House of Commons
Monday 10 January 2011
The House met at half-past Two o’clock
[Mr Speaker in the Chair]
Oral Answers to Questions
Work and Pensions
The Secretary of State was asked—
Happy new year, Mr Speaker. We published the full invitation to tender for the Work programme shortly before Christmas. Would-be bidders have until early February to submit their bids and we remain on track to launch the Work programme in the summer.
That is an important point because many of those who go on to the Work programme will be former offenders or, in some cases, people going through community payback who are on welfare. I am in close contact with my colleagues in the Department for Justice and we are working together to try to ensure that we integrate their work on rehabilitating offenders with our work to get former offenders back into work.
In my constituency of Stafford, a number of local voluntary organisations and social enterprises are committed to getting people back into work. What assurances can the Minister give us that they will be taken into account when it comes to awarding the sub-contracts under the main contractors?
My hon. Friend makes an important point. We are very clear that we want to see small local community, voluntary sector, social enterprise and private sector groups having the opportunity to work alongside major contractors in the Work programme. We have been very clear to would-be prime contractors that if they do not bring together a consortium of smaller organisations that demonstrate the breadth of skills necessary to deliver support to all the different groups that will be helped under the Work programme, they will not be successful in their bids. That is of paramount importance.
I very much welcome the assurances we have received from the Minister about the small-scale organisations that are being brought in to the larger contracting. What assurances can he give my constituents and others in Cornwall who benefit from EU convergence funding that the locally identified priorities under that programme and the excellent work that has been done to get hard-to-reach groups of people back into work will continue and will benefit from the Work programme?
I can absolutely give my hon. Friend that assurance. At the moment, we are considering the next phase of the European social fund contracting. I am absolutely clear—indeed, the objectives of the scheme make it clear—that it must sit alongside the Work programme as part of a drive to help some of those who are furthest from the workplace to make the move back into work and to lift them out of poverty. That will remain a priority for us.
Is not the Work programme undermined from the outset by the cuts that the Minister is making to the child care component of the working tax credit, which will hit families in my constituency to the tune of some £500 a year? Why is he instituting such a disincentive to work?
The hon. Gentleman has to remember the financial mess his Government left behind. If we do not sort out the deficit and create a stable economic environment in this country, there will not be secure jobs in the future. That is and will remain our No. 1 priority.
On Thursday, I visited my borough’s alcohol and drugs service and spoke to service users and providers. One of the biggest problems found by people who have a history of misuse is moving from treatment into work. I hope that the Work programme will address that, particularly given the issues that I have been told that they have with Jobcentre Plus. We are told that the pricing system in the new programme will reward providers who help those who are hardest to reach. Will that pricing structure account for those with a history of alcohol and drug misuse?
The simple answer to that question is yes, it will. The hon. Gentleman makes a very important point and I want to refer to one other dimension of the issue. A key point is giving those people opportunities to volunteer while claiming benefit. Volunteering can be an extremely important part of the pathway from a long-term problem into work. We have changed the guidance for Jobcentre Plus and will proactively promote volunteering opportunities to those who face those challenges in the hope that we will help them take that extra step on the way.
Just before Christmas, the all-party Select Committee on Work and Pensions—may I be the first to congratulate its Chair, my hon. Friend the Member for Aberdeen South (Dame Anne Begg), on her well deserved honour in the new year’s list?—warned of a looming gap between the future jobs fund closing to new referrals of young people at the end of March and the start of the Work programme in June. In an article this morning, the Secretary of State, commenting on rising youth unemployment, promised that
“the programmes we inherited will remain in place until we replace them later this year.”
Can we therefore take it that referrals to the future jobs fund will continue until June?
I start by offering my congratulations to the hon. Member for Aberdeen South (Dame Anne Begg). There are moments when awards are acclaimed in all parts of the House, and hers certainly has been.
We have already extended the contracts for all the legacy programmes, which people will take advantage of until June. There will be people on the future jobs fund in the new financial year, and we are working through the detail of the transition for the final few weeks before people join the Work programme. Obviously, some people will be referred for a short period before the start of the Work programme, and we will negotiate with the would-be contractors to ensure a smooth transition. Our goal is to ensure that there is proper continuity for all those who need specialist support.
2. What assessment his Department has made of the effects of changes to prices in January 2011 on the incomes of pensioners. (32643)
In April this year, benefits and pensions will be increased by more than £4 billion, more than three quarters of which will go to pensioners. In addition, price rises in January 2011 will feed through into the September 2011 price indices, which will be used in future benefit uprating.
Pensioners on fixed incomes will be among the hardest hit by the Government’s VAT rise. Will the Minister confirm that the VAT hike will mean that pensioners are worse off in 2011 under this Government than they would have been under the previous Government’s plans?
I am grateful to the hon. Gentleman for referring to the previous Government’s plans. In his constituency, vulnerable pensioners, vulnerable disabled people and vulnerable families with young children received four or five cold weather payments this winter to help them with their fuel bills in January 2011. His policy, and the plans that we inherited, would have reduced those payments to £8.50 a week. We have paid £25 a week four or five times to vulnerable pensioners in his constituency.
I will give the Minister another try: will he accept that with pensioners set to pay an extra £217 in 2011 because of the VAT rise, the basic state pension rising by only the same amount as planned by the previous Government and now news that the Department for Work and Pensions and the Treasury cannot agree the £140 flat-rate pension that he has extolled, pensioners have very little to look forward to in 2011 but a lot to fear?
The hon. Lady used to be an economist, so I would not dream of suggesting that any of the figures that she has quoted are in the slightest bit dodgy. She will be aware that colleagues at Her Majesty’s Treasury have calculated that the impact of the VAT rise for each percentage point increase is just less than £1 a week for single pensioners. The 2.5% increase will cost pensioners £2.50 a week, which compares with our £4.50 pension increase this April, and there will be additional increases in 2012 because of the VAT rise, so I dispute her figures.
There is no time limit on entitlement to income-based jobseeker’s allowance. I remind the hon. Lady that the conditions that pertain to withdrawal of benefit are that individuals must be available for work and seeking work, and they have to sign up to an agreement. If they continually refuse to do any of that, that is when the sanctions come in.
I am aware that those sanctions will be applied after a decision by the independent decision maker. What reassurances can the Minister give me about the role of the independent decision maker and the criteria that will be used? I am particularly concerned about the appeal process, because, as one can imagine, mistakes can be made and there should be a right of appeal. I am keen that that right is open to anybody who is sanctioned in that way.
We will strengthen the role of the independent decision maker to ensure that decisions are made for the right reasons. The hon. Lady can rest assured that we will ensure that is the case. If she has any concerns, she should raise them with us, and if she has any thoughts, we are open to dispute.
Does the Secretary of State agree that one implication of this question is that jobs are not available in the marketplace? Just before Christmas, we conducted a survey in my constituency, where there were more than 700 job vacancies. People from Swansea are as welcome to take up those job vacancies as people from anywhere else in the country.
My hon. Friend is right. Over the past nine months, we have seen a huge increase in part-time work with more than 400,000 new jobs. [Interruption.] The answer to Labour Members is that jobs are being created even though we are coming out of a recession, which was brought on by their policies.
The Secretary of State’s colleague, the Under-Secretary of State for Business, Innovation and Skills, the hon. Member for Kingston and Surbiton (Mr Davey), has said of the Government’s plans for the long-term unemployed:
“You have been unemployed for 12 months, you are passing the actively seeking work test…we are/the Government is saying that your housing benefit will be cut by 10% just because you have been unemployed for 12 months. I don’t understand why. You are on the breadline, you’ve been trying to look for work, you’re passing all the Government tests and you’re suddenly going to have your rent, which is your highest cost—your help with that—taken down by 10%. No logic behind that whatsoever.”
Can the right hon. Gentleman tell the House with which part of that statement he disagrees?
The reality is that the coalition—I emphasise coalition—position is that we will withdraw some of that money, 10%, before the 12 month point. The point about the 12-month stage is that more than 90% of all those seeking work will be in work by that point. That gives us an opportunity to make sure that those who are having the greatest difficulty can be properly reassessed, and if there are particular problems, they can be dealt with. It also acts as a spur and incentive to others who are not exactly playing the game in line with the question asked by the hon. Member for Swansea East (Mrs James). On balance, I think the coalition will find that the policy will work very well.
I listened with care to that answer, but given that the number of people who have been unemployed for more than 12 months, on the broader measure, went up by 41,000 in the most recent figures, can the right hon. Gentleman tell us whether the Business Minister is the only member of the coalition who thinks that the present proposals are “unsupportable”?
That is like my asking whether the right hon. Gentleman’s leader and his shadow Chancellor agree on everything, which I do not think they do. The coalition has a clear statement of policy and that policy exists. The reality of that policy is exactly as he has been debating and I would not trouble him to find out exactly what he agrees with his leader about after this morning’s statement that his side apparently now agree with most of the changes we are making.
11. What recent representations he has received on his plans to help disabled jobseekers into work. (32652)
The coalition Government have an ongoing commitment to co-production, which involves disabled people in how our policies develop. The Government also regularly meet charities and voluntary organisations to discuss new policy ideas. For example. Mind, Mencap and the National Autistic Society are working with Professor Harrington as part of the independent review of the work capability assessment. On 2 December 2010, I also announced an independent review into specialist employment support for disabled people led by Liz Sayce, the chief executive of RADAR—the Royal Association for Disability Rights.
I thank the Minister for that response. One of my disabled constituents uses the access to work travel assistance, which has helped him into a full-time job, but he finds the monthly form-filling quite onerous and believes that his case is handled by several different people. Does the Minister have any plans to streamline the system and reduce the burden of paperwork on disabled people, perhaps by putting some of it online?
I thank my hon. Friend for that question and underline the Government’s commitment to access to work. The monthly claim form is kept as simple as possible but we really have to make sure that we are protecting public funds, so we require confirmation that a customer has been in work during the month and any receipts. We must also make sure that we have a confirming signature. Such documents would go straight to one of our payments team and would, I hope, be dealt with quickly, with the payment being made directly into the customer’s bank account. If my hon. Friend’s constituent is having particular problems, I advise her perhaps to seek further help at Jobcentre Plus. We understand the importance of refining the administration of access to work. That is why we have introduced the pre-employment eligibility letter—to give individuals assurance about their eligibility for access to work funding when they are looking for a job, not just after they have secured it.
I thank the Minister for her response and commend the work she is doing in this field. Voluntary organisations in my borough of Bexley are very keen to assist the disabled into work and many are already doing so. What more can the Government do to help utilise the talent and skills of disabled people in the work force?
I thank my hon. Friend for his question and I absolutely endorse his wish to have more local organisations involved in helping to get disabled people back into work. I know that through the Work Choice programme that we launched last year we already have Scope and the Shaw Trust actively working in his constituency in providing support for disabled people. I encourage him to ask more of his local organisations to get involved in that and other schemes.
The Minister will be aware that anyone who has come off incapacity benefit to move into work in the past two years was promised a two-year linking period, during which they could return to the benefit at the original rate. The new employment and support allowance conversion regulations, which are due to take effect next month, remove that protection, and those returning to work will be required to return to the ESA at the assessment rate for the first 13 weeks. Will the Minister urgently reconsider those new regulations, and their impact on a small number of benefit claimants who appear to have been affected by the backtracking on a commitment on which many of them had relied?
The hon. Lady brings up a very detailed point, and I should be very pleased to look at it with her separately, but I should underline the fact that in all the changes we are making, we want to make sure that we are judging disabled people on what they can do, not what they cannot, and we want to make sure that more disabled people are able to get back into work. At the moment, 50% of disabled people work, and many more want to, with the right support.
The Minister will be aware that the employment and support allowance has largely superseded incapacity benefit. In week 11, the claimant is assessed by a medical board. What plans does the Minister have to involve a claimant’s GP in future assessments, so that we can ensure that they are more accurate, as opposed to being a snapshot at week 11?
I am pleased to say that last week we announced that the new enterprise allowance would expand to become a nationwide scheme from next autumn. It will first be launched in Merseyside in about three weeks’ time, and it will be rolled out across those parts of the country that have a particular unemployment challenge from spring onwards.
I welcome the fact that the enterprise allowance scheme, which had such a positive effect in the 1980s, is being reinstated. However, I have a concern about the eligibility criteria: one has to have been unemployed for six months or more to be eligible. The National Audit Office noted in the 1980s that the longer someone spent on unemployment benefit before going into self-employment, the less successful that tended to be. Given that, will the Minister consider reducing that time and allowing people who have been unemployed for less than six months to go on to the scheme?
I would very much like to improve the support that we provide, but obviously we have to do that in the context of the finances that we have inherited from the Opposition. The big difference that the new scheme will make is that it will also take advantage of the expertise of existing business people. I hope that my hon. Friend, who has a strong track record in business, will look to become a mentor for one of the new business people. That is an important difference from the previous scheme; the new scheme offers both financial and practical support, and not just financial support.
Enterprise allowance will work all the better if young people are educated into the idea of creating their own businesses, yet thousands of people from Rotherham and other parts of south Yorkshire who go into work experience via the education business partnership scheme do not know whether the scheme will be continued. It is funded by the Department for Education, but we do not know whether it will be cut or continued. Could the Minister’s Department talk to the Department for Education and get a bit of joined-up government on this?
One of the things that we are doing is introducing changes to the guidelines to ensure that young people who find themselves unemployed have a much greater opportunity to get work experience in enterprises while they are on benefits. We have also announced tens of thousands of extra apprenticeships to give young people the chance to get involved in, and understand, business. Young people will be among those who are eligible to take advantage of the new enterprise allowance, if they are unfortunate enough to find themselves unemployed.
Today, the JSA rate for a person over 25 is, as the hon. Lady knows, £65.45, and that will rise in April to £67.50. In 2010-11, the average weekly JSA rate was about £63.00. In addition, there are housing benefit, council tax benefit and employment support costs. However, the vast majority of jobseekers spend only a very short time in that situation; over half are back in work within 3 months.
According to the New Economics Foundation, there is a jobs gap in the north-east of 447,000 jobs, and PricewaterhouseCoopers estimates that we will lose an additional 4.1% of our total jobs base as a result of this Government’s cuts. Ministers have spoken about help for the longer-term unemployed, which I welcome, but what assurances can the Secretary of State provide that those additional job losses will not simply represent additional benefit payments, as well as lives wasted?
The question that the hon. Lady asks is a pertinent one. The Work programme that my right hon. Friend the Minister of State was just speaking about is to make sure that those who go beyond a certain point at differing levels are swept up because they have particular problems. We need to deal intensively with them and use the private and voluntary sector. But to help earlier, Jobcentre Plus has been pretty successful at getting people matched up with the work that they need to be in and getting them back into work. When it comes to skills, the Government are increasing the number of apprenticeships—50,000 rising to 75,000 extra—which will help hugely with skilling, and the mentoring and work for yourself programme, which are part of the Work programme, will have a huge impact, by advising young people and enabling them to take the right jobs and get the right skills. The hon. Lady is right. Skilling up is important, but we think we will be on the right track to do that. Overall, the Office for Budget Responsibility said that employment will rise over the period.
Does the Secretary of State accept the Office for Budget Responsibility figures, revealed to my right hon. Friend the Member for Paisley and Renfrewshire South (Mr Alexander), that an extra two thirds of a billion pounds will be spent on housing benefit as a result of rising unemployment over the next four years?
The OBR is independent and the Government of course accept what it publishes as independent figures. We go by what the OBR’s figures say. As the hon. Lady knows, we inherited a financial mess left by the previous Government. What we are doing is to make sure that we reduce the ballooning cost of, for example, housing benefit that she left behind—a bill that doubled in the past five years.[Official Report, 12 January 2011, Vol. 521, c. 6MC.]
Unfair Dismissal (Age)
We are moving in that direction. Our changes will abolish the default retirement age, and we will make sure that people can no longer be kicked out of work because they have reached a certain age. By getting rid of that, we will improve the economy and help older people find work for a longer period, which is beneficial to the economy and beneficial for those people.
In the recession redundancies have been higher among the over-50s than any other age group, including in Harlow. Many people, like my constituent, Kevin Forbes, who applied for more than 4,500 jobs, are worried that employment law is biased against older people. What are the Government doing, apart from what my right hon. Friend has just described, to make work fairer for the over-50s?
The reality for companies and for those who are seeking work is that, because of the need for employment over the next few years, we will need more and more of the skills that are present in the age group to which my hon. Friend refers. Therefore, companies have to reach the sensible solution, which is that people who have those skills and ways of doing their jobs can stay in work much longer. The Work programme will be set up so that they can be helped back into work if they become unemployed. My concern is that companies should recognise that older workers have huge value, well beyond the cost of paying their wages.
Constituents in Northampton have raised with me the fact that they have been forced to retire because of their age before they were ready to do so. As I know my right hon. Friend accepts, older people offer a wealth of experience and skill. What progress have the Government made on the consultation on the default retirement age?
The consultation has gone very well. We are sifting through the responses. There have been more responses than we anticipated. The vast majority have been positive, although there are some, in some areas of business, that were not as positive as we had hoped. We will publish those results and press on. I can guarantee to my hon. Friend and the rest of the House that we will press on with the issue.
I am glad to hear that the Secretary of State is keen to extend fairness to workers. It is important that people are not discriminated against, regardless of their age. Does he agree that unfair dismissal is unfair dismissal whenever it takes place, and that any steps that the Government take that make it easier for unscrupulous employers to sack people without the right of appeal will be a retrograde step?
I am not aware of any plans to change that. I agree that it is important that older workers in particular are recognised for the skills and benefits that they bring to the company concerned. Whatever changes are made, we must recognise that it should not be easier to get rid of somebody for the wrong reasons. If an employer has the right reason for getting rid of somebody, that is one thing, but people who are working hard should not lose their jobs just because they are older.
With respect to the hon. Gentleman, he asks a question that is a direct concern of the Department for Business, Innovation and Skills. However, from our point of view I have no such plans. It is a matter that he might wish to raise with the relevant Department.
Fixed-interest Income Bonds
For pensioners with savings, the Government ignore the first £10,000 of their capital when assessing them for pension credit, as a result of which almost nine out of 10 pension credit applicants have no capital taken account of at all. In addition, to support all pensioners the basic state pension will rise by £4.50 this April and the standard minimum guarantee for pension credit by £4.75.
My hon. Friend raises the very important point that falling interest rates and rates of return on savings tend to affect older people in particular. When we look at state pension reform, the return to saving and the reward for saving will be a particular priority for us. Many pensioners have their savings in very low-interest accounts, sometimes paying as little as 0.1%. There are much better rates out there, and I encourage all pensioners to shop around extensively to find the best rates possible.
Just to be clear, no one currently receiving pension credit will have reduced payments at all because of the revised state pension age timetable. In future, however, we anticipate that about 120,000 households could be affected by the increase in the pension credit qualifying age as a result of the change to the equalisation timetable between 2016 and 2020.
Given that we know that the poorest pensioners are some of those who will be hardest hit by the Government’s changes in respect of equalisation, will the Minister consider de-linking entirely the increase in the qualifying age for pension credit, which is paid only to the poorest, and the increase in the threshold for women’s pensions? He says that he is worried that the relationship with his Tory masters is a bit cosy; here is an opportunity for him to strike a rare, Liberal, fair blow.
The hon. Gentleman is right that, on average, people of lower social classes and on lower incomes tend to have a shorter life expectancy. The good news is that life expectancy is rising for people on all income levels, so as we raise the state pension age, it is only right and proper that we raise the starting point for pension credit. It would be very strange to go on paying at 60 something called pension credit when the state pension age rises, as under the previous Government’s plans, to 66, 67 and 68.
In a reply to a written answer, the Minister admitted that half a million women will have to carry on working for longer than a year as a result of accelerating the equalisation of the state retirement age. In particular, women who were born in 1954 and expected to retire in 2018 aged 64 will not now get their state pension until they are 66 in 2020. That strikes me as incredibly unfair. What is the Minister going to do about it?
The hon. Lady is right: of the 5 million people who will be affected by the increase in the state pension, a relatively small age group will be affected as she describes. It would be an option to go more slowly, as the previous Government did, but, if we deferred all changes until 2020 in order to deal with the point that she makes, it would cost an extra £10 billion. Once again, we have a suggestion for £10 billion of extra spending but no suggestion of where the £10 billion might come from.
Welfare Reform (Multiple Births)
14. What recent assessment he has made of the likely effects of his welfare reform proposals on families with multiple births. (32656)
The changes that we have proposed for welfare reform are intended to make work pay for everyone and to tailor specific back-to-work help to meet individual circumstances. Approximately 10,000 births in the UK are multiple births, from a total number of 800,000 births.
Reforms to the Sure Start maternity grant have protected cases where the first birth is a multiple birth; the Sure Start maternity grant will be payable for all children when the first birth is a multiple. I would welcome any further views or thoughts from anybody about what they feel we ought to be doing about this issue.
I thank the Secretary of State for that reply and declare an interest, as the father of one-year-old twins.
Although having twins is a very rewarding privilege, it is, as has been remarked before, often a case of two for the price of three. Research undertaken by the New Policy Institute on behalf of the Twins and Multiple Births Association, or TAMBA, shows that multiple-birth families will suffer more than most under the proposed reforms. May I ask the Secretary of State whether he or one of his Ministers will meet me and representatives of TAMBA to discuss some of the perhaps unintended consequences of their reform proposals for families with multiple births?
I congratulate the hon. Gentleman on his twins; I have four children, and one at a time was quite enough. I hope that he benefits greatly from that double-up. We will definitely see him and any group that he wishes to lead to discuss the matter further.
I welcome the Government’s decision to pay a maternity grant for each child when the first birth is a multiple birth, but does the Secretary of State not accept that parents can face exceptional costs when a multiple birth follows an earlier, single birth? Could he not apply the same rationale and pay the maternity grant in those circumstances?
Claimant Count (Wellingborough)
The Department for Work and Pensions does not itself produce forecasts of unemployment. However, the latest UK claimant count forecast for 2011-12, published as part of the Office for Budget Responsibility’s autumn forecast, was 1.52 million at the start of 2011-12, falling to 1.47 million at the end of the financial year. I am afraid that no figures are produced at constituency level looking ahead.
Having watched the skill of my hon. Friend over the years in combating the former Chancellor and Prime Minister over the increased level of unemployment in his constituency compared with 1997, I am relieved to be able to stand at the Dispatch Box and note that unemployment today is lower than it was under the previous Government. Let us hope that it stays that way.
I thank the Minister for his kind words. Every Labour Government have left power with unemployment higher than when they came to power. When they came to power, unemployment in Wellingborough was 1,826; when they left, the figure was 2,916—an increase of 60%. Does the Minister agree that the Labour party is the party of unemployment and the Conservatives are the party of employment?
In view of some of the propaganda put out by the Government and their supporters, saying that unemployed people are reluctant to find work, I should tell the Minister that over the past few weeks the local press in my area has reported that where there are vacancies, more than 100 people have applied for one single vacancy. Does that not demonstrate that up and down the country the unemployed are desperate to find work?
I have never doubted that there are very large numbers of people on benefits who want work. Our challenge is to make sure that there are sustainable jobs for the future. That is why we are investing in apprenticeships, trying to create a better climate for business and trying to make Britain a good place to create employment for the future. The great tragedy of the past decade is that the previous Government failed to do those things in good times.
No one in the House wants to see the claimant count rise—most especially, no one wants young people to have to add themselves to the rolls of the unemployed. Given what has happened in the past few months, does the Minister now think that summarily cancelling the future jobs fund was the right choice?
The whole problem with the future jobs fund was that, first, it was extremely expensive—twice as expensive as the new deal for young people; and secondly, it did not create long-term jobs. This Government believe in creating apprenticeships, which create skills that lead to a career, not in six-month expensive work placements that lead nowhere.
I refer my hon. Friend to the answer I gave to the hon. Member for Battersea (Jane Ellison) earlier today.
I raise the example of a constituent who is almost entirely blind—among a number of other disabilities—and is trying to set up his own business. As hon. Members can imagine, that involves a lot of communication with the local DWP office. My constituent needs that communication to be in an e-mailable form because he has a machine that will read the message for him in confidence without personal information being seen by his carer. The local office has said that it can send communication only by letter, citing security as a reason. Will the Minister look into that unsatisfactory situation?
Figures show that people with a disability find it more difficult to enter the workplace. What discussions has the Minister had with her ministerial colleagues from the Department for Business, Innovation and Skills about the number of employers who are showing a genuine interest in employing people with a disability?
I not only have discussions with BIS, but have gone out to talk to employers about their commitments to employing disabled people. There are some great examples of major and smaller employers who have a real commitment to ensuring that disabled people have a level playing field when it comes to taking on jobs. Through that and the support provided by access to work and other programmes that the Government are running, I am sure that we can help more disabled people to get back into gainful employment.
Is the Minister satisfied that the people who operate the Motability scheme and those who sit in judgment on appeal tribunals are aware that the Government’s intention is to encourage disabled people into work? Those people should not drive disabled people who had work out of work by taking away their Motability cars.
I can assure my hon. Friend that we greatly value Motability’s work in supporting not only disabled people who are in employment, but disabled people who are not in employment. We will be ensuring that that scheme is robust into the future. Many thousands of people enjoy the support of Motability and get great value from it.
Pensions (Administrative Burden)
We are taking forward the recommendations of the independent “making automatic enrolment work” review, many of which were aimed specifically at making automatic enrolment in workplace pensions more straightforward for employers.
I thank the Minister for his answer. Although it is crucial that the Government do everything possible to get people to save for their retirement, does he agree that currently it is even more critical to reduce the burden of red tape and bureaucracy which is preventing small businesses from creating the new jobs we desperately need?
My hon. Friend is right to suggest that we need to minimise the burden of quality workplace pension provision on firms. When the pensions Bill is published, she will see that all the changes we are making to the provision for enrolment in workplace pensions are deregulatory and will reduce the cost and burden for firms.
I refer my hon. Friend to the answer I gave earlier.
I thank the Minister for her earlier response. I have been concerned that the number of people with mental health disabilities referred straight on to jobseeker’s allowance has been greater than the number of people with physical disabilities. Can the Minister give an assurance that those undertaking workplace capability assessments will have access to high quality mental health expertise, and will she or the Minister responsible meet representatives of mental health charities from my constituency?
I thank my hon. Friend for her question. That issue was looked at in detail as part of the Harrington review. The Government accepted all the recommendations put forward by Harrington and I assure her that mental health champions—one of the proposals put forward—will be in place by March. I believe that the Minister for Employment, my right hon. Friend the Member for Epsom and Ewell (Chris Grayling), will be meeting my hon. Friend to discuss those matters further.
Although I support the recent changes to access to work, which have offered a reassurance to prospective employers that they will be able to use ATW, I am concerned that the money available is to be reduced. Will the Minister reassure me that the access to work fund will always be adequate as the Government’s policies rightly help more disabled people back into work?
I thank my hon. Friend for his question. I can reassure him about the Government’s commitment to access to work. I can go one stage further and say that more people will receive support from access to work this year than received it in the final year of the previous Government, and that that support will continue. We will be considering how we can make access to work provide really good value for disabled people and for the taxpayer.
Severe Weather (Vulnerable People)
This winter we have paid a record £427 million in cold weather payments, with 17 million separate payments.
As my hon. Friend suggests, there are two systems of support during the winter months: the winter fuel payment, which the Chancellor has confirmed will continue on exactly the basis budgeted for by the previous Government; and the cold weather payments, which will not continue on the basis budgeted for by the previous Government because they were going to cut them by two thirds and we are going to keep them at £25 a week.
I am concerned that the figures show that some 600,000 16 to 24-year-olds in the UK have never held regular work since leaving education. While this is a tragedy for them, it is part of a much longer-term problem that is not just to do with the recession. Unemployment among 16 to 24-year-olds stood at about the same level in 2008 as it had in 1997, despite some £3 billion spent on young people via the new deal and other programmes. That is why we are planning to phase out the old schemes with the new enterprise allowance scheme and the new Work programme and provide for 75,000 more apprenticeships as part of our package to improve the situation.
I am particularly concerned about the 820 young people in my constituency who are starting the year without a job. I spent some time in my local jobcentre in Ilkeston before Christmas, and I am very impressed with the efforts being made by staff there to help young people. However, can my right hon. Friend assist the House by setting out what efforts the Government are making at this time to help young people to access apprenticeships and skills training?
As my hon. Friend will know, the Government are increasing the number of additional apprenticeships from 50,000 to 75,000 over the period of this Parliament. We are also bringing forward the Work programme. It is interesting to note that young people who have been out of work for a long time, as that is defined, will be entering the Work programme a month earlier than they would have done under the new deal for young people, which will be very good for them. Prior to that, jobcentres will work very closely with young people to make sure that they get the right choices and opportunities. It is worth noting that we are also doing an awful lot in trying to get those who are still at school set ready for the world of work when they leave school.
On the subject of unemployment, the Government are meeting businesses in Downing street today and asking them to create jobs, but in its latest forecast published since the last DWP questions, the Office for Budget Responsibility revised upwards its unemployment forecasts for 2011, 2012, 2013 and 2014. Does this not confirm that it is as a direct result of the Government’s macro-economic judgments that the unemployment queue is now forecast to be longer and the unemployment bill to be higher?
The right hon. Gentleman seems to forget the financial situation that we inherited from his Government. I know that it is an uncomfortable fact, but the reality is that we had a major recession and we are taking the decisions that are necessary to get this economy back on track. If the hon. Gentleman looks at the OBR forecast, he will see that we are going to create many more new jobs and that unemployment will be falling all the way through the rest of this Parliament.
I have recently received a number of complaints that jobcentres are sending applicants for jobs to which they are not at all suited. Can my right hon. Friend give an assurance that with the introduction of the integrated Work programme, there will be new checks and balances to ensure that applicants are not sent for jobs for which they are totally unsuitable?
My hon. Friend is absolutely right. It is important that we try to match individuals with the vacancies that are best suited to them. Under the Work programme, providers will not be paid if they do not give people the right opportunities and they do not get the jobs, because there is a payment by results system. That system is the best route to ensure that those who are on benefits for the longer term get the best possible support and access to vacancies.
We welcome the hon. Gentleman back to the House after a breathless new year. We intend to find the right mix between the different channels of access to Jobcentre Plus. Many younger claimants prefer to access services online, many claimants prefer to deal with such matters face to face, and others are happy to apply for benefits and deal with such matters over the phone. The trick is to get the right mix, and that is what we will seek to do.
T3. Atos Healthcare, which provides the Department’s medical examiners, has told me that it does not provide physiotherapy services in its assessments of incapacity benefit claimants. Will Ministers consider including core physiotherapy checks for Atos so that people who are in genuine need of help and those who claim to have bad backs but are not in such genuine need can be better identified? (32670)
I am a little confused by my hon. Friend’s experience, because tests and assessments of people’s physical capabilities are carried out under the work capability assessment. Our goal is to ensure that the WCA continues to improve and is the best possible mechanism. I am happy to talk to him about his constituents’ experiences.
T4. Further to the Secretary of State’s previous answer, will he confirm that unemployment will return to pre-recession levels by the end of the Parliament? (32671)
T5. My constituent William Pender approached me to say that the removal of the mobility component of disability living allowance from his son, who resides in a state-funded care home, will leave his son more isolated, because the care home can provide only limited trips out. I invite the Minister to confirm that the full and true nature of my constituent’s mobility needs will be properly catered for under the new system after the reforms. (32672)
Local authorities’ contracts with care homes cover daily living activities, which may include providing access to doctors, dentists and local services such as libraries and banks. In addition, care homes have an obligation to help residents to pursue their independence. Our proposals will therefore remove an overlap in public funding.
T7. The Government’s ethnic minority impact assessment of the housing benefit changes states that it is not possible, because of a lack of data, to make a proper assessment. In my constituency, it is estimated that 8,500 people will be displaced. On the register, 64% of claimants are from ethnic minority backgrounds. That rises to 83% and 84% for the most vulnerable groups of those in temporary accommodation and those in houses of more than four people. Will the Government assure me that they will do what they said they might do and conduct further research into the disproportionate impact that the changes will have on ethnic minorities? (32674)
I do not recognise the estimate of 8,500 displaced families. We have made changes to the proposals so that the changes to housing benefit will be phased in and existing tenants will have nine months’ protection starting from the anniversary of their claim, with the result that local authorities will have time to manage the transition and that there will be more direct payments to landlords, so we will be able to negotiate rents down. We will of course monitor the impact of the changes as they go on, but 8,500 displaced families is not a number that we recognise.
T8. Although I welcome the Government’s payment by results model as a way of delivering value for the taxpayer, the challenge for a lot of small organisations is that it will pose huge cash-flow problems. They will have to deliver the work and pay their staff, and then they will be paid by the Government. What steps is the Minister taking to ensure that small organisations that can deliver effective work programmes are not disfranchised by the Government’s payment by results model? (32675)
I recognise the problem to which my hon. Friend refers, which is one reason why we have been absolutely clear to would-be bidders for the prime contracts for the Work programme that we expect them not simply to build but maintain a network of smaller providers. Where they have such cash-flow problems, it will be the big guys with the capital who are expected to carry the burden. In addition, we have put in place the Merlin standard, a code of conduct for contractors that basically states that if they do not do right by smaller organisations, and if they treat them badly commercially, they can lose their contracts.
T9. Will the Minister join me in welcoming the establishment of the York Disabled Workers Cooperative, in which former Remploy workers, with the support of the GMB union and others, have established a factory making garden furniture and other products and selling them directly to the public? Does that not show that there remains a place for supported employment factories in the UK, and will she bear that in mind in the context of the review of Remploy? (32676)
I join the hon. Gentleman in applauding the work of the York Disabled Workers Cooperative. It is important that we consider new ways of ensuring that organisations can help disabled people to have sustained employment, whether through social enterprises, Remploy’s enterprise services or factories.
Special Metals Wiggin is a large and important employer in Hereford city, but it has several hundred pensioners who have not had an increase in their company pension since 1995 and who have therefore suffered a more than 50% loss in the value of their pensions. Will the Minister examine the matter, and is he prepared to meet pensioners’ representatives to discuss it in more detail?
I am happy to look into the individual situation to which my hon. Friend refers. In general there are statutory requirements for the uprating of pensions in respect of service post-1997, but occasionally, when schemes are wound up underfunded and fall under different regimes, different indexation rules can apply. I would be very happy to receive more details and to meet my hon. Friend.
Given the importance of tackling social security fraud, which depends in part on promoting a sense of responsibility and honesty across the whole of society, does the Secretary of State agree that that is undermined by the widespread tax evasion by rich individuals and companies? If honesty is good enough for the poor, surely it is good enough for the rich.
Of course if one defines tax evasion as doing something utterly illegal, it is quite wrong and we should bear down hard on it. That is the reality for everybody—if they do something that is beyond the law, that is wrong and we should bear down on them no matter how wealthy they are. That should be a rule for everybody, not just for the poor.
The Secretary of State may be aware that in my constituency, we have enlisted the support of companies and the voluntary sector to host a jobs fair on 21 January, to create local jobs for local people. That could not have been done without the support of the jobcentre agencies. Will he encourage other jobcentre agencies, as a matter of policy, to support the idea?
I congratulate my neighbour on his role in that idea, which reflects the fact that as the Minister of State, my right hon. Friend the Member for Epsom and Ewell (Chris Grayling), has made clear, Jobcentre Plus has worked really well in various constituencies to try to get work clubs going. In fact, the level of work club start-ups so far has been beyond what we expected at this point. Jobcentre Plus and my hon. Friend need to be congratulated, and I look forward to coming to see him in his constituency this Friday.
The Demos report “Counting the Cost”, funded by Scope, shows that the number of disabled people who currently live in poverty is far higher than official estimates show, as their lower incomes and higher living costs are not taken into consideration. What action will the Secretary of State take to rectify that anomaly?
I thank the hon. Gentleman for his question. The Government are doing two things. First, they are ensuring that more disabled people can get into employment. As I said earlier, around half of disabled people are in employment; many more want to work and cannot. The coalition Government have made clear their commitment to access to work as a way of helping disabled people into work, as well as to the work of the Minister of State, my hon. Friend the Member for Thornbury and Yate (Steve Webb), through the Work programme and Work Choice. However, we also recognise the extra costs that disabled people face, and our reform of disability living allowance and the introduction of personal independence payments will help to ensure that we have a robust mechanism in place, which is not means-tested but can support disabled people. I am glad to hear that the Opposition will perhaps support some of our reforms of disability living allowance.
More than 100 disabled members of Chippenham’s Gateway club have written to me about the mobility component of disability living allowance, which they use to fund their transport to voluntary-run activities, which make a huge difference to their quality of life. Given the Minister’s earlier answer, how can we ensure that care homes begin to meet those transport needs so that such activities can continue, even after her reforms?
I thank my hon. Friend for his question. I do not think I can be clearer than to say that it is a condition of the registration of care homes that, when practical, they promote the independence, participation and community involvement of their residents. That is an important part of their job, and it is important that we ensure that disabled people who live in care homes continue to enjoy an independent life. Of course, if they are looking to move into employment, they are also eligible to apply for funding from the access to work scheme.
The consultation that we undertook on the RPI-CPI change was about occupational pensions, and the majority of responses were from occupational pension organisations. Unsurprisingly, as CPI is generally lower, members of the schemes were not so keen and those who have to pay for the schemes were rather keener.
Is the Minister aware that, at the weekend, the disability charity Scope described her plans to remove the mobility component of disability living allowance as “a callous decision”, which would
“result in people being prisoners in their own homes”,
and that disability lawyers have expressed concerns about the compatibility of the changes with the European convention on human rights? When will the Minister join the growing national consensus that the plans are unfair and unacceptable, and withdraw them?
I thank the hon. Gentleman for his question. It is important to make it clear that our proposals apply to people who live in residential care homes, not those who live in residential accommodation. That was slightly unclear from the question. Obviously, any measure that the Government propose is subject to a full impact assessment, in which human rights and other legislation will be examined in detail. I can assure the hon. Gentleman that we have already taken advice on the matter, and that the measures fully comply with human rights legislation.
Thank you, Mr Speaker, for allowing this urgent question to ask the Secretary of State for Health if he will make a statement on the Government’s preparations for and response to the current flu outbreak.
Every winter, flu causes illness and distress to many people. It causes serious illness in some cases and, unfortunately, some deaths. I know that each death is a tragedy that will cause distress to family and friends.
The NHS is again well prepared to respond to the pressures that winter brings—it has responded excellently this year. I thank in particular general practitioners, who each year work tirelessly to look after the health of their patients—especially this winter when the weather, as well as flu and other viruses, has presented challenges.
The rate of GP consultations for influenza-like illness is currently 98 per 100,000 people, down from 124 per 100,000. Those figures are lower than the numbers recorded during the pandemic in 2009-10 and below epidemic levels, which are defined as 200 per 100,000 people. The most recent data showed that 783 people were in critical care in England with influenza-like illness.
Where necessary, local NHS organisations have increased their critical care capacity, in part by—regrettably—delaying routine operations that require critical care back-up. That is a normal local NHS operational process; critical care capacity is always able to be flexible according to local need. We have also increased the number of extracorporeal membrane oxygenation beds, for patients with the most severe disease, from five to 22. A seasonal flu vaccine is again available this year. Our surveillance data show that the vaccine is a good match to the strains of flu that are circulating.
GPs in England order seasonal flu vaccine direct from the manufacturers, according to their needs. Vaccine supply is determined in the early part of the year, for autumn delivery. We recently became aware of reports of flu vaccine supply shortages in some areas in England. We are working with the NHS locally to ensure available supplies of surplus vaccine are moved to where they are needed. In addition, the H1N1 monovalent vaccine is now available to GPs for patients who are eligible for the seasonal flu vaccine.
The Government continue to take expert advice from the Joint Committee on Vaccination and Immunisation. Last year, the JCVI advised for the first time that, in addition to usual risk groups, healthy pregnant women should be vaccinated with seasonal flu vaccine. It did not recommend that children under the age of five outside the at-risk groups should be vaccinated. On 30 December, the JCVI assured me that this advice remains appropriate.
The number of deaths in the UK this winter from flu, verified by the Health Protection Agency, currently is 50. The number of deaths from seasonal flu varies each year, with over 10,000 deaths from seasonal flu estimated in the winter of 2008-09.
Antiviral medicines can also help clinical at-risk groups who have been exposed to flu-like illness. We notified clinicians that the use of antiviral medicines in these groups was justified and, at their discretion, with other patients. We have given access to the national antiviral stockpile to support that.
We are making publicly available for the first time a range of winter performance information, published on the Winterwatch section of the Department’s website. I wrote to all Members last week to inform them of the NHS response to flu, and updated them further in a written statement published this morning.
I thank the Health Secretary for that statement, but the truth is that he has been slow to act at every stage of this outbreak, and that is putting great pressure on the NHS across the country. It is working flat-out in our local hospital in Rotherham. We have had to open extra beds, and since last Tuesday have cancelled all non-urgent surgery. Four of the 50 patients in the UK who have so far died linked to this flu have been in Rotherham, and two were constituents.
The Health Secretary talks about seasonal flu, but we knew this would not be like normal winter flu because we knew swine flu would be dominant, so the central question for the Health Secretary is why he made less preparation for a flu outbreak that was expected to be more serious. Why did he axe the annual autumn advertising campaign to help boost take-up of the flu jab and help the public understand who is at risk and what treatment is available? We know it works, and this was a serious misjudgment.
Why was the Government’s first circular to midwives, urging them to help get pregnant women to take up the flu jab, not sent out until 16 December? Why has there been no move to offer vaccines through antenatal clinics, and why are the Government not publishing details of the numbers of pregnant women who are seriously ill or who have died, as they are with other groups that are most at risk?
With proper planning and preparation, we should not have seen GPs and pharmacies running out of the vaccine in some areas last week, nor should we have seen parents confused about the treatment available for their young children. I hope last week’s figures mean we may be over the worst, but, with 783 people in critical care and a long winter still ahead, what steps will the Health Secretary take if the numbers of ill people continue to rise? Can he now, today, give the House the reassurance he has failed so far to give the public, which is that he really has got a grip on this situation? Finally, when all the bodies he is relying on to sort out this situation will be abolished under his internal organisation, what assurance can he give the public that this will be any better handled in the future?
I share the right hon. Gentleman’s deep sadness at the deaths in Rotherham and join him in expressing clearly my condolences to the families of his and other Members’ constituents who have died. Regrettably, there will, I fear, be further deaths from flu—that is in the nature of the winter flu season—but I have to explain to him that we are in the midst of a seasonal flu outbreak that has not reached epidemic levels. Neither is it a pandemic, which is clearly a different situation in which a novel virus, to which there is not acquired immunity, is in circulation.
The right hon. Gentleman asked some specific questions. First, on having to cancel operations, I have made it clear that that is, unfortunately, a consequence: if the NHS’s critical care capacity is under pressure, it cannot admit large numbers of patients for elective operations that might require critical care back-up. The seasonal winter flu outbreak has led to an increase in the number of patients with flu in critical care beds, although they still constitute only about one fifth of the total number of critical care beds, and I pay tribute to hospitals across the country that have increased their critical care capacity, particularly in intensive care, to deal with the situation.
We are also providing assistance to the NHS. I am sorry that the right hon. Gentleman did not refer to my important announcement last Tuesday that, because we made savings in the Department of Health’s central budgets, on things such as management consultancy costs and the IT scheme, we have been able to issue this financial year—in other words, starting now—an additional £162 million to primary care trusts throughout England. They will be able to use that money directly with their local authorities to facilitate the discharge of patients. There are currently about 2,500 patients in hospital who could be discharged if the appropriate arrangements were in place. That will accelerate the relationship with social care that we are looking for.
It is pretty rich for the right hon. Gentleman and the Labour party to say that there should not have been any shortages. The number of vaccines supplied to the United Kingdom was determined before the Government took office. It was determined under the previous Administration, in the early part of last year, not by this Administration. Furthermore, it was equally not just presumptuous but unhelpful for him, during the Christmas period, to talk inaccurately about whether children under the age of five should be vaccinated. He knows perfectly well that like his predecessors we take advice from the Joint Committee on Vaccination and Immunisation. With the chief medical officer, we asked the committee to look at the issue again, and it met on 30 December and reiterated its advice that young children should not be vaccinated. So for him to stimulate press reports suggesting that parents should have their children vaccinated, when the expert advice was not that that should be done, was deeply unhelpful.
The right hon. Gentleman’s final point was about the organisations. It is clear to me that, by abolishing the Health Protection Agency and bringing its responsibilities inside the Department of Health under the new Public Health England, we will have a more integrated and more effective system for responding to seasonal flu in future years.
The Secretary of State is right that general practitioners are on the front line, and it is to them that patients will turn. Does he have any thoughts on the case of a constituent of mine who contacted me yesterday to say that he has been trying to get a vaccination, but has been unable to do so because he wants to have one after 4 o’clock in the afternoon, when he can get away from work? He does not want to jeopardise his job and is finding it difficult to access the vaccination before then, but GPs would rather vaccinate in the morning.
The arrangements that individual GP surgeries make for ordering and administering doses of the vaccine have been, since October, for them to make. From our point of view, as soon as we were aware that local supply would not necessarily match local demand in the places it should, we took the decision last week to make available the NHS stockpile—there are 12.7 million doses of the H1N1 vaccine—and I can tell my hon. Friend that 20,000 doses began to be distributed this morning. There is no reason why we cannot meet the requirement for vaccinations, whether through GPs’ own doses and local arrangements, through issuing NHS prescriptions that can be fulfilled at local pharmacies or through surgeries ordering the H1N1 vaccine from us.
Happy new year, Mr Speaker. Is the right hon. Gentleman aware—he should be because I have written to him about this—of serious concerns in my constituency about the shortage of flu vaccine, including for chronically sick people? Will he tell the House, in the most specific way, what action he is taking to ensure that sufficient flu vaccine is available in the city of Manchester and in Greater Manchester?
May I reiterate to the right hon. Gentleman that the amount of vaccine supplied to the United Kingdom is determined by manufacturers on the basis of discussions with not only the Department, but others, and that the vaccines are ordered by individual GP surgeries? The total amount of vaccine was 14.8 million doses, which is comparable to the level in previous years. Although GP surgeries have shortages, because of the preparations made during the pandemic in 2009 and given that the principal strain of flu circulating is the H1N1 strain—it is not the only strain, but it is the most relevant to guard against for many in the at-risk groups under the age of 65—we made it clear that we would back up GPs who had any shortages with access to our stockpile of H1N1 vaccine. Orders have come in and they are being filled.
Governments do not control diseases yet, but in my constituency elective surgery has been cancelled and pharmacies have run out of vaccine. What is the serious long-term alternative to the over-provision of last year and the localised under-provision of this year?
I do not think one can say that there was over-provision during the pandemic, because one could not have been at all clear about the nature of the progress of H1N1. However, what that meant is that we have the stockpile of vaccine available to back up the NHS this year. My hon. Friend makes a very good point, because there is clearly an issue to deal with regarding how this is properly managed. Before Labour Members start talking from a sedentary position, they might wish to re-examine the 2007 flu review. It was conducted by the Department of Health under the previous Administration and recommended that there should be central procurement of flu vaccine in England, but the previous Administration did nothing about it.
I am grateful to my right hon. Friend for the information that he has provided so far, but I wonder whether he could reassure the parents of a 13-year-old boy. They came to see me on Saturday because their son is egg allergic and also suffers from asthma, and they are concerned about the availability of a flu vaccine this year.
Last week, 30 beds at York hospital were occupied by people with suspected or confirmed cases of flu. That is costing the local NHS £7,500 a day—£50,000 a week—and that money could be spent on treating patients with unavoidable conditions. What lessons will the Secretary of State learn from the failure to promote the uptake of the flu vaccine this year to ensure that we do not encounter a similar problem next year?
The hon. Gentleman’s question is based on a false premise, because the level of vaccine uptake this year among over-65s is 70% and among under-65s is 45.5%, which is comparable to previous years. He did not refer to this, but because we made savings we provided the NHS with considerable additional resources in the last three months of the year precisely to manage winter pressures and ensure that beds in hospitals are available.
I congratulate my right hon. Friend on the increase in the critical case capacity and in the number of extra corporeal membrane oxygenation—ECMO—beds from five to 22, which has made a difference. Will he also pay tribute to others who help in these situations, such as the manufacturers of homeopathic medicines and homeopathic chemists? They provide preparations that may be suitable for people, such as the constituent of my hon. Friend the Member for Rugby (Mark Pawsey), who are unable to take flu vaccines and others who choose not to do so.
I am grateful to my hon. Friend for that question. His local hospital, the Glenfield in Leicester, leads on specialised ECMO bed services. In this country, we have increased the number of ECMO beds; we have more per head of population than any of the developed health economies, including the United States. As for treatments and vaccinations, I continue to rest upon the scientific and expert advice. Indeed, I hope that patients will consult their clinicians about their treatments.
I announced just after Christmas the “catch it, bin it, kill it” campaign. I had not—[Interruption.] Let me explain to Opposition Members. In 2009, the campaign took place in November. Why? It was because the spread of flu took place in late October, early November. Therefore, it occurred at the point at which there was a substantial spread of the influenza in the community. That is precisely what we did this year.
As an asthma sufferer, I am pleased to report that just this morning I had the benefit of the flu jab and it was professionally and painlessly administered. However, constituents have come to me concerned about, in one case, a child who has had the respiratory syncytial virus, or RSV and, in another case, an adult who has had pneumonia, who have been denied the flu vaccine. Will he examine how the guidance to GP practices can be amended to include such groups?
I will of course write to my hon. Friend about the nature of the advice provided by the joint committee, but we follow and have followed at each stage the advice given to us by that independent expert committee, the Joint Committee on Vaccination and Immunisation. I will certainly write to him to explain how it has determined the at-risk groups for these purposes.
Earlier, the Secretary of State made the astonishing admission that he has done nothing since the Labour Government left office. He rightly drew attention to the work being done for at-risk groups. However, emergency planning requires the sustaining of the emergency services. Why is he not giving priority to those who work for the emergency services—the police, the fire and ambulance services?
They are all offered it, so they can all be provided with it. I am not in a position to require people to take a vaccine. We are not providing mandatory vaccination in this country yet, and I do not suppose that we shall.
Secondly, I was not admitting that I had done nothing—on the contrary. What the right hon. Gentleman perhaps does not understand is that one cannot simply order additional large-scale supplies of a vaccine. A long process of manufacture is required, as it is an egg-based culture system. The amount is ordered in the spring for autumn delivery, so the amount was determined in the spring. When I entered office in May, there was not any reason particularly to think that we would need more than in other flu seasons, and we knew that we had the back-up of the H1N1 vaccine if we needed it. In early August, I made it clear that I intended to review further the system of procurement, distribution of flu vaccine and its supply. That review is ongoing and will be published shortly.
My hon. Friend makes an important point. Primary care trusts and local authorities working together should now be able to have confidence that the resources are available in this financial year—and £648 million will be available in the next financial year, and more in years beyond—to improve the relationship between health and social care not only through things such as step-down beds, but through operating, for example, hospital at home services, community equipment services and home adaptations to ensure that only those people who need to be in hospital are in hospital.
There have been several reports about children having to travel extremely long distances to access critical care in children’s hospitals. Is the Secretary of State satisfied that there is sufficient capacity for paediatric intensive care and high dependency care?
Yes, I am. The hon. Lady will know that there have always been occasions when paediatric intensive care capacity in a particular hospital is full and when it is necessary for children to be taken a distance. On Christmas eve, I was at the intensive care unit at Alder Hey and I want to pay tribute to the tremendous work done by staff there. They acknowledge that this was not just about H1N1. One reason the committee did not recommend vaccinating all children under the age of five was that children, particularly very young children, were in intensive care because of a combination of H1N1 and/or bronchiolitis and RSV. A range of conditions was impacting at that moment on very young children.
Several chemists and GPs’ surgeries in Merseyside have run out of the flu vaccine, leaving at-risk patients unable to obtain the jab. The Health Protection Agency has highlighted Liverpool as having significantly higher rates of swine flu than the English average. Will Liverpool therefore receive a higher proportion of the £162 million that the Secretary of State has made available to primary care trusts to help those affected?
The £162 million will be allocated to primary care trusts based on the social care allocation formula, which will be the same for next year. Any GP surgery, or for that matter the primary care trust in Merseyside, is free to come to us to order supplies from the national stockpile of the H1N1 vaccine to ensure that those who require vaccination can receive it.
In his answer to my hon. Friend the Member for Walsall South (Valerie Vaz), the Secretary of State was clearly giving an after-the-fact justification for his failure to act on the winter awareness campaign earlier in the year. He is fond of telling anyone who ventures to criticise him that they are completely wrong. Will he admit that on this occasion, as far as the awareness campaign is concerned, he was the one who was completely wrong?
No, absolutely not. I was simply pointing out to Opposition Members that the principle that applied in 2009, which was that the point at which flu was circulating in the community was the point at which the “catch it, bin it, kill it” campaign was initiated, was precisely the same principle that I applied this year.
May I say in response to the hon. Member for Liverpool, Wavertree (Luciana Berger) that the supplies of vaccine provided to primary care trusts or GPs’ surgeries from the national stockpile of swine flu vaccine will be provided free?
No. I have made it perfectly clear that the principle we applied is exactly the same and was based on the medical advice given to me, which was to pursue an awareness campaign on respiratory and hand hygiene at the point at which flu was circulating in the community. That is what I was asked and that is the decision I took.
Will the Secretary of State comment on the worrying media reports emanating from Scotland that at a time when there were shortages of vaccine the Department of Health was scrabbling around trying to get supplies from other countries when there was a surplus in Scotland, but it never asked the Scottish Government? Is that the case, or is it nationalist mischief making from Edinburgh?
All I can tell the hon. Gentleman is the simple truth. In the early part of last week, we asked manufacturers whether they had additional supplies. I believe that some additional seasonal flu vaccine that is licensed for use in this country probably will be made available. In any case, we have the H1N1 vaccine to support the immunisation, where required. Early last week, we did ask Scotland. The amounts that would have been available in the short run were not significant at all, so it was better for them to be retained in Scotland because there might be a continuing need for the vaccine there, rather than here.
H1N1 deaths are especially tragic because they involve people with expectations of a long life. Last year, 65,000 deaths were anticipated but fewer than 500 died with swine flu and 150 died of swine flu. If the priorities of the health service are not to be distorted, should not we approach this problem with a sense of both caution and proportion?
I share the hon. Gentleman’s deep regret. H1N1, unlike many previous flu strains, does not particularly impact on the elderly; it impacts on younger people and on younger adults in particular. That is the principal reason why we are seeing a relatively larger number of people occupying critical care beds. The NHS response has been to accelerate the provision of critical care capacity and of ECMO beds in particular.
The Secretary of State will be aware that tragically there have been 14 flu-related deaths in Northern Ireland during this winter. Given that that figure is proportionately higher than in other parts of the United Kingdom, what discussions has he had or does he intend to have with his counterpart in Northern Ireland to assess why the proportion is so much higher and whether there is a black spot with regard to that disease?
The figure of 50 deaths to which I have referred is the total number of deaths verified by the Health Protection Agency. There have been more deaths than that, but they have not been verified to have been caused by flu. I cannot comment on the relationship between the number that I quoted for the United Kingdom as a whole and that for Northern Ireland, because we are not dealing with comparable figures. My colleagues in the devolved Administrations and I will continue to keep in touch. It is important for us not to be simplistic about this. There are differences in vaccine take-up between Administrations—they are not major, but they exist. There are differences in the prevalence of swine flu, and the prevalence of flu in Northern Ireland is very high compared with England—it is even a great deal higher than that in Scotland. Happily, the number of deaths is only ever a very small proportion of the people who contract flu. To that extent, it is difficult to draw from the number of deaths conclusions about the nature of the response to flu overall, not least because the prevalence is overwhelmingly among people who are not in the at-risk groups, who, I hope, were vaccinated.
Mr Speaker, I am not sure whether you have noticed that since the Secretary of State started making his excuses for this problem, Government Front Benchers and Back Benchers have looked more and more unwell. Will the Secretary of State confirm that he has had the flu jab and that he has made sure that his Front-Bench team have had it?
I take this issue seriously, even if the right hon. Gentleman does not. As it happens, I fall into one of the at-risk groups, because I had a stroke in 1992, so I have had the flu jab. I would not ask members of my ministerial team who are not in the at-risk groups to have the vaccination, because it is not recommended.
The biggest tragedy is that the Secretary of State has learned no lessons whatsoever from what has happened. As a result, it is likely that the same mistakes will be made in the future. His answers about the advertising campaign are completely unconvincing. Will he explain why he cancelled the advertising campaign, which GPs were demanding at the time, to increase the take-up of vaccinations?
I cancelled no campaign; I proceeded only with the awareness campaign on respiratory and hand hygiene. An advertising campaign aimed at the general population would not have been effective, and I was advised that there was no evidence that it would be effective. We knew who the at-risk groups were, and it was possible to reach them directly rather than engaging in wider advertising.
Will the Secretary of State tell us what role primary care trusts and strategic health authorities are playing in dealing with the crisis? Will he explain what dismantling the SHAs and PCTs will do in terms of central planning for future crises?
The role of SHAs and PCTs is, as in previous years, to manage the NHS response to winter pressures. In future, the commissioning consortiums together with the NHS Commissioning Board, will fulfil similar responsibilities. In future years, there will be a stronger ability to integrate the response of the Department of Health and the Health Protection Agency, working together as one new organisation, Public Health England, which will have a stronger public health infrastructure.
With permission, I would like to make a statement on hepatitis C and HIV-infected blood.
What happened during the 1970s and 1980s, when thousands of patients contracted hepatitis C and HIV from NHS blood and blood products, is one of the great tragedies of modern health care. It is desperately sad to recall that during this period the best efforts of the NHS to restore people to health actually consigned very many to a life of illness and hardship. As the current Health Secretary, and on behalf of Governments extending back to the 1970s, may I begin by saying how sorry I am that this happened and by expressing my deep regret for the pain and misery that many have suffered as a result?
It is now almost two decades since the full extent of the infection was established and two years since the independent inquiry led by Lord Archer of Sandwell reported. The majority of Lord Archer’s recommendations are in place, as are programmes of ex gratia payments, which are administered by the Macfarlane Trust and the Eileen Trust for the HIV-infected and by the Skipton Fund for those with hepatitis C. However, significant anomalies remain and I pay tribute to Lord Archer, to other noble Lords and to hon. Members in this place from all parties for highlighting them.
In October, the Under-Secretary of State for Health, my hon. Friend the Member for Guildford (Anne Milton), announced a review into the current support arrangements —to look at reducing the differences between the hepatitis C and HIV financial support schemes and to explore other issues raised by Members during the recent Back-Bench debate, including prescription charges and wider support for those affected. We also asked clinical experts to advise on the impact of hepatitis C infection on a person’s health and quality of life and to consider whether an increase in financial support was needed. My hon. Friend the Under-Secretary has met representative groups to understand the impact that these infections were having on people’s lives and has also met many Members of both Houses who have been strong advocates on behalf of those affected.
We have now considered the findings of the clinical expert group and we accept that the needs of those with advanced liver disease from hepatitis C merit higher levels of support. At present, the amount of money paid to this group depends on the seriousness of the infection. There are two stages at which the Skipton Fund will make a payment, the first of which is when the person develops chronic hepatitis C infection. At this point, a person is eligible for a stage 1 relief payment—currently a lump sum of £20,000. Some may reach a second stage of developing an advanced liver disease such as cirrhosis or cancer, or of requiring a liver transplant; they then become eligible for a stage 2 payment, which is currently another lump sum of £25,000. Under new arrangements that we will introduce, this second stage payment will increase from £25,000 to £50,000. This will apply retrospectively, so that if a person has already received an initial stage 2 payment of £25,000, they will now get another £25,000 lump sum, bringing the total to £50,000.
In addition, we will also introduce a new, annual payment of £12,800 for those with hepatitis C who reach this second stage. This is the same amount as those who were infected with HIV receive. Those infected with both HIV and hepatitis C from contaminated blood will now receive two annual payments of £12,800 if they meet the stage 2 criteria—one payment for each infection—along with the respective lump sums. All annual payments that are made, both to those so infected with HIV and to those with hepatitis C, will now be uprated annually in line with the consumer prices index to keep pace with living costs.
We know that some of those infected with HIV or hepatitis C from NHS blood and blood products face particular hardship and poverty. Those infected with HIV can already apply for additional discretionary payments from the Eileen Trust and the Macfarlane Trust, but no equivalent arrangements are in place for those infected with hepatitis C, so we will now establish a new charitable trust to make similar payments to those with hepatitis C who are in serious financial need. These payments will be available for those at all stages of their illness, based on individual circumstances. Discretionary payments will also be available to support the dependants of those infected with hepatitis C, including the dependants of those who have since died. Again, this will echo the arrangements in place for those infected with HIV and will enable us to give more to those in the greatest need.
We must also ensure that those infected through NHS blood and blood products get the right medical and psychological support. I can therefore announce two further measures. First, those infected with hepatitis C or HIV will no longer pay for their prescriptions. They will now receive the cost of an annual prescription prepayment certificate if they are currently charged for prescriptions. Secondly, the representative groups raised the issue of counselling support for those infected through blood and blood products. We fully recognise the emotional distress that they have experienced. As a result, we will provide £300,000 over the next three years to allow for around 6,000 hours of counselling to help those groups.
While we focus on those still living with infections, we must also recognise the bereaved families of those who have died. At present, no payment can be made to those infected with hepatitis C who passed away before the Skipton Fund was established. That is a source of understandable distress to those who survive them, and that is something that we now want to put right. I can therefore announce that, until the end of March 2011, there will be a window of opportunity in which a posthumous claim of up to £70,000 can be made on behalf of those infected with hepatitis C who died before 29 August 2003. A single payment of £20,000 will be payable if the individual had reached the first stage of chronic infection. Another single payment of £50,000 will be made if their condition had deteriorated to the second stage, in which they suffered serious liver disease or required a liver transplant. We will work with the Skipton Fund and various patient groups to publicise this new payment to those who may benefit. Those new payments, which will go to the individual’s estate, should help more families to get the support that they deserve.
Taken together, these announcements represent a significant rise in the support available to those affected by this tragedy. Putting an exact figure on the package is difficult, as there is some uncertainty about how many people will be eligible, and how their illnesses may progress. However, we believe that the new arrangements could provide £100 million to £130 million-worth of additional support over the course of this Parliament. All payments will be disregarded for calculating income tax and eligibility for other state benefits, including social care. Although the changes apply only to those infected in England, I will be speaking to the devolved Administrations to see whether we can extend the measures across the United Kingdom.
Today’s announcements cannot remove the pain and distress that individuals and families have suffered over the years, but I hope that the measures can at least bring some comfort, some consolation, and perhaps even some closure to those affected. I commend the statement to the House.
The Opposition welcome the review and today’s statement, and we note that Labour Health Ministers had agreed the review in principle before they left office. We are glad that the statement was made on the very first day back after the Christmas break, because we are aware that the statement was promised before Christmas. We appreciate it being made as soon as it could be made.
Does the Secretary of State agree that the House owes a tremendous debt of gratitude to the patient groups that have campaigned for more than 25 years on the issue? They include the Haemophilia Society, the Hepatitis C Trust, the Taintedblood group, the Manor House Group, and individuals such as Haydn Lewis, who unfortunately passed away before he could see this resolution. Without the campaigning of those groups and individuals over two decades, the issue would have been one of private misery and private suffering. It is because they campaigned and kept the issue before the public and before the eyes of politicians that we are able to move decisively towards a proper resolution today.
Many of the measures in the statement will be welcomed, particularly the help with prescription charges and the £300,000 for counselling—I have seen with my own eyes the awful mental effect of this tragedy on people—as well as the payments for dependants, the provision for posthumous claims, and above all, the move towards parity in the cases of HIV and hepatitis C. All that will be welcomed, but there will still be campaigners who will regret that we have not been able to achieve parity with the compensation that was offered and handed out in the Republic of Ireland. It would be silly to pretend that there will not be many people still saying today, “Why could we not achieve what was done in the Republic of Ireland?”.
Finally, when we remember that more than 4,500 completely innocent and trusting patients contracted HIV, hepatitis C or both as a consequence of tainted blood, and that more than 1,900 of those people have died, leaving thousands of dependants behind, should we not, as a House, resolve that it should never again take 25 years for perfectly innocent victims of errors and mistakes to have proper justice and recompense?
I am grateful to the hon. Lady and I entirely endorse her opening and closing remarks paying tribute to all the patient groups. My hon. Friend the Under-Secretary of State for Health has met many of those groups and individuals, and I know that she would heartily endorse what the hon. Lady said about how they have brought these issues time and again to the forefront of attention in the House and the other place. I do not want to underestimate the many in the House and the other place who responded to that and did so very well by bringing these cases forward. I hope that they will see in today’s statement a proper response.
We do not know whether there will ever be a similar case. I hope we can avoid it—it would be much better to avoid it—but if we were ever in a situation where such a consequence flowed from the NHS seeking to do its best to treat patients but such harm nevertheless occurred, I hope we would recognise that, be able to identify it and not allow decades to pass before proper recognition took place.
That brings me to the hon. Lady’s substantive point, which is the relationship between what we are doing and the compensation provided in the Republic of Ireland. As we explained in October, we do not regard these as comparable cases. In the Republic of Ireland, mistakes were made by the Irish Blood Transfusion Service which led to a recognition of liability, leading to a determination of compensation. In this country we are not providing compensation. We are recognising the harm that occurred, notwithstanding the fact that the NHS at the time sought to provide the treatment that it thought was in the best interests of patients.
That harm occurred. As an ex gratia payment and in recognition of the harm that occurred and the distress that followed, we have sought to ensure that there is proper support, financial and otherwise, for the victims and their families. I hope that by getting rid of the anomalies and recognising—in particular, through the work of the clinical expert group—the impact on those with hepatitis C, we are giving the support that those who were damaged should expect.
Although I welcome my right hon. Friend’s statement, I should point out that Lord Archer recommended that there should be compensation along the Irish lines. That is a little of the context of what has taken place.
I take the opportunity of congratulating the Under-Secretary of State for Health, my hon. Friend the Member for Guildford (Anne Milton) on all the work that she has done on the matter, which I know has been welcomed across the House.
May I ask my right hon. Friend about the position in Wales? I was a little taken aback by the fact that he said that he intends to speak to fellow Ministers in Wales. I have a statement from the Welsh Minister indicating that as far as she is concerned, these issues come next to be considered by her in 2014, which was the previous agreement with the Department of Health. Many of my constituents will want to know what discussions have so far taken place and whether the arrangements will be replicated in the Principality.
The Under-Secretary will have heard what my hon. Friend said. I am grateful for it, too.
I am speaking on behalf of England in this respect. As the Department of Health, we administer the payments system. We had to reach the decisions and we have done so. We always intended to do so as rapidly as we could for England, but as I explained in my statement, these decisions have yet to be made by the devolved Administrations. It is reasonable for them to see the review report that I am publishing today, not least the clinical expert review that goes with it, in order for them to make their own decisions. Those are decisions that they must make, but if they wished us to continue to administer the system on the same basis across the United Kingdom, we would be happy to do so.
In the debate on the subject in the autumn, the Under-Secretary of State agreed to speak to her colleagues in the Department for Work and Pensions about the changes to benefits and how those would affect people who had received contaminated blood products. Can the Secretary of State give any guarantee about passporting people affected by the changes in benefits so that they do not lose out and have to go through a further set of medicals?
I am grateful for that. This is not a response to precisely the question that the hon. Lady asks, but Lord Archer made a point about whether payments should be made through the Department for Work and Pensions. We do not see that any tangible benefit would flow from that.
No, I acknowledged that. I will of course respond to the hon. Lady, but I think it better for us to administer all the payments through the system that I have set out. As I say, they will be disregarded for the purposes of calculation of benefits, so to that extent they will not impact adversely on current benefits.
Having spoken in the debate in October and having asked a question in Prime Minister’s questions in November, I very much welcome a number of elements in the Secretary of State’s statement, particularly those on free prescriptions and counselling help. Will he, however, promise to meet the Taintedblood campaigners and perhaps even to look at the overall level of compensation?
May I say two things to my hon. Friend? My hon. Friend the Under-Secretary has met those groups and will continue to meet them, because we want to ensure not least that those who are now eligible for enhanced payments and so on make proper applications. We have looked very carefully with the clinical expert group at the support that we ought to give. It is not compensation as such; it is an ex gratia form of support. We have made judgments, and if we were to go further, there would be significant additional costs. My hon. Friend the Under-Secretary and I have made it clear to the House in the past that to provide payments on the scale of the Republic of Ireland might involve up to, or perhaps even in excess of, £3.5 billion a year, so I am not in a position to say to my hon. Friend the Member for Colne Valley (Jason McCartney) that I expect to go beyond the support that I have set out today.
It is to be regretted that the review’s terms of reference were so narrow, as it did not consider overall levels of compensation or HIV. If the Secretary of State believes that the Republic of Ireland case is simply too expensive, will he please say so and not rely, as the Department has, on either the idea that the Taintedblood campaigners and others are asking him to look at that and tying us to the Irish system, or the idea that they are asking us effectively to look at those levels of compensation because negligence was involved? That was not the case in Ireland. Is not the result likely to be more litigation? The levels of remuneration are still far too low.
With respect to the hon. Gentleman, in response to previous questions I made it very clear that the question was not simply about the amount of money. The situation in the Republic of Ireland is unique in respect of its determination of liability because of mistakes made by the Irish Blood Transfusion Service. To that extent, we are making ex gratia payments. The nature of our payments stands comparison to other countries, particularly now, in respect of hepatitis C and my announcements this afternoon.
I really welcome today’s statement and, in particular, the apology, which will go a long way to ease some of the pain that some of the victims have suffered. Proper support for those infected with hepatitis C is also long overdue. Gareth Lewis, who was a leading Taintedblood campaigner—I believe he met the Under Secretary—tragically died just before Christmas, only a few months after his brother, Haydn, whom the hon. Member for Hackney North and Stoke Newington (Ms Abbott) mentioned. That highlights the urgency of my question. Governments are not known for moving quickly, particularly when it involves handing out money, so will the Secretary of State reassure us that everything that can be done will be done to ensure that the payments announced today are made as soon as is humanly possible?
May I pay tribute to my hon. Friend, who has on many occasions spoken up on behalf of her constituents and others who were affected by the tainted blood and blood products? The answer to her question is yes—absolutely we will. When we came into office, we were determined to implement the review. As she said, we sought to complete the review before Christmas—technically speaking, we did, but we were not in a position to announce it before Christmas. We are doing this at the first available moment, and we will do everything that we possibly can to ensure that potential beneficiaries are notified and reached as quickly as possible so that the payments are in place as soon as possible.
It would be one of the greatest catastrophes if what happened were able to happen again. That is why it is so vital that the Government constantly keep under review the policy on donating blood. As the Secretary of State will know, men who have had sex with men are one of the categories of people who are not able to give blood at the moment, and that seems intrinsically unfair and prejudiced. I urge the Secretary of State to look only at the scientific evidence in the ongoing review; that, and not any other political consideration, is the basis on which the decision should be made.