EU Nationals in the UK

Debate between Kate Green and Andy Burnham

Wednesday 6th July 2016 Commons Chamber

[Andy Burnham]

My hon. Friend puts her point very well.

If it were only Labour Members saying this, the public might think it is partisan or point-scoring—but it is not, is it? We have just heard from somebody as senior as the hon. Member for Uxbridge and South Ruislip (Boris Johnson). Yesterday, the hon. Member for Reigate (Crispin Blunt) said that the failure to carry out any contingency planning in the event of Brexit amounted to “gross negligence” and a “dereliction of duty” on the part of the Prime Minister. He went on to say that there was not a majority in the Conservative party in support of the Home Secretary’s current position. We saw that for ourselves during the urgent question earlier this week. If there was ever a day for Parliament to do the right thing, surely it is today. I hope that Conservative Members will put their conscience and their constituents first and do the right thing.

[Kate Green (Stretford and Urmston) (Lab)]

Although the Government may be woefully unprepared for the consequences of the referendum outcome, my right hon. Friend will be interested to hear that a number of non-governmental organisations and charities, including Citizens Advice and groups that support Roma families, are already putting plans in place to support worried EU residents. Will my right hon. Friend join me in encouraging the Minister to meet these charities as quickly as possible so that, at the very least, he can have meaningful discussions about the need for security and certainty for the people they represent?

[Andy Burnham]

In the absence of the Home Secretary, somebody needs to provide some leadership, don’t they? Somebody needs to meet the community groups that are worried about the current situation. I hope that the Minister is listening to what my hon. Friend has just said, because the sheer lack of any direction at the moment is causing real difficulties on the streets of her constituency, mine and others.

NHS

Debate between Kate Green and Andy Burnham

Wednesday 5th February 2014 Commons Chamber

[Andy Burnham]

No, I do not accept that. This has been the worst year in a decade in A and E departments. Almost 1 million people have waited more than four hours to be seen. In my year as Secretary of State for Health, the figure was 350,000. There has been a big increase in the number of people who are waiting a long time. I was going to come on to the average waiting time, but since the hon. Gentleman mentions it, let me make the situation clear now. The figure that he is talking about and which appears in the Government amendment relates to the waiting time until an initial assessment, not the total waiting time in A and E. [Interruption.] The Secretary of State is nodding because, as ever with him, it is all about the spin. That figure does not mean anything to the public. They want to know how long they will spend waiting in A and E in total. We need to have a bit of truth in this debate.

[Kate Green (Stretford and Urmston) (Lab)]

My right hon. Friend was making a point about the wider economic pressures that are leading to greater pressure within A and E. Was he as shocked as I was to read in the Manchester Evening News last year that people in our area are presenting at A and E as a result of malnutrition? Is it not an appalling indictment of the Government that they have allowed that to happen in the 21st century? It is putting huge pressure on A and E departments across the north-west, including those at Wythenshawe hospital and Manchester Royal infirmary.

[Andy Burnham]

That is an indictment of the Government. They have made it harder for people to afford a good basic diet. We have seen a rise in hypothermia, rickets and scurvy. Sadly, we have also seen the rise of food banks under this Government. That is why I am beginning my speech by saying that there is a range of reasons for the sustained pressure on A and E.

--- Later in debate ---

[Kate Green (Stretford and Urmston) (Lab)]

It is a great pleasure to follow the hon. Member for Suffolk Coastal (Dr Coffey) and to speak in this debate.

I have spoken several times about the experience in my area, where in recent months we have been undergoing a major reconfiguration of hospital services, particularly accident and emergency. I have to report that, whatever the metrics or the resourcing may be demonstrating, the patient experience as reported to me, particularly regarding our A and E departments at Manchester Royal infirmary and at Wythenshawe hospital, is that there is a great deal of pressure and strain in the system. People are reporting long waits in very pressured environments, and there is a genuine sense of unhappiness about the atmosphere in which they feel emergency care is being provided because of the stretched services. A whole range of pressures are coinciding. There is rising demand due to some of the social reasons that right hon. and hon. Members have mentioned, including individuals’ behaviour; public health crises; pressures on resourcing in the NHS; and the pressures brought about by reconfiguration itself. It is hard to disentangle which of those different pressures is contributing to so much stress in the system.

I would like to highlight a few key points that I hope the Minister will take on board. There is no doubt that more change is coming in the NHS and we are learning quite a lot in my area as we go along. First, the reconfiguration of accident and emergency services and their downgrading to an urgent care centre at Trafford general hospital has immediately been followed by rising numbers at neighbouring A and E departments. My hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) mentioned the huge rise, in percentage terms, at Salford Royal hospital. That is also the case at Wythenshawe, in particular, as we are discovering on the doorsteps in Wythenshawe and Sale East. My colleague Mike Kane, who I hope will very soon be an hon. Friend in this House, has been talking to hundreds of local people, and we know that Wythenshawe hospital is experiencing very great pressure.

On 10 out of 13 days in January, Manchester Royal infirmary’s A and E department failed to meet the four-hour waiting time target, as did Wythenshawe on 11 out of 13 days, and four Manchester trusts failed to meet the target in quarter 3. It is difficult to disentangle whether that is attributable wholly or in part to the reconfiguration of services. None the less, there are real pressures in our A and E departments in Greater Manchester. Particularly in the immediate aftermath of the reconfiguration at Trafford, there have been reports of long ambulance queues, especially at Wythenshawe. That is not surprising, because the reconfiguration has inevitably created significant numbers of additional ambulance journeys as people are presenting at what is now an urgent care centre but may have to be transferred elsewhere for specialist care. I understand that there have been 100 extra ambulance journeys in the immediate aftermath of the reconfiguration. People are also going to what are, in effect, their own places. I think that is understandable, because, as the hon. Member for Stafford (Jeremy Lefroy)—who is no longer in his place—has said, the picture is confusing.

Local road signs used to say, “A&E”, but now they say, “A&E not 24 hours”, following the reconfiguration at Trafford. To be frank, that is an utterly meaningless piece of information for somebody driving to an A and E department, because it gives them no idea of when during those 24 hours the service will not be open. There is also real confusion about what is or is not available at the urgent care centre and whether it is safe to go there.

Local people tell me that the reason they do not go to Trafford is that they do not believe they are any longer allowed to go there. That was not the clinicians’ planning assumption when the urgent care centre was introduced, but that is what patients believe. As the hon. Member for Stafford said—Sir Bruce Keogh has put his finger on this, too—it is really important that patients are given clarity about what is available, where to go and when. We have to pay much more attention to educating the public about that.

Another difficulty that we discovered very quickly is that the decision tree used by North West ambulance service has resulted in its taking cases to Wythenshawe and to Salford Royal and Manchester Royal infirmary which should, under the original plan, have gone to Trafford urgent care centre. We are learning a lot from what is going on in the aftermath of the reconfiguration. It would be interesting to hear from the Minister how the lessons will be taken on board and distributed.

Pressure is also being created in a wider context. My right hon. Friend the Member for Leigh (Andy Burnham) mentioned in particular the pressure of rising poverty, which is, without question, leading to higher levels of need and people presenting at our hospitals. The number of hospital admittances as a result of malnutrition nearly doubled—it went up from 3,161 to 5,499—between 2008-09 and 2011-12. They did not all present at A and E, but they did all present at a hospital and that is of real concern.

[Andy Burnham]

Was as my hon. Friend as surprised as I was at some of the sneering from Government Members when she intervened on me to point out that the number of malnutrition cases has gone up significantly? All we got from them was sneering abuse, but the facts speak for themselves.

[Kate Green]

When the Manchester Evening News published a report about the shocking rise in malnutrition in our region, people were horrified and commented voluntarily on how disgraceful and shameful it was that, in such a rich economy, we could be in such a situation. There is no doubt that that is partly because of pressure on family incomes.

I want to highlight the position of disabled people in particular, who face extra costs for special diets, aids and adaptations, prescription charges and continence pads. All of those costs have to be met by disability benefits that are of dwindling value. There is also further pressure on the services on which they rely, including day services, respite care, access to mobility aids and care at home, which is under great pressure because of social care budget cuts.

In conclusion, against a backdrop of great pressure—some of it to do with changes to the NHS, some with rising remand and some with wider environmental factors—change and further reconfiguration may be necessary, but it is very difficult to do it. I want to finish by making three points to the Minister about what we are learning from the situation in Trafford, where we are integrating health and social care. First, it is not a quick fix. Secondly, it is not possible to remove services from our hospitals before the care and provision is available in the community—that is of real concern at a time when budgets are pressed. Thirdly, there is a huge piece of work to be done—the Government have not embarked on it—on educating the public and driving up public understanding. The public in my local area are extremely confused about what the NHS is able to provide to them and where they should go to get it. I am sure we are not unique. The situation is undoubtedly creating additional pressure for hospitals and other NHS providers, and I hope the Minister and his colleagues will address it.

Care Bill [Lords]

Debate between Kate Green and Andy Burnham

Monday 16th December 2013 Commons Chamber

[Andy Burnham]

The Secretary of State began by quoting the principles of the NHS. I was always led to believe that one of the principles is that the NHS should respect need—that funds should follow those in greatest need. [Interruption.] The Secretary of State says, “Absolutely.” In constituencies in parts of London, the midlands, the north-west, Yorkshire and the north-east, male life expectancy is 10 years lower than in other parts of the county. There is real need in those communities, but they will be the biggest losers if the change goes ahead. I believe that it is immoral to take money out of those communities to hand it to areas where life expectancy is already longer.

I hope that NHS England is listening to this debate. Quite apart from the morality of whether the change should be made, how is it that a quango can distribute about £80 billion of public money to our constituencies while we seemingly have no locus whatever in such a decision? Should not the Secretary of State be at the Dispatch Box either to defend changes that he makes or to say that such changes will not go ahead, so being accountable to this House? Instead, a quango—the biggest in the world—seems to be about to take money out of some of the most deprived parts of the country.

[Kate Green]

I was very disappointed that the Secretary of State would not give way to me, because he did not once mention the position of disabled people in his opening remarks. Does my right hon. Friend not agree that councils being forced to raise the threshold to “substantial” or “critical” will pile up costs for disabled people and their isolation? They cannot get access to moderate levels of care, go out to work or volunteer in their communities, but are shut at home unable to participate. That is bad for them, and it is a false economy.

[Andy Burnham]

I could not agree more. I would guess that disabled people listening to the debate today will be very worried about what they are hearing. The change will restrict support for them, and it is a false economy. If they cannot go out to work, how on earth does that help them or, indeed, anybody? The change will have an impact on disabled people, with some losing their support.

I was going on to make the point that disabled people and older people are already paying much more for care as a result of changes in recent years. As research by my hon. Friend the Member for Leicester West (Liz Kendall) has shown, they are paying almost £740 more a year for vital home case services compared with 2010, up on average by almost £50 a month. That is a hidden cost of living crisis, because who sees that older people have to pay more out of their bank accounts? It goes unnoticed by the media and large parts of society, but the most vulnerable people in society are bearing the brunt.

Accident and Emergency Waiting Times

Debate between Kate Green and Andy Burnham

Wednesday 5th June 2013 Commons Chamber

[Kate Green (Stretford and Urmston) (Lab)]

rose—

[Andy Burnham]

I will give way one last time to each of my hon. Friends, but then I must finish my speech.

[Andy Burnham]

I think that everyone needs to consider their position in the light of the evidence that is emerging about pressure on A and E, particularly in London. I pay tribute to the excellent and determined campaign run by my hon. Friend, and I noted what was said yesterday by the hon. Member for Enfield North. Perhaps one of the consequences of today’s debate will be agreement across the Floor of the House to delay any closures pending a personal review of the evidence by the Secretary of State.

[Kate Green]

rose—

[Andy Burnham]

I will give way for the last time.

[Kate Green]

As my right hon. Friend will know, my local A and E unit at Trafford general hospital is one of the 30-odd units that are scheduled for downgrading. Meanwhile, it is more than 30 weeks since the two nearest A and E units, at Central and South Manchester hospitals, failed to meet the 95% performance target last September. Does my right hon. Friend agree that the Secretary of State should also publish advice that he has received from the Independent Reconfiguration Panel which will inform his decisions, so that we can determine whether the latest pressures have been taken into account?

[Andy Burnham]

I think that full openness about these decisions is essential in the current context. I know that the panel’s report is with the Secretary of State, and I think he owes it to local Members of Parliament to be open about its conclusions and the evidence on which they were based. That is why I ask him to review every proposed A and E closure personally, and to give a guarantee to communities such as that represented by my hon. Friend that no changes will be made unless he is personally satisfied that it is safe to make them.

In conclusion, this is a crisis that could have been avoided. For the last three years the NHS has been struggling with the toxic medicine of budget cuts and top-down reorganisation. All the focus should have been on the front line, but instead the Government siphoned £3 billion out of it to pay for a back-office reorganisation that no one wanted and no one voted for—a reorganisation that has placed the NHS on a fast track to fragmentation and privatisation.

But it is worse than that. The Government’s own risk registers, which they refused to publish during the passage of the Health and Social Care Act 2012, warned them of the consequences of pushing ahead with a reorganisation when the NHS was facing great financial stress:

“The consequences could be compromised clinical care and patient safety, the failure of the 95% operational standard for A&E wait and a concomitant impact on other trust services”.

So they knew the risks they were taking when they reorganised the NHS at a time of financial stress; they were warned about this A and E crisis, but ploughed on regardless. It is the height of irresponsibility. No wonder they wanted to keep the risk registers secret. But with the looming cuts to jobs and social care, the problems in A and E will get worse, not better, if no action is taken on the points I have outlined today.

We have given the Secretary of State a practical plan, and he either needs to accept it or put one forward of his own. Right now, his complacency is one of the biggest dangers facing the NHS. He has failed to act on warnings about the collapse of social care. He has sat on his hands while front-line jobs are cut in their thousands. He has presided over the disastrous 111 service. He has closed NHS walk-in centres and downgraded A and Es without a convincing clinical case. It is no good his standing up today and blaming everyone else: this is a mess of his making—his first real test as Secretary of State and he has been found badly wanting. People want answers and action, and he needs to start providing them right now.

NHS (Private Sector)

Debate between Kate Green and Andy Burnham

Monday 16th January 2012 Commons Chamber

[Andy Burnham]

I wish I could allay the fears of those people, but when there is a proposal placed at the heart of the NHS for hospitals to devote half their facilities—their beds, their appointments—to private patients, how is it possible to give that guarantee to those patients, particularly when the Government are relaxing the waiting time standards that we did so much to establish in the NHS, with the two-week wait for cancer referrals and 18 weeks for elective operations, and a four-hour wait in A and E? How can we have that confidence when, effectively, the Government are taking those safeguards off the public and giving the green light for a massive expansion of private sector treatment in NHS hospitals?

[Kate Green (Stretford and Urmston) (Lab)]

Does my right hon. Friend have any answer to the question whether private providers with obligations to their shareholders will inevitably face a conflict if risk is offloaded to them when their responsibility to their shareholders is naturally to ensure the best possible financial outcome for them?

[Andy Burnham]

My hon. Friend is absolutely right: this proposal brings that conflict right to the heart of the NHS. At the moment, NHS hospitals have a paramount and overriding duty to the treatment of NHS patients, but considering a health care system whereby services would be delivered through a series of commercial contracts brings that conflict of interest into the health care system—shareholders on the one hand, patients on the other. That is why there is such deep disquiet among health professions about these proposals. It is why those professions applied so much pressure last year, and the pause was ordered. It is why, I am afraid, they are still unhappy today—the Government have not addressed their concerns.

School Sports Funding

Debate between Kate Green and Andy Burnham

Tuesday 30th November 2010 Commons Chamber

[Andy Burnham]

It certainly does. Such stories, much more than statistics, illustrate the success of what has been achieved.

I felt a raw injustice on this issue because I saw that such opportunities were not available in the 1980s, although they are the right of all young people. When I came into politics, I wanted to do something about it. As an adviser to the then Secretary of State for Culture, Media and Sport, Chris Smith, I encouraged him to set up a lottery programme under the New Opportunities Fund called “active sports co-ordinators”. It was the start of the school sports programme. A BBC report in 1999 said:

“The first wave of sports co-ordinators to boost competitive sports in schools will be in place within the next year”.

It is a total myth to say that they have not boosted competitive sport. They have succeeded in that regard.

The coalition says that only one in five pupils play inter-school competitive sport regularly—that is, nine times a year. I have two comments to make. First, that represents a big increase on the proportion many years ago. In itself, it is an impressive figure. However, it is only part of the story. Last year, 49% of children took part in inter-school competition, playing on at least one occasion. There was also a large increase in the number of pupils taking part in intra-school competition: it rose from 69% in the preceding year to 78%.

[Kate Green (Stretford and Urmston) (Lab)]

Does my right hon. Friend agree with Rachel Redmond, partnership development manager of the North Trafford school sport partnership, that such partnerships have not only increased the level of activity in competitive sport, but improved quality through access to high-quality coaching and facilities?