Covid-19 Update
Toby Perkins Excerpts(3 years, 4 months ago)
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Matt Hancock
Yes, we are working exactly on how to demonstrate that in a numerical rather than a narrative form, not least for the reasons that my hon. Friend sets out. We have seen a very sharp rise in cases across Bedfordshire, especially in the more rural areas, including North East Bedfordshire, so it is so important that people across Bedfordshire take that personal responsibility and follow the new tier 3 rules. I hope that we can get the rate to come down as fast as it has gone up.
Mr Toby Perkins (Chesterfield) (Lab) [V]
People across Chesterfield will be very disappointed that, with all the work that they have done and with Chesterfield having lower transmission rates than some of the areas in tier 2, they remain in tier 3. They will be especially disappointed by the Health Secretary’s suggestion that the communities that have worked hardest and been the most disciplined are the ones that are in tier 2. We know that that is not the case. Does he not realise that, if the Government could offer a support package that supported our hospitality sector, and if they were not, at the very last minute, announcing changes to our schools just two days before they break up, there would be more credibility to the sense that it is personal responsibility that is the problem here, rather than the ineptitude of this Government?
Covid-19 Update
Toby Perkins Excerpts(3 years, 4 months ago)
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Matt Hancock
I am tempted to try to give an answer to that question, but it is very much a matter for the MHRA. I am very grateful to my hon. Friend for the good wishes that he sends. In the Department these days, we no longer say at the end of a week, “I hope you have a good weekend.” We say, “I hope you have a weekend.” Likewise, I share his hope that we have a happy Christmas, but frankly I hope I get a Christmas.
Mr Toby Perkins (Chesterfield) (Lab)
Pubs in tier 2 areas are very heavily regulated environments, and in tier 3 they are completely closed. Nothing like the same restrictions are in place on public transport, in retail shops, in care homes and in other areas where we have seen much more of a spread than in pubs. Will the Health Secretary consider not just shifting areas from tier 2 to 3 when tier 2 clearly is not working, but rethinking his whole approach so that the pub sector is given the support it needs? It is actually a much more regulated, much safer environment than many of the areas that the Government have not regulated.
Matt Hancock
Many of the facilities that the hon. Gentleman talks about, such as care homes, are doing unbelievable work to remain covid secure. I understand the impact on hospitality. I love the hospitality businesses of our country—I love going to pubs—but unfortunately we need to tackle this virus, which means that some very difficult decisions are necessary.
Coronavirus Vaccine
Toby Perkins Excerpts(3 years, 5 months ago)
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Matt Hancock
Yes, I am very glad that we changed the law to allow the MHRA to make this authorisation on UK terms. This House voted unanimously to do that—well, we did not even have a vote as it went through without one. I am really glad that we were able to do that. I want to thank my right hon. Friend for his support and encouragement throughout this period. It has been a very, very long year as Health Secretary and I really appreciate his support.
Mr Toby Perkins (Chesterfield) (Lab)
The Health Secretary spoke about learning lessons and continuing to improve the system. My partner’s daughter is currently self-isolating because someone in her class at school has got coronavirus. She comes home and lives with her sister who is still expected to go to school. Surely a world-class testing system would be testing everyone in the bubble of those who had been sent home so that immediate family could be identified as having the virus or not, and could take appropriate action. Is there any more that can be done to improve this so that people such as my partner and many other parents at Holymoorside school will be able to take the necessary steps?
Matt Hancock
Yes, we are piloting exactly that idea in, I think, eight schools right now and I hope to be able to roll it out once we have learned from those pilots.
Covid-19 Update
Toby Perkins Excerpts(3 years, 6 months ago)
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Matt Hancock
Yes, absolutely. Support proportionate to the support made available to Lancashire is on the table. We are willing to meet anybody from Greater Manchester to help make this happen, and it is best done as a team effort. The offer was there on the table. I, like my hon. Friend, regret that it was not taken forward. However, I hope that council leaders in Wigan, colleagues from across the House and, if he wants, the Mayor will come back to the table and work together for the people of Greater Manchester.
Mr Toby Perkins (Chesterfield) (Lab)
The Health Secretary’s attempt to divide and rule the Mayor and the Members of Parliament in Manchester is absolutely transparent. It is shameful that some of those Conservative colleagues, who have been working collectively, should collapse like they appear to be doing today. Does it not say everything about this Government that they should believe £7,000 a day is an adequate amount to pay consultants to work on his failing track and trace programme, but £8 per head is more than enough for people in Manchester and right across the north and the midlands to go into this tier 3 after the tier 2 programme has not worked?
Matt Hancock
On the contrary, we are working hard across party lines and trying to rise above that sort of political attack to work for the benefit and the public interests of everybody in this country.
Local Contact Tracing
Toby Perkins Excerpts(3 years, 7 months ago)
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Mr Toby Perkins (Chesterfield) (Lab)
I spent an early part of my career in the sales industry, selling in the IT sector. I just wish that at some point I had come across a customer with as much money as this Government, and one so easily impressed and willing to give money to suppliers and then to defend them when they let them down. I never came across a customer nearly as naive as this Government.
Occasionally, a story seems to demonstrate a much wider point. So it was today with the scoop revealed by Ed Conway of Sky News that the Government are paying £7,360 per day to the management consultants at Boston Consulting Group, who are in charge of test and trace. That is the equivalent of a £1.5 million salary to preside over this shambolic system that is letting down all the people in my constituency and so many others. We will not find dedicated public servants being paid £7,500 a day or £1.5 million a year, but we will find a basic competence, a knowledge of their area and a desire to ensure that systems work before they are implemented. That is what we need right now in our system.
It is telling that, in a debate of this importance, with every Back-Bench Member of Parliament invited to contribute, just three Conservative MPs wanted to put their name on the list and say, “I will go in and speak up for the Government, because I think they are doing a good job.” That is because people in their constituencies know what is happening, and Conservative Members do not want it to be on their record that they were the ones speaking up for the Government, so they leave it to us to come here and expose the reality. That is what is happening. There are 365 Tory MPs—where are they? They are off in their offices hiding, while people in my constituency are being let down. [Interruption.] I accept that three have turned up, and I thank them for that, but I am talking about the rest of them.
We all remember when Leicester first went into lockdown and everyone said, “Oh my God! The rate in Leicester is appalling—those poor people.” The infection rate was less than 100 per 100,000 then.
Mr Perkins
Yes, I do, and I had an experience of that recently.
Leicester had a rate of 100 per 100,000 when it went into lockdown. In Chesterfield, we have a rate of 143 per 100,000, and we are still in tier 1. The scale of how bad this must be before the Government are shocked is changing all the time.
I was recently in self-isolation because a friend told me that he had been diagnosed with coronavirus four days before Test and Trace got in touch with me. The date that Test and Trace had was nine days after I came out of self-isolation. The whole system is not working, and when you experience it yourself, you can see why this failure is happening.
Covid-19 Update and Hospitality Curfew
Toby Perkins Excerpts(3 years, 7 months ago)
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Mr Toby Perkins (Chesterfield) (Lab) [V]
I accept what the Secretary of State has said about the science, but he must realise that there were many publicans who were really struggling to get by before this, and the new things that have been put in have just made their businesses untenable. Does he accept that getting support for the measures that he has put in place has to come with a financial package that supports our publicans to remain open after covid?
Oral Answers to Questions
Toby Perkins Excerpts(3 years, 8 months ago)
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Aaron Bell (Newcastle-under-Lyme) (Con)
Mr Toby Perkins (Chesterfield) (Lab)
The Secretary of State for Health and Social Care (Matt Hancock)
We have developed capacity to over 200,000 antigen tests per day across the testing programme. We are planning for the next phase of testing and are committed to rapid and accessible testing at scale for everyone who needs one. Localisation of testing in accessible places is absolutely critical.
Matt Hancock
I am very grateful to my hon. Friend for the work he has put in over the summer to make sure that the challenges we have seen in Newcastle-under-Lyme are dealt with as well as possible. Of course, when we put in extra testing and extra mobile testing units, making sure that that is tied in with the online booking system is critical. I am very happy to work with him to resolve the specific issues in Newcastle.
Mr Perkins
Alongside the need to increase capacity, there is a real need to make sure that what is already there is working properly. In Chesterfield, I have had many people contact me over the summer to say they have been waiting four or five days to get a test result back. I have also had people who have applied online and been told to go for testing 20 or 30 miles away, when there is a testing centre in Chesterfield. With Chris Hopson of the NHS Providers organisation saying that the current system is not even
“fit for purpose, much less world class”,
will the Secretary of State tell us what he can do to ensure that the system is ready when we approach the potential increase in cases in the autumn and winter?
Matt Hancock
Of course, we are constantly working to improve the system, but as the statistics that I read out at the start of this Question Time show, we have made very significant progress over the summer. NHS test and trace is just over three months old, and is now reaching 84% of contacts when contacts are given. On testing expansion, of course when a testing site is full, people will be directed to a nearby but not immediately close testing centre. That does sometimes happen when there is an increase in demand for testing, but we try to respond by putting in more testing where it is needed and in the highest-risk areas, of which, thankfully, Chesterfield is not one.
Oral Answers to Questions
Toby Perkins Excerpts(4 years, 2 months ago)
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Helen Whately
I am well aware of concerns about the surcharge. Many overseas nurses coming to work in the NHS do not have to pay the surcharge, as it is covered by their employer.
Mr Toby Perkins (Chesterfield) (Lab)
The phrase “brightest and best”, when it appears in immigration talk, is obviously subjective and deliberately vague. What the private sector and local authorities want to know is: under the new Government system, will they be able to get people to come in who want to provide care—people we are desperate for?
Helen Whately
For the NHS, we have the NHS visa and a clear route to come to work in the health sector. For social care, there is a job to be done by employers, to make sure that working in social care is an attractive job that is well paid. I also recognise that there is a role for Government and for all of us in Parliament, to come together and support changes to how we fund social care. We need to fix the social care system for the future.
Matt Hancock
My hon. Friend is quite right to raise this—it is true that that the NHS has had to rise to address the scandal over mesh. There is a lot of work still to be done.
Mr Toby Perkins (Chesterfield) (Lab)
Matt Hancock
No, the hon. Gentleman is wrong to raise this issue in this way. It was addressed in the House yesterday actually—the Prime Minister was explaining that that is not Government policy.
Health Inequalities
Toby Perkins Excerpts(4 years, 2 months ago)
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Jonathan Ashworth (Leicester South) (Lab/Co-op)
I beg to move,
That this House notes the publication of Health Equity in England: The Marmot Review 10 Years On; is concerned by its findings that since 2010 improvements to life expectancy have stalled for the first time in more than 100 years and declined for the poorest women in society, that the health gap between wealthy and deprived areas has grown, and that the amount of time people spend in poor health has increased across England; agrees with the review that these avoidable health inequalities have been exacerbated by cuts to public spending and can be reduced with the right policies; and calls on the Government to end austerity, invest in public health, implement the recommendations of the review, publish public health allocations for this April as a matter of urgency, and bring forward a world-leading health inequalities strategy to take action on the social determinants of health.
A former Health Secretary, Frank Dobson, whom we sadly lost towards the end of last year, said:
“Inequality in health is the worst inequality of all. There is no more serious inequality than knowing that you’ll die sooner because you’re badly off.”
He was absolutely right. Poverty and deprivation mean that people become ill quicker and die sooner. The current Health Secretary—I understand why he cannot be here for this debate; I do not criticise him for that, given what is going on, and we welcome the Under-Secretary of State, the hon. Member for Bury St Edmunds (Jo Churchill), to the Chamber—said, when we last debated health inequalities, that
“extending healthy life expectancies is a central goal of the Government, and we will move heaven and earth to make it happen.”—[Official Report, 14 May 2019; Vol. 660, c. 153.]
Well, last week the respected academic, Sir Michael Marmot, gave us his assessment of the Government’s attempts to move heaven and earth to narrow those inequalities and extend healthy life expectancy.
Mr Toby Perkins (Chesterfield) (Lab)
I absolutely congratulate my hon. Friend on bringing this crucial issue to the Chamber. The health inequalities that we have seen in our communities are bad enough, and the additional inequalities regarding access to GP appointments are even worse, but we are also seeing cuts in local government funding hitting the most deprived areas and adding to those inequalities we are already aware of.
Jonathan Ashworth
My hon. Friend makes that point very well. Not only are there inequalities in health outcomes, but inequalities are opening up in access to health services.
I said that I understood why the Secretary of State cannot be here, but he has now joined his colleagues on the Front Bench. I will state, just for the record so that he can be reassured, that I did not criticise him for not being here—I said that I entirely understood why he could not be here. But he is always welcome to listen to my pearls of wisdom, of course.
Michael Marmot’s analysis was shocking, and his conclusions devastating. Let me remind the House of what Professor Marmot found: for the first time in more than 100 years, life expectancy has essentially flattened overall since 2010, and has actually declined for women in the poorest areas of England. In last week’s Opposition day debate, the Health Secretary told Opposition Members that we must debate these issues based on the facts. In fairness, he said that there were life expectancy differences between, for example, Blackpool and Buckingham. [Interruption.] Indeed—gulfs. The Secretary of State made that point. If I may say so, however, I do not believe that he was as clear as he could have been in presenting the full picture for the benefit of Members. When we look at the figures, we see that for more than 100 years, life expectancy has been increasing by about one year every four years. More recently, from 2001 to 2010, the increase was 0.3 years for each calendar year for men and 0.23 years for women. Between 2011 and 2018, the average rate of increase was 0.07 years for males and 0.04 years for women. By any standards, that is a truly dramatic lowering in the rate of improvement in life expectancy between 2011 and 2018.
Jo Churchill
The hon. Gentleman makes a good point, but it typifies the problems we deal with, because air pollution is the responsibility of the Department for Environment, Food and Rural Affairs, the Department for Transport and the Department of Health and Social Care. They all have a role to play, and we must ensure we take account of that—it is important that we think about all these different challenges. Helping people to live longer healthier lives while narrowing the gap between the richest and the poorest needs action, a point made by the hon. Member for Coventry South (Zarah Sultana).
Jo Churchill
If the hon. Gentleman will just bear with me and let me make a little more progress, I will come back to him.
Going forward, I am clear that we must integrate good health into decisions on housing, transport, education, welfare and the economy, because we know that preventing ill health, both physical and mental, is about more than just access to our health services.
Jo Churchill
I will come on to that point in a few minutes, if my right hon. Friend will bear with me.
Mr Perkins
The Minister is right that this is a very complicated issue and that health inequalities have existed for a considerable amount of time. On the research she refers to, will she tell us whether local government cuts, which have been greater in the poorest areas, with a significant reduction in health education and prevention work, were mentioned as factors for why this continues to be such a major problem?
Jo Churchill
The problems we are dealing with are complex across the piece, which is why we have held the public health budget at the same level this year so that we can start to deliver on them. It is important that local people have local ownership over the issues and challenges in their area, because one size will not fit all.
Social Care
Toby Perkins Excerpts(4 years, 2 months ago)
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Barbara Keeley
I thank the hon. Gentleman for making that point; he does make it on every occasion that we debate this subject, so I congratulate him on doing so again. However, the person he needs to be directing his comments about cross-party talks to is sitting on the Government Front Bench. I am hopeful that the Secretary of State is going to tell us what he is going to do about cross-party talks, because those 15-minute visits are really not good enough.
Mr Toby Perkins (Chesterfield) (Lab)
I agree entirely about the need for cross-party consensus on this issue, but there can be no consensus until there is an acknowledgement of what has caused the care crisis—the underfunding of the health service and cuts to local government budgets, which have had an impact on A&Es, GPs and other services. Until there is an acknowledgement of what caused the situation, there can be no consensus towards a solution.
Barbara Keeley
My hon. Friend is right. I will come to the causes, because it is important to mention them.
The 15-minute care visit reduces the giving of care by care staff to a series of physical tasks, rather than the staff being able to see a person with their own interests, desires and opinions. It really strips them of the time to do the job they want to do. I pay tribute to all care staff, who go above and beyond in their jobs to improve the lives of the people they support. Without them, our social care system would not work, but they do not get the pay and recognition that they deserve.
Care staff, who provide essential practical and emotional support to some of the most vulnerable people in society, are among the most poorly paid workers. The average hourly pay for care staff is below the rate paid in most UK supermarkets. On average, care staff are paid less than cleaners and healthcare assistants in the NHS, and this has led to a vacancy rate of 122,000 care jobs and a turnover rate of 33%. Now the Government are planning to make the situation worse by turning away people who want to come to this country to work in social care. One in seven care workers is from outside the UK, but the average care worker earns £10,000 a year less than the Government’s immigration salary threshold, so will the Secretary of State tell us just how he thinks he is going to be able to fill the large number of vacancies in the social care workforce?
Mr Toby Perkins (Chesterfield) (Lab)
It is a great pleasure to follow the right hon. Member for Ashford (Damian Green). I found myself agreeing with many of the priorities that he set out; that gives us some hope about cross-party consensus.
I wish to talk about three things: first, the proposal by Derbyshire County Council to close the Spinney care home in Brimington in my constituency and six other homes throughout Derbyshire; secondly, the wider implications of Government funding decisions over the past 10 years; and finally, the role of carers and the impact of councils’ use of private sector agencies to reduce council budgets on the quality of care provided.
First, the Spinney is a care home built in 1974 and run by Derbyshire County Council. Up until the Conservatives took over in 2017, it had been rated good by the CQC and was full; since 2017, the council has stopped taking new residents, and gradually numbers have fallen as residents have passed away. All the residents and their families to whom I have spoken speak warmly of the quality and culture of care provided by the Spinney and oppose the council’s call for closure. In the past two years, five of the rooms in the Spinney have been fitted with en suite bathrooms—the lack of en suite facilities being one of the reasons given for the closure—but none of those rooms has been used. Now, Derbyshire County Council says it will close the home and allow the residents to live more independently.
The comments from residents make it clear what they feel. One said:
“I have no relations, no family, the carers and staff are my family…I want to live the rest of my days here it has all come crashing down around me”.
Another said:
“People will not get more than 10 minutes three times a day”
if they leave and go independent. They went on to say that
“this doesn’t stop people roaming the streets and the police having to bring them back.”
A family member said:
“My mum lived independently till she was 96 years of age. We all rallied round to look after her, but she was only safe once she was here at the Spinney.”
There are many, many more stories.
I note that the county council had a £5.7 million underspend last year in its social care budget, so I roundly condemn it for its decision, and I hope that it listens to reason when the consultation finishes and that it agrees to improve the Spinney rather than to let it close.
More broadly, we all know that the money available to councils for social care has been savagely cut during the nine years of austerity. Indeed, at the very time when our ageing population were demanding an increase in care spending, the Government were cutting £5 billion from council budgets for care. The money that the Prime Minister has promised, welcome as it is, is simply one step back up the mountain.
The failure to provide care for some of our most vulnerable citizens is not just morally repugnant and does not just shame us as a society, it is also economically illiterate. Failure to care for people in residential or domestic settings and leaving them to fend for themselves means that they end up in A&E. It means that they end up being treated more expensively in our hospital system. The 148 people who were left in hospital beds in Derbyshire because there was no care package available for them were costing us more than they should have done as a result of cost savings. Cuts in care are not only barbaric, but economically crazy too.
There is no way that a Government who have reduced council spending by 50% in real terms over 10 years can be anything but complicit in the care crisis that faces us, but providing ring-fenced money for care alone will not be the step required to make this right. There must be a whole-system approach that addresses the many causes of the crisis in care. Those causes include the inadequate number of GP appointments available, particularly in more deprived areas; the crisis in the recruitment of GPs, nurses and carers; and the casual and unprofessional way that carers are recruited, trained and employed, which means that workers at McDonald’s are given greater job security and better rates of pay than someone who plays a crucial role in the health of the most vulnerable citizens in our society. There is also the crisis in A&E, which sweeps up the greater share of the NHS budget. That crisis is then exacerbated by people taking up hospital beds when they could be at home receiving care, and so the vicious cycle continues.
Finally, I would like to touch on the issue of how carers are employed. Council budgets are a part of this equation, but, in truth, councils were outsourcing these services long before council budgets were shrunk. It should never be said that people who provide care on behalf of private companies—or, in many cases, those companies themselves—have any less capacity to care or any less empathy for their customers than people who do it in the public sector. However, many councils are signing tenders that can only lead to the provision of inadequate care.
Hillcare Group, a nursing care home provider in my constituency, wrote to me recently to say that the funding provided by Derbyshire County Council was £150 per resident per week less than in other local authority areas, and that ends up having an impact on the care that is provided. I have an idea: when councils set tenders, they should be setting a rate of pay at the time they use private companies. The reason for using private companies is not just about saving budget, but about that company providing care in a better way. It is not just a way of undercutting the wages of unionised council staff. If rates of pay across the sector were set by the councils, we would not find council contracts being provided by private companies in such an inadequate way.
This is a multifaceted and real problem. Residents and families of the Spinney are just the latest victims of our failure to take this matter seriously. I hope that it will be solved, because our older people desperately need it to be.
Helen Whately
I have already visited two care homes since becoming Minister for Care, and I want to visit many more. I hope I will be able to take up my hon. Friend’s invitation and see that good work for myself.
I pay tribute to my predecessor as Minister for Care, my hon. Friend the Member for Gosport (Caroline Dinenage). I hear that she was visiting a hospice on reshuffle day—her actions illustrate the enormous commitment and compassion she brought to this role. I sincerely hope to follow in her footsteps.
I also thank all the hon. Members who have spoken today. Social care is important to many thousands of our constituents, and their interest and input are incredibly valuable.
Mr Perkins
I welcome the Minister to her post, and I welcome what she says about carers. Would it not be wonderful if, rather than just giving them her warm words, support and admiration, she were able to join a cross-party campaign to see that carers get paid more than burger flippers in McDonald’s so that we actually start recognising them with the same prestige as nurses and the same earnings as people in our health service?
Helen Whately
I thank the hon. Gentleman for his suggestion. It is almost as if he has seen my notes.
One thing I particularly welcome is the number of hon. Members on both sides of the House who spoke about the importance of careworkers, who provide such important care.
My hon. Friend the Member for Peterborough (Paul Bristow) mentioned that both his parents were nurses in the care sector. He drew on his knowledge of care and rightly said that the profession should be held in higher esteem and that, just as we hugely value NHS staff, we should hugely value careworkers. The hon. Members for Warrington North (Charlotte Nichols), for Blaydon (Liz Twist), for Dulwich and West Norwood (Helen Hayes), for Putney (Fleur Anderson) and for Liverpool, Wavertree (Paula Barker) and my hon. Friend the Member for Bury North (James Daly) spoke along the same lines, and I could not agree more.
Not long after I became the Member of Parliament for Faversham and Mid Kent, I joined a careworker, Kim, on her daily round. By the time I met her at 7.30 am, she had already started washing her first client. By lunch time, she had washed, dressed, fed, medicated and chatted with six or seven men and women. Some of them were grateful and some of them, quite honestly, were not grateful, but they were all utterly reliant on her care. That experience really brought home to me the skill, knowledge and compassion of our social care workers. For those who need help, there are amazing carers with hearts of gold, like Kim.
Our care system depends on an extraordinary workforce of capable and compassionate carers, but we need more people to choose care as a career. That means changing the perception of being a care worker. As a society, we must truly recognise the importance of the work. We must make sure that more people realise the range of jobs in care and the opportunities for progression. The Government are currently investing in an adult social care recruitment campaign with the strapline “When you care, every day makes a difference”. We are working with Skills for Care to support workforce development and there is funding for a workforce development fund. That is really important, but we know that we must go further in making sure that we truly value the important work that the care sector does and to make sure that the care profession attracts the workforce that we need and gives them the opportunities to lead a truly fulfilling career.
Several Members rightly talked about unpaid carers, who also provide so much vital care. We fully recognise the value of that work and know the importance of support for those people who do so much caring. That is one reason why the Government will introduce a statutory right to leave from work for one week a year for the 5 million people who juggle work alongside being an unpaid carer.
My hon. Friend the Member for Bury North talked about quality of care, and it was really important to hear that mentioned as part of the debate. He spoke about how good care is in his constituency, and he is absolutely right that we should talk about how good care is throughout England. Some 84% of adult social care providers are currently rated good or outstanding by the CQC. Let us recognise the high quality of care.
My hon. Friend also spoke about the importance of integration—of the NHS, local authorities and care providers working together—as did my right hon. Friend the Member for Ashford (Damian Green), who is knowledgeable on this subject. The interplay between the NHS and social care is critical. The better care fund and the improved better care fund are a success story in respect of enabling more co-operation between the systems. It is crucial that we continue to build on that success so that our care system meets the needs of the individual, not just of the system.
My hon. Friend the Member for Watford (Dean Russell) made some excellent points about how, paradoxically, we can use technology to help to achieve more human and more personal care for a more cohesive and effective care system.
Both my hon. Friend the Member for Thurrock (Jackie Doyle-Price) and the shadow Minister for Care, the hon. Member for Worsley and Eccles South (Barbara Keeley), mentioned those with learning disabilities and autism who are being cared for in in-patient settings. I am new to this job, but I absolutely appreciate the importance of making sure that we do better in this regard. People should be cared for in the best place for their needs. At the end of last month, the number of those in in-patient settings had been reduced by 24% compared with 2015—