House of Commons
Wednesday 11 July 2012
The House met at half-past Eleven o’clock
[Mr Speaker in the Chair]
Oral Answers to Questions
The Secretary of State was asked—
Bilateral Aid Review
As is made transparent in the Department for International Development’s annual report, since 2010 the United Kingdom has given 2 million people access to clean drinking water, 2 million people improved access to sanitation and 7.4 million people improved hygiene services. The right hon. Member for Leeds Central (Hilary Benn) was candid in 2007 when he admitted that the Labour Government had taken their “eye off the ball” in relation to water and sanitation. I assure my hon. Friend that the coalition will not make the same mistake. In April, my right hon. Friend the Secretary of State announced our intention to double our results by reaching 60 million people.
I welcome the fact that under this Government, 7.4 million people have seen improvements in their hygiene conditions over the past two years. That is testimony to the Government’s strength of commitment. What assessment has my hon. Friend made of the disparity in sanitation between rural and urban dwellings?
My hon. Friend makes an extremely important point. The Government see providing adequate sanitation for poor people in the world’s growing cities as crucial. We keep a record of the proportion of our results that are achieved in rural and urban areas. We have six bilateral water, sanitation and hygiene—or WASH—programmes in urban areas, including a programme to improve WASH service delivery in 31 slums in Freetown, including in Kroo bay. I volunteered there two years ago and went back last week to see the progress that has been made.
What steps is the Minister taking to improve the situation in the Occupied Palestinian Territories, given that 80% of water in the west bank is stolen by Israeli settlers and 90% of the water in Gaza is contaminated with sewage due to the blockades?
Part of our contribution to the multilateral agencies goes towards that, not least through the United Nations Relief and Works Agency. Its work is important in the provision of water to the peoples of the Occupied Palestinian Territories, not least to provide fair access to drinking water.
Having visited the Gaza strip earlier this year, may I stress to the Minister the importance of the breakdown of the water and sewerage systems in that benighted territory? Some 20,000 children under three are suffering from avoidable illnesses because 90% of the water is contaminated. Whose fault that is does not bother the Gazans; they just need the systems to be sorted out. Britain could play an important role in doing that.
My hon. Friend makes an extremely powerful point. Broadly, the answer is yes, not least because we make extremely strong representations at every opportunity on all the points that he has raised. Equally, we are working closely with UNRWA to provide a practical solution to many of these difficult problems.
There are still 2.6 billion people worldwide who lack basic sanitation. What are the Government doing to get the international community to meet its obligations in that respect?
As my right hon. Friend the Secretary of State announced, we are increasing our approach to water and sanitation to double our results and reach 60 million people. Indeed, we are seeking to match one person in the poor world who does not have access to water and sanitation to every single person living in the United Kingdom. In particular, it is incredible value for money that about $10—which is often provided by households themselves—can provide sanitation for one household.
Development Aid (Legislation)
The 0.7 Bill is ready and is with the business managers. As the Prime Minister has said, the coalition Government will introduce the Bill when parliamentary time allows.
The commitment was referred to in the Gracious Speech. The most important thing is to get on and fulfil the commitment, which has been made on both sides of the House and by all parties, to give development aid equal to 0.7% of our gross national income. That is what we are doing. The right hon. Gentleman makes a fair point. We must get on with the legislation. As soon as the business managers say that there is a slot, we will take it.
To those who continue to doubt whether, in this time of austerity, we should stick to our eminently worthwhile target, is it not worth pointing out that 99.3% of gross national income will still be available for all other purposes?
My right hon. Friend makes an extremely good point. Many Members will agree that under 1% of gross national income is an incredibly good investment in the future prosperity and security of the countries in which we work as well as in Britain’s prosperity and security.
I say to the Secretary of State that we can get on with it. My hon. Friend the Member for Preston (Mark Hendrick) has tabled a private Member’s Bill that would enshrine the 0.7% commitment in law. It has all-party support and is consistent with promises made in all three main parties’ election manifestos and the coalition agreement. The Secretary of State is fully aware that the success of private Members’ Bills depends on Government support. Will he confirm that that support will be forthcoming? If not, why not?
The Secretary of State is fully aware that my hon. Friend offered to take the Secretary of State’s Bill and use it as the basis of his private Member’s Bill, so let us get on with it.
Enshrining the 0.7% commitment in law is only one way of fulfilling our obligation to the world’s poor. Can the Secretary of State explain why he has done nothing to stop measures in the Finance Bill that will enable UK multinational companies to avoid paying approximately £4 billion in tax to developing countries? That could be called legalising tax dodging. Is he concerned that his Government’s legacy will be to increase aid dependency by reducing self-sufficiency in many developing countries?
The hon. Gentleman is referring to the controlled foreign companies provisions of the Finance Bill and the ActionAid campaign on them. There have been discussions between Treasury officials and ActionAid, and there is significant disagreement about the effect of those measures.
I warmly welcome the coalition Government’s commitment to spend 0.7% of gross national income on international development, particularly to help us make progress towards the millennium development goal on reducing maternal deaths, which we are furthest from achieving. Will the Secretary of State outline how UK aid money will be spent to save the lives of women and girls in light of today’s excellent family planning summit, where global leadership is being shown?
My hon. Friend is entirely right to underline the fact that the coalition Government have put girls and women right at the centre of everything we do in development. She refers to the family planning summit, which the British Government are co-hosting with the Bill and Melinda Gates Foundation. That summit has the power, if successful, to reduce by half the number of women in the poor world who want access to contraception but do not have it.
As the UK emerges—hopefully—from recession over the next two or three years, 0.7% of GNI will represent a significant increase in spending. What is the Secretary of State doing to ensure that UK citizens see value for money?
The hon. Gentleman rightly identifies the importance of being able to demonstrate to hard-pressed taxpayers that every pound of their hard-earned money is really delivering 100p of value on the ground. That is exactly what the Government are doing in the case of development policy. The 0.7% commitment to which the hon. Gentleman refers reflects the state of the economy, because the spending figure will go up and down with economic health. Many of us think that is what it should do.
In addition to the support that we are providing within the country itself, my right hon. Friend the Secretary of State recently announced that we were increasing our funding to £3 million to support the UN-led response for Syrian refugees, providing humanitarian assistance for up to 185,000 people in Jordan, Lebanon, Turkey and Iraq.
I thank the Minister. It is really important that I can show my constituents that we are supporting the Syrian people in these difficult times. How many people have fled across the border to Jordan, and does he think Jordan can cope with the influx of refugees?
Three weeks ago I was in Ramtha, on the Syrian border in Jordan, just 2 miles away from Daraa, from where we could hear the gunfire. Some 140,000 people have left Syria for Jordan since the start of the crisis, more than 30,000 of whom are seeking assistance. The Jordanian Government and host families have generously accommodated a great number of refugees. We are concerned, however, that they may soon reach capacity and that the UN may need to create tented camps to accommodate the increasing numbers.
Amnesty International has reported that some refugee camps in Turkey are so close to the Syrian border that refugees have suffered injuries as a result of stray bullets from clashes in Syria. Have any representations been made to the Turkish authorities to relocate the camps and allow human rights organisations access to them to meet Syrian refugees?
The answer to the hon. Gentleman’s question is emphatically yes. More than 35,000 Syrian refugees are being assisted in Turkey and thousands more are fending for themselves. The Turkish Government are leading and co-ordinating the assistance to Syrian refugees, supported by the United Nations High Commissioner for Refugees and other humanitarian agencies. Registered refugees are hosted in 10 camps, which are fully funded by the Turkish Government, but there is, by and large, no problem with access.
We have channelled significant funding through UN agencies such as the World Food Programme, the UNHCR and the Office for the Co-ordination of Humanitarian Affairs. Some humanitarian agencies have requested us not to name them publicly as they are concerned that their staff and operations could be put at risk. We fully respect those concerns, and I can assure the House that all UK funding is nevertheless going to humanitarian agencies with a proven ability to operate in Syria.
As the Minister has said, we must be grateful to neighbouring countries such as Lebanon and Jordan. Is it correct that Iraqi Kurdistan and Switzerland are considering taking Syrian refugees because some of the neighbouring countries are already saying that they cannot cope?
The Minister mentioned Ramtha on the Jordan-Syria border. In drawing attention to my entry in the register, may I tell the Minister that I have also visited and endorse what he says about the generosity of the Jordanian people? What extra assistance can be given there? Refugees fleeing Syria is a humanitarian issue, and refugees should be treated equally whether they are Syrians or other nationalities, such as Palestinian.
A number of Palestinian refugees are indeed among those who have been forced to flee their homes in Syria and cross into neighbouring countries. We recognise that that raises difficulties, particularly in Lebanon and Jordan, and we continue to work with country Governments, the UNHCR and UNRWA to ensure that the needs of all refugees are met. Contingency planning for greater numbers is in place.
A number of my constituents have relatives who are refugees from Syria or who are trying to exit Syria, where there is shelling in cities such as Aleppo. What steps is the Minister taking to work with the Home Office to identify British people and people who have contacts in Britain to support them to return to the UK?
Discussions between Departments take place in the normal way. The prime responsibility of the Department for International Development is for the humanitarian need of people in Syria, but we will continue to work with other Departments to see what it might be possible to do to alleviate the suffering and plight of those who face such difficulty.
It is right that the international community and the UK respond to people in need at a time of crisis, but does the Minister accept that, as the crisis intensifies, Syria will get poorer and the people’s needs will become greater? Does he agree with Kofi Annan that anybody who has an interest in the future of the region and the well-being of its people, including Russia, China and Iran, should have an interest in ending the conflict?
Overseas Territories White Paper
The overseas territories White Paper reflects the Government’s collective vision for the territories and our commitment to their future through good governance and economic growth. DFID fulfils its obligations primarily through its regular support to Montserrat, Tristan da Cunha, St Helena and Pitcairn Island.
I welcome a focus on increased support for our overseas territories as opposed to the bizarre focus we currently have, whereby support in aid goes to countries such as Argentina for bilateral relations and mutual understanding, which—I suggest—is clearly not working.
I assure my hon. Friend that DFID does not directly provide any such aid to Argentina. The World Bank has not considered any loan request from Argentina recently and the UK has refused to support recent loans considered by the Inter-American Development Bank. As well as supporting the four overseas territories that I have just mentioned, we are helping Turks and Caicos to turn around its previously dire financial situation. Any such needs in the overseas territories are, of course, a first call on our aid budget.
Can the Minister confirm that there are two banks, mutual funds or tax-dodging offshore companies for every citizen of the Cayman Islands? Will the new White Paper deal with the fact that around the world the overseas territories and dependencies are seen as the tax evader’s paradise network?
With respect to my ministerial responsibilities, I can assure the right hon. Gentleman that DFID is not providing any financial aid to tax havens. The UK recently signed agreements with the Cayman Islands and the British Virgin Islands Governments, but those agreements set out what we expect of those overseas territories in how they manage their public finances.
Nepal is the world’s 16th poorest country. As I saw during my recent visit, it faces enormous political and development challenges. We are tackling them by focusing on wealth creation, strengthened governance and security, health, education, and disaster risk reduction.
According to WaterAid, only 31% of Nepal is covered by proper sanitation, and 7,900 under-fives die every year from diarrhoea. Following the high-level water and sanitation conference in April, can the Minister give me some assurance on what is being done to try to put right that appalling situation?
I assure my hon. Friend that things are just a little bit better than he says. The latest data from a highly regarded national survey suggest that 55% of people in Nepal have access to safe latrines. Despite total child deaths having almost halved in the past 10 years, child deaths from poor water and sanitation are still unacceptably high. Our programmes will help to avert 3,500 child deaths and should ensure that 110,000 more people have access to safe latrines by 2015.
The hon. Gentleman hits on a most important point. At the moment, there is constitutional and governmental deadlock in Nepal. When I was there, we were doing our utmost as an influential friend of Nepal—as I hope the UK can continue to be—to help to break the deadlock and ensure either that a new constituent assembly is formed or that there are elections, and each can facilitate and assist the other.
On 1 March we announced a doubling of British aid to Burma. We are supporting the World Bank in conducting an assessment of the development opportunities there following the remarkable changes which Aung San Suu Kyi underlined in her historic visit to Westminster last month.
We are engaged in Kachin and Rakhine states, both of which are receiving British humanitarian support. I can also announce today that a team of Members of this House, under the Westminster Foundation for Democracy, will be visiting the Burmese Parliament in Naypyidaw later this month.
Despite the signs of hope, I am sure that the Secretary of State will share my concern about the recent reports of human rights abuses in Kachin state—Christians being persecuted, women being gang raped and internally displaced persons camps becoming pools of prey for human trafficking. Can he assure me that international aid with robust human rights protection will reach the Kachin people?
At the weekend, I represented the Government at the Afghanistan summit in Tokyo, at which Britain made long-term pledges to support the development of Afghanistan and called on the rest of the international community to do the same. Today, the British Government and the Gates Foundation are co-hosting a global summit that aims to cut by half the number of women in developing countries who want access to contraception but cannot get it. [Interruption.]
Thank you, Mr Speaker. What opportunities exist for pushing for financial transparency worldwide, including budgetary transparency and transparency in natural resource management? Will my right hon. Friend’s Department seek to promote financial transparency initiatives such as GIFT—the Global Initiative for Fiscal Transparency?
My hon. Friend identifies transparency as a most important aspect of development, and it is why Britain was a key leader at the launch and implementation of the international aid transparency initiative, and we continue to work hard with partners all around the world to ensure that the emphasis on transparency and good spending that was championed at the Busan conference in November continues.
Today the Government are hosting an important summit on family planning, which we welcome. However, the brutal murder last weekend by the Taliban of an Afghan woman for adultery shows that women’s rights and freedoms remain elusive goals. Does the Secretary of State agree that the credibility of the summit will depend on women’s human rights being at the heart of the actions that follow it?
I thank the hon. Lady for her question. The summit is about ensuring that women have the ability to choose whether and when they have children, and the spacing in between their children. We need to keep the focus of the summit on that issue. She will have heard the Government’s strong condemnation of the Taliban’s execution in Afghanistan. We set up the Tawanmandi fund last year specifically to empower women in the areas that the hon. Lady describes, and its work is ongoing. Three quarters of the grants from the fund have gone to organisations involved in protecting women.
T2. Conditions in Afghanistan after the external forces leave are becoming a matter of increasing importance to us. Will my right hon. Friend update the House on the outcomes of the Tokyo summit on Afghanistan that he attended at the weekend? (116168)
The Tokyo summit was essentially a grand bargain between members of the international community to ensure that funding and support will continue through 2015 to 2017, and indeed throughout the decade of transformation to 2025. In return for that, the Government of Afghanistan need to continue to place a strong emphasis on governance reforms and economic reforms.
T3. We have just marked the first anniversary of the creation of South Sudan, but 1 million people there require food aid, and along the border the situation is even worse, with between 15% and 22% of under-fives suffering from malnutrition. Will the Secretary of State ensure that the United Kingdom’s response targets the needs of those children, who are the future of that struggling country? (116169)
The hon. Lady rightly identifies the plight of the many people caught up in that conflict. A girl born today in South Sudan is more likely to die while having a baby than to complete her primary school education. However, the position on the border, particularly in Abyei, is now easing, and there are some signs of optimism in the direct negotiations that are taking place between South Sudan and Khartoum.
Will the Secretary of State join me in applauding the strong lead being given by the UK in the arms treaty negotiations in New York and, in particular, our support for provisions that will allow legitimate arms sales but discourage wholly disproportionate spending on arms that is detrimental to sustainable development?
Yes. My hon. Friend identifies an important point. There is strong support on both sides of this House for the arms trade treaty. The Minister of State, my right hon. Friend the Member for Rutland and Melton (Mr Duncan) will be going to New York to take part in those negotiations, and it is interesting to note that, even in the defence industry in Britain, there is strong support for a level playing field and for transparency in the sale of weapons.
The hon. Gentleman accurately identifies the position of children in South Sudan, which I set out in answer to his hon. Friend the Member for Warrington North (Helen Jones). It is true that diarrhoea needlessly kills thousands upon thousands of children every day. That is one of the reasons why last year Britain led the replenishment for GAVI—the Global Alliance for Vaccines and Immunisation—so that Britain will be vaccinating a child in the poor world every two seconds and saving the life of a child every two minutes, precisely from these sorts of ills.
T4. Further to my visit to Helmand with the International Development Committee, I would like to pay tribute to the hard work and dedication of our forces and DFID staff operating in extremely difficult circumstances. The Secretary of State is aware of the shocking execution in Afghanistan a week ago of a 22-year-old woman accused of adultery. What are the Government doing to mitigate the risk of a return to Taliban-style treatment of women in Afghanistan, post our withdrawal in 2014? (116170)
The Government vigorously condemned the execution to which my hon. Friend referred. One of the key ways of transforming Afghan society to prevent the return of the Taliban’s evil practices is, of course, to get girls into school. When they are a critical mass, that will have a big effect on Afghan society. Nine years ago, there were no girls in school in Afghanistan; today, there are nearly 2.5 million.
The Prime Minister was asked—
Before I list my engagements, I am sure the whole House will wish to join me in paying tribute to Police Constable Ian Dibell of Essex police, who was shot and killed in Clacton-on-Sea on Monday. Even though Ian was off duty at the time, he acted selflessly when he saw members of the public at risk. This is typical of the behaviour of our brave police force. His death is a reminder of the great debt we owe everyone in our police force. We send our deepest sympathies to his family, his friends and his colleagues at this tragic time.
This morning I had meetings with ministerial colleagues and others, and in addition to duties in this House, I shall have further such meetings later today.
May I associate myself and the whole House with the Prime Minister’s remarks about the brave police officer who lost his life? We all send our condolences to his family.
Will the Prime Minister explain why he is making it easier to amend copyright law by secondary legislation, affecting our creative industries? Does it have anything to do with the 23 meetings he and his Ministers have had with Google?
A report on the Yorkhill child heart unit in Glasgow conducted by Sir Ian Kennedy says that
“the provision of paediatric intensive care may be unsafe if critical staffing problems are not addressed.”
The safe and sustainable review conducted by Sir Ian Kennedy now suggests that Leeds heart unit, which is safe, be closed while Glasgow’s, which is not, is not affected. It is absurd. This review needs to be thrown out.
My hon. Friend rightly speaks up for his local hospital, which is an excellent one. My local hospital has not been selected either under the safe and sustainable review, but I would say—as Prime Minister, but also as a parent—that we have to recognise that the heart operations now carried out on children are incredibly complex. In the end, this review was led by clinicians, and it is about trying to save lives to make sure that we specialise the most difficult work in a number of hospitals around the country. It does lead to difficult decisions, but I am sure that what really matters is that more parents do not suffer the agony of losing their children because we do not have the very highest standards of care in the hospitals that are chosen.
I join the Prime Minister in paying tribute to PC Ian Dibell. He demonstrated extraordinary bravery while off duty. His selfless act and his tragic death remind us what the police do for us right across this country. I am sure that the condolences of the whole House go to his family and friends.
At this last Question Time before the recess, may I remind the Prime Minister of what he said before the election when he was asked why he wanted to be Prime Minister? He paused, and with characteristic humility said:
“Because I think I’d be good at it.”
Where did it all go wrong?
It is this Government who have capped benefits, capped immigration, taken 2 million people out of tax, cut taxes for 25 million people, cut the fuel duty, increased spending on the NHS and cut the deficit by 25% in two years. I can’t read out the list of all the things he got wrong. We haven’t got time.
Government Members are obviously well whipped today. It is a shame it didn’t happen last night.
Last night the Prime Minister lost control of his party, and not for the first time he lost his temper as well, because we understand that it was fisticuffs in the Lobby with the hon. Member for Hereford and South Herefordshire (Jesse Norman). I notice, by the way, that the posh boys have ordered him off the estate today, because he does not seem to be here. Who does the Prime Minister blame most for the disarray in his Government? The Liberal Democrats or his own Back Benchers?
Oh dear. If the best the right hon. Gentleman can do today is a bunch of tittle-tattle and rumour, how utterly pathetic. On the day we are introducing social care reform that is going to help people up and down the country, we get that sort of half-baked gossip.
Let me say this to the right hon. Gentleman. If we want to see House of Lords reform, all those who support House of Lords reform need not only to vote for House of Lords reform but to support the means to bring that reform about. He came to the House of Commons yesterday determined to vote yes and then to vote no. How utterly pathetic!
It is the same old story with the Prime Minister: he blames everybody but himself. The Government are a shambles and he blames the Leader of the Opposition. That is what it has come to, but his problems did not start last night; they started months ago with the part-time Chancellor’s Budget, because they make the wrong choices and they stand up for the wrong people. Will the Prime Minister remind us, after all the Budget U-turns, why he still thinks it is right to give a banker earning £1 million a £40,000 income tax cut next April?
It was the Chancellor’s Budget that cut taxes for 25 million working people, that took 2 million people altogether out of tax and that has left us with a top rate of tax which is higher than any of the times the right hon. Gentleman or his neighbour were in the Treasury, literally wrecking the British economy.
The Prime Minister has no answer on his millionaires’ tax cut, but we are going to keep asking the question between now and next April because he has no answer. He is raising taxes on ordinary families, he is raising taxes on pensioners and he is cutting taxes on millionaires—[Interruption.] They say that they are not raising taxes. Will he therefore explain what has not been explained—[Interruption.] An hon. Member says “Weak”, by the way. What could be weaker than having 91 people vote against you in the House of Commons?
Will the Prime Minister explain what has not been explained since the Budget? Why is it fair, when he is cutting taxes for millionaires, to ask pensioners to pay more?
What we did in the Budget was to increase pensioners’ weekly income by £5.30—the biggest increase in the pension in the pension’s history. But let me repeat: what the Budget did was to cut taxes for every working person in the country and to take 2 million people out of tax, and the change in the top rate of tax was paid more than four times over by the richest people in our country. That compares with what we were left by the Labour party: the biggest bust, the most indebted households, and the biggest budget deficit in Europe, and never once an apology for the mess that it left this country in.
No answer on the disarray in the Government, no answer on the tax cut for millionaires, no answer on the tax rise for pensioners. Perhaps the right hon. Gentleman has an answer on the biggest issue of all. In his new year message he said:
“We’ve got to do more to bring our economy back to health.”
What has he delivered since then? A double-dip recession made in Downing street. Is not the reality that the biggest failure facing this Government is not the programme motion on Lords reform, but their whole economic plan?
It was under this Government that we got 800,000 more private sector jobs. Inflation is down, unemployment is down, and interest rates are at a record low. We are now a net exporter of cars for the first time since 1976. We have completed the biggest construction project in Europe, which is for the Olympics, and we have started the next biggest project, which is Crossrail. It is this Government who set up the enterprise zones, backed the apprenticeships, and are seeing business rebalance in this country.
We will never forget what we were left by the Labour Government. They were bailing out eurozone countries with taxpayers’ money, they were paying £100,000 for just one family’s housing benefit, and they presided over uncontrolled welfare, uncontrolled immigration and uncontrolled Government spending. Never has so much been borrowed, never has so much been wasted, and never have so many people been let down. This country will never forgive the Labour Government for what they did.
It is the same lecture on the economy that we have had for the last two years, and things are getting worse, not better. Every time the Prime Minister gets up with that list of statistics, he just shows how out of touch he is. We have tax cuts for millionaires, a double-dip recession, and U-turn after U-turn after U-turn. Is not the truth that the Prime Minister did not just lose the confidence of his party last night, but he is losing the confidence of the country?
There is only one person who is red around here, and that is Red Ed, running the Labour party. Who backed Red Ken Livingstone? They did. Who backed Red Len McCluskey? He did. Who opposed every measure to deal with the deficit? Who proposed £30 billion more spending? Who has given the unions even more say—[Interruption.]
Let us take what the Leader of the Opposition has done in the last year. He has opposed an immigration cap, opposed a welfare cap, opposed a housing benefit cap, opposed every single measure to cut the deficit. We know what he is against, but when on earth are we going to find out what he is for?
Q2. This Government have a great record on education reform. [Hon. Members: “ Hear, hear.”] Given the huge success of the university technical college initiative—more than 25 such colleges have been created—will the Prime Minister please confirm that he will support a further round of applications this autumn, and that funding will be available so that businesses, universities, carers and young people in Devon—[Interruption.] (116138)
It is good to see my hon. Friend on such feisty form. She is absolutely right to speak up for university technical colleges, which I think are a great addition to the schools that we have in our country. They are a really high-profile way of providing proper vocational education so that we can give young people the skills that they need in order to have a great career in the future.
On Monday 25 June, the Health Secretary announced the possible administration of the NHS trust that covers Bexley, Bromley and Greenwich. That night he met the hon. Members for Old Bexley and Sidcup (James Brokenshire) and for Bromley and Chislehurst (Robert Neill). However, although the Greenwich Members asked for such a meeting, at present there is no date in the diary and no date forthcoming. Can the Prime Minister explain why the residents of Greenwich are not given the same respect by his Minister as the residents of Bexley and Bromley?
The hon. Lady raises an important point. The situation at this NHS trust is very difficult, and it is quite right that the Health Secretary is using the powers put in place by the previous Government to deal with the issues. They are partly because of the completely unsustainable private finance initiative contracts. I take what she says very seriously and will see whether I can arrange a meeting between her and a Health Minister to discuss this important issue.
Q3. In my constituency, the average pre-tax income is just under £25,000 a year. Does my right hon. Friend share my incredulity that the Labour party still opposes a benefits cap of £26,000 a year after tax? Does this not demonstrate who really is on the side of hard-working families trying to do the right thing? (116139)
My hon. Friend makes an important point. The Opposition came to the House of Commons and said they would back a welfare cap but, when it came to the crunch, they opposed it. He is absolutely right. That shows who is on the side of those who work hard and want to do the best for their families, their country and their communities, and who thinks that people should be better off on benefits. We back the workers; they back the shirkers.
Q4. The 2nd Battalion the Royal Regiment of Fusiliers is to be disbanded, which means that 600 soldiers face redundancy. These are a battalion and regiment with a proud history of service to this country. Will the Prime Minister reconsider the cut to this battalion? (116140)
We looked at this issue incredibly carefully and took our time—we were criticised for that many times—to ensure we got it right. The decision to have a smaller Regular Army of 80,000 but a much larger reserve force—Territorial Army—of more than 30,000 strikes the right balance. The Government are putting £1.5 billion into building up those reserves, and I hope that Members across the House will help with the process of encouraging employers to allow Territorial Army reservists to serve their country. It is the right decision. We have ensured that no existing regimental names or cap badges will be lost, so it is the right package for the future force of our country.
Q5. On Sunday, independent observers hailed the first free elections in Libya for 47 years as broadly free, transparent and offering real hope for the future. Does my right hon. Friend agree that we should congratulate the Libyan people on the progress made since their successful struggle to overthrow a brutal 40-year-old dictatorship? Does it not also send a message to others, including Aung San Suu Kyi, who yearn for democracy in their countries? (116141)
I am sure that my hon. Friend speaks for the whole House and country in wanting to send our congratulations to the Libyan people on what looks like a successful set of elections. It is worth remembering that one year ago it did not look as if everything would turn out well in Libya, but I am proud that the NATO alliance and this country stayed true to the course and helped to secure the right outcome in Libya. The people there now have the chance of the successful democracy and prosperity that are denied to far too many in our world.
Q6. NHS North West London is currently consulting on the closure of four out of nine accident and emergency units. The medical director has said that North West London would literally run out of money if these closures did not go ahead. What kind of consultation poses a choice between the closure of half the A and E units in north-west London and the potential bankrupting of the local NHS? (116142)
First, on the issue of money, we have put £12.5 billion extra into the NHS. That decision is opposed by her party, which says that extra money for the NHS is “irresponsible”. We will ensure that all consultations are properly carried out and that local people, clinicians and general practitioners are listened to. We want to ensure that we have good access to accident and emergency units for all our people.
Has my right hon. Friend’s attention been drawn to BAA’s advertisement claiming that the regular train service to Stansted takes 47 minutes, which is not universally correct across the timetable and in any case is too long? Will he commit to a major upgrade of the West Anglia line so that airport passengers can get the truly fast service they need and my constituents who regularly commute can get the one they deserve?
I quite understand why my right hon. Friend wants to speak up for people in his constituency who want a better train service. What I can say to him is that as part of the new rail franchise in East Anglia, which will be let in the summer of 2014, we will be asking bidders to propose affordable investment aimed at improving services. I am sure that they will listen carefully to what he has said today.
Q7. The Government rightly donate millions in overseas aid to developing countries, including India, to eradicate poverty and disease. Despite that, the Canadian Government, including the Government of Quebec, are to invest 58 million dollars in an asbestos-producing mine; this is not for use in Canada, of course, but to export to developing countries, including India, which will put thousands of poor people at risk from deadly asbestosis and mesothelioma. Will the Prime Minister and the International Development Secretary encourage international communities, including the World Health Organisation, to oppose this quite outrageous decision? (116143)
I will be seeing the head of the WHO later today, so I can raise this issue with them. As the hon. Gentleman knows, asbestos is banned in the UK, in the EU and in a number of other countries. We are totally opposed to its use anywhere and would deplore its supply to developing countries. The Department for International Development does not provide funding to projects that encourage developing countries to import asbestos from any country or for any purpose. We are not aware that DFID funds have been used in that way at all and I would take urgent action were they to have been, but he makes a strong point about the Indian situation.
On 4 September, the European Court of Human Rights is hearing the case of Miss Nadia Eweida, the lady who lost her job at British Airways for wearing a crucifix as a mark of her Christianity. The behaviour of BA in this was a disgraceful piece of political correctness, so I was surprised to see that the Government are resisting Miss Eweida’s appeal. I cannot believe that the Government are supporting the suppression of religious freedom in the workplace, so what are we going to do about this sad case?
For once, I can say that I wholeheartedly agree with my right hon. Friend. I fully support the right of people to wear religious symbols at work; I think it is a vital religious freedom. If it turns out that the law has the intention as has come out in this case, we will change the law and make it clear that people can wear religious emblems at work.
Q8. Does the Prime Minister accept the findings of the independent Action for Children report, which show that by 2015 the most vulnerable families with children in this country, including those in employment, will lose up to £3,000 a year because of this Government’s policies? At a time when millionaires are getting tax cuts of more than £40,000 a year, can he stand at the Dispatch Box and say that we really are all in this together? (116144)
I know that the report the hon. Gentleman quotes does not actually include some of the steps that we have taken, such as providing more nursery education for disadvantaged two-year-olds. Above all what I would say is that if he looks at universal credit and the design of it, he will find that we are actually going to be helping parents with the most disabled children to make sure that they get the help they need.
Will the Prime Minister comment on the worrying stand-off between the Egyptian military, who are clearly trying to cling on to power in defiance of the Arab spring, and Mr Mohamed Morsi, who may not be a Liberal or a Conservative but is undoubtedly the democratically elected President of Egypt?
My hon. Friend makes an important point. I have been very struck by what the President-elect has said about how he wants to govern on behalf of everyone in Egypt and how he wants to respect religious and other freedoms. I very much hope that the current tension can be resolved, but I think that people have to respect the democratic will of the Egyptian people as they expressed it.
Q9. At the last election, the Prime Minister promised that pensioners’ bus passes were safe. Will he today reject calls from the Liberal Democrats and now from his close ally the hon. Member for Grantham and Stamford (Nick Boles), and categorically rule out the means-testing of bus passes, including in his manifesto for the next general election? (116145)
As Melinda Gates has recently said, women in developing countries want to raise healthy and educated children who can contribute to building prosperous communities. Does my right hon. Friend agree that one of the ways in which we can support that aspiration is to help those who wish to plan their family to do so?
My hon. Friend is absolutely right, and later today I will be speaking at a seminar event with Melinda Gates and a whole range of leaders from across Africa and other parts of the developing world about exactly this issue. We should be doing more to allow mothers access to birth control so that they can plan their family size. All the evidence shows that as countries develop, family size does reduce and populations become more sustainable, but we should help people to plan that process. It is not about telling people what to do; it is about allowing people the choice that in this country we take for granted.
Q10. Members will know that St Patrick, a Roman Briton respected by all traditions in Ireland, is a unifying figure. He established his mission in my constituency of South Down, where today many people of all faiths, drawing on his legacy, work unstintingly to build peace across the divide. When the Prime Minister is next in Northern Ireland, perhaps during the Olympics, will he come to St Patrick’s country and the Mournes, where he can meet these people and witness St Patrick’s unique heritage for himself—and where he will not find any rebel Tories? (116146)
I do not know whether the hon. Lady can guarantee that—we have an active branch in Northern Ireland—but that is an intriguing and very kind invitation. I hope the Olympics will bring the whole of our United Kingdom together. I think the torch relay has already helped to achieve that; I was very privileged to see it in my own constituency, and I know it had a very successful tour around Northern Ireland. If I can take up the hon. Lady’s intriguing invitation, I will.
Q15. One of the success stories of this Government has been their commitment to rural communities, and farming in particular. Today almost 2,000 dairy farmers are meeting in Westminster to fight drastic reductions in their milk prices at the hands of processors and supermarkets. Will the Prime Minister join them in their fight to get a fair deal for their product? (116151)
My hon. Friend is absolutely right to speak up for British farmers, and he does an extremely good job in doing that. This Government are investing in our countryside, not least through the rural broadband programme, but we do want to see a fairer deal between farmers and supermarkets, and that is why we are going to be legislating for the adjudicator, which I know my hon. Friend supports. I can also tell him that today we are announcing £5 million extra in additional funds under the rural economy grant scheme, which can help to make our dairy industry—which we should be very proud of in this country—more competitive.
Q11. What will the Prime Minister say to the 150,000 adults that the Government themselves estimate will be denied a second chance of education as a result of their plans to charge full cost fees to over-24-year-olds studying A-level and equivalent programmes and access courses? (116147)
There will be a full statement on this issue this week, but it is important that we expand further education opportunities in our country, and if we are going to expand them, we need to make it clear how we are going to pay for them. The hon. Gentleman’s question highlights what we repeatedly get from the Opposition: a complaint about this policy or that policy, but absolutely no idea of how they would pay for any of their policies.
The Government have certainly achieved a great deal in the last two years. Given that new issues are emerging as we enter the third year of the coalition, does the Prime Minister agree that now would be a good time for the political parties to review the coalition agreement for the future?
I absolutely agree that in a coalition we need to keep working out the next set of things we want to achieve. This coalition has achieved cuts to corporation tax, taking people out of income tax, a massive expansion in trust schools, and a huge contribution to our health service—which is now performing better than at any time in the past decade—and I am committed to making sure we now look at all the next steps we want to take to make our country a better place to live.
Q12. A grandfather from Blaenau Gwent fears the dole for his grandson returning from Afghanistan; some 20,000 soldiers face losing their jobs. Labour has persuaded big firms, including John Lewis, to guarantee veterans a job interview. Will the Prime Minister get the public sector to do the same? (116148)
I welcome what the hon. Gentleman says. We should do everything we can to work with employers, whether in the public or the private sector, to help find ex-service personnel jobs. They are people who have been trained brilliantly and who have contributed incredible things to our country, and I am sure we can do much more to help them find jobs. For instance, in the public sector my right hon. Friend the Education Secretary has a programme of “troops to teachers” to try to get people who have served our country to inspire future generations. I think that is an excellent scheme.
On the Prime Minister’s watch, the Army will reduce to its smallest size since 1750 and will be half the size it was at the time of the Falklands war. Does he accept that history is not kind to Prime Ministers who are perceived to have left our country without a strong defence capability?
I know that, with Colchester garrison in his constituency, the hon. Gentleman speaks with great power about military issues. If he looks at the overall balance of what we are doing, with 80,000 regular soldiers and 30,000 Territorial Army fully funded, that will mean that the Army is a similar size after the reforms to what it was before. Much the most important thing is that we inherited a £38 billion deficit in our defence budget. We have closed that deficit and it is now fully funded. We have some huge investments going ahead for our Army, our Navy and our Air Force. This country under this coalition Government will always be well defended.
Q13. Will the Prime Minister assist the House and tell us when the Chancellor of the Exchequer will take the advice of the hon. Member for South Northamptonshire (Andrea Leadsom), admit that he made false allegations last week and finally apologise? (116149)
Let us look at what my right hon. Friend the Chancellor said. He said that the shadow Chancellor had some questions to answer. I am not sure that there is anyone in this House who does not think that the shadow Chancellor has some questions to answer. Perhaps before we break for the summer we should remember what a few of those questions are. Who designed the regulatory system that failed? Who was City Minister when Northern Rock was selling 110% mortgages? Who advised the Chancellor and the Prime Minister that there was no more boom and bust? Who helped create the biggest boom and the biggest bust and who has never apologised for his dreadful record in office?
Shrewsbury remains the only county town in England without a direct rail service to our capital city. When the new rail franchises are apportioned in August, will the Prime Minister use his good office to ensure that the Government do everything possible to ensure that Shrewsbury is connected to our capital city?
My hon. Friend always speaks up for Shrewsbury. He is absolutely right that when these franchises are considered, there are opportunities to make the case for more investment and more services. I am sure that the rail operators and others will listen very closely to what he has said today.
Q14. My constituent is recovering from cancer but she has had her employment and support allowance stopped after 365 days. The Government’s consultation on changing the rule ended in March. When will we see justice for the 7,000 cancer patients in that situation? (116150)
I have looked carefully at that case and I know that the hon. Lady has now had a response from a Minister. As she knows, there are two types of ESA: one that provides permanent support that is not means-tested and another that is means-tested after a year. We are ensuring that more people with cancer are getting more help and more treatment, which is very important. It is right that there should be two forms of ESA so that those people who genuinely cannot work or prepare for work get supported throughout their lives.
Care and Support
With permission, Mr Deputy Speaker, I would like to make a statement on the future of care and support for adults in England.
The coalition programme said that reform is needed urgently. We inherited a system that too often let people down and was unfair; a system that was complex and confusing, and which responded to a crisis, but too rarely prevented it. For many years, people have called for a system fitted around the needs of care users, not the preferences of the service; one that puts people at the heart of the service and delivers high-quality care with dignity and respect.
We knew two years ago that we had to offer urgent support to social care. In the spending review 2010, we provided an additional £7.2 billion for social care over the course of this Parliament, including nearly £3 billion from the NHS to deliver more integrated care. This gives the current system resource backing, but not reform. We need also to build a better service for the long term.
The White Paper I am publishing today represents the greatest transformation of the system since 1948. The practical effect will be to give service users, their carers and their families more peace of mind. Services will be organised around each individual's care and support needs, their goals and aspirations. Intervention will be earlier, promoting independence and well-being.
The White Paper will support people to remain active in their own communities, connected to their families, friends and support networks. We will invest an additional £200 million over five years in the development of specialised housing for older and disabled people, so that people can stay independent in their own homes for as long as possible. The role of carers is critical, so we will transform how the system views and treats carers. We will extend rights for carers to have an assessment and for the first time provide a clear entitlement to the support they need to maintain their own health and well-being.
The measures in the White Paper will make it easier for people to understand how care and support services work, and what their entitlements and responsibilities are. To give people greater consistency of access, we will introduce a national minimum eligibility threshold, as the Dilnot commission suggested. We will require councils to start supporting people as soon as they move into a new area, so that it is easier for people to choose to move home, to be nearer, for example, to their relatives. Local authorities will be under a duty to ensure continuity of care, and that care users are able to take their assessments with them if they move area.
We will establish a single website to provide clear and reliable information about all care and support services for self-funders and local authority supported users and carers. As well as these improvements to national information, we will invest £32.5 million to ensure that there is better local information about the range of local care and support services available in each area.
We want people to be confident that the care and support they receive is delivered by a compassionate and caring work force. We will place dignity and respect for care users at the heart of a new code of conduct and minimum training standards for care workers. Alongside the new minimum standards, we will train more care workers, with 50,000 more apprenticeships by 2017.
A key requirement is for people to be confident that they will be treated with dignity and respect, and that providers deliver high-quality care at all times. We will rule out the crude practice known as “contracting by the minute” that can so undermine people’s dignity and choice. We should contract for quality and service, not by the clock. We will call on local HealthWatch organisations to make active use of their new power of entry, allowing them to visit care services in their local area, and to make recommendations to the providers and to local authority commissioners.
People should also be entitled to expect that services will be maintained if a provider fails. Working with local government and the care sector, we successfully handled the consequences of the Southern Cross crisis, but we also learned lessons, so we will consult on how we can anticipate and act to ensure continuity of care if a provider goes out of business. Care itself, not the provider of care, is the most important factor.
A key theme of the White Paper is that those receiving care and support know what is best for them. It is right that they must be in control of their care and support. We will make sure everyone is entitled to a personal budget, so they can be in control of their own care. We will offer all who want it a personal budget, and by 2015 support that with a legal right to request this as a direct payment. To make it easier for people to get the care they want, we will ensure that they have better access to independent advice. We will make it easier for people to see whether a care provider is good or not so that they can make real choices through an online “quality profile” for each provider. We will work with a range of organisations to develop comparison websites so that people can give feedback and compare the quality of care for themselves.
Integrated care is important for everyone, regardless of age or the reason they need care and support, but getting integration right is particularly important for those moving from one service to another. That is why we will transfer an additional £100 million in 2013-14 and £200 million in 2014-15, beyond previous plans, from the NHS to support social care services that benefit people’s health and well-being and promote better integrated care.
The White Paper will help people get better joined-up care at key points in their lives. We will legislate to give adult social care services a power to assess young people under the age of 18, and we will ensure protection so that no young person goes without care while waiting for adult support to start. We want people to receive the best possible care at the end of their lives, including a choice over where they die. The palliative care funding review recommended that all health and social care should be funded by the state once someone reaches the end of life and is entered on the end-of-life care locality register. We think that there is much merit in this and will be using the eight palliative care funding pilot sites to collect the data and experience we need to assess the proposal.
Alongside the White Paper, I am today publishing the draft Care and Support Bill. Many of the White Paper reforms need new legislation to make them work, but the draft Bill is also a major reform in its own right. The law for adult social care is complex and outdated. All those involved know how it has made the system harder to work in. The draft Bill sets out a single, modern statute for adult care and support. It brings together and simplifies provisions from at least a dozen Acts of Parliament, reflecting the recommendations of the Law Commission. It builds the law around people’s well-being and needs and outcomes—clear principles, clearly set out in law.
I am also today publishing a progress report on funding reform. In July 2010 I asked Andrew Dilnot to review the funding of the system of care and support in England. I can confirm today the Government’s support for the principles of the Dilnot commission’s report as the right basis for any new funding model: financial protection through capped costs and an extended means test. As Andrew Dilnot himself has said, that would enable people to plan and prepare so that they are not so vulnerable to the arbitrary impact of catastrophic care costs.
The progress report sets out a detailed analysis of the funding model, giving us a better basis for making decisions on how these changes can be funded. Of course, any proposal that includes extra public spending needs to be considered alongside other spending priorities, including the demographic pressures on social care services. The right and necessary time to do that is at the next spending review. Our talks with the Labour party were constructive, but no plan for funding Dilnot was agreed or, indeed, proposed by either side. A decision at the next spending review will allow time for continuing discussions with stakeholders and between the parties, and we can undertake open engagement on detailed implementation issues and options. These discussions will include the level of the cap, whether a voluntary or opt-in approach is a viable option in addition to the universal options and whether legislative provision is required.
However, as the report makes clear, we are also taking definitive steps now by accepting a number of the Dilnot commission’s recommendations. Most notably, we will introduce a universal deferred payments scheme. This will mean that no one will be forced to sell their home in their lifetime to pay for care. Provisions for this are included in the draft Bill.
The White Paper, the draft Care and Support Bill and the progress report on funding together set out our commitment to a modern system of care and support, one designed around the needs of individual people, one with dignity and respect at its heart, and one that brings care and support into the 21st century. These reforms are also the product of immensely helpful reviews by the Law Commission and the Dilnot commission and a positive and wide-ranging engagement with the care sector and the public, which is helping us to design the kind of care services and support that we would all like to see for ourselves and our families. We are determined to secure these reforms to achieve in this Parliament that which our predecessors failed to achieve in over 13 years. I intend to continue and develop an open and co-operative approach in developing these reforms. I commend this statement to the House.
I thank the Secretary of State for his statement—and, indeed, for the constructive cross-party discussions that we have held on these crucial matters.
First, let me say that we welcome many of the ideas in the White Paper that the right hon. Gentleman is publishing today. A universal deferred payment scheme would help to spare vulnerable people the agony of watching savings and assets being washed away. National standards on eligibility could help to bring some consistency to a care system in England that is today the ultimate postcode lottery. Stronger legal rights for carers are overdue, as are improvements to end-of-life care.
The proposals are important steps forward; they were also in my own White Paper, “Building the National Care Service”, which was published before the last election. I take the right hon. Gentleman’s decision to carry the proposals forward into his White Paper as a positive sign of the developing consensus between the parties, but there is one crucial difference between his White Paper and ours. Despite the obvious political risks of doing so, we faced up to the difficult issue of how to pay for care and support in the century of the ageing society. The Government have failed to do that.
With no answers on money, the White Paper fails the credibility test; it is half a plan. The proposals that the right hon. Gentleman has set out are in danger of appearing meaningless and may raise false hope among older people, their carers and families. The proposals have no answers to the immediate funding crisis that is engulfing councils and resulting in thousands of older people seeing support taken away or facing huge increases in charges for day care and meals on wheels—stealth taxes on the most vulnerable in our society. Furthermore, there are no answers on how we pay for a fairer care system in the long term. Let me take each of the two issues in turn. I shall start with council funding.
Today we have a promise of new standards, new services and new rights for councils to deliver. I fear that that will be greeted with sheer disbelief in town halls up and down England. Councils are already facing a major funding shortfall, estimated to be at least £1 billion. They cannot cope with what they already have to do, never mind their being burdened with additional unfunded pressures. What is the Government’s assessment of the extra costs that will fall to local authorities in England from the proposals in the White Paper? Will the Secretary of State tell us how and when he plans to pay for those costs, as well as make up the existing shortfall in council budgets?
There is simply no point in promising new ideas if they come on top of the crumbling foundations of inadequate care budgets. Councils need emergency support. The right hon. Gentleman has allocated just £100 million and £200 million today, but last week it was confirmed that the Treasury had clawed back £1.4 billion from the Department of Health budget. Surely it would have made sense to have reallocated at least half that clawback—£700 million—to council budgets, to relieve pressure on care. Does he not accept that such a move is needed if his plans are to have any credibility in local government circles?
Let me turn to the flagship proposal—the new duty on all councils to provide loans to older people so that people can pay care costs after they die. Before we judge that, we need more detail. Can the Secretary of State tell us what the upfront set-up costs will be to local authorities? Currently, there is a deferred payment scheme based on no interest, but we read that, when his scheme is up and running, councils will be able to charge interest so as not to lose money.
Will the Secretary of State confirm that that means that councils will have to charge close to commercial rates of interest? Does he not accept that, if that is the case, taking on such large amounts of debt might be very frightening for older people? Was it not for that very reason that the proposal really made sense only if it came as part of a package alongside a cap, as promised by the Dilnot commission? This is the problem with the Government’s White Paper: they are adopting a pick-and-mix approach to the Dilnot package, which was conceived as a coherent and complementary whole.
That brings me to my second issue. I hear talk only of a vague commitment in the progress report to the main principle of Dilnot, so are the Government not in danger of sliding back on their own independent commission, which had produced the best hope for years of a consensus between us? I know, perhaps more than anyone, how politically charged these issues are, but I also know that progress will never be achieved if politicians cannot put difficult options on the table for fear of being accused of political point scoring. That is why my right hon. Friend the Leader of the Opposition made a genuine offer of cross-party talks to give the coalition the political space to look at those difficult options. I thank the Secretary of State for the way in which he conducted those talks—indeed, I thank the Minister of State, the hon. Member for Sutton and Cheam (Paul Burstow), too—and I have welcomed his idea of producing a joint progress report on funding.
I do not doubt the Secretary of State’s personal commitment to making progress, but I suspect that he was thwarted by the Treasury and a Chancellor who is making one wrong judgment call after another. The Government’s decision to change course at the eleventh hour and produce their own progress report, without input from Labour Members, reflects a Treasury decision to try to close these issues down—a mistake and a missed opportunity. Let me say this to the Government: if they offer a genuine, two-way discussion on the funding of care, with honesty about existing pressures and the difficult options, we will play our part, but they cannot expect us to provide political cover for a failure to face up to the scale and urgency of the care crisis in England. To do so would be to fail the millions of older people, their carers and families who have already waited long enough for politicians to get their act together.
The truth is that the Government are ducking one of the biggest issues of our time, with a White Paper that has today been branded a “massive failure” by the Alzheimer’s Society. Today’s announcements are designed to create a false sense of momentum and to disguise a Government decision to kick the funding of care into the political long grass. They have made their choice—they have placed Lords reform at the top of the agenda and shunted the care of older people into “Any Other Business”. That is the clearest sign yet of a Government who are losing their way and have their priorities completely wrong.
I am grateful to the right hon. Gentleman for welcoming the announcements about access to universal deferred payments, national eligibility criteria, and the work that we are undertaking on promoting free care at end of life. I am surprised, however, that his final remarks seemed to be completely contrary to what he said at the outset. Let me be very clear: the White Paper is the product of the priorities of the people with whom we have engaged throughout the “Caring for our future” process. It directly reflects the priorities of the care and support sector, and I would therefore be surprised if anybody in the sector failed to recognise that and to support it. It is focused on delivering quality and promoting the work force. For the first time, it gives access to legal rights for carers in terms of support. It is very clear about the issue of personal budgets, where there has been a dramatic expansion over the past two years.
Let me deal with the right hon. Gentleman’s specific questions. Since we came into office, we have continually recognised the need for support for social care and for the funding of local authorities for this purpose. That is why we made provision for £7.2 billion of additional support, £3 billion of which comes from within the NHS. As he will see from page 64 of the White Paper, the £300 million of additional resources that it announces more than meets the cost of the White Paper to local government. We are continuing to support social care within the NHS. The latest figures from the Association of Directors of Adult Social Services suggest that only about 13% of total savings took the form of reductions in any service for care users, with the rest relating to efficiency savings redirected into the service that is being provided.
It is simply not the case that we are adopting a pick-and-mix approach to the commission of Andrew Dilnot and his colleagues. We are proceeding with some of its recommendations—for example, on eligibility criteria and deferred payments—and supporting the principles for a new funding model based on the capped cost and extension of the means test. The right hon. Gentleman said that we have to be able to pay for it; yes, indeed we do. That is why we will continue to engage with him and his colleagues and with the wider sector. It is very important that we take people with us on this.
It cuts no ice for the right hon. Gentleman to say that after 13 years of a Labour Government he published a White Paper days before the announcement of the last general election. If he wants to go back to the proposal that he made at that time, which was to impose a tax in order to pay for this and to means-test access to disability benefits, then let him say so, but that is not the basis on which we are proceeding. Andrew Dilnot considered those proposals and did not recommend them. We need a proposal that garners wider consensus and support than was evident for the right hon. Gentleman’s White Paper. I am determined to try to secure that, and we will continue to engage with the sector to make it happen.
I welcome the package of measures that my right hon. Friend has announced, which represent important progress towards the delivery of many objectives that are, as we have heard, shared across the House. May I ask him two specific questions? First, he has published a welcome draft Bill showing that many of these aspirations can be brought into effect. Do the Government expect to be able to provide time to make that draft Bill law in the next Session of Parliament? Secondly, in the context of that Bill, does he hope that the continuing cross-party talks may yet provide the basis for answering the funding question that has bedevilled those talks for so long?
I am grateful to my right hon. Friend. It was neglectful of me not to mention that the White Paper and the announcement that I have made also drew on the recommendations and work of the Health Committee, and I am pleased to have been able to respond to its report as well.
First, matters relating to the legislative programme for the next Session will be announced in the normal way in the Gracious Speech. Secondly, I am determined that we will not only, I hope, have continuing cross-party talks but that they will be conducted, as I think that the shadow Secretary of State himself would wish, with the sector in a more open, public debate. If we were able to arrive at a position whereby, notwithstanding the fact that funding decisions might be made in the spending review, there was scope to put in place legislative provisions that allowed that to happen and could be agreed in time for the introduction of the draft Care and Support Bill, then we would look to make that happen. However, that is conditional at this stage.
The Secretary of State seems to forget two things. First, his Government did not implement the Personal Care at Home Act 2010, which would have made a difference to people. Secondly, they did not ask Dilnot to consider where the money was coming from, so he can hardly be blamed for not putting forward suggestions. The Secretary of State has committed to a few of Dilnot’s principles but ignored the fact that he advised the closure of the current funding gap in social care. Will he back Labour’s call for the Treasury to use £700 million of this year’s health underspend to close that funding gap, which is the cause of the crisis in social care?
First, it is ironic that the shadow Secretary of State said that local authorities would be aghast if they were asked to do extra things without resources given that we are providing those resources and that the Personal Care at Home Act was completely unfunded, which is why local government was desperate for us not to proceed with it. Andrew Dilnot and his colleagues are very clear, as are we, that there are, as I said in my statement, baseline funding pressures on local authorities in relation to social care. That will be addressed in the next spending review, as it was necessarily addressed in the previous spending review in direct response to recommendations that Andrew Dilnot gave us in 2010.
I welcome the statement, which contains many good things, but without financial clarity we risk offering an unsustainable solution to an unsustainable problem. What can coalition Back Benchers do to get the Treasury to go further and faster?
The statement I have made is a Government statement. We are working closely with our colleagues across Government to secure these proposals. I know that my hon. Friend understands these things very well. He will know that if there are significant public expenditure implications beyond the current spending review period, they must be dealt with in the context of a spending review. All Government Members are committed to deficit reduction. Understanding where, within those constraints, our priorities lie is the essence of a spending review.
This is a much more important issue than Lords reform. It is important to millions of people in this country and I am happy to have the opportunity to discuss it. There is clearly a huge shortfall and a crisis of funding in social care. The Secretary of State is not hoodwinking anybody by suggesting anything other than that. What has changed since he walked away from the cross-party talks led by my right hon. Friend the Member for Kirkcaldy and Cowdenbeath (Mr Brown)? The Secretary of State dressed up the proposal made before the general election as a “death tax”, yet he has come back with a proposal that is broadly similar.
I am not attempting to hoodwink anybody. I have made the point very clearly that in this financial year the Association of Directors of Adult Social Services is making total savings of £891 million, of which only 13%, some £113 million, is being achieved through reductions in services. We are investing in and supporting such services. In 2012-13, £930 million of extra funding will go to local authorities through formula grant to support social care. The NHS is transferring £622 million and we are doubling last year’s figure so that £300 million will be available through the NHS for re-ablement. Those are major additions to the support for care.
On the other point that the hon. Gentleman made, even the right hon. Member for Leigh did not try to return to the debate that we had before the election, and rightly so. The right hon. Gentleman eschewed party political point scoring; the hon. Member for Easington (Grahame M. Morris) did not. I think he should have done.
I warmly welcome the statement. There is clear commitment in a number of good areas, including improving the portability of services, providing greater support for carers, improving respite care and having more joined-up working between the NHS and adult social services, which will save social services and the NHS money, and improve the care that is delivered to patients. Does the Secretary of State agree that when local government commissions services, it should do so with a view to improving the quality of care and moving away from the care-by-the-minute mentality to which many local care providers seem to adhere?
My hon. Friend is absolutely right in all respects. I know that local government will welcome the philosophy of commissioning for quality, rather than commissioning simply on the basis of watching the clock. That will also be welcomed by older people who are in receipt of care.
It is clear that the Secretary of State is moving on from causing chaos in the NHS to causing it in the care service. Given the crisis in the budgets of social services, will he set up an independent body to look at how much money local authorities require to provide high-quality social care?
I am sorry, but the hon. Gentleman simply demonstrates his ignorance of what is in the White Paper. Those who work in social care, those who represent care users, care recipients and carers want the changes in legislation and in support to focus on looking after people. That is absolutely our agenda. We know that there are funding needs. That is why, in the spending review, we have provided the sums that I have set out. That will enable local authorities to maintain their eligibility to care. This year, only six authorities have reduced their level of eligibility to care from moderate to substantial.
My right hon. Friend’s statement will be widely welcomed, especially the loans aspect and the emphasis on personal care budgets. Will he confirm that his Department’s trials are showing that personal care budgets are very effective in empowering patients, reducing costs and bringing in a wider range of services and greater patient choice?
My hon. Friend is absolutely right. A study published in the latter part of last year demonstrated exactly what he has set out. There has been a major increase in access to personal budgets. When we came to office, about 168,000 people had access to a personal budget. The latest figures show that we have reached 432,000 people. We are aiming for everyone who wants it to have access to a personal budget by April 2013. The draft Bill that we have published today would give legal backing to that and to access to direct payments.
On 5 December last year, the Minister with responsibility for disabled people said in a written ministerial statement that a consultation on the independent living fund would be published in conjunction with a White Paper on social care this year. Will the Secretary of State say how a consultation on a review of the independent living fund will be meshed with the proposals in the White Paper? Will he assure me that there will be a coherent approach in Government to deal with the ILF in the context of the proposals that he is announcing today?
I am grateful to the hon. Lady, because she gives me the opportunity to say that my colleagues at the Department for Work and Pensions will publish a document shortly. That will enable her and other hon. Members to see the relationship between the two documents.
I welcome my right hon. Friend’s statement, and in particular the recognition of the role of housing in helping people to live independently in their own homes. Will he elaborate further on how the £200 million extra may be spent by local councils? Does he support the recommendation of the Health Committee that we have a single commissioner for health, social care and housing?
The £200 million over a period of five years that I have announced today will be able to be leveraged, with the involvement of private sector investment and social landlords, to provide an opportunity for several thousand additional places in specialist housing for older people and those with disabilities. We are talking about the kind of extra-care homes that give people the sense that they are moving into their own home, but with care available. That will be available in people’s own communities to a greater extent if we can increase the supply.
The Secretary of State says that he can give no commitments past the spending review in 2015. However, he said that by 2017—two years after that—we will have 50,000 more care workers. There is a big question over how that money will be found. He makes a big point of saying he has given local authorities all these extra resources to deal with the extra tasks that they will have. In the discussions on that, have local authorities said they are satisfied that he is providing enough money for them to carry out those extra tasks?
I know that the hon. Gentleman will not have had a chance to look in detail at the White Paper, but it makes it clear that the costs in the spending review period are more than adequately met by the additional resources. [Interruption.] The hon. Gentleman and his colleagues are confusing two different things. The White Paper looks at specific additional tasks—for example, in the provision of independent information and advice, including local information about access to care services. That is more than fully funded. The figure he mentioned referred not to the number of care workers but to the number of care apprenticeships that are being developed with the sector.
As co-chair of the all-party parliamentary group on carers, I welcome the new rights for carers that are proposed in the White Paper. However, a couple of things follow from that. First, GPs, social workers and others have a responsibility to do everything possible to identify carers, because unless people identify themselves as carers, they will not be able to access those rights. Secondly, we should support carers by developing training programmes for them, so that those who find themselves in that position are empowered to undertake their caring role.
I am grateful for the work of my hon. Friend and the all-party group. This is an important moment. If the House approves the draft Bill, the rights and entitlements of carers to assessment and support will be set out in law for the first time, in the same way as we have done for those for whom they care. He makes an important point. The draft mandate for the NHS that I published last week gives specific attention to the need to identify and support carers. I hope that these proposals will also enable the NHS and social care to join together in support of carers.
May I return to the point that my hon. Friend the Member for Halton (Derek Twigg) made? Have local authorities confirmed that they are satisfied that the funding that has been made available will cover the new duties they have to undertake?
There is much to be welcomed in today’s announcement. After so many years, people all over the country will be pleased that so much progress has been made, particularly for carers and in improving the quality of care and professional standing of paid-for carers. Will the Secretary of State confirm what I think I heard him say—that if the Opposition were to redouble their efforts and the whole country were to engage in the debate that today’s announcement will trigger, the mechanisms to solve the bigger problem of how the funding can be provided could be included in the forthcoming Bill within the next 12 months?
Yes, and I am grateful to my hon. Friend. I will not reiterate what I said in response to the Chair of the Health Committee, but I hope that as we make progress we will be able to see what legislative provisions are required and make them available at the earliest opportunity. She makes an important point, because we must not lose sight of the opportunity to improve quality. There are certain things that require resources, such as access to quality profiles of care providers so that people can make proper assessments of the quality of service that they will receive, increasingly using their personal budgets or direct payments. There is dramatic potential in that. Starting today, quality profiles of 12,000 care providers will be made available.
A delayed solution to the growing crisis in social care is no solution. In Birmingham, there are none more noble than those who care and none who deserve our support more than those in need of care. Does the Secretary of State not recognise that in failing to act now he is both surrendering a historic opportunity for a new settlement based on Dilnot and letting down the most vulnerable in our country?
I, too, greatly welcome today’s statement and congratulate my right hon. Friend on taking forward this important policy. Health and social care is devolved to the Welsh Government, but it is inevitable that statements, decisions and policy changes in England have a major effect on Wales as well, because some of the services provided to people in Wales are over the border in England. As well as cross-party talks, may we have cross-border talks to ensure that the system works well in Wales?
My hon. Friend makes an important point. We want people who move from England to Wales or from Wales to England to have continuity of care, so I will make it clear to my counterpart in Wales that I am entirely open to discussions about that. Given that it is a devolved matter, it is better in a sense if the initiative for those discussions comes from Wales, because I do not want to be interpreted as trying to impose any solution on Wales, but if the Welsh Government look for such discussions I will be open to them.
In response to the White Paper, the NHS Confederation has said that people are
“staying in hospital longer…because the right services are not in place to allow them to go home when they are medically fit to do so.”
Given that it is estimated that delayed discharges from our hospitals cost some £18 million a month, what action are the Government taking to get rid of that waste of public money?
The total number of delayed discharges is broadly the same as it was last year and, I believe, from memory, the year before—I will correct the record if not. Some 29% of the delays in discharge from hospital are due to the inability to access social care. Most of them arise because people are awaiting further assessment or treatment in the NHS. We have all the details of delayed discharges and are working actively to reduce them.
I very much welcome many of the measures that my right hon. Friend has announced, particularly on the improvement that he wishes to see in the dignity and respect accorded to those in our care homes and NHS hospitals, especially older people. Will he say a little more about the minimum standards for staff working in the care sector, and about the qualifications that people who apply for care apprenticeships might require to provide the right quality of care?
Yes, I am glad to do so. Through the work that we are doing with Skills for Health and Skills for Care, we will set out more clearly the training requirements for those undertaking care work and care assistance in the NHS. In addition, we set out in the White Paper that there should be a code of conduct, and I hope that across the service the philosophy of commissioning for quality, not simply commissioning or contracting by the minute, will help push us towards improvements in the dignity and respect with which care users are treated.
There are 800,000 people in this country with dementia, a devastating condition for themselves and their families. Many of them rely on the support of community-based services, which means that they are not admitted to residential care and may have a crisis that results in hospital admission. It is a false economy not to support community services. If the Secretary of State were really in touch, he would know that there are massive cuts across the country in exactly those services. Will he go back to the Chancellor now and say, “We need some money now to deal with the crisis”? Otherwise, the integration that he talks about in the White Paper will not happen and the crisis in local authority care will continue.
I am sorry that the right hon. Lady does not seem to recognise that in addition to what I have announced today, about three months ago the Prime Minister launched the dementia challenge. It provides resources in the NHS, through the commissioning for quality incentive, for the identification of patients with dementia and for follow-up assessments and support. It is doubling research into dementia and supporting a programme for the creation of dementia-friendly communities. As part of that dementia challenge, local authorities and the health service will work actively together to make communities far more dementia-friendly and more effective in treating dementia.
Like carers and many vulnerable people across the country, I warmly welcome the White Paper and the progress that is being made. People are keen to see a continued political consensus, which existed, and on which the Opposition were to be congratulated, until about half an hour ago. May I urge the Secretary of State to do everything he can to ensure that that consensus continues? Will he also set out a bit more about what the national minimum eligibility threshold will mean, so that people across the country know what they are entitled to?
On the latter point, my hon. Friend will be aware that the national eligibility threshold that we are legislating for will come into effect in 2015. We will of course make it clear before that at what level it will be set. I cannot provide that information at the moment, not least because we have reservations about the overall effectiveness of the classification of need under the fair access to care services system in the intervening period. If we can improve the eligibility framework, we will set out to do so.
I say to the right hon. Member for Leigh and his colleagues that I am very happy to continue to talk. I know that he did not want us to proceed on a unilateral basis from the progress report, but in truth what we published did not represent our making decisions unilaterally but instead reflected the point that we had reached. I am happy for further talks to take us beyond that point.
If we are to offer people the dignity and respect that the Secretary of State has talked about and prevent the type of abuse that both shocks the nation and frightens care users and their families, although training is very important, so is monitoring. Will he guarantee that the money necessary for monitoring will be available to HealthWatch, the Care Quality Commission and similar agencies? At the moment, people do not believe that those agencies are requested to monitor them properly.
The hon. Gentleman will know that we are making resources available for HealthWatch. It also has additional powers and a remit that extends in a way that the remit of LINks never did. There is therefore a patient and care users’ voice, and a much more effective power to enter, view and report. The link of HealthWatch England to the Care Quality Commission is important. We have increased the resources of the latter. I am sure that when he sees its annual report, he will appreciate the steps it is taking to extend its inspection more reliably on an unannounced basis, including into domiciliary care provision.
I have a great deal of respect for the Secretary of State, but I agree with the chief executive of the Alzheimer’s Society, who has said:
“Every day without a funding decision is another day where people…with dementia…face huge costs for…substandard care.”
Will the Secretary of State therefore take this opportunity to assure the House that any new system of funding will end the current dementia tax, under which those with dementia are penalised as a result of their condition with some of the highest social care costs?
In this instance, I completely understand where the Alzheimer’s Society is coming from. We all want to achieve what Andrew Dilnot made very clear in presenting his report. Any of us or any members of our families could be subject to catastrophic care costs as a consequence of a diagnosis of dementia and several years’ need for care. We want people to be able to plan and prepare, and to protect themselves against that. From the Government’s point of view, and as I have said today, the Dilnot commission’s report is the basis for a funding model for that, but it must be paid for. As with anything else, we are not going to start promising things that we do not know we can pay for. We therefore have a job of work to do, and I am determined that we will do it as speedily as we can.
The Secretary of State referred to deferred payments. In the time before the individual dies, who will pay for that care? Is there any estimate of how much the care will cost? It seems to be an extremely bad deal for the individual if they must also carry the interest rates of that loan. Will it be administered by local authorities? Who will fund that local authority?
The residents of Thanet will be reassured by the paper, particular when it comes to caring by the minute, which shows so little respect and dignity for the elderly. However, I urge the Secretary of State to look at the culture of social care, in which funds go more to crisis management than to prevention. I urge him to understand that we could introduce many new measures that will keep people healthy as they get older rather than ambulance-chase after a crisis.
I agree with my hon. Friend. That is why we want the focus to be on maintaining well-being and independence. More specialist housing will help with that. The doubling this year compared with last year of resources from the NHS to support re-ablement—when people are discharged from hospital after, for example, a fall and a hip fracture—will directly enable people to be more independent. A lot of the resources that the NHS is putting in with social care is directed towards that kind of preventive work rather than to crisis response. I hope we can do more of that in future.
Without underestimating the inherent challenges, may I welcome the statement and commend the approach of the shadow Secretary of State? The draft care and support Bill makes provision in respect of the portability of care packages between local authorities in England, but it does not yet provide for the “passportability” of care packages to Northern Ireland and Scotland. Historical migration factors mean that many Irish people are lonely and in remote care settings in England who would much rather be in a care setting in which they can enjoy the support and contact of their families—their families want them there too. When will that finally be addressed?
As I told my hon. Friend the Member for Montgomeryshire (Glyn Davies), I completely understand the problem. I will be entirely open to representations from, and discussions with, the Wales and Northern Ireland Administrations on the scope for achieving continuity of care for those who move between different parts of the UK. There are differing systems, but we can at least try to ensure that we build continuity of care around the needs of the individual care user rather than constantly being obsessed with the characteristics of our own systems.
As the Member of Parliament who represents the area with the highest elderly population in the north-west of England per head, I welcome the statement and the importance that the Government place on care and support, which is the most challenging issue authorities such as Cheshire East council will face over the next few years. The Secretary of State is right to talk about working with local authorities, but how will this work on greater support for carers include greater support for, and, importantly, dialogue with, community and voluntary organisations, such as Crossroads Care Cheshire East, which does excellent work and provides real added value? It tells me that it could do so much more if it was given such support.
I am grateful to my hon. Friend. I know how important the work of Crossroads Care is in my constituency and others. The “Caring for our future” engagement over a number of months was a major contributory process to the White Paper. I believe we have accurately reflected in the White Paper the priorities set out then. This is not the end of the process. We have important and positive messages to take forward, and further work to do, not least on funding. I hope we can do that equally in close co-operation with the Care and Support Alliance and its members.
Given the scale of the care crisis in Wirral, I have listened to my constituents at a number of public meetings. They tell me that their priority is for loved ones to live at home with dignity, but local authority cuts make that harder, and—I am sorry—the NHS reorganisation is just a distraction. Contracting by the minute, which the Secretary of State mentioned, is far from the only problem. How will he tackle other problems in the care industry, such as older people being disrespectfully told what time to go to bed and get up?
As I said in the statement, we absolutely intend for care services to be responsive to the needs of patients, and to their goals, aspirations and wishes. That is not only a cultural shift, but a financial one—the availability of personal budgets and direct payments for everybody in the social care system will give patients the financial levers to make that cultural shift happen. However, the situation in the Wirral she describes is not how it was described to me when I was there in April. I was told that the health and wellbeing board brings together social care, public health and the NHS so that they are far more effective in the delivery of services locally.
I thank my right hon. Friend for making progress on this problem, which is a worry for so many of my constituents. They will welcome the proposals, but does he agree that the proposals for paying for care fees by way of a one-off insurance premium, which are contained in the Conservative party manifesto, would have been far better in promoting personal responsibility?
I welcome many measures in the paper, including on the transition from being a child needing care to becoming an adult needing care, and on allowing people to choose where they want to end their life in palliative care. I represent a coastal constituency. Many people retire to the coast to enjoy the benefits of the sea air. Will he assure me that Suffolk county council will not be penalised by the fact that, in bringing families together, they will not take on extra care burdens for which they had not planned?
I completely understand my hon. Friend’s point. We very much reflect the need for care and health care in the allocation of resources to local authorities through the formula grant, and the allocation of resources to the NHS through the NHS resource allocation.
Councils have faced a £1 billion cut in their funding for care of the disabled and elderly since the right hon. Gentleman’s Government came to power. Without the cash, the White Paper will be meaningless. How confident can he and everybody else in the country be that the Treasury will cough up, given the track record so far of a £1 billion cut to councils?
I am sorry, but I simply do not recognise the figures that the hon. Gentleman is using. The Association of Directors of Adult Social Services has suggested—these are not my figures—that this year the service reduction in adult social care budgets on a monetary basis was £113 million and last year it was £226 million. The great majority of the figures he is quoting are actually not cuts at all; rather, they are service efficiencies, which are being reinvested for the benefit of maintaining eligibility.
My constituent who has been campaigning on portability of care packages outwith England will be extremely disappointed, because he was given to understand in correspondence from the Secretary of State that this would be covered in the White Paper and it clearly has not been. While we are thinking about Scotland, does the Secretary of State accept that the problem will not be solved even by shifting some of the costs of care from the individual to the state? We have had free personal care in Scotland for some years, but it has not resolved the problems because no additional money was put into the system.
I will not attempt—not least because of time—to give an analysis of the difficulties that have been experienced in Scotland. From my point of view, I had understood that what we have set out to do in the White Paper is very much to ensure continuity of care, so that when people move—certainly in England, for which I am responsible—local authorities have a duty to ensure continuity of support. If we can make it so that this happens across the United Kingdom, I am absolutely open to having the discussions necessary to do so.
The Health Secretary has spoken about the catastrophic costs that face some older adults suffering from dementia. My nan was one of those people. She had to sell her home and spent more than £100,000 on her care costs. Under the loan scheme proposed by the Government today, would somebody like my nan not just end up paying more for the costs of their care? Can the Health Secretary also clarify whether the interest payments would eat into the small amount of money that people like my nan can pass on to their families?
We are very clear—I hope I have been clear—that the adoption of a universal deferred payment scheme gives people an opportunity. We are not talking about something that people are required to do; rather, they can choose to do it. One of the things that has most distressed some of those who go into residential care settings is that, as a consequence, they are required to sell their homes—they are forced to do it. What we have announced gives people an opportunity for that not to happen, but as the White Paper and the progress report make clear, we would like to proceed on the basis of a funding model, based on the Dilnot commission, that enables people also to have a cap on their care costs. If we can do that, the combination of the two will be an effective solution.
Without a cap on costs, which is what the Dilnot commission proposed for universal deferred schemes, will this measure not potentially leave some families with massive debts to pay when their loved ones die, far in excess of the £35,000 cap that the commission proposed?
I am sorry that the hon. Gentleman has read out the Whips’ question, but he did not listen to the last answer. We are both implementing the universal deferred payment scheme and proposing in the draft Bill that we should legislate for that. We are, as I have made clear, supporting the principle of Dilnot that we should implement a capped-cost model with an extended means test, but we have to demonstrate, as we know, that it needs to be paid for, and if those decisions involve public expenditure, they must necessarily be held for the spending review.
Points of Order
On a point of order, Mr Speaker. I would like to raise a point of order for which I have given prior notice. As my hon. Friend the Member for Sheffield Central (Paul Blomfield) made clear in Prime Minister’s questions earlier, Ministers are poised to announce detailed plans to scrap direct financial support for more than 350,000 adult learners and replace it with a loan system. Their regulatory assessment suggests 150,000 adults falling by the wayside as a result, yet we are being told that regulations will be laid imminently, via the negative procedure, just before the House’s summer recess, offering no opportunity from the Government for debate. Is it in order for those changes to come into force, as they will, on 1 September, before we return, and is it acceptable that the further education sector should see the largest change in adult learning funding in a generation, with no opportunity offered to Members in this House to question Ministers or have a debate on the Floor of the House?