Merton and Sutton PCT (Prescribing Policy)
Nigel Evans Excerpts(11 years, 2 months ago)
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Anna Soubry
I was coming to that in due course.
Apart from making these comments at the Dispatch Box, I cannot advance Mr Aziz’s case, because I do not know his case. I know what the hon. Lady has said, and I know that he has been through, to use these awful words, due process. His application has been considered. Having looked at what the PCT says in its letter, I can see that his case has been through all the sorts of processes that one would expect. I hope and pray that in the course of all that and through the various appeals that he has made, everything has been properly considered by the PCT.
It strikes me, however, that the most obvious thing that should have been done has not been done. Nobody seems to have sat Mr Aziz down—this is not the hon. Lady’s job, because she knows no more than I do—and explained things to him. If there is a good reason, he should be told. If it is about the money, we need to know exactly what the problem is. I suggest that those who may be listening, whether they be in this building or watching on television, should sit down with this man and discuss the way forward for his treatment. They should provide him with an explanation, because he is not just a human being—and it does not matter whether he is a good or a bad man—but one who is extremely ill with a life-threatening disease. Somebody needs to sit down and do a proper job on this, just like the hon. Lady has done in bringing the case to the House.
I despair—we should not have to be here, but we are. The emergence of the clinical commissioning groups will lead, I hope, to a far better system. They will make decisions based on their own knowledge and understanding as clinicians. They will also, in many ways, be far more accountable than primary care trusts have been. Every CCG will have a representative on the upper-tier local authority’s health and wellbeing board. The theory that generated the highly controversial legislation that went through this place is that it would be much better for decisions to be made at a more local and accountable level by those best placed to make them, namely health professionals.
I fear that I have not been able to answer the question asked by the hon. Lady and Mr Aziz, whom I wish well, as we all do. I hope that, as a result of this debate, which the hon. Lady quite rightly called for, people will sit down and not only perhaps have a rethink, but certainly give a human being an explanation, if for no other reason than because, at the end of the day, he pays their wages. On those somewhat positive remarks, I hope that this matter might be concluded to everybody’s advantage.
Mr Deputy Speaker (Mr Nigel Evans)
As we conclude proceedings, may I wish you all a happy St David’s day.
Question put and agreed to.
Accident and Emergency Departments
Nigel Evans Excerpts(11 years, 3 months ago)
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Mr Sharma
I disagree with that. The evidence shows that all these decisions are finance-led. It is not to do with the clinicians’ or consultants’ proposals. That may apply in the hon. Gentleman’s constituency, but I can assure him that it is not true of west London.
My hon. Friend the Member for Ealing North (Stephen Pound) will join us later and the hon. Member for Ealing Central and Acton (Angie Bray) will speak later, too. I thank them for their support for our campaign. I would also like to acknowledge the tremendous efforts of my hon. Friend the Member for Hammersmith (Mr Slaughter), who would be in his place here were it not for his Front-Bench duties in the Justice and Security Public Bill Committee. Back in June, when North West London NHS announced its plan to close four of our A and Es, my hon. Friend organised a public meeting, which gave rise to the Hammersmith “Save our Hospitals” campaign. He has been at the forefront of the community campaign in his own constituency and has been instrumental in organising MPs of all parties to come together for this debate. He asked me to mention particularly the threat to Charing Cross hospital, which will lose not merely its A and E but 500 in-patient beds, turning a world-class hospital into a local urgent care centre.
My hon. Friend would have reminded us that this is the second time he has defended Charing Cross from closure. He stands now with his constituents, as he did in the last century during the dark days of John Major’s Government, holding a candle for Charing Cross at its Sunday evening vigils. That light did not go out, and I am sure it will not be allowed to go out now.
Let me now raise some of my specific concerns—as well as welcoming you to the Chair, Mr Deputy Speaker. I have very grave concerns about the way in which the consultation was carried out in north-west London. It was carried out over the Olympic summer months, with an impenetrable document of 80-plus pages and a response document with leading questions that set community against community, doctor against doctor, and hospital against hospital. There were also significant parts of the consultation period when no translated materials were available for many of my constituents who speak various community languages. That was totally unsatisfactory.
Notwithstanding those difficulties, some people in Ealing were able to complete the consultation and overwhelmingly rejected the preferred option that means the closure of Ealing’s A and E, maternity, paediatric and other acute services, and the closure of Central Middlesex, Hammersmith and Charing Cross A and Es. Moreover, a majority of respondents across the whole of north-west London rejected the fundamental premise of the proposed changes—that acute services should be concentrated on fewer sites. I fear that such an inconvenient consultation response will be ignored and ridden roughshod over.
Equally, I fear that the clinical opinion of Ealing’s GPs and hospital consultants who opposed the preferred option will be ignored, despite this being one of the Government’s four tests for such reconfigurations. The clinical concerns are real and should not be brushed over. Let me address some of the key concerns.
First, the scale of change being proposed in north-west London and the associated risks of such large-scale changes is causing great concern. Taking out in one go four of nine A and Es that serve a population of 2 million—set to grow continually over the next 20 years —is a high-risk strategy. Concerns over A and E capacity are growing, as hospitals up and down the country say that their A and Es are full and that they are putting patients on divert to other hospitals. This has happened recently at Northwick Park hospital—one of the hospitals that Ealing patients are meant to be treated at if the four A and Es close. If these proposals go through, yes, there are plans for some increased investment at both Northwick Park and Hillingdon A and Es, but there are well over 40,000 patients a year using Ealing hospital’s A and E alone, in addition to those currently attending Central Middlesex, Charing Cross and Hammersmith—
Mr Deputy Speaker (Mr Nigel Evans)
Order. I think the hon. Member was told that he had a 10-minute limit imposed on him, as applied in the previous debate. Sadly, however, his time is up. If he wants to make a concluding remark, however, I think the House would allow him to do so.
Mr Sharma
Thank you very much, Mr Deputy Speaker.
Let me finally say to the Minister that there should be a moratorium on all A and E closures until a proper, considered and full review of A and E services has been carried out, as opposed to the current rushed review. I hope that the Minister will listen.
Mr Deputy Speaker (Mr Nigel Evans)
I am extremely grateful to you, Mr Sharma, for your understanding.
From now on, Back-Bench speeches will be limited to eight minutes.
Mr Burrowes
I commend my hon. Friend for his continuous efforts, although perhaps he should take his seat since he has given way.
Mr Burrowes
My hon. Friend has continuously stood up, not just in the House but in his constituency, against the closure of the A and E in Chase Farm and for securing health improvement in Enfield. He has secured a cross-party delegation meeting with the Secretary of State, at which we want an assurance that the £10.6 million being invested in primary care in Enfield ensures we get effective primary care improvements before the reconfiguration.
Mr Virendra Sharma
How disappointed I am that the Minister failed—utterly failed—to address the issue—
Suicide Prevention
Nigel Evans Excerpts(11 years, 3 months ago)
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Mr Deputy Speaker (Mr Nigel Evans)
Order. The debate will finish at 5.55 pm and the two Front Benchers still have their winding-up speeches to make. Will hon. Members therefore be mindful when they are making their contributions so we can get everybody in?
Mark Durkan (Foyle) (SDLP)
Like other hon. Members, I congratulate the hon. Member for South Antrim (Dr McCrea) and his colleagues on giving the House the opportunity to discuss this very important issue, which, as we have heard, touches many people in many ways, and in ways that they find hard to express or represent. For all the reasons that we understand, it is important that we in the House—again, in our own inadequate and inarticulate way—not only try to express our feelings and represent the feelings of those who have lost people through suicide, but try to feel our way towards some sort of policy answer and structural response to a very serious problem that is growing in many ways.
It is not just because the statistics are better collated that we can say that the problem is growing. There are issues, and people can analyse and compare the different statistical bases over the years. It is a problem that has gradually been able to express itself a bit more. Reference has been made to the fact that it has been a taboo subject. The first time that I heard of suicide was when I was in primary school in the late 1960s, and a family friend committed suicide. She was a great friend of my mother—she was great to all my brothers and sisters whenever we were in her fruit and vegetable shop—and I remember that my mother’s distress as a friend was based not only on all the usual questions that arise from suicide and the loss of a lovely friend. It was also based on the fact that her friend was denied a Christian burial and denied the rites of her own Church. That is what taboo meant then. Luckily, Churches have become more enlightened and many people have helped them to become more enlightened. So we can celebrate the fact that spiritual enlightenment can inform Churches in different ways, and their response to something that they class as a sin can change and develop. That has been very positive and has helped all of us as a community in many ways.
I have found the debate hard. I agreed with many of the points, and I also felt many of the points. I have experienced suicide in my family more than once. I also have experience of suicide by people whom I regard as close—good friends, family friends and so on. All the things that all the right hon. and hon. Members have said are so, so true. We are stuck with that—the questions that will never leave, and the answers that will never come. There are people finding and developing answers, however. Maybe they are not answers to the particular suicide that has grieved me or grieves other members of my family and extended family, but answers as to how we may be able to get on top of the problem and as to how we can avert such tragedy and prevent it from afflicting other people as well.
In many cases some of those answers are being driven by the families and the very people who have experienced suicide, and by the professionals who have witnessed that, provided support and said, “There has to be a better way. There has to be more that we can do. There has to be more that we can do together.” The hon. Member for Bridgend (Mrs Moon) referred to the work of the all-party group and the report. I do not speak often at the all-party group, for reasons that people will understand; I find it hard to contain my emotions on these things. One thing struck me as I was listening to people give evidence to the group—people who did not know which area I represented. A few times when people from parts of England were giving evidence about their experience and the things that they were trying to do in their area with their trusts and well-being boards, they referred to what they called the Derry model, which they wanted to see in their area.
That is because in my constituency, in my city of Derry, as other hon. Members have said, we have grave levels of suicide, but there has been a strong community response and the local Western Health and Social Care Trust has tried to engage strongly on it. The trust has a suicide liaison officer, Barry McGail, who does not just work well locally, but is globally active and is part of progressive policy-pushing networks on the subject. When people spoke about the Derry model, part of what they meant was that suicide liaison service.
The service is notified of a suicide by the police within 24 hours and its staff make family contact. They are there at the wakes, able to talk to the family and friends. They are able to bring leaflets and draw attention to other services in a sensitive way, so the issues are immediately picked up and the people who might be most emotionally affected or vulnerable after the suicide—other family members, friends, classmates and so on—can be identified and supported. That has worked well and has helped families through and has helped them feel that they are helping others, which is so important.
More widely in Northern Ireland, we have a self-harm register, another positive development. It is run now by the Public Health Agency and is co-ordinated on a north-south basis. The register provides up-to-date information on people who may have attempted suicide or have self-harmed, so that the right services can be in touch with them or they can at least know that services such as counselling and other opportunities are available for them. Again, that is important in prevention. It is also important to learn the lessons of experiences and making sure that things that are known to one service are not lost to the knowledge and intelligence of another service that may be the right one to provide help.
Some hon. Members have referred to the media in this regard. Of course, the media have particular responsibilities. They need to be very careful and sensitive in how they present any film or TV storylines depicting suicide. If they make suicide simply the natural conclusion to a narrative, that is completely wrong. Unfortunately, too often in the media it seems as though the suicide itself makes the statement, and that is very dangerous. Equally, the media, whether the print media or any other kind, need to be very sensitive in how they cover deaths by suicide. If they treat speculation about clusters—the hon. Member for Bridgend, who is unfortunately no longer here, has experienced this directly in her constituency—in an insensitive, invasive, exploitative and sensational way, that can add to the problems. It can not only add to the suffering and stress of families, but put more families at risk of loss and distress.
Over a dozen years ago—this is not a new problem in Northern Ireland—people like Barry McGail worked on developing guidelines for the local media to use. One of the guidelines in circumstances where a suicide took place was for the media not to treat it in a way that linked it to a single dramatic event. I found myself in a situation where there was a suicide in another family that followed a death in my own family. With the support of education professionals, people like Barry McGail, and other people in the Western health board, I tried to prevail on the media not to treat the young man’s suicide as a “Romeo and Juliet”-type story. It was a struggle to get the media to comply with guidelines that had been drawn up sensitively with their own co-operation, and unfortunately we did not succeed in all instances. The media do have responsibilities in this regard.
Then there is the new media, with the digital age and all the opportunities that are there. In relation to the sites that offer methods and techniques of suicide and appear to be encouraging it, Barry McGail says that although most young people will engage in social media, most of them will want to do so positively. As well as trying to police and shut down all the negative, dark sites, we need to think of more ways of making sure that there are far more positive connections and real pathways of assistance and communication. We need to develop new things such as apps that will be suitable for young people, in particular, who could be at risk.
That is not to say that only young people are at risk of suicide. In my constituency and elsewhere, it affects the old and the young—mothers, fathers, and children. However, one of the things that gives me heart is that people who have been through these dark difficulties, and who are still not out of all that darkness, are desperately trying to remedy the situation through different networks, charities and support groups. In my town, they are supported by people such as those at Foyle Search and Rescue, who do such a good job in helping families who suffer following suicide in the river. When we were building the new iconic peace bridge in Derry, they worked with us to prevail on the architects to understand that it needed to be designed in a particular way with rails shaped so as not to lend themselves readily to suicide attempts.
Foyle Search and Rescue houses and accommodates various groups of families who have come together. We also have groups such as Zest for Life, which work so well to counsel people who are suffering from problems, and HURT (Have Your Tomorrows), which particularly helps people who have been suffering from addiction or dependency and have specific vulnerabilities. These groups are succeeding in helping to reduce and to solve the problems, but they constantly come up against funding difficulties. There is also the issue of making sure that all the policies and services can mesh together.
Finally, another positive feature in Northern Ireland is the ASIST—applied suicide intervention skills training— model, which has been borrowed from Canada and is working well where people engage with it. The big problem, however, is getting GPs to engage with it—they are not—because they are the vital cog and the key people. The issue has come up in the work of the all-party group on suicide and self-harm prevention. As the hon. Member for Bridgend will know, one of the questions that constantly comes up is: how do we get GPs involved in and engaged with this? Their input is vital and they are vital channels, but in their absence, people’s sense of purpose starts to wane and get weaker.
I am not blaming GPs. Obviously, there are a lot of pressures and demands on them, so they need time out of their practice to do this. We need to see what locum support and other things are available to allow them to play their part in the very good efforts that are being made and to make good the investment being provided by the Department of Health, Social Services and Public Safety. Other Members have been right to acknowledge the work of that Department, including that of the current Minister, Edwin Poots, and his permanent secretary, Andrew McCormick. We should also acknowledge the work of the previous devolved Ministers. It is a pity that the ministerial group did not meet for about 18 months, but that does not mean that other good work was not going on. For that work to be done, it needs to be supported, and I hope that today’s debate will help to support and encourage those people who deserve it in their important work on such a huge issue.
Mr Deputy Speaker (Mr Nigel Evans)
To resume his seat no later than 5.35 pm, I call Kevan Jones.
Mr Kevan Jones (North Durham) (Lab)
I congratulate the Democratic Unionist party on securing this debate. It is a privilege to follow a very moving speech by the hon. Member for Foyle (Mark Durkan).
The right hon. Member for Belfast North (Mr Dodds) is right to say that the reasons for suicide are complex. The question that most families usually ask is: why? My constituency has a great organisation called If U Care Share, which was set up by Shirley Smith, whose 19-year-old son, Daniel, hanged himself a few years ago, having not showed any of the signs referred to by the right hon. Gentleman. He was, the family thought, a perfectly happy, contented teenager. The family then wondered what they could do. They set up If U Care Share, and Shirley, her husband, Dean, and their children, Ben and Matthew, go into schools to talk to young people about suicide and people’s feelings. People should not be ashamed to open up and talk about their feelings. They also work with youth clubs and the Football Association to get their message across.
The hon. Member for Pudsey (Stuart Andrew) noted how the highest number of suicides seem to be among men, and the hon. Member for Upper Bann (David Simpson) mentioned the figure of 6,000. I have just looked up the figure and it is about 4,500 who are actually men. As the hon. Member for Pudsey has said, mental health is not an issue that we talk about. I might sound like a broken record, but we need to keep talking about mental health.
Today’s debate is good because, as the hon. Member for Foyle has said, we are talking about one of the great last taboos. The more we talk about mental health and the effect of suicide—not just on the individual and the lost opportunities for them and their family, but on society—the better we can draw up the systems to help.
There is nothing wrong about talking about mental health, or about people admitting that they need help. As the right hon. Member for Belfast North has said, that is the big step that needs to be taken in most cases. We need to get the message across, not only to young people, but to everyone, that if they are in distress they need to ask for help. In my area, the statistics show that an older generation of men in their 30s and 40s are committing suicide. A reason for that might be the issue of the economic role of men in society, which has been mentioned. Unless we talk about it and put it on the national agenda, we will continue to come up against these issues.
I have just one point to make. We need to join up the services, because the roles of the voluntary sector and the NHS are vital. GP commissioning could have great benefits, but it also brings great risks. I fear that when GPs commission services, mental health services might again be seen as the poor relation. We need a joined-up approach if we are to prevent the tragic losses that are now at a level which most people would say is unacceptable.
I will finish by saying—again, I will sound like a broken record—that the more we speak about these issues, the better it is, because it will help young people and others who are in distress to take the major step of getting the help that is there if they only ask for it.
Mr Deputy Speaker (Mr Nigel Evans)
To resume his seat no later than 5.45, I call Mr Jim Shannon.
Dementia
Nigel Evans Excerpts(11 years, 4 months ago)
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Mr Deputy Speaker (Mr Nigel Evans)
After Mr Burstow has finished his contribution, I will announce whether there is to be a time limit, and, if there is, what it is.
Mr Deputy Speaker (Mr Nigel Evans)
Order. We are going to be brave—or foolish—and start without a time limit on Back-Bench speeches, but it would be helpful if Members aimed to speak for 10 to 12 minutes. Anything beyond that would not be helpful.
NHS Funding
Nigel Evans Excerpts(11 years, 5 months ago)
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Grahame M. Morris
Probably not, in the very limited time available, but I can tell my hon. Friend that proton therapy is a form of advanced cancer treatment.
My argument is that the money the Department is proposing to spend on those incredibly expensive machines would be far better spent on advanced radiotherapy machines such as the stereotactic body radiation therapy machines that the hon. Member for Stevenage mentioned. There are other forms of therapy that are far more cost- effective. I might add that we in the northern region have no access to such therapies. Indeed, whole regions of the country do not.
The one remaining proton machine in Germany is at the university of Heidelberg, and it treats a maximum of 1,200 patients each year. The German Radio-oncology Society has said—[Interruption.] I hope that the Minister will listen to this. The society has said that
“for the vast majority of cancers there is no proof that proton therapy is more beneficial than other forms of innovative radiotherapy that are one hundred times less expensive”.
This proton debacle highlights the perversity with which the Government are running the NHS budget, and these questions lie at the very heart of whether we can trust Conservative promises on the NHS.
The Prime Minister tells the public that by April next year every cancer patient who needs innovative radiotherapy will get it, while at the same time the Secretary of State for Health starves dozens of hospitals and cancer networks of vital money needed to buy innovative radiotherapy equipment. We now know that money is being redirected into those two highly dubious projects. The Secretary of State needs to cancel those projects now and redirect the money into radiotherapy machines that will help tens of thousands of people in my constituency and across the country. This has the potential to be a monumental scandal and a waste of public money. I urge hon. Members who share my concern to sign early-day motion 773, to lobby the Health Secretary and ask him to reconsider his spending priorities in relation to cancer therapies, and to support the motion on the Order Paper.
Mr Deputy Speaker (Mr Nigel Evans)
I call Jim Shannon. I am not putting the clock on him, but he must resume his seat by 4.44 pm.
Regional Pay (NHS)
Nigel Evans Excerpts(11 years, 6 months ago)
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Mr Anderson
Clearly, there are issues about foundation trusts, but the Government can do what they want—or they can as long as the Liberal Democrats help them. Tonight, however, the Liberal Democrats have a chance of stopping the Government doing what they want, by doing what their party wants, and what the people they represent want—by throwing out the proposal, and voting on the clear principle that national pay bargaining should happen in the national health service, and nothing should be done to undermine it, including supporting the amendment.
Mr Deputy Speaker (Mr Nigel Evans)
I call Sir Nick Harvey, who should resume his seat no later than 3.40.
Health
Nigel Evans Excerpts(11 years, 9 months ago)
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Mr Deputy Speaker (Mr Nigel Evans)
I thank the Minister. I wish him and those Members not staying for the other debates a happy and productive recess. We now move to a short debate on foreign and commonwealth affairs, after which we will proceed to a debate on the environment, food and rural affairs. Members listed under other topics will then be taken in the general debate. We still have the five-minute limit on speeches.
Adult Social Care
Nigel Evans Excerpts(11 years, 9 months ago)
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Mr Deputy Speaker (Mr Nigel Evans)
Order. To accommodate as many Members as we can, a five-minute limit will be introduced, with the usual overtime for two interventions.
Nic Dakin (Scunthorpe) (Lab)
Adult social care is probably one of the biggest, if not the biggest, challenges that we as politicians and policy makers face. We have heard thoughtful contributions from Members on both sides of the House explaining why it is so difficult. If people are fortunate, they never need to access adult care. If they are unfortunate, they do need to do so, or members of their family do. As we heard from the hon. Member for Southport (John Pugh), it can be a cruel lottery. One of our purposes should be to minimise the extent of that lottery and maximise entitlement and support for all individuals.
One of the most humbling experiences I have had since becoming Member of Parliament for Scunthorpe was going to visit a constituent in his home last week on this very issue of care and support. He is a similar age to me. When he was younger, near the end of his training in the medical profession, he went out into the sea and suffered a terrible accident. As a result, he was paralysed from the neck down. Since then, he contributed to society in a number of different ways. He retrained in higher education until he was advised by his GP to retire because if he did not, in the GP’s words, “the wheels would come off” and he would no longer be able to contribute to society.
After going to see my constituent, he wrote to me—this is about individuals and real people’s lives—about the publication of the draft social care bill:
“I have just been reading the latest on social care funding on the BBC website—it would seem that meaningful cross-party dialogue re Andrew Dilnot’s recommendations has broken down and that the government wants to put decisions off until the spending review late next year.
My suspicions about kicking into the long grass appear justified!...I have already contributed over £60000 towards my care package and seem to be paying more and more each year—despite the fact that North Lincolnshire council reduce the value of my care package every time there is a review.
My condition has not improved. I am, in fact, starting to suffer more and more of the long term complications that inevitably hit ageing tetraplegics.”
The worry and concern are there. When visiting my constituent in his home, I observed that the people who were providing the care were brought in at his expense. Resources were not adequate, because that cost was being taken out of his small pension from working in higher education, which went up by 5% a couple of weeks ago, although the contribution to North Lincolnshire council went up by 25%. What is the incentive to do the right thing in difficult circumstances when those sort of things happen?
What I have described was additional care. The core care was provided by my constituent’s mother, who was in her mid 80s, and his sister, who travelled for two and a half hours to spend half the week helping to care for him. As politicians, we need to step up to the plate. It is about leadership—cross-party leadership—and being able to do the right thing for people, such as my constituent, who suffer misfortune. Had that misfortune occurred, as he said to me, in a car crash, he would have received insurance compensation, which would have paid for his care package. Because it took place in a situation of utmost tragedy—nobody was responsible for it, but it was a total misfortune—there is no underpinning support from the state, which should properly protect him and his family from having to pay more and more money. My plea is for us to show the leadership across the parties—
Kelvin Hopkins (Luton North) (Lab)
The hon. Member for Southport (John Pugh) was kind enough to say that people of a pensionable age can sometimes make useful contributions. He is very kind to me—I am the only Member of a pensionable age to speak in the debate. I am 37 in my mind, but with a son of 42, that is rather unlikely.
The Government have failed at the core of the White Paper on the question of funding. This is about money, not leadership or consensus or saying nice words in the Chamber. I am very pleased that Labour Front Benchers have accepted Dilnot. His proposals are not perfect, but he goes a long way to proposing a free national care service, which my hon. Friend the Member for Blaydon (Mr Anderson) and I want.
I know Andrew Dilnot well—he is a fine, highly intelligent and compassionate man. He went to great lengths to tailor a precise scheme that could be accepted by the Government, but at the last minute, they have buckled and not committed to it. The problem is the Treasury—the worst Government Department of all. It has failed the country over and over again with terrible mistakes. The European exchange rate mechanism destroyed the credibility of the Conservatives, but the Treasury has done lots of other bad things. It is a dreadful Department. I hope that Ministers now tell me how wonderful it is.
There has been almost no mention of the royal commission on long-term care from some 14 years ago—I think my hon. Friend the Member for Blaydon mentioned it—which recommended free long-term care, which is precisely what he and I want. However, the Government at the time—they happened to be a Government I supported—could see that the report was going to be unanimous, so they slotted in two people at the last minute to ensure that it was not unanimous, and from that point onwards they hung on to the minority report of those two members. It was a bit of a disgrace, and I made that point strongly. I tabled an early-day motion in the 1997 to 2001 Parliament calling for implementation of the royal commission’s recommendations, which was signed by more than 100 Members of the House at that time, and in the 2001 to 2005 Parliament I tabled another early-day motion saying the same thing, again with the same sort of support. I also have the support of the National Pensioners Convention—a body with which I am closely associated—which also wants free long-care on the same basis as in the NHS.
In Scandinavia they do it. Indeed, what I have always wanted my party to do—as well as the others, but particularly mine—is to move in the direction of Scandinavia, not the United States of America. If Members read the book “The Spirit Level”, they can see that the civilised societies—where people are happier and all sorts of social problems are lesser—are in the Scandinavian- style countries. The worst end of the spectrum is in America, and we have been steadily moving towards the American end, not the Scandinavian end.
In the end it is about cost and this word “affordability”. We choose what is affordable. It is not written in stone: we can choose to make things affordable, and we can choose to pay for them by progressive taxation—if we wish. It is a political choice. People say, “Oh, well it’s not affordable.” However—I have told this story many times—I remember that when my children were young, if they asked for a second ice cream, my wife would say to them, “Mummy can’t afford it,” when what she was really saying was: “You can’t have another ice cream.” Of course she could afford it. We can afford to pay for free long-term care too, but we choose not to—so far. I hope to persuade my side at least to commit to it in time.
The extra costs of Dilnot would initially be £2 billion a year. That is the equivalent of 0.5p on the standard rate of income tax. I have put this to many people in meetings and asked them, “What would you choose: the threat that your home would be taken away, with no equity to hand on to your grandchildren, or an extra 0.5p on the standard rate?” Without exception, they say 0.5p on the standard rate. Of course, we do not have to do it that way, because there is plenty of cash in the tax gap, which is estimated to be as much as £120 billion a year, or even more. If we collected a tiny fraction of that—one sixtieth—we could cover Dilnot’s proposals; and, if we have to have a bit more, let us squeeze the tax gap a bit further. However, since Margaret Thatcher’s time as Prime Minister, we have seen the standard rate cut by 5p, which is 10 times more than the cost of Dilnot, so do not let us pretend that it not affordable. We choose not pay for it, because we think—or some people think—that low taxes are better or that letting tax evaders and tax avoiders get away with it is better than looking after elderly people in great need.
We are also committed, apparently—I understand that this goes for both sides of the House—to the idea of owner occupation, but we are actually seeing the gradual erosion of owner occupation, particularly by poorer people having their houses taken away when—
Sarah Newton
Would my hon. Friend like to comment on some of the Opposition’s assertions that the efficiency savings from reductions in management levels in NHS are not being put back into front-line services to enable integration, and that they are somehow being siphoned off to the Treasury? I do not believe that—
Mr Deputy Speaker (Mr Nigel Evans)
Order. I must ask the hon. Lady to turn round so that the microphone can pick up what she is saying. I know that she is finding that difficult, but she should be heard by everyone in the Chamber.
NHS (Rationing of Care)
Nigel Evans Excerpts(11 years, 9 months ago)
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Mr Deputy Speaker (Mr Nigel Evans)
Order. You can make an intervention, Mr Reed, but not from the Opposition Front Bench. If you step up to another Bench, you may intervene from there.
Mr Reed
Thank you, Mr Deputy Speaker. I trust that this is in order.
Will my hon. Friend join me in asking the Minister, who has indicated that he will not take interventions from me this evening, whether he will undertake a nationwide investigation into the clear rationing that is occurring in the NHS, and whether the Government will publish a list of procedures in which the eligibility criteria for treatment are now being changed? Will she join me also in asking the Government to act where various NHS organisations are breaching NICE guidelines on treatments offered to patients?
Mental Health
Nigel Evans Excerpts(11 years, 11 months ago)
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Mr Deputy Speaker (Mr Nigel Evans)
Order. As hon. Members can see, about nine Members are trying to catch my eye and we have just over an hour. We want to get everyone in, do we not? If everybody speaks for only six or seven minutes we can accommodate everybody, so I ask Members to be time-focused, please.
Mr Deputy Speaker (Mr Nigel Evans)
Order. To help the remaining speakers keep to time, I am introducing a six-minute limit.