noble Lord Prior will be listening closely to the debate, and he will be in contact with all those here today to make sure we can resolve details that I cannot get to in the time available.

Let me turn to where we are. The reforms guarantee that all those who are chronically affected will, for the first time, receive a regular annual payment in recognition of what has happened to them. That includes all the 2,400 individuals with hepatitis C stage 1, who previously received no ongoing payment, but who will now expect to receive £3,500 a year.

Increases to existing annual payments have also been announced. These are not designed in themselves to guarantee a reasonable standard of living. The package needs to be considered in the context of the whole range of support that is available for the patient group, including support being exempt for the purposes of tax, and benefits being claimed by beneficiaries of the schemes, as the hon. Member for Glasgow South West (Chris Stephens) rightly mentioned.

I would like to address a couple of the issues raised by the hon. Member for Kingston upon Hull North about finances. We do expect to spend all the budget allocated to the scheme in the year, but the budget for the scheme does come within the Department of Health’s budget, not the Treasury budget, so if there is an underspend in any one year, the money will remain in the Department of Health. If any payments that should be made within that year fall into the next year, we can take that money forward.

I would also like to address the concerns that have been raised about the tendering for the scheme. The shadow Minister is, I am afraid, not quite correct that Capita and Atos have already bid to administer the scheme. The invitation to tender has not yet been issued, so no initial bids have been received so far. We intend to issue the invitation to tender shortly, and I am absolutely sure that, as the tender is being designed, the concerns that have been raised in the debate will be heard, and that the concerns about trust and the history of this situation will be well understood by all those involved in the design.

[Diana Johnson]

I am grateful to the Minister for clarifying the position around the tender, but could she confirm that the only organisations or businesses that have been invited in for conversations with the Department of Health were the two that have been mentioned by a number of hon. Members today? Is that correct or not?

[Nicola Blackwood]

I have had no meetings on this issue, because it is obviously not within my departmental brief. I am happy to try to find out about that issue, if the hon. Lady would like.

--- Later in debate ---

[Diana Johnson]

I will try to be brief. I thank, and am grateful to, hon. Members from across the Chamber for their excellent contributions. I spoke for quite a long time at the beginning, but I missed out some very important points, including the fact that the new scheme will be in place only until the end of the spending review in 2021, and that is of concern to many people. I was also remiss not to welcome my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson) to her new role. She is a good friend and this is the first time that I have been in a debate with her as the shadow Minister for public health.

I know that the issue under discussion is not part of the Minister’s policy area, but I was pleased that she offered some reassurance on particular areas, including that any budget underspend by the trusts and charities in the new scheme will stay in the Department of Health budget and not go to the Treasury. I hope that it will be used to help beneficiaries. Her comments about death certificates were also welcome.

I am still very worried, however, about the tendering process that the Government seem to be set on pursuing to decide the scheme’s new administrator. It would be absolutely wrong if the they chose a private sector provider to do that.

I welcome the stage 1 hepatitis C payments.

[Sir Peter Bottomley]

Does the hon. Lady agree that, whoever administers the scheme, if there are anomalies or cases that come outside the rules, they should be free to tell the Government that they should change them?

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

May I interrupt? The winding-up speech is meant to be very brief. I do not mind, but there is a big debate to follow with a lot of speakers, and we are eating into that time.

[Diana Johnson]

I will be very quick. The ongoing payment of £3,500 for people with stage 1 hepatitis C is not a large amount of money for those affected. Under the Scottish model, a £30,000 lump sum payment is made if people have already received the £20,000 lump sum payment. Over the spending period, therefore, I am not sure that the Government can really say that the help that they are providing to people affected with stage 1 hepatitis C is greater than that provided to those in Scotland.

Question put and agreed to.

Resolved,

That this House notes the Government’s recent announcement on the reform of the support schemes for people affected by contaminated blood and blood products; recognises that the contaminated blood scandal was one of the biggest treatment disasters in the history of the NHS; believes that those people affected should have a reasonable standard of living and not just be removed from poverty; is concerned that bereaved partners of people who died with HIV/AIDS and those reliant on regular top-up payments will be worse off; is concerned that the new payments for people infected with Hepatitis C are not commensurate with the pain and suffering caused; notes that people who were infected with other viruses, those who did not reach the chronic stage of Hepatitis C and bereaved parents are not mentioned in this announcement; and calls on the Government to use the funds from the sale of Plasma Resources UK to bring forward revised proposals that are properly funded and which provide appropriate support to all affected people.

Social Care

Diana Johnson Excerpts

Wednesday 16th November 2016 Commons Chamber

[Barbara Keeley]

That is what we are debating. Of course the NHS should put its own house in order, too, but delays should not happen on account of social care. People should not be stuck for weeks or months in hospital, waiting for a care home placement or a nursing home placement. I shall go on to say why.

Returning to the issue of the backloading of funding, in view of what was happening to social care, the Local Government Association and the Association of Directors of Adult Social Services appealed before the last autumn statement for £700 million of the promised better care funding to be moved forward to this year and next year. That appeal was ignored. Reacting to that, Ray James of ADASS said:

“Ministers must know that their proposals do not deliver sufficient funding to meet the growing number of older and disabled people requiring increasingly complex care and support…The Council Tax precept will raise least money in areas of greatest need which risks heightening inequality. Councils in deprived areas will have greatest social care needs, yet they will raise less than a third of what more affluent areas do through this approach.”

He went on by clarifying that ADASS does

“not believe that the funding for the next couple of years will anywhere near meet the costs of the national living wage and the increasing demand for social care.”

[Diana Johnson (Kingston upon Hull North) (Lab)]

In my Hull constituency, not only have we seen massive cuts to the local government budget since 2010, but the precept that we can raise—2%—is much smaller than the gap in the budget for social care. By comparison, wealthier areas of Yorkshire such as East Riding are able to raise far more, so this is a double whammy for deprived areas.