Wednesday 24 April 2019
[Mrs Madeleine Moon in the Chair]
Russian Annexation of Crimea
I beg to move,
That this House has considered the Russian annexation of Crimea.
[Geraint Davies in the Chair]
It was a great pleasure to serve under your chairmanship, Mrs Moon, however briefly, and it is a great pleasure to serve under yours, Mr Davies. 18 March 2019 was the fifth anniversary of Russia’s annexation of Crimea. It is worth stopping at this point to dwell on the fact that Russia has been allowed to annex Crimea for five years, to carry out military activities in the Donbass, and also to invade two enclaves of Georgia. As I said in my speech in this Chamber in July last year,
“we are dealing with a serial offender.”—[Official Report, 18 July 2018; Vol. 645, c. 102WH.]
I will first detail what happened five years ago, move on to the impact of the illegal annexation, then finally examine the current situation in the Azov sea.
On 20 February 2014, Russia’s “little green men”—military without insignia—started the occupation of the Crimean peninsula. That began the process of annexation, as soldiers wearing Russian combat fatigues and carrying Russian weapons began seizing important institutions in the peninsula. Russia initially denied that those were Russian soldiers, but later said that they were. As a result of that annexation, a range of sanctions was imposed on Russia by the EU, the US and allies, including economic sanctions such as restrictions on access to financial markets; an arms embargo; restrictions on the export of oil extraction technology; targeted sanctions against certain individuals; and diplomatic sanctions, including exclusion from the G8 and the suspension of voting rights in the Council of Europe. I will return to that last point towards the end of my speech.
The Foreign Secretary has said:
“I condemn the illegal annexation of the Autonomous Republic of Crimea and the city of Sevastopol…five years ago. The UK will never recognise Russia’s illegal annexation of Crimea and we call on Russia to end their illegitimate control of the peninsula and their attempts to redraw the boundaries of Europe.”
Ambassador Jonathan Allen, who was the UK deputy permanent representative to the UN, has said:
“Russia’s aggression towards Ukraine is not limited to the Donbas and Crimea—Russia seeks to undermine Ukraine at every opportunity…supplying the Russian-backed separatists with weapons and calling illegitimate elections—all in breach of the Minsk agreement.
Only this year, in a written answer in the other place, Lord Ahmad said:
“Sanctions imposed alongside our international partners, including the US, in 2014 have had a coordinated impact on Russia by increasing economic pressure to change its Ukraine policy and sending a clear, united message that Russian aggression in Ukraine will not be tolerated. This impact has been strengthened by the continuation and maintenance of 2014 sanctions since their implementation.”
There has been widespread condemnation by the UK of Russia’s activities, and it is good to see that strong line continuing.
I commend my hon. Friend on the beginning of his speech, which is superb. Does he agree that part of the problem with Russian aggression, and the boldness with which Russia has acted in Ukraine, has been the lack of a proper and effective response when Russia moved into South Ossetia and Abkhazia in Georgia?
My hon. Friend makes a good point. Many reasons have been given as to why Russia annexed Crimea, one of which is that keeping Ukraine at war prevents it from joining NATO. That goes beyond being a conspiracy theory; it is something we ought to recognise.
On 16 March 2014, Russia organised a sham referendum in Crimea. That referendum was followed on 18 March 2014 by the so-called agreement on the accession of the Republic of Crimea to the Russian Federation. Voters were not given the chance to choose the status quo in that referendum, which was conducted in polling stations under armed guard. That violated Ukraine’s constitution and international law. It is claimed that 97% voted to join Russia, and according to Russian official results, that was on a turnout of 87%. However, it is interesting that later, a member of the Russian human rights council mistakenly posted the real election results, showing that only 55% had voted to join Russia on a turnout of 40%— a very significant difference.
The UN General Assembly produced two resolutions; I understand that we co-sponsored one. Those resolutions called on states and international organisations not to recognise any change in Crimea’s status, and affirmed the commitment of the United Nations to recognise Crimea as part of Ukraine. The referendum also violated, among other agreements, the 1994 Budapest memorandum on security assurances for Ukraine. Under that agreement, Ukraine gave up the nuclear weapons that were on its territory in exchange for independence and undertakings given by Russia.
There is no precise data on what effect the illegal annexation of Crimea by Russia has had, but a quick calculation shows that Ukraine has been robbed of the following assets: 3.6% of GDP; 4,000 enterprises; 10% of port infrastructure; 80% of oil and gas deposits; and 70% of potential natural gas deposits in the Black sea.
My hon. Friend is painting a very bleak picture, but in his introduction, he mentioned sanctions applied to Russia by the United States, the European Union and other allies. Do we have any measure of how effective those sanctions have been?
I thank my hon. Friend for that question. Interestingly, in the other place, Lord Ahmad said that those sanctions had been very good at sending a clear and united message that Russian aggression in Ukraine would not be tolerated. However, I am not sure that they have had that much effect in practice: for example, Russia has been able to get round the arms embargo. The only sanction that has had some impact on the state of Russia has been the measure to deprive it of access to the financial markets in London and elsewhere.
I will now examine the impact on Ukraine of the annexation of Crimea, and will first deal with the illegal imposition of Russian law. Contrary to its obligations as an occupying power under the fourth Geneva convention, Russia has imposed its legislation in the occupied territory of Crimea. What is extremely dangerous is that Russian laws have been applied retroactively to acts and events that took place in Crimea prior to its occupation. This is not a dry legal debate; it has severe implications for the people of Crimea. For example, the policy of automatic naturalisation means that all Ukrainian citizens who remained in the occupied territory have had Russian citizenship forcibly imposed on them, which is a big change for them. Moreover, Russia’s occupation and purported annexation of Crimea complicated the question of citizenship for children born after February 2014, since it is difficult for parents to register a child as a citizen with the Ukrainian authorities. Eight campaigns conscripting Crimean residents into the Russian Federation armed forces have been held since the beginning of the occupation. During the latest campaign, which ended in December 2018, approximately 2,800 men from Crimea were enlisted, bringing the overall number of Crimean conscripts to almost 15,000. As draft evasion is punishable under Russian criminal law by up to two years in prison, Crimean citizens are de facto forced to enter the Russian armed forces.
The atmosphere of fear, intimidation and physical and psychological pressure has forced 35,000 to 40,000 Ukrainian citizens, including an enormous number of Crimean Tatars, to leave Crimea and settle in other areas of Ukraine. The 2018 human rights report by the US Department of State states that the actual number could be as high as 100,000, as many remained unregistered. To replace those who left the peninsula, up to 1 million Russians have been brought in from Russia and resettled in Crimea.
Religious freedom has also been compromised, with 38 parishes administered by the Orthodox Church of Ukraine closing down in the occupied Crimea. Eight parishes of the Orthodox Church of Ukraine remain on the peninsula, but they have been constantly targeted by the occupying authorities since Russia seized control. It is not just individual churches that are affected. Russia has launched legal proceedings to seize the land where the only Orthodox Church of Ukraine cathedral in Crimea is located. Mosques and the Jewish community have been targeted, too. In March 2014, Reform Rabbi Mikhail Kapustin of Simferopol was forced to leave Crimea after denouncing Russian actions. His synagogue had been defaced by a swastika and, a month later, vandals defaced Sevastopol’s monument to 4,200 Jews killed by the Nazis in July 1942.
Russia has set out systematically to eliminate Crimean Tatar and Ukrainian languages and culture. No schools are now left in Crimea with a curriculum entirely in Ukrainian and Crimean languages. Contrary to the 2017 order of the International Court of Justice, which requests that Russia ensure the availability of education in the Ukrainian language, the number of children studying in Ukrainian has decreased from 14,000 in 2013-14 to 172 in the 2017-18 school year.
Russia has banned the highest representative body of Crimean Tatars—the Mejlis—under false allegations of extremist activity. Despite the clear meaning of the 2017 International Court of Justice order to
“refrain, pending the final decision in the case, from maintaining or imposing limitations on the ability of the Crimean Tatar community to conserve its representative institutions”,
two years have passed and Russia continues to maintain its ban. Members of the indigenous Crimean Tatar minority, many of whom vocally oppose the Russian occupation, have faced particularly acute repression by the authorities. In 2018, 367 infringements of the right to a fair trial were registered. More than 90 people, mostly Crimean Tatars, have been detained and/or sentenced under politically motivated charges, with some being transferred into Russia across an internationally recognised border. In detention centres, they are being mistreated and tortured as punishment or to extort confessions.
On 12 December 2018, Russia detained the amputee Crimean Tatar, Edem Bekirov. He has diabetes and four shunts in his heart. Since then, he has been denied urgently needed medical care. He now has an infection in the open wound where his leg was amputated. He is not allowed to go outdoors. His blood sugar level and blood pressure have gone up. He sleeps in a sitting position. The Russian FSB rejects his alibi in favour of a secret witness. Recently his detention was extended until June.
From 2014 to 30 June 2018, 42 people were victims of enforced disappearances, including 27 ethnic Ukrainians and nine Crimean Tatars. It is believed that Russian security forces kidnapped individuals for opposing Russia’s occupation to instil fear in the population and prevent dissent. The Russian occupation continues to deny access to international human rights monitors to Crimea—access that is in line with United Nations resolutions.
Ukrainian cultural heritage is also under threat. One very big world heritage landmark and four landmarks submitted for consideration to UNESCO are located in the occupied territory. Having illegally announced the right of ownership for 32 historical buildings of the Khan’s Palace array, the Russian occupying power has undertaken an unprofessional and incompetent reconstruction. That may seem insignificant in comparison with the life of the individual suffering from diabetes, but it has a personal association for me, as I was an archaeologist before I came into the House and it is sad to see such things happening. The removing of valuable cultural artefacts from Crimean museums to Russia continues.
That is as nothing compared with the Russian militarisation of the peninsula, which has continued at pace. Russia has substantially reinforced and modernised its Crimean military land, air and naval components. The militarisation of Crimea is a threat not only to Ukraine, but to the security of the whole of Europe. At any moment Russia can provoke a military conflict in the Black sea region with NATO.
I thank the hon. Gentleman for giving way. He is a fellow member of the Council of Europe delegation. I have been to Ukraine three times in the past few weeks to monitor the election process, and I was privileged to witness the peaceful transfer of power on Sunday. In many ways and to most people’s minds, it was a rather unexpected democratic change in Ukraine. Does he agree that that is something to celebrate? There is clear evidence that the Ukrainian people are embracing the democratic path to change. Ukraine is embracing democratic values. On that basis alone, should we not continue to fully support the country in its assertion of its territorial integrity?
I pay tribute to the hon. Lady for her work with us on the Council of Europe. She makes a very good point. It would be so easy for Ukraine, when it is threatened with Russian annexation and military activity in Donbass, to take a very restrictive attitude to the conduct of elections and what they can achieve, but it has not. It has had full democratic elections that have produced a startling change. She is right that we should compliment Ukraine on that election and do all we can to support it.
My hon. Friend has rightly set out a litany of sad human rights abuses and cultural vandalism—not only in Crimea and Donbass, but in South Ossetia and Abkhazia in Georgia, too. Volodymyr Zelensky said in his campaign that he would not see Crimea exchanged for peace in Donbass. Does my hon. Friend agree that he needs to hold fast to that pre-election commitment? When he becomes President in the next couple of weeks, he needs to be robust with Russia and work along with western partners, which was another commitment he made. In seeking peace, he should not seek peace at any cost.
I agree. I think we have all looked at the results of the Ukrainian elections with a degree of caution as to what the attitude of the new President will be, but this is not a time to back down from the demands being made for the restoration of Crimea and for an end to the fighting in the Donbass. This is a time for allies to keep making and pushing that point strongly.
Since 2014, Russia has increased the number of troops in occupied Crimea by three times. Armoured vehicles have been increased by five times; artillery by 10 times; jets by five times; and multiple launch rocket systems by 10 times. Most recently, Russia has deployed four battalions of S-400 Triumf missile systems in Crimea, which allows it to cover all of the Black sea, the Azov sea area and most of Ukraine. The Russian Black sea fleet can now fire in a single shot 86 Kalibr, known as “Sizzler”, nuclear-capable missiles, able to reach not only Kiev but other EU capitals.
The hon. Gentleman is giving an amazing speech - a real grounding in the problems faced across the region since the annexation of Crimea. This is not just a problem for Ukraine; as he said earlier, it is a problem for the whole of Europe. He is right about the weapons increase, but the real live-fire risk, towards Europe in particular and against Ukraine on a regular basis, is cyber-attacks.
The NotPetya attack cost the world economy $10 billion. Unless we also pay attention to sandboxing, the cyber-weapons that have been targeted on Ukraine, its infra- structure, airports, utilities and banks, will turn on Europe. They have been demonstrated to be lethal and will start attacking us, particularly as European elections loom.
The hon. Lady makes a valid point. I do not underestimate the effect of Russian cyber-attacks not only on Ukraine, but on the whole of Europe. I am not sure what we can do about them, except to make sure that we are strong in resisting them. She has highlighted the key point: that the issue affects all of us. Once an attack has been launched on Ukraine, it can affect the rest of Europe.
What are we to make of the actions of the Council of Europe, which has now produced a motion that makes it easier for Russia to return by not having the credentials of its members challenged? The Parliamentary Assembly of the Council of Europe has not suspended Russia; the decision was taken by Russia in 2015 not to present credentials for its own delegation in response to voting restrictions placed on it by PACE following the illegal annexation of Crimea.
The UK is clear that a Russian return to PACE would be contingent on the withdrawal of all Russian military personnel and support for separatists in eastern Ukraine, as well as an end to the illegal annexation of the Crimean peninsula. I urge the Minister to reject or at least heavily modify the recent recommendation from PACE, which is coming his way as part of the Committee of Ministers and which liberalises the PACE approach.
The hon. Gentleman is being generous in giving way. Does he not agree with me that the credibility of PACE and all the institutions of the Council of Europe is at stake here? It will be very difficult for bodies such as the Venice Commission to go into Ukraine and recommend legal reform if the Council of Europe is seen to be giving way to Russian threats to withdraw financial support for the institution.
I agree. At the previous meeting of the Council of Europe, I moved what seemed like countless amendments to try to make the report that had been produced much better. Unfortunately, they were all defeated, although I pay great compliments to one of our Ukrainian colleagues, Serhii Kiral, who led a brilliant campaign with us at various times during the Council’s proceedings. I agree with the hon. Lady that the credibility of the whole organisation is affected.
As president of the European Conservatives Group, of which Serhii Kiral is a member, I want to echo my hon. Friend’s sentiments that he did a phenomenal job. Also, the Ukraine delegation in the Council of Europe, regardless of party—socialists or whatever—are a formidable bunch of characters who really do credit to their nation under the most difficult circumstances. My hon. Friend the Member for Ribble Valley (Mr Evans) is not in his place at the moment, but at the Inter-Parliamentary Union we have had to separate the Russians and Ukrainians because of provocation. The work that the Ukraine delegations do has been remarkable. I pay tribute to Serhii Kiral.
I thank my hon. Friend for that tribute, and I agree with it. The Ukrainian delegations have been absolutely fantastic, regardless of politics. They have all stood as one in the Council of Europe and it has been a great pleasure to work with them.
Finally, I turn to the situation in the Azov sea. Stability remains elusive in eastern Ukraine, and Russia has moved to shore up its hold on Crimea. Russia has built a bridge across the Kerch strait, connecting Crimea to Russia. On 25 November 2018, Russian border patrol ships attacked and seized three Ukrainian navy vessels attempting to enter the sea of Azov from the Black sea through the Kerch strait, in a move that looked designed to gain complete control of the sea of Azov.
In December, suspicions that Russia has nuclear arms in Crimea were reported. Such developments suggest that, although the conflict in the eastern mainland regions of Ukraine may be resolved, Russia does not intend to restore Ukrainian sovereignty over Crimea. I am worried that succour may be given to the views I heard coming out of various organisations that both sides in the conflict are to blame. They are not. This is naked Russian aggression. The bridge breaches Ukrainian sovereignty—a particularly dangerous development that we need to condemn.
For all those reasons, the Secretary of State for Defence made a visit to Ukraine before Christmas and we sent a naval vessel to the area—not quite a harking back to gunboat diplomacy, but nevertheless a move that certainly sent a great deal of patriotism through some people’s blood. It was meant to send a clear signal to Russia that we will stand by Ukraine, rather than being an act of further provocation.
I understand that we intend to send other Royal Navy ships to provide a more constant British presence. To our Ukrainian friends, I say, “We will support you. I hope that you take that in the intended spirit.” This is a terrible tale of a big country throwing its weight around to the detriment of a country which, as its role in the Council of Europe shows, is playing a full part in western culture while retaining its own identity. This is not a good situation. It has made Europe much more prone to instability and increased conflict. I look forward to the Minister’s comments and his continuing commitment to trying to ensure that Russia withdraws from Crimea.
Thank you very much, Mr Davies. I warmly commend the hon. Member for Henley (John Howell) for introducing the debate, which is both timely and important. I gather that a joke is going round in Moscow these days: President Putin is asking General Secretary Stalin for advice on what he should do politically, and Stalin says, “You should execute all members of the Government and paint the Kremlin blue.” Putin replies, “Why blue?” and Stalin says, “I thought that was the only part you would query.” Perhaps there is some exaggeration in the joke, but perhaps there is some truth as well.
The point that the hon. Member for Henley, and others who have been on the delegation with him, made very clearly, and which I am sure the right hon. Member for Maldon (Mr Whittingdale), who is a known expert on the subject of Ukraine, will make as well, is that the annexation was illegal, full stop—end of story, in a sense. That is, of course, contested by the Russian Federation, but under any judgment of international law, it is clear that the annexation of Crimea was illegal.
As the hon. Member for Henley said, it followed on from other annexations, attempted annexations or invasions that were also illegal. I warmly commended David Cameron for going to Georgia, as one of his first acts as Conservative leader, to stand with the Georgian people and say that the invasions of Abkhazia and South Ossetia were illegal acts. Unfortunately, the agreement that was subsequently signed with President Sarkozy has still not been implemented. There are still Russian troops in Georgia and, as has been laid out today, the problems in relation to Crimea grow day by day.
The truth of the matter is that the annexation would not have happened had the Russian Federation not signed up to the Budapest memorandum, because Ukraine would have had nuclear weapons. In that accord, the Russian Federation guaranteed the territorial integrity of Ukraine, including Crimea as part of Ukraine, so there is understandable cynicism and scepticism. I do not know what the highest level of cynicism and scepticism that one can have is, but that is what the international community shares regarding any international treaties signed by the Russian Federation under President Putin.
Many have drawn comparisons with the situation in the 1930s. Such comparisons are important to bear in mind, though it would be wrong to make a direct comparison between Putin and Hitler, because their ideologies were fundamentally different. However, their nationalism and deliberate attempts to use violence to secure their aims probably amounted to the same.
In 1938, the German Chancellor was determined to persuade the international community that he would seize only the Sudetenland—the part of Czechoslovakia that, in his words, was dominated by German-speaking German nationals. In fact, by seizing the Sudetenland he undermined the whole of the rest of Czechoslovakia and made it impossible for it to survive as a nation state. I think that is exactly the intention of the Russian Federation in relation to Ukraine. In the 1930s, British politicians did not really care; they thought that Hitler sort of had a point. Politicians in the UK have also said that President Putin sort of has a point about Crimea, because a lot of the people in Crimea are Russian and identify as Russian speakers. However, that is wholly to miss the point that there has been a deliberate process of political destabilisation in Ukraine that went on for a considerable number of years. As the hon. Member for Henley said, it included a fake referendum that was deliberately engineered. The results were falsely counted, and an incorrect version of them was given out.
One of the most important things that we must focus on is the softening-up period before invasion takes place. There is a deliberate disinformation campaign targeted at the Russian-speaking populations, not just in Georgia and Ukraine but on a daily basis in the Baltic states. Such disinformation prepares an expectation among the Russian-speaking population that change is coming, and that they should support it. Is that something to which we should also pay attention?
I commend my hon. Friend. She is right, and that is one of the reasons why I am particularly anxious that we, as a political class in this country, have seemingly decided that we are not all that interested in Russian interference in our elections and electoral processes. I think that we will rue the day in the end. We need to be extremely careful, because we have seen what the Russian Federation has managed to do through cyber-warfare in other countries around the world, and continues to do in Ukraine, because it wants to soften up the rest of the country.
The process of misinformation continues. The latest version of that is the Russian Federation maintaining that Crimea lost 1.5 trillion roubles during the 25 years that it was part of Ukraine. Many would argue that the loss to Crimea is from being taken out of Ukraine. Russian spokespeople do not half have a cheek sometimes.
There is another clear aspect to the annexation. In 1938, Hitler wanted to seize the Skoda factory, which was one of the most productive factories in Europe, and turn it into an arms manufacturer; it was soon making Panzers for the Wehrmacht. Just so, Putin has had his eye for a considerable period on not only the natural resources in Crimea but the ports, which are vital to any future military intentions that he may have. It is all part of a pattern; President Putin always has a tendency to resort to violent options when they are available to him.
Putin was, of course, in political trouble in his own country when the annexation commenced, and it was extremely popular, re-enhancing that nationalist sense in Russian politics. In large measure, one can see the reinvention of Putin as a nationalist hero, in Russian terms, on the back of the annexation of Crimea. There is a sense of political doldrums in the Russian Federation, because Putin clearly has no idea who his successor should be or where the future should lie. He is kind of bored with governing Russia, which potentially makes for a very dangerous time for the international community.
The Government need to be careful about key issues of UK policy. We have referred already to sanctions policy. As I have said to the Minister many times, I fear that the Government are still dragging their heels—he will say that they are not—on implementing a full set of secure sanctions in relation to individuals who have committed human rights abuses in the Russian Federation and Crimea. I think that the Russians have noticed that that has not yet happened, and that other countries have moved faster. It is time that we proceeded faster. I am sure that the Minister will say that the Government are doing their best, and that it will all happen in the fullness of time, but I am not convinced.
Secondly, there was a time when the UK led within the European Union on trying to bind Ukraine into the international community, and on standing up for it in international affairs. That will be more difficult in the future when/if we are no longer a member of the European Union. I wish to know how we will achieve that in the future. I hope that the UK has made strong representations to the United States of America that one cannot oppose annexation in Crimea and support it in the Golan Heights. Annexation is annexation. One cannot simply turn a blind eye because it involves a big ally on one side of the Atlantic, rather than a country that one wants to criticise on the other.
Finally, we of course wish Mr Zelensky, who has been elected, well. It is difficult to see exactly how things will play out. I very much hope that the UK will want to extend a warm hand, to ensure that he ends up on the right side of the argument.
I congratulate my hon. Friend the Member for Henley (John Howell) on securing this debate at an extremely important time for Ukraine, and on doing an excellent job of setting out the facts about the Russian occupation of Crimea.
Like the hon. Member for Penistone and Stocksbridge (Angela Smith), three weeks ago I spent my Sunday sitting in a polling station in Desnianskyi district, a poorer suburb of Kiev, and this Sunday I was in a polling station in Bucha, watching democracy in action. It is always inspiring to see a democratic election in a country that has only recently become free.
One of the striking things about the Ukraine election was that there was absolutely no question about the people’s desire for change. As overseas observers, we had some criticisms about access to the media, financing and resources, but there can be no doubt that the result—the election of President-elect Zelensky—reflects the will of the Ukrainian people. I pay tribute to President Poroshenko, who I think achieved many things, but there is a real and deep-seated wish for change, and it was undoubtedly a genuine election.
One of the first things that President-elect Zelensky will have to do is decide how best to confront the Russian aggression and the occupation of parts of his country. The war in Donbass gets a lot of attention—it is a hot war and people are dying there; I went last year to Avdiivka, which is right up against the frontline and is regularly subject to shelling—but we must not overlook Crimea, which has spent five years under occupation.
President-elect Zelensky has not yet said a great deal about his policy, and we must wait to see who he will appoint to key positions such as Foreign Minister, but he has referred to the Budapest memorandum. The signatories to that memorandum—my hon. Friend the Member for Henley rightly drew attention to the fact that the UK is one—have said that they will protect the territorial integrity of Ukraine. The Ukrainians have an expectation that that commitment will be honoured, even though one of the signatories is responsible for the invasion and occupation of their country. I know that our Government want to pursue the existing dialogue with Russia through the Normandy agreement and the Minsk process, but President-elect Zelensky has said that he sees a role for the Budapest signatories, so if he approaches the UK Government to assist in resolving the situation, I hope that they will respond positively.
My hon. Friend made several points about the invasion of Crimea five years ago; I do not want to repeat them, but I will make a couple of observations. One of the reasons given for the invasion was that, following the revolution of dignity in the Maidan, Kiev was under the control of a fascist and antisemitic Government. Ironically, not only is there no evidence of that Government ever being fascist or antisemitic, but as of Sunday, Ukraine will be only the second country in the whole world, after Israel, to have a President and a Prime Minister who are both Jewish.
The second reason given for the invasion was the referendum in which the occupants of Crimea expressed a wish to rejoin Russia. It is true that in 1990, when there were genuine plebiscites across Ukraine to determine its future, the biggest minority in favour of joining Russia was in Crimea, although it was only 41%. However, the so-called referendum that took place five years ago did so under the barrels of Kalashnikovs after all media from Ukraine had been cut off. There was a relentless barrage of Russian propaganda, including footage that showed thousands of Ukrainians allegedly fleeing from what the Russian Foreign Ministry described as threats of a massacre—I say “allegedly” because it subsequently emerged that it was footage of a traffic jam of Ukrainian vehicles heading across the border to Poland to do some weekend shopping.
The referendum offered a choice between joining Russia immediately and retaining independence with the right to join Russia after a specified period. Remaining part of Ukraine was not on the ballot paper. Just imagine if a similar question had been asked in our EU referendum three years ago. As my hon. Friend said, the referendum on joining Russia rightly received international condemnation, including by the United Nations General Assembly; resolutions have been passed that point out that the annexation and occupation continue to be illegal.
My hon. Friend was right to highlight the relentless abuse of human rights in Crimea since the Russian occupation. I draw particular attention to the events of 27 March, less than four weeks ago, in which 23 Crimean Tatar civic journalists were arrested, beaten by the Russian FSB and taken out of Crimea. It is not clear where some of them are being held; I am afraid that they are just the latest in a long list of people, particularly Tatars, who have been subjected to torture, abuse, kidnapping and imprisonment.
My hon. Friend rightly referred to the military build-up in Crimea since the Russians took over. There was already a naval base at Sevastopol, of course, but before the occupation there were only 12,500 Russian troops there, whereas there are now estimated to be 32,000. There has also been a build-up of aircraft, naval forces and military vehicles; indeed, it is now reported that there may well be nuclear weapons in Crimea, which is ironic given that the Budapest memorandum was signed specifically in return for Ukraine’s agreement to give up its nuclear weapons.
My hon. Friend also spoke about the situation in the sea of Azov. Just before Christmas, I travelled to Berdyansk and Mariupol, which are both on the sea of Azov, to see the effect of the blockade across the Kerch strait. The bridge that was built prevents a large number of larger ships from entering the sea of Azov, and since the blockade Russian warships have imposed checks on all ships going in. That has had the effect of delaying passage and rendering the businesses of Mariupol and Berdyansk almost uneconomic. Those two cities are subject to economic warfare and must be relieved.
My hon. Friend was right to say that the Ukrainians have done a fantastic job of raising these issues in every international forum. He spoke about his and his colleagues’ work in the Council of Europe; at the annual Inter-Parliamentary Union Assembly some 10 days ago, I listened to a very powerful address by Mr Parubiy, the Speaker of the Ukrainian Rada. It was then countered by the Russians, who said that of course there were no Russians whatever in Donbass and that there never had been—it was an entire fiction. There is an absolute denial of reality by Russia, despite overwhelming evidence.
I pay tribute to the representation of Ukraine in this country. It is a great pleasure to see the Ukrainian ambassador, Her Excellency Natalia Galibarenko, listening to this debate. She is an assiduous attender of such events and does a fantastic job.
My hon. Friend spoke about the need to increase the pressure on Russia, particularly through sanctions. I agree absolutely that it was very important that we passed the Magnitsky amendment. We eagerly await its implementation; I know that the Government intend to move forward, but we would like them to do so somewhat quicker.
I hope that the message that comes out from this debate, and the number of speakers in it, will demonstrate that across the House of Commons there is unanimous support for Ukraine against the illegal occupation of part of the country and the aggressive action of the Russian Federation.
It is good to see you in the Chair, Mr Davies.
It is quite unbelievable that the events in the Maidan, in which hundreds of peaceful protesters were murdered by the Yanukovych regime, happened only five years ago, because the sequence of events that his flight to Russia set in motion have changed so much. As for the justifications for the invasion, the most prominent of which seems to have been the idea that Crimea was somehow being returned to the Russian Federation, it is as if the decision of the Presidium of the Supreme Soviet in 1954 was some sort of bureaucratic error that could be corrected only by the application of blunt military force.
The point was well put by the hon. Member for Henley (John Howell), whom I thank for securing this debate: the invasion had less to do with the rights of Russophone Ukrainians living in Crimea than with the most brutal of geostrategic realities, namely that Russia needs a Black sea port, its “place in the sun”, just as much now as when Her Imperial Majesty the Empress of All the Russias first annexed it for her Empire in 1784. One could equally say that the presence of Ionian colonists in the 7th century BC means that it should be made an outpost of the Hellenic Republic. If it were predicated on the rights and needs of the people who live there, the Russian Government’s record of maltreatment towards those people would not be so prominent, which is a point that was well put by the hon. Member for Henley in his discussion of the Tatars.
The only extremism we have seen in Crimea is the clampdown on ethnic and religious freedoms enjoyed by the residents of what is a multi-ethnic, multi-confessional place. Just as Crimea’s Tatar population has seen persecution, so has the Ukrainian-language community, with the closure of several Ukrainian Orthodox churches, and the arrest of Archbishop Klyment last month, and the persecution of the Ukrainian Greek Catholic Church. This attack on the most basic rights and democracy in Crimea leads me to my last point, and I hope hon. Members will allow me to indulge in a little introspection.
The Russian invasion of Crimea was followed by a referendum that fraudulently stated that 97% of participants had voted to be subsumed into the Russian Federation, although the real number was closer to 55%, and there was open intimidation at polling stations, so many would be forgiven for not taking part. As someone who has campaigned for the independence of my own country all my adult life and saw the independence referendum in Scotland as a final point in a democratic process that should be held up as the gold standard for this type of constitutional referendum, I say that that standard was not even close to being met in Crimea. Colleagues agreed and disagreed with me during the Scottish referendum, but we all agreed on the process. That was not true in the case of Crimea. Furthermore, when my country does become independent, it will not be to the detriment of the rights and lives of my fellow Scots.
I ask the Government of the Russian Federation to have the courage of their convictions. If the principle of self-determination is so important to them, why do they not extend it to their own subjects and allow status referendums inside the Russian Federation? I am sure the Tatars, Bashkirs, Chuvashs, Chechens, Avars, Udmurts, Dargins, Tuvans, Ossetians and Kalmyks, among others, would be delighted to be asked about their participation in the Russian Federation. To begin with, I would settle for Russia returning Crimea to Ukraine and withdrawing its forces and military completely.
I pay tribute to the recent electoral process in Ukraine and I thank the ambassador, who is in the Public Gallery today, for the commendable work that she does across the whole of the United Kingdom of Great Britain and Northern Ireland in promoting peace and democracy within the Ukrainian state.
My hon. Friend the Member for Henley (John Howell) is the most assiduous of members of the Parliamentary Assembly of the Council of Europe and I am delighted that he secured this debate. I am also very pleased, as the leader of the delegation, to have seen so many hon. Friends from that delegation here this morning.
I ask the Minister specifically to address the situation that currently faces the Parliamentary Assembly of the Council of Europe. My hon. Friend the Member for Henley was absolutely right when he said that, following the annexation of Crimea, the Assembly suspended certain voting rights for the Russian Federation’s delegation. We must make it absolutely clear that the Russians were not expelled from the Parliamentary Assembly of the Council of Europe; they chose to walk out. Having walked out, they have since singularly failed on any potential occasion to present their credentials.
Far from taking any remedial action in respect of Donbass, Crimea, Georgia or Moldova, the Russians have now threatened to withhold their payments to the Council of Europe to the tune of many millions of euros, which of course causes financial embarrassment. The United Kingdom delegation has made it plain that the Council of Europe is not for sale and its principles are not open to blackmail, but, unfortunately, money has become the driving force that has driven the outgoing secretary-general Thorbjørn Jagland and the current president of the Parliamentary Assembly, Liliane Maury Pasquier, to seek to negotiate with Russia, not over the Donbass region or Crimea or human rights, but over money. We now find ourselves in a position of grave danger. Diplomatically, the Russians expect that there will be an extraordinary session of the Parliamentary Assembly of the Council of Europe to seek to readmit Russia and to lean upon the rules committee of the Parliamentary Assembly to change the rules to make that possible. That would be an absolute outrage. It would make the future of the Parliamentary Assembly of the Council of Europe and its whole raison d’être very precarious indeed.
The Russians have made no move to release the sailors who were arrested on the warships that were boarded, no moves towards improvements in human rights, no movement towards withdrawal from Donbass and no movement towards a resolution of the situation in Crimea. That is entirely unacceptable.
It cannot be right that the Parliamentary Assembly of the Council of Europe, established after the war by Churchill, Jean Monnet and others to seek to bring an end to the twin threats of fascism and communism, should be sold out by its current leadership in this way. The new President of Ukraine, Volodymyr Zelensky, needs the support of the western world, not appeasement. I hope that my right hon. Friend the Minister will send the message very clearly through the ambassador to the effect that the United Kingdom stands resolute, and will remain resolute, in its support of Ukraine.
History is everything and the history of Crimea is a lot more complex than today’s debate has so far suggested. Crimea was annexed by Catherine the Great in 1783 and was Russian for the best part of two centuries. After the Russian revolution and the establishment of the Soviet Union, Crimea was part of the Russian, not the Ukrainian, Soviet Federative Socialist Republic. Changes to boundaries in the USSR were of course arbitrary and were decided solely by Moscow, with no reference to the peoples of the Soviet Union.
In 1946, Crimea was stripped of its status as a so-called autonomous republic and reduced to a mere oblast of Russia, equivalent to a county. In another entirely arbitrary move by Khrushchev, the oblast of Crimea was transferred from Russia to Ukraine in 1954. Needless to say, not a single Member of the House of Commons or the House of Lords objected to that arbitrary denial of the right of self-determination of the people of Crimea.
During the fall of the USSR, we recognised self-determination as the paramount factor. That is why we supported the independence of Kazakhstan, Belarus and other federative republics. The Crimea oblast also wanted self-determination and in January 1991, Crimean voters voted to be an equal partner in Gorbachev’s new union. A few months later, of course, Ukraine voted for independence. We never recognised the Crimean right to self-determination.
As we know, Russia annexed Crimea in 2014. I am sure the referendum was inadequate and we have heard all about that, but no one doubts for a moment that for a considerable part of its history, Crimea has been part of Russia and that the overwhelming part of the population, following heavy immigration over the best part of two centuries, is Russian. The people of Crimea would probably—although we really have no idea—rather like to be independent of both Ukraine and Russia. Ideally, there would be a referendum held under independent international scrutiny and that would be the result, but we do not know.
The situation is extremely complex. Russia is not going to give up Crimea. I do not condone that, and I do not condone the annexation. I have argued against the annexation in the Council of Europe. With my colleagues, I have argued that the Russians should not be allowed in just because of the blackmail to which they are subjecting the Council of Europe. We should stand firm. I think the Council of Europe would benefit from restructuring and becoming a leaner place, and after that, of course, we on the Council of Europe have to decide whether Russia should be readmitted, despite the fact that it will almost certainly never give up Crimea.
That is why the Minister’s summing-up speech is all-important. As my right hon. Friend the Member for North Thanet (Sir Roger Gale) said, the Council of Europe has simply stripped Russia of its voting rights; it has refused to present its credentials, but it is still a member of the Committee of Ministers. The Minister must now tell us what the attitude of the United Kingdom Government is. Do the Government believe that Russia should stay in the Council of Europe as a member of the Committee of Ministers? Following the debate we had in the Council of Europe a couple of weeks ago, the decision on whether Russia should be readmitted to the Parliamentary Assembly will almost certainly depend on the Committee of Ministers. Frankly, the Government can no longer be mealy-mouthed about this. They can no longer have good relations with Russia but say that we should bear the brunt in the Council of Europe for its exclusion. We look forward to hearing what the Minister says.
It is good to see you in the Chair, Mr Davies. I congratulate the hon. Member for Henley (John Howell) on securing the debate, and on his excellent speech. It was factual, considered and forensic in laying out the current situation in Crimea.
Like other hon. and right hon. Members, I congratulate President-elect Zelensky. As the right hon. Member for Maldon (Mr Whittingdale) mentioned, Zelensky is a Jewish national, and Ukraine becomes only the second country in the world with both a Jewish President and Jewish Prime Minister. I look forward to Sputnik news and the Russia Today headline telling us that the fascists and Nazis have just elected a Jew as their leader—no doubt such nonsense will follow. It somewhat scorches the myth that Russian speakers in Ukraine are being uniquely persecuted by the Government, given that the new President-elect is a Russian speaker and Russian is his first language.
Given that the ambassador of Ukraine joins us here today, I want to mention the appalling events that took place in Holland Park two weeks ago this coming Saturday, when the ambassador’s car—thankfully, she was not in it—was deliberately rammed more than once by someone who is currently being held under the Mental Health Acts.
I want to address a few of the issues that have been raised by hon. and right hon. Members, starting with the illegality of the referendum. The Scottish National party does not recognise the referendum that took place in 2014, and we do not recognise the status of Crimea somehow being reunified with Russia either. We know a thing or two about independence movements and referendums in my party. Indeed, the hon. Member for Ayr, Carrick and Cumnock (Bill Grant) knows a thing about them as well. What took place in Crimea in 2014 was a sham and should be called out as such by anyone who believes in the democratic rights of people to express how they wish to be governed.
Like other hon. and right hon. Members who have spoken, I have visited Ukraine on a couple of occasions. In common with the right hon. Member for Maldon, I once went out to Avdiivka. As he says, it is right on the frontline with the illegally occupied Donbass region. In that context, we need to get the terminology right. Indeed, the last time I was there, I had this discussion with a journalist. These are Russian-led forces. They are not Russian-backed separatists or forces; they are Russian-led, and they are not all separatists. Some of them wish Donbass to be independent, some wish it to join Russia, and some wish it to be more autonomous within Ukraine. They are Russian-led terrorists and nothing else.
I turn to how we can support Ukraine as individual Members of Parliament, part of which includes not appearing on channels such as Russia Today and Sputnik. Indeed, there are hon. Members who have spoken in this debate—they are no longer in their place, so I will not name them—who do exactly that. They are part of the problem. They include members of my own party, and one quite high-profile former member even has his own television show on Russia Today. For shame that they continue to appear on those channels. For shame that there are Members of this House who not only appear, but take money in return. There are also former Ministers of the current Government who appear on RT. It must stop: otherwise all the poetic speeches mean absolutely nothing.
I apologise, as I could not be here earlier, as I wanted; I was at a Northern Ireland Affairs Committee hearing. The hon. Gentleman is referring to Crimea, where human rights have been denied. In eastern Ukraine, Baptist Church ministers have gone missing and cannot be found. Churches have been destroyed and people have been persecuted. Wherever Russia’s right-wing influence is, it is clear that Christians are persecuted and human rights are abused. Does the hon. Gentleman agree that we should take every opportunity to approach the Russian Government, and Putin in particular, to ensure that Christians are not persecuted beyond any other religion in that part of Ukraine?
I absolutely agree. The hon. Gentleman speaks on these issues regularly and with authority. He is an hon. Gentleman, and I chastise him gently by pleading with him—beseeching him—not to appear on the state broadcaster of the Government who do the terrible things that he has outlined.
I shall conclude, because I see that time is pressing on. The Minister is sound on the issue of Ukraine. Will he tell us what work is being undertaken to free the Azov sailors who are being held illegally by the Russian Federation? In addition to strengthening the sanctions, which he is regularly asked to do, can we lead an international effort to halt Nord Stream 2? It is one of the most dangerous economic and political projects going on in Europe right now. In response to questions that I have asked, the answers that have come from the Minister suggest that the Government do not see it as their issue. It is an issue for all of Europe and everyone who believes in the stability of Europe.
I believe that Crimea will come back to Ukraine one day. Just as the Berlin wall fell, surely Crimea will be reunited with Europe, as it rightly should be. There are Russians who look on with envy at what took place in the Ukrainian elections, and they deserve better than what they have right now. We should extend our friendship to them, because some people want to see a change in Russian society and its political leadership so that it too can be democratic, prosperous and free, and get rid of the miserable tyranny that it suffers under right now.
It is a pleasure to serve under your stewardship, Mr Davies. I congratulate the hon. Member for Henley (John Howell) on securing this debate. I commend him for the great interest he has taken in this issue for a long time, and for the depth of experience that he showed in his speech. It was very comprehensive and it enlightened people who have not visited Ukraine or been so aware of the relevant issues.
The hon. Gentleman raised the issue of the non-suspension of Russia from the Council of Europe. How we deal with Russia is important, particularly as it is not currently taking part in the Council. As a former member, I understand that. The Council of Europe occupies a pivotal position in this dispute and in relation to Europe as a whole. In that sense, it is a phenomenally important institution, and its great work must continue.
The hon. Gentleman also referred to the “sham referendum” in Crimea and challenged the official statistics. An issue of concern to us all is the illegal occupation of Crimea and the legislative position that Russia has taken, particularly in giving people Russian nationality. The conscription of the Crimean people into the Russian army is also a significant concern.
The hon. Gentleman mentioned, too, the desecration of religious places, which is really important for us to address. Certainly, Orthodox churches, the Jewish community and mosques have been targeted. As he rightly said, the treatment of the Tatar community, a significant group in Crimea, has been a long-standing issue in the occupation of Crimea. Russia’s treatment of the Tatars, its persecution of the Jewish and Muslim communities and its targeting of Orthodox churches is to be condemned.
My hon. Friend the Member for Penistone and Stocksbridge (Angela Smith) spoke about the military activity in Donbass and praised the election. I, too, welcome the election of Volodymyr Zelensky, who has followed a fairly untraditional route. The right hon. Member for Maldon (Mr Whittingdale) observed the election, and deemed the process to be reasonably good. When the election was suspended in December, I was slightly concerned that it would not go ahead, but Ukraine has shown itself to be a mature democracy. That peaceful election is a positive step forward for it, and electing somebody who was not previously involved in the political process is a phenomenally good thing. The new President will have to look at serious issues, such as corruption and how to move democracy forward.
I was slightly concerned by the comments of the hon. Member for The Wrekin (Mark Pritchard), who said that the President may seek to exchange peace in Donbass for Crimea. It is not our place to direct the thinking of the President of Ukraine or influence how he sees fit to negotiate. No elected Member of any country would seek to give away any part of their territory. On the contrary, Ukraine continues to fight to be reunified with Crimea.
If the hon. Gentleman is not seeking to tell people how we should react to situations, he will need to clarify why he said during the Kerch strait aggression that there needs to be de-escalation on both sides, when there was no fault from the Ukrainian side: the only aggressor was the Russian Federation. Will he clarify whether he believes that the Ukrainian Government were an aggressor, or whether it was just the Russian Federation?
I certainly agree that there was no aggression on the part of Ukraine. There has only been aggression by the Russian state in relation to the occupation of Crimea—I say that unconditionally. I was trying to say that it is not our position to guide or interfere in the policies that the President of Ukraine makes in relation to his own country. He was elected in a peaceful, democratic election. I was taking issue with the comments of the hon. Member for The Wrekin. It is important that we look at those issues and resolve them.
My hon. Friend the Member for Bridgend (Mrs Moon), who, I believe, is on her way to Brussels as we speak, made some pointed comments about interference in elections, particularly in relation to cyber and digital aggression against Ukraine. The Digital, Culture, Media and Sport Committee has published a fairly significant report into that, and its Chair has done some significant work on the matter. We continue to be concerned about that issue, and my hon. Friend the Member for West Bromwich East (Tom Watson) continues to take a keen interest in it.
What is happening in the Azov sea is a very serious issue, and we should look at addressing it through sanctions. That is where the Nord Stream 2 pipeline comes into play. We must look not just at Russian participation in the Council of Europe, but at how the Minister can work with Germany, given that a significant trade deal involving gas supplies has been done. There are underlying problems with Nord Stream 2. The initial pipeline that was put in takes money away from Ukraine as a way to punish it, so we must look at how we can support Ukraine. We should use the pipeline as a negotiating tool to try to push this issue forward. That is a serious issue for us to deal with. My hon. Friend the Member for Rhondda (Chris Bryant) made, I think, a reasonably good joke. He made a comparison with Georgia. We must bear that in mind and ensure we stop any further interventions.
Time is running short, and the Minister wants to get in. I ask him to address the issue of the sailors currently being held by the Russians. We must look at how we can influence that situation. The passage to the Azov sea, the bridge that has been built and the Nord Stream 2 pipeline are serious issues. We must try to get influence so that we gain a reasonable negotiating position with Russia to deal with the issue of Crimea. The Magnitsky amendment, which the right hon. Member for Maldon spoke about, is very important. If the Government can push it along, it would go some way to dealing with the situation.
Finally, I pay tribute to the Ukrainian ambassador, who is in the Public Gallery, for the great work that she continues to do. I hope that the recent attack on her car will not hinder our relationship or her great work.
I thank my hon. Friend the Member for Henley (John Howell) for initiating this debate, and for setting out the arguments so clearly and in such a well-informed manner—as did all hon. Members who contributed.
At the outset, I want to comment on the outcome of Ukraine’s presidential election. With the vast majority of votes counted, Volodymyr Zelensky won Sunday’s second round run-off with just over 73% of the vote. It is a testament to the development of Ukraine’s democracy that the Organisation for Security and Co-operation in Europe’s Office for Democratic Institutions and Human Rights judged the second round to be peaceful and competitive. Its representative stated that the process respected fundamental freedoms.
I also pay tribute to President Poroshenko, who led Ukraine over the past five years in the face of unprecedented security and foreign policy challenges. He has accepted the choice of the Ukrainian people with great dignity and has offered to work with the President-elect. Our Prime Minister spoke to President-elect Zelensky yesterday. She congratulated him on his clear victory and assured him of the UK’s ongoing support. That important commitment is at the heart of today’s topic. We will debate one aspect of Ukraine’s territorial integrity: Russia’s illegal annexation of Crimea. The Government’s position is absolutely clear: Crimea and Sevastopol are part of Ukraine. Russia’s illegal annexation and its continuing destabilisation of Ukraine is reprehensible. This Government will never recognise or legitimise Russia’s status in Crimea.
It is now five years since Russia illegally annexed 10,000 square miles of sovereign Ukrainian territory. Russia’s military intervention and subsequent unlawful referendum violated not only the Ukrainian constitution, but international law. As my hon. Friend the Member for Henley clearly outlined, Russia is now using a whole range of strategies to maintain its hold on Ukrainian territory and undermine Ukrainian sovereignty. It uses political manipulation and disinformation to fuel the conflict and interfere with elections; it forcibly moves Ukrainian citizens out of Crimea and moves Russian citizens in, in violation of the Geneva convention; and it persistently fails to meet its commitments under the Minsk agreements. It should withdraw its forces from all of Ukraine.
As we have heard, in November, Russia attacked and seized Ukrainian vessels and 24 servicemen as they sought to enter the sea of Azov through the Kerch strait, as they have every right to do. Those servicemen continue to be detained in Moscow. I call on Russia to release these servicemen immediately and return the vessels to Ukraine.
Russian authorities have overseen the militarisation and the systematic restriction of fundamental rights and freedoms in Crimea, including freedom of expression, of movement and of religion, as well as the right to peaceful assembly. Despite repeated calls in UN General Assembly resolutions, Russia has not permitted the UN High Commissioner for Human Rights to visit to make a full independent assessment of the human rights situation. Even without such an assessment, the weight of evidence is damning. Minority groups, such as Crimean Tatars, face clear and increasing levels of persecution. Twenty-three Tatars were unlawfully detained following raids on their homes on 27 March, for example. Russia continues to ban the Tatars’ representative institution, the Mejlis. That violates a 2017 International Court of Justice order.
The UN Office of the High Commissioner for Human Rights has also documented a catalogue of abuses against political opponents and minorities in Crimea. Those abuses include arbitrary detentions and arrests, enforced disappearances and torture. Those who refuse to recognise Russian-based legislation applicable to Crimea are denied their basic human rights. Ukrainians face pressure to renounce their citizenship in favour of Russian citizenship; if they refuse, they are denied access to basic services. Crimeans are being forcibly conscripted into the Russian military—nearly 15,000 have been conscripted since 2015.
The UK is instrumental in ensuring a robust international response to Russia’s actions. Following the annexation of Crimea, Russia was suspended from the G8. The EU, the US, and partners including Canada and Australia, imposed a robust package of sanctions targeting key sectors of Russia’s economy, and we continue to co-ordinate our response to Russia’s actions.
I hope that everyone in this Chamber is in favour of the consistent application of such rules across the world, be it with Israel or with Russia. That consistent application is essential if we are to defend what is widely known as the rules-based international order.
Many of those responsible for the annexation have been sanctioned. We have imposed stringent restrictions on doing business in Crimea, for instance. Importing goods from Crimea is illegal and exports to key sectors are banned. We will not legitimise the annexation by making it easy to do business there.
Following the visit to Odesa in December by my right hon. Friend the Secretary of State for Defence, the UK also extended and deepened our military assistance to Ukraine through the Operation Orbital training mission. NATO measures to enhance allies’ capability and presence in the Black sea will also contribute to an increased regional deterrent.
When we have something to say, we will choose the time to say it. This is not the forum in which to comment on the Council of Europe, because the debate, as on the Order Paper, is on Crimea.
With respect to the human rights situation, the UK continues to provide funding to Crimean human rights non-governmental organisations and to the UN human rights monitoring mission in Ukraine, to help document and highlight human rights abuses.
It is testament to the bravery and fortitude of Crimean civil society that it continues to speak out in the face of relentless harassment. I know that some hon. Members took the opportunity to meet some remarkable Ukrainian human rights activists in Parliament last month. They were here for the screening of a documentary—partly funded by the UK—that highlights Russia’s human rights record in the peninsula, and the plight of over 70 political prisoners. Among such prisoners is Oleg Sentsov, who has been detained since 2014. The Foreign Secretary and I have consistently voiced our serious concerns about his welfare and deteriorating health. We have also condemned Russia for failing to provide Pavlo Hryb and Edem Bekirov with the urgent medical care that they need. They have been detained since August 2017 and December 2018 respectively.
Russia’s illegal annexation of Crimea and Sevastopol, and its continued interference in Ukraine, are illegal under international law. Ukraine chose a Euro-Atlantic future, and Russia must respect Ukraine’s sovereign decision, its independence and its territorial integrity. Until that happens, there can be no return to normal relations with Russia. That is why we will work to strengthen the resolve of the international community to stand firm against behaviour of this sort by Russia, to keep Crimea in the spotlight, and to expose Russia’s human rights violations.
We will continue to work with the Ukrainian Government to support its sovereignty and territorial integrity. We welcome the peaceful conduct of the presidential election on Sunday, and I congratulate Ukraine on holding the elections in an open and transparent manner. I offer my personal congratulations to Volodymyr Zelensky. Not only are the Prime Minister and the President-elect both Jewish, but they are both called Volodymyr. I also express gratitude to President Poroshenko for his leadership over the last five years in the face of the unprecedented security and foreign policy challenges for Ukraine. I welcome the strong partnership that we have built with Ukraine, in which we will continue to invest considerable energy.
In her call with President-elect Zelensky, the Prime Minister reiterated that the UK stands shoulder to shoulder with Ukraine. We will continue to remind the world that Crimea and Sevastopol are Ukrainian, that we will not recognise Russia’s illegal annexation, and that Russia will continue to face costs for its flagrant disregard for international law.
The debate has been excellent. I thank all who participated, and the Minister for his response. I add my welcome to the Ukrainian ambassador, who has sat through our proceedings and witnessed every moment of the debate. Ukraine can be assured of our support, and that we will do everything we can to ensure that it is safe and has an integral border on which it can rely.
Question put and agreed to.
That this House has considered the Russian annexation of Crimea.
Pension Credit Changes
I beg to move,
That this House has considered pension credit changes.
It is a pleasure to see you in the Chair, Mr Davies.
14 January was a pivotal day: not only was there a meaningful vote on Brexit but on that day the Government announced in a written statement that from 15 May 2019 both partners in a couple need to reach state pension age to claim pension credit or pension age housing benefit. That change has been on the statute book since 2012, but the announcement was made quietly through a written ministerial statement on one of the busiest days in Parliament, only four months before it was due to come into effect. Full details of the impact have not yet been published, nor do we have detailed information on how the proposal will operate in a wide range of possible circumstances.
My first question for the Minister is: why was the proposed change made in a written statement and not by a vote of the House? That sets a dangerous precedent—a change put on the statute book two Governments ago, two Parliaments ago, in 2012 is being made now via a written statement instead of another vote in the House.
The Government say that 115,000 mixed-age couples receive pension credit and/or housing benefit. Couples who claim after 14 May could be up to £7,000 worse off compared with a couple claiming now. I will come back to those figures and give some examples. The Department for Work and Pensions estimates that in 2019-20, 15,000 mixed-age couples will be affected by the change. That rises to 30,000 in 2020-21 and 40,000 in 2021-22. In theory, the change applies only to future claimants, but it will also hit any pensioner in a mixed-age couple in receipt of pension credit whose claim is interrupted. As Age Scotland and Age UK point out, couples claiming in the future could be nearly £140 a week worse off than before the change—as I said, an incredible £7,000-per-year cut for some pensioners.
That figure is noteworthy when taken in the context of another one: 40% of people entitled to pension credit do not claim it, whether through lack of knowledge or because of accessibility issues. What are the Government doing to assist such people to take up pension credit, given that alarming figure of 40%?
Age Scotland and Age UK provided me with a figure for an average Glasgow South West constituent in two scenarios, both taking into account state pension, pension credit, housing benefit, council tax reductions, health vouchers and the cold weather payment, and both for a mixed-age couple renting a one-bedroom, council tax band C property, paying rent of £510 a month and receiving state pension of £160 a week.
In the first scenario, the couple would receive total benefits of £395.46 a week, £1,581.84 a month or £19,097.08 a year; the total annual state pension income would be £8,320, so the income lost if no benefits were received and they relied only on some state pension would be £10,777.08. Secondly, the charities investigated how the same couple would fare if they were claiming universal credit, which is already a decisively less generous benefit and has well documented difficulties in claiming and sustaining payments. Even so, they would face a total annual loss of £6,751.24.
Under the universal credit rules, rather than the existing state pension credit situation, older people face a particularly substantial loss of income—a devastating loss, especially for those on low incomes. It is therefore vital that in the first instance we encourage everyone eligible for pension credit to claim it. It is scandalous to think that people would be financially better off if they lived apart than if they lived together.
I congratulate the hon. Gentleman on securing the debate. He is making a powerful speech. A lot of people who reach pension age are struggling to be able to work, although they may not be able to access disability or sickness benefits because of their condition. Does he agree that this change will affect such couples in particular, many of whom include a WASPI—Women Against State Pension Inequality Campaign—woman unable to claim the state pension or, as part of a couple, pension credit? Those women will be doubly dissatisfied.
The hon. Lady is absolutely correct. I will come on to the 1950s-born women and the double whammy affecting them. She makes an excellent point about those on benefits and low income and, as she will be aware because we have just come from the Select Committee on Work and Pensions where we were discussing “No DSS” adverts in the private rented sector, the change could have devastating implications for those people too.
Will the Minister therefore accept the calculations from Age UK and Age Scotland? Will he advise us whether there has been a recent equality impact assessment since January’s announcement? I understand that there was an impact assessment back in 2012, but will he tell us whether there has been an updated equality impact assessment on the pension credit change?
In 2010, a woman aged 60 and her partner aged 65 would both have been entitled to their state pension and both been considered pensioners for pension credit. From 15 May 2019, they will have to wait an extra six years to be in that position. In essence, the change will impose a financial penalty on pensioners who have a younger partner. That is why some WASPI women in Glasgow refer to the change as the “toy boy tax”, as well as the “age gap tax”.
According to the Joseph Rowntree Foundation, one in six pensioners in the UK already live in poverty. This Government policy will mean that many pensioners might find themselves in the position of being financially better off if they split up with or lived apart from their partner. Pensioners should not be put in a position where it would be better living alone.
As the hon. Member for High Peak (Ruth George) outlined, the policy change will adversely affect women born during the 1950s—precisely the group impacted by other Government decisions to raise the state pension age. Anyone hit by that double whammy will be entitled to feel especially aggrieved, and I can tell the hon. Lady and the Minister that certainly in my constituency the campaigners for the 1950s-born women do feel especially aggrieved by the change and regard it as a double whammy.
The public will be left with little faith in the Government and their ability to deliver pension justice for women born in the 1950s. The Women’s Budget Group states that
“pension credit is the single most important poverty alleviation mechanism for older people that we have in this country”.
The Government should make time for a new debate and a vote on the change, given that the decision was made seven years ago—two Parliaments ago. Rather than just enforcing the change, it is time to have another debate and vote.
According to OECD figures, the UK has the lowest state pension in the developed world; the change will only increase discrepancies. The Joseph Rowntree Foundation’s “UK Poverty 2018” report highlighted the fact that previous falls in pensioner poverty were in part due to the introduction of pension credit. Universal credit will not adequately meet the needs of a household of retirement age because of the strict requirements for seeking work, such as signing on at the jobcentre, qualifying as an unpaid carer or proving inability to work. Changes should be immediately introduced to ensure that older people do not suffer as a result. The policy change will be seen as a stealth tax on ageing couples on low incomes.
The Department for Work and Pensions has confirmed that it expects to save almost £1.1 billion over the next five years due to the changes. Tom McPhail, head of policy at Hargreaves Lansdown, commented that
“the impact on individuals and their household spending will amount to hundreds or even thousands of pounds per year and for some it could present real problems”.
The meagre savings that the Government will make from the policy change will not match the disastrous consequences that will ensue. If the change is not abandoned, it is anticipated that there will be a consequential increase in demand for support from the Scottish welfare fund, which provides crisis grants to families and people in Scotland on low incomes.
Pensioners could face a heavy financial penalty for having a younger partner. That could affect the health and well-being of those affected and is likely to increase the number of older people living in poverty. Pensioners should not be put in a situation where they could be better off living alone and claiming pension credit than living as part of a couple and receiving universal credit. The change could put pressure on existing relationships. Although the intention is to protect those receiving pensioner benefits before 15 May, they could lose their entitlement if their circumstances change, even if only for one day.
Does the hon. Gentleman share my concern that thousands of pensioner couples are affected but unaware? I highlighted to the Minister before the recess my concern that the gov.uk calculator incorrectly shows people that they cannot claim pension credit when, in fact, they are entitled to it.
The hon. Lady makes an excellent point; the lack of information has been a real issue, particularly for women born in the 1950s, many of whom did not receive letters about the pension changes. I have previously joked that I would be more likely to find a golden ticket in a Wonka bar than find a woman who received a letter about the pension changes.
The universal credit system was designed for people of working age, not pensioners. For example, it includes no additional support for a couple where one member is not expected to work because they are over state pension age.
I thank hon. Members for attending the debate. The pension change is a toy boy tax for many; it is certainly an age gap tax. I look forward to the Minister’s response. I hope he will tell me that the changes will be paused so that we can vote in the House on whether they should take place.
It is a pleasure to serve under your chairmanship, Mr Davies. I congratulate the hon. Member for Glasgow South West (Chris Stephens) on securing a debate on this important issue.
The Government believe that work is the best route out of poverty. Our reforms of the welfare system are designed to help people into work, make work pay and provide support for those in need. Those are the principles that underpin universal credit—the most significant change to the welfare system for decades—and are the context for the changes we are talking about today.
Single people can claim pension-age benefits only when they have reached state pension age. However, a person under state pension age who has a partner over that age can currently receive benefits intended to support economically inactive pensioner households, without having to meet any work-related conditions. That runs counter to our aim of encouraging people of working age to remain in the labour market and continue saving for their retirement.
As part of the reforms introduced by the coalition Government in 2012, the Welfare Reform Act 2012 set out that a couple will be able to access pensioner levels of means-tested support only when both partners have reached state pension age. In response to one of the hon. Gentleman’s first points, we have been clear that the change will not be introduced until the roll-out of new claims to universal credit is complete. That roll-out was completed earlier this year; consequently, on 14 January we announced that we will implement the mixed-age-couples change with effect from 15 May.
I will try to address all the hon. Gentleman’s points. Regarding the change being made by a written statement at a particular time, the changes to pension credit that commenced following the order made on 14 January were fully debated on three occasions during the passage of the Welfare Reform Act, and were voted on in Committee. The powers under which the order was made do not require the order to be subject to any further parliamentary scrutiny, since it brings into force primary legislation that Parliament already agreed should be implemented by a commencement order.
When the changes were debated back in 2012 as part of the Welfare Reform Act, universal credit was still a similar level of benefit to tax credits. Since then, following the 2015 budgetary changes, universal credit has been worth significantly less, and increased numbers of people on universal credit are in poverty. Does the Minister not agree that that should be a reason for Parliament to debate again the changes that will affect hundreds of thousands more, often vulnerable, households, in the light of the changed circumstances?
With respect, Parliament has debated the matter and made a decision. The hon. Lady will be aware of the 2011 equality impact assessment, the 2012 risk assessment, the universal credit impact assessment, and the ad hoc statistical analysis published on 28 February, which outlined the number of people affected, as the hon. Gentleman mentioned—approximately 115,000 mixed- age couples in the United Kingdom.[Official Report, 16 May 2019, Vol. 660, c. 4MC.]
I want to come back to the ministerial statement. There have been various changes to the political make-up of Parliament since 2012. There must be at least 200 new MPs since then, and I think they would want to consider the change, particularly in the light of other benefit changes, as the hon. Member for High Peak (Ruth George) said. Did the Department consider a fresh debate? The Minister mentioned the quality impact assessment. Could he tell us whether a fresh equality impact assessment was made this year prior to the announcement on 14 January?
I cannot go back to the specific debates in 2012 and say chapter and verse what was discussed at that stage, but it is a relatively normal procedure for this House to legislate on matters that will be contingent on a written ministerial statement or a commencement order. That standard practice was followed in this case. I am not aware of a fresh equality impact assessment being done. The equality impact assessment was done in respect of the Welfare Reform Act.
It is interesting to listen to hon. Members. I often find that the SNP tend to weaponise welfare issues to make the charge for independence. My understanding is that powers have been devolved to Scotland under the Scotland Act 2016. Could the Minister confirm what powers are available to the Scottish Government to address this issue? Has he had any constructive discussions with the Scottish Government on the issue that the hon. Member for Glasgow South West (Chris Stephens) raises? I understand that they are pushing back the use of those powers until 2024. Does the Minister agree that rather than giving her sixth statement on indyref2 today, perhaps the First Minister should make a statement about how she will use her powers to address the issue?
I will deal with that point and then perhaps return to it in more detail later. I accept that there are other points relevant to this debate, but it is inevitable that devolution will come up when one discusses welfare with a colleague from the Scottish National party and other Scottish colleagues. Certainly, it has come up in relation to the campaigns on the state pension age.
My hon. Friend will be aware of two facts in particular. First, Jeane Freeman, who was my opposite number as the Scottish pensions Minister, wrote to my predecessor on 22 June 2017 concerning the powers under sections 26, 28 and 24 of the Scotland Act. Of particular interest is section 26, about which she wrote:
“This power is limited to providing help with ‘short term needs’, and those needs must require to be met to avoid a risk to a person’s wellbeing. That would not readily allow assistance to the majority of the women affected by the acceleration of the increase in their State Pension Age. Their needs and the risks to their well-being would have to be assessed individually.”
She also dealt with the creation of a new benefit under section 28, which is a possibility, and the top-up of reserved benefits under section 24, which is a wide-ranging power to make discretionary payments.
That deals with the original point in 2017. The point can then fairly be made that if the Scottish Government disagree with any of the UK Government’s welfare reforms, they have powers to do something about that in Scotland. I want to make it absolutely clear that, in addition to the substantial support that the UK Government are providing, the Scottish Government have significant new powers available to them to tailor welfare provision for people in Scotland. Although pensions themselves are very definitely a reserved matter, the Scotland Act gives the Scottish Government the ability to use a wide range of new welfare provisions.
I was asked specifically whether I have been engaged with by Scottish Ministers who seek to provide specific top-up support for mixed-age couples. I have not been made aware of any such information being provided to me. Frankly, it is not for the UK Government to do that. If the Scottish Government wish to do that, the ball is in their court, given their powers under the Scotland Act. Clearly, that is a matter for the hon. Member for Glasgow South West to take up with the Scottish Government at Holyrood.
Let me return to the change itself, which ensures that the younger partner has the same work incentives as others of the same age. Those claiming universal credit have access to tailored support from work coaches to help them find work, and universal credit is designed to ensure that work always pays, which is not the case for pension credit.
Let me try to address the specific point raised by the hon. Member for High Peak (Ruth George). First, I endeavoured to address her emails of 10 and 11 April, which arrived shortly before Easter and were looked at by the Department over Easter. I have written her a letter. We exchanged comments before the debate, and I accept that she has not received that letter. I signed it off late yesterday afternoon, on my first day back in the Department; to be fair to the Department, there is no criticism of it whatever. I also wrote a letter to the hon. Member for Glasgow South West, but we managed to get that to him in time.
I am conscious that the hon. Lady raised a specific fault. I am happy to put it on the record that there was an acceptance that that was a fault, and that, as of 18 April, it has been fixed. The reality of the situation is that the calculator provided the wrong outcome in one particular instance—for couples where one member is in receipt of carer’s allowance and the other retains an underlying entitlement to carer’s allowance. I will leave her to look at the specifics of the letter when she receives it later today. I am grateful to her and the Derbyshire team for bringing the issue to our attention. It has been rectified, and I hope the position on that matter has been addressed.
The hon. Lady raised a separate issue about pension credit generally. It is entirely the case that we are attempting to encourage people to be in a position to take up pension credit in a particular way, and there most definitely is a desire for that to happen. All 115,000 existing mixed-age couples involved were written to subsequent to the decision being made in January. Although I do not have a regional breakdown of that figure, 8,000 people will potentially be affected in Scotland. I do not have localised figures for the hon. Lady’s area.
I want to stress that the change does not in any way affect entitlement to state pension or the level of state pension. Mixed-age couples who are already receiving pension credit or pension-age housing benefit on 14 May will not be affected for as long as they remain entitled to either of those benefits. As I said, we have written directly to those couples to inform them of the change. The change therefore will apply mainly to working-age couples currently claiming means-tested benefit, or to mixed-age couples who apply for benefit only after the date of the change.
Age UK has met repeatedly—as recently as last month, as I understand it—with civil servants and special advisers in the Department for Work and Pensions. It is almost impossible to state what a future calculation will be without taking into account whether the individual will apply for a job and what their allowances for caring responsibilities and their other entitlements will be. There is a requirement and a desire for universal credit to incentivise and reward paid work, while pension credit is intended to provide long-term support to pensioner households who have left the labour market permanently through retirement.
Well, I will write to the hon. Lady on that point, because I want to address the point made by the hon. Member for Glasgow South West, whose debate this is, about pensioner poverty. He criticised the Government in that respect, but I would push back on that.
We are forecast to spend £120 billion on benefits for pensioners in 2019-20, including £99 billion on the state pension. He will be aware that, by reason of the triple lock, from April 2019 the yearly amount of the basic state pension will be around £675 higher than if it had just been uprated by earnings since April 2010, and that the value of the full state pension as a proportion of average earnings is at one of its highest points since the late 1980s.
I could go on about the number of people in employment, which has risen dramatically, the increases in state pension and the successes of automatic enrolment in the employed sphere, but I thank the hon. Gentleman for the opportunity to address this matter. If I have missed anything, I will of course write to him.
Question put and agreed to.
Ten Years of the Work Capability Assessment
[Sir Henry Bellingham in the Chair]
I beg to move,
That this House has considered 10 years of the work capability assessment in relation to employment and support allowance and universal credit.
This feels like such an inadequate environment to describe the work capability assessment and its brutal consequences. I wish that every single person affected by the system could be here with us in the Chamber and look in the eyes of those who defend the system. I hope that when they have heard what I am about to describe, Conservative Members—there are not many of them—will feel shame, and that in this debate we can do justice to the experiences of those subject to the work capability assessment.
The work capability assessment for the employment and support allowance and universal credit should be a simple concept: people who have a physical or mental health problem or a disability that means that they cannot work or have a limited ability to work will receive a replacement income from the state. I will talk about the face-to-face application process and the assessment, which are draconian, elicit fear, deny justice and have, in some circumstances, ended up contributing to the end of life. As Frances Ryan wrote recently in The Guardian, suicide is becoming a feature of the system.
Everyone in the Chamber will know someone who is unable to work for whatever reason. Those with personal wealth are often able to avoid having to prove that they are worthy of income replacement. Because they have that personal wealth, they are safe from having to share every single detail of a condition or illness, and do not have to wonder if they will be believed. People without savings, on the other hand, are only one step away—one accident or one conversation with the doctor—from being subject to that system.
Let me set out some of the elements that we believe are wrong with the system; this is based on evidence gathered from my constituents when they come to surgeries, on submissions by professionals, and on the vast number of submissions I have received from people currently applying for this social security payment. In both the application form and the face-to-face assessment, the descriptors that enable a score to be given to assess a person’s ability to carry out tasks are essentially a functionality test. They cannot capture the fluctuating nature of physical and mental unwellness or disability and how that could prevent or limit the ability to work. People often describe feeling punished for telling the truth. Yes, perhaps they could go out unescorted on a journey somewhere, but the test is not interested in, for example, the panic attack before leaving the house, or the emotional recovery afterwards. Perhaps venturing to the supermarket will have been their only trip out that month, but making that journey could lose them their entitlement.
In reality, one day someone may be in the depths of despair, and the pain from their condition may be unbearable; the next day, they may be able to have a laugh over a cup of tea with a loved one. The question is, should they lie about that laughter or feel shame about it because they might get points deducted? Does that laughter render meaningless the pain felt the day before? Fundamentally, does that have any bearing on someone’s ability to work? I think not. The test ignores the complex reality of living with long-term or fluctuating conditions.
Many people have told us that they do not feel accurately represented by the reports written about them. Advisers have openly claimed that they see copy-and-paste jobs. A constituent read that they were apparently happy and confident during the assessment, when in fact they were crying and shaking. No wonder as many as 74% of ESA decisions are overturned at appeal, according to Citizens Advice. That, of course, is one of the consequences of using a private company to assess the medical conditions of people who need support. Not having people qualified in the condition or illness with which assessors are presented is also a huge issue.
It is claimed that Maximus incentivises health professionals through the number of reports they complete. Logic says that that could directly lead to a proliferation of inaccuracies. Ultimately, profit should not be made from ill health; it leads to corner cutting and misplaced priorities. To defend the marketisation of the process is obscene.
I am not sure whether the Government or Conservative Members realise just how truly terrified some people are of the brown envelope from the Department for Work and Pensions. They know that they will be forced through a long and extremely difficult process. They will have to attend an assessment, and the decision notice they receive about the outcome of their work capability assessments is often inaccurate and misleading, leading to a long and stressful appeal process of up to 18 months; that is 18 months without the entitlement that those people deserve and need.
The process exacerbates poor health, and the Government make things worse. When people, because of their physical or mental health condition, ask that their assessment be carried out at their home, the answer given is almost always no. My caseworkers and agencies have sent substantial evidence to private contractors to show that my constituents would have severe difficulty attending the assessment centre. The stock response is, “If the claimant can get to their GP or to the hospital, they can attend the assessment centre.” How cold-hearted is that?
Does my hon. Friend not agree that there is a difference between someone going to a location quite close to their home, which they are familiar with, and an assessment centre that may be many miles away and difficult to get to unless they have their own transport?
That is right, and in a place like North West Durham, where we have an inadequate and expensive transport system, it is unjustifiable not to have assessments carried out at home if someone is feeling unwell and faces stress in having to go to that assessment.
If the person does manage to get to the assessment centre, the assessor uses that as evidence of their ability to travel, walk, sit comfortably and cope with social interactions. One person got in touch with me to say that they had to sit in the assessment centre waiting room in soaking wet clothes due to their incontinence issues. Is this a system anyone can really defend? Is anyone really comfortable with a private provider forcing people to attend assessments in pain and with worry, to be degraded by the DWP?
If a person is found fit for work when they are not, that can have a huge impact on their mental and financial wellbeing. It can have a direct impact on their entitlement to housing benefit and council tax benefit, plunging them into destitution, and resulting in increasing debt, risk of eviction and untold stress. People wrongly found fit for work are then expected to do job searches and training, and are even sanctioned. It came as no surprise to any of us Opposition Members that in 2016 the UN concluded that the Government had committed “grave and systematic violations” of the rights of people with disabilities. That report should have seen an end to the Government, but they limp on.
For people who do go on to win at appeal, reassessment is too frequent. No sooner have they won than they are being reassessed—even people with terminal illnesses have to endure that. Imagine the retriggering of mental health difficulties when people have to describe, in assessment after assessment, historical sexual abuse to which they were subject.
Let me mention some of the contributions from people who got in touch. One person said:
“The process feels like psychological rape, expressly designed to make you feel that you are the absolute property of the state, that you are not a human being and that your continued survival is basically an affront to society.”
“When you are disabled, you are defined by the able-bodied by what you cannot do, rather than what you can do. No disabled person wants to be a burden on society. They want to be an active contributor but are denied this by society”,
“The whole thing should be abolished as it’s a cruel and pointless exercise in ideology.”
It is about ideology, isn’t it? This system, with its complexities, its high thresholds and the way in which employment and support allowance and higher rates of universal credit have been denied to so many, cannot be seen outside the context of almost 10 years of austerity and budget cuts, which have literally taken money from people who are disabled, unwell or dying.
What are the worst consequences, the ultimate results, of this brutality? Jodey Whiting, who lived in Thornaby, not too far from my constituency, took her life 15 days after her benefits were stopped for missing a work capability assessment when seriously ill. The independent case examiner found multiple failings on the part of the DWP, including it simply not following its safeguarding procedures. Her mum, Joy Dove, is campaigning for an independent inquiry into benefit death and I am sure everyone on this side would say “All power to her” in that campaign.
Stephen Smith, aged 64, who had chronic obstructive pulmonary disease, osteoarthritis and an enlarged prostate that left him in chronic pain, failed a work capability assessment in 2017, which meant that his employment and support allowance payments were stopped. Anybody who saw Stephen’s emaciated body on social media will have been horrified. Stephen died last Monday. Jeff Hayward, who won his appeal seven months after his death, had a debilitating skin condition and spent his last 18 months fighting a “fit for work” decision. Michael O’Sullivan, aged 60, from north London had long-term mental health problems, and the coroner found that the benefit process was a key trigger for his death.
These are the real-life tragedies of a broken system. I do not think I can bear to hear the Minister say, yet again and as his predecessor did, that we should come to him with our individual problems with the system. They are not individual problems; they are systemic failings, and a consequence of privatising social security and making £37 billion in welfare cuts.
Let us be honest: this is institutionalised bullying and harassment of sick and disabled people. I have no doubt that administrative ineptitude is part of it, but when the issue is on this scale, there can be no other conclusion. By deliberately stripping people of their rights, in order to disrupt the welfare state and the very concept of legal entitlement, the Government have trodden all over the expectation of citizens that they will be looked after in their hour of need. And what for? To replace the state with private and family provision, to boost the coffers of private insurers, and to replace legal rights with charity, subject to moral judgments of deservingness.
It does not have to be like this. How can our social security system be about security and not about punishment? The Labour party has rightly committed to scrap the work capability assessment. That will be a big step forward and will no doubt be welcomed by disability rights groups and welfare rights agencies alike. In the meantime, why do the Government not start rectifying injustices in the system by taking the vast amount of evidence from medical professionals, including GPs, consultants and nurses, into account? Testimony should be fundamentally believed. The culture permeating the DWP is one of disbelief that looks cynically on those who request help. Stressful, face-to-face assessments should be used only if there is an absolute necessity, such as a lack of evidence on which to decide on entitlement. Assessments should be a last resort.
The system should be designed by people who are experts through experience. Experts who understand how conditions affect the ability to work should be employed. Any social security system that replaces the work capability assessment as it exists today should not be a functionality test with arbitrary rules that do not account for the fluctuating nature of a person’s condition, disability or illness. There needs to be a revision of the assessment criteria, so that they are linked much more closely to the real world of work, or the work that the person was doing. Knowing whether someone can move a carton of milk with one hand cannot allow us to understand a person’s comfort or ability to work in a specific environment. Any process should include an assessment of the additional support that person would need to ease them back into the workplace. Recording of assessments should be standard, unless a person asks not to be recorded. The Government are dragging their heels on that recommendation.
Private outsourcing of the assessments has to be scrapped. The market has failed all aspects of the social security system, placing company profit before the needs of the people interacting with the system. When will the Government understand that private enterprise and illness are incompatible, and inevitably lead to the injustices that we see today?
When people are dealing with the stresses of not being in full health and of needing support for their disability or mental health condition, they should fundamentally not be subject to further stress, degradation and even abuse by the state. The system should be designed on the presumption that people are telling the truth when they come to see the assessors. They should not be forced though a humiliating and exhausting process that often results in them winning appeals at tribunal, with the help of the excellent but underfunded advice agencies and many of our caseworkers. For many people, their last fight on this earth is not with their illness, but with the state, and that fact alone should lead us to scrap this dreadful system.
I thank the hon. Member for North West Durham (Laura Pidcock) for her moving and impressive speech. We will have an informal limit of seven minutes from now on. If right hon. and hon. colleagues could adhere to that, I would be grateful.
Thank you for calling me, Sir Henry. I congratulate the hon. Member for North West Durham (Laura Pidcock) on presenting the case so well, with the passion and belief that we all know she has for the subject.
To say that the difficulty with ESA and the transition to universal credit is evident in my constituency is a gross understatement. I have talked to the Minister about this on a number of occasions. His door has always been open and he has told me to bring any issues I have to him. I have done that, and found him responsive and helpful. I hope that at the end of the debate, when we have all made our contributions, the Minister will be able to address some of the issues that I and others have, and put our minds at ease.
The difficulties that people face are astronomical. My comments will not be a surprise to anyone here; I am known as a man with a very soft heart. When I look at a person who is clearly ill and vulnerable, who has tears in their eyes because they simply do not understand what is happening and feel that they are alone and helpless, it is hard not to be upset and angry for them at a system that puts so much stress and pressure on the most vulnerable in our society. I am all for getting people up and out to work, giving training and helping to build and boost confidence to start a job. I do not want to see one able person out of work in Strangford, but in seeking to weed out the few who could work but will not, we are mentally exhausting and physically injuring those who are not capable of working.
I want to give an example that exemplifies all my comments. My staff recently dealt with the case of a young man who was living in his car. It became clear to me that this young man was broken; there is no other way to describe it. I called my parliamentary aide into the meeting. She is a sympathetic person and she had her arm around him, telling him that he was important, that he mattered and that we would help him get a fresh start. This was definitely a man on the edge, whose only companion was his dog. I do not know how he got to that position or what mistakes he had made, but I do not need to know that; I just needed him to know that we would help him.
We spoke to the phenomenally helpful Elizabeth, who is the manageress at our local jobcentre, who worked her way through the issues with his benefits and helped him. He could not face people, so he was outside the system. We had to take him and do everything for him. We spoke to the housing executive who managed to sort out hostel accommodation for him in the short term and now he has his own flat; that all happened at the meeting we had.
We spoke to the local food bank, based at Thriving Life Church in Newtownards, who provided him with food and sanitary products. We spoke to all these people. He was so low and so down that he could not have spoken to them because he had not got the ability to socially interact with people. We spoke because he could not speak for himself. The staff in my office were able to help him and get him out of the dark hole that he was in.
When I think of this young man—a man who could not even look us in the eye that day, who I knew was on the precipice, at the point of no return, and was expected to work in that state, with no mercy shown—I am reminded of the role that we have in this House. As MPs, we are blessed and privileged to represent those people and to try to help them in the times when they need help.
There are too many people living in their cars who cannot get a break and do not know where to turn. Too many people have been pushed to the edge of darkness and feel alone, and that tells me that we need more Elizabeths and Lees in our jobcentres. We need more Owens and Irenes in our housing executives. We need more Natalies and Susannes in our food banks. Those people could not wave a magic wand to make it all okay, but they played their part to see this young man, over a few weeks, into a position where he could look me in the eye and thank me. What a turnaround that was!
Unfortunately, that was only one example. In that three-week period, there were a number of people who were under the radar, who had slipped out of touch with the benefits office and were not in touch with the Executive or with others. We need to task all civil service staff with the fact that compassion is as much a qualification as an English GCSE.
The hon. Gentleman mentions compassion, but is it not also correct that there must be professionalism? Linda Hending in my constituency set up a support group for people with myalgic encephalomyelitis. She found that, while 10 of those 11 people had either been found fit for work or had insufficient points for the Personal independent payment, all those decisions had been overturned on appeal. While it is inevitable that there will need to be some assessment, is it not critically important that those decisions are got right the first time, so that people do not have to go through the strain of an appeal, even if it is successful in the long term?
The hon. Gentleman is absolutely right. I have a number of girls in my office, and one in particular who does nothing but benefits. She works full time on ESAs, PIPs and DLAs as the turnover goes for income support and all those other things. She works full time on benefits, and the other staff fit in work with that as well. We win a number of appeals because of the advice that is given. To be fair to the Minister, I have suggested to him that we need staff who are professional and able to advise in the way they should.
Yes, there are those who take advantage—I know that that happens sometimes—but I want to talk about those who need the help. Ten years into this, I still do not think we have the balance right, and that is part of many people’s mental health struggles. In the short time that I have, I want to mention that we need compassion for those with cancer who are claiming universal credit. Alongside the physical and emotional impacts, cancer brings with it a real risk of financial hardship. Macmillan Cancer Support has found that four out of five people with cancer are, on average, £570 a month worse off because of their diagnosis. Last year, Macmillan’s support line advisers received 26,500 calls from people seeking advice on applying for universal credit.
The first problem is access: people who are hospitalised often do not have access to the internet, and navigating a long and complex online application form is a horrendous thing to go through at a time when their body will not let them attend to it. Those who are undergoing treatment or have a terminal diagnosis have also had to attend the jobcentre, which can be distressing, and in some cases go against medical advice.
The initial five-week waiting time for universal credit is causing problems for people with cancer, many of whom have had to give up their work completely due to their condition and treatment. That even applies to people with a terminal illness, meaning that people who may have less than six months to live now spend more than one month of those six waiting for their benefits. Under the old system, people with a terminal illness could expect to get paid as soon as their claim was processed. The Minister knows, because I have spoken to him about it, but I believe we need to address these delays. Some 67% of people are not receiving their full payment on time.
This year, the Government will pilot the managed migration of people to universal credit. It is welcome that this process will be piloted before Parliament is asked to make a final decision; I welcome that and it is good that we have that process, but it will not solve the problems for people already receiving universal credit. We need to do this better, for everyone’s sake. I look to the Minister at this point: we need a sea-change of attitude, with compassion at its heart, working its way from this place to every level of public service. Young men such as Michael and others will simply not survive without it.
It is a pleasure to serve under your chairmanship, Sir Henry. I reiterate the congratulations to my hon. Friend the Member for North West Durham (Laura Pidcock) on an excellent speech, outlining some of the range of problems that we have with this work capability assessment process.
This feels like déjà vu: we are here, yet again, to argue that the current system of work capability assessment is not fit for purpose. We can use the latest available data that tells us that nearly three out of every four claimants who appeal their assessment decision telling them that they are fit for work will have the decision overturned. We can reference the five reviews of work capability assessment over the past 10 years, which have repeatedly raised problems with the assessment process, ranging from medical reports being mislaid to blatant lies in assessment reports. We can look at the Work and Pensions Committee’s report from last year on ESA and PIP assessments, which saw an unprecedented 3,500 individuals share their experience and what they had been through, as my hon. Friend described.
We can discuss the death rates for people on ESA and, before that, on incapacity benefit. In 2013 that death rate was 4.3 times that of the general population, increasing from 3.6 times in 2003. That shows the level of sickness and ill health of people in this group. As has already been said, this is a poorly group of people who deserve to be listened to and respected. We can talk about the peer-reviewed research that estimated that between 2010 and 2013, work capability assessment was independently associated with an additional 590 suicides, 280,000 cases of self-reported ill health and 725,000 additional anti- depressant scripts.
However, anyone watching this debate will be thinking, “What on earth is the point?”, because to date the Government have taken not a jot of notice. Little has changed. We know how this is affecting people, as we have already heard: people living in fear and dread of the envelope dropping on their doormat, inviting them for their work capability assessment.
The Government have said they want to amalgamate the work capability assessment and PIP assessments by 2021. They say they want a more personalised approach and will involve disabled people in this process. I ask the Minister which disabled people’s organisations have been involved in the decisions. I appreciate that charities may have been involved, and it is important that they be involved, but what DPOs and disabled people have been involved? Were they involved in the decision to put the contracts for this new assessment process out to tender? That has already happened; we had one week, and then the contract for this new process went out to tender.
What are the Government going to do in the meantime, while this Government-orchestrated harm—it is a Government policy—continues? I am really concerned, and I hope the Minister can respond, because to date there has been little but warm words and platitudes.
As we have heard, on Monday we learned that Stephen Smith, the Liverpool man whose emaciated body was reminiscent of someone found in a concentration camp, not in 21st-century Britain, had died as a result of multiple organ failure after being found fit for work. We know he is not the first. My hon. Friend mentioned Jeff Hayward, who died in 2018 of a heart attack, seven months before a tribunal overturned a decision that he was fit for work.
Also in 2018, Jimmy Ballentine committed suicide after being found fit for work, as did Amy Nice, Kevin Dooley and Brian Bailey. Jodey Whiting, my hon. Friend’s constituent, Elaine Morrall, Daniella Obeng and Brian Sycamore all committed suicide in 2017 as a result of being found fit for work. In July 2017, Mark Scholfield, a terminal cancer patient, received no universal credit before he died, in spite of his illness. Chris Gold, in 2017, was found fit for work following a stroke. He was facing foreclosure when he died as he could not work. Lawrence Bond died in 2017, collapsing and dying on the street after being found fit for work.
Julia Kelly committed suicide in 2015, as did Ben McDonald. Chris Smith, who had terminal cancer, was found fit for work right up until his death. David Clapson died in 2014, as did Michael Connolly. “George, from Chesterfield” died that year as the result of a heart attack, again after being found fit for work. Robert Barlow, another terminal claimant, died after losing his ESA. David Barr, Trevor Drakard, Shaun Pilkington and Terry McGarvey also died in 2014. Lee Robinson, Robert Christian, Jacqueline Harris, Nicholas Peter Barker and David Groves died in 2013.
That is not an exhaustive list, but those names are an indictment of this Government and their policy, and so is the lack of change that has happened as a result of those deaths. There needs to be an independent inquiry, as Jodey Whiting’s mother says, into the deaths of claimants found fit for work. Until then, there should be a moratorium on all reassessments; for new assessments, as has been said, medical evidence should be the primary data used, not the blatantly flawed assessment processes.
Sir Henry, I am sure you agree that any Government’s first duty is to protect their citizens, but our disabled citizens have been spectacularly failed by this Government. Like millions of people across the country, I condemn the attacks in Sri Lanka, and I share concerns about the emergency that is climate change, but the deaths of disabled people as a result of Government policy are nothing less than a scandal. I challenge each and every one of us, in this room and outside, to rise and say to the Government, “Enough is enough!”
It is a pleasure to serve under your chairmanship, Sir Henry. I thank the hon. Member for North West Durham (Laura Pidcock) for securing the debate. I pay tribute to my parliamentary casework team, and to Citizens Advice and Money Matters, local organisations that work with the casework team to ensure that people who are going through the ESA and PIP system or who have other issues get their social security. The assistance that they provide to my constituents is invaluable. Without those organisations, it is quite clear that more people would suffer.
I will confine my observations to a Work and Pensions Committee report. As a member of that Committee, I can say that, such was the level of interest in PIP and ESA assessments, 200 organisations submitted evidence and there were 3,500 individual submissions. That tells us more than anything else the level of interest, and the pain and suffering that people are going through as a result of these assessments.
Let us look at the Department’s own statistics. There have been 3.1 million ESA applications, with 1.7 million assessments completed, but with payments and awards issued to only 1 million people. That suggests low confidence and trust in the assessment system. The hon. Member for Cheltenham (Alex Chalk) quite rightly said that it is important that the Department and the assessment process are correct first time. However, that is not the experience of far too many people, which is why I am delighted to take part in this debate secured by the hon. Member for North West Durham.
The simple fact is that claimants can have multiple health conditions, which can mean that they have severe limitations. There was a recommendation to commission and publish independent research on the impact of the application and assessment processes of both ESA and PIP on claimants’ health. Will the Minister tell us whether the Department accepted that recommendation and will take it forward?
Claims are often made by telephone, Sir Henry, and you and others will be aware that one campaign I launched since I got here was to abolish the telephone tax. I am delighted to say that the Government finally listened, and that the telephone tax was abolished. It is ludicrous to suggest that it should cost claimants phoning a telephone helpline 55p a minute, and I am delighted that that has now gone. However, as a result of health conditions, there are claimants who require communications in specific formats—I think particularly of those with hearing impairments—and we need to make sure that there are other methods for them to apply for ESA or PIP and the like. I hope that the Minister will update us on that.
The hon. Member for North West Durham was absolutely right on home visits. Maximus told the Select Committee that decisions on any request for home visits that they would carry out would be based on medical fact, not medical opinion. I hope that the Minister will say a bit about the guidelines on home visits that the Department gives to assessors. That brings us to the assessors and their knowledge; they can have partial knowledge or no knowledge at all of specific conditions. I still remember asking Maximus and Atos who a claimant with multiple sclerosis and a history of depression would see if they were to visit an assessment centre. The answer came back that they would see a general occupational therapist. If the assessment process is to have that conditionality, which I personally oppose, claimants must see people at the assessment centre with some knowledge or expertise on specific conditions.
We really need to improve understanding among healthcare and social care professionals and claimants about what constitutes good evidence, including measures, monitoring and reporting, and the supply of evidence. For far too many people, the assessment process has become a lottery. I agree with the recording of assessments, because we really need to end the mistrust around assessments. The fact is that appeals are upheld based on oral evidence given at the original assessment, not at the appeal. That is why recording is a must, and I hope the Minister will tell us that there has been progress on that.
A full copy of the report should be given, to increase transparency, and the quality of reports really must improve. We have contractors who have not once hit their targets for acceptable reports. If they cannot hit that target, we have to ask why they were given the contracts in the very first place. If a contractor failed to hit targets in any other part of the public sector, they would have that contract taken off them. I hope that the Minister can tell us what feedback and quality control measures the Department has put in place, because far too many people are suffering under this system. We have to ensure that it improves. I am delighted that the Scottish Government will do away with private contractors to undertake assessments. The Westminster parties should consider that too.
It is a pleasure to serve under your chairmanship, Sir Henry. I congratulate my hon. Friend the Member for North West Durham (Laura Pidcock) on securing the debate and on the excellent way in which she introduced it, covering a range of issues. I felt compelled to speak because many of my experiences with constituents are similar to those we have heard. I have received the clear message—I hope the Minister receives it as well—that improvements to the assessments process are very much needed.
Some constituents who have attended assessments have raised concerns with me about the fact that assessors carry out the assessments very quickly and do not listen to their answers. We have touched on the refusal to conduct home assessments, sometimes despite medical evidence that they are necessary. On one occasion, a constituent suffering from agoraphobia was refused a home assessment. Surely the need for one in that situation was obvious.
I note from an overview of the work capability assessment mandatory reconsideration and appeals process that, from October 2013 to June 2018, 33% of assessments were closed by the claimant. That is 1.3 million people—not a trifling number. The Government line may be that all those people pulled out of the process because they were fit to work, but I doubt it is as simple as that. My worry is that there are people within that 1.3 million who would be entitled to ESA but did not go through with the process because they were too anxious or worried about the assessment or because they simply could not cope with the idea of having to discuss their intimate medical issues with a stranger. I would like to know from the Minister whether any research has been done into those 1.3 million people, the reasons why they withdrew and whether people in genuine need have been failed.
The study goes on to say that 15% of all applicants go on to register a mandatory reconsideration, which is 370,000 people within that five-year period. Some 85% of those reconsiderations stick with the original decision, and 21% of those people then go on to submit a formal appeal. There is sometimes a misconception that the mandatory consideration is the appeal stage, and that there are no further opportunities to challenge. However, those who carry on to launch an appeal have a success rate, according to these figures, of 63%, although we heard from my hon. Friend that, according to the CAB, it is more like 74% or 75%.
My office team has experience of constituents challenging assessments and getting nowhere until they come to our office and we get a reconsideration straightaway, which gives the impression that they are not taken seriously. It is the exact same evidence, but they are not listened to until we get involved. Does my hon. Friend agree that that is a sad state of affairs?
I find that disappointing, but not surprising. The fact that the appeals success rate is so high suggests that not only the initial assessment is flawed, but the mandatory reconsideration stage is not a proper appraisal of the full merits. Perhaps that takes place only when Members of Parliament get involved. A cynical view would be that the mandatory reconsideration stage is just a hurdle put in front of people to make life a little more difficult for them. I am shocked that recent figures for the appeal stage show that the DWP does not even bother to turn up to about 80% of the appeal hearings.
I want to pay tribute to my fantastic local CAB, which represents people at the appeal hearings. However, it cannot help everyone, and it is the people who are not able to get representation I worry about.
Given my constituents’ experiences, there is no doubt that the original assessments are flawed. Many decisions are overturned at tribunal, and it seems the system does not learn from its mistakes. For example, one constituent was assessed five times in eight years of being on ESA. At each assessment she was found fit for work. On each occasion she appealed and on each occasion she won that appeal. In the process she paid £150 to get medical evidence to support her appeals. How can the assessment process get it wrong five times? How can the absolute waste of public money that five separate appeals must have cost be justified when the final decision was the same every time? What does it say about the Government’s approach to people with long-term conditions? How many times does someone have to prove that they are ill and unable to work?
Last-minute cancellations have also been an issue. I have heard from constituents whose assessments have been cancelled on the day the assessment is due to take place, and in some cases the constituents were actually at the assessment centre when their appointment was cancelled. That seems to be particularly the case when the assessment is scheduled for a time after half past three. The most recent example involved a lady who was struggling when entering the assessment centre. Obviously, it is a very stressful experience. She was shaking, crying and not engaging, and then she was told that her assessment would be delayed by another 45 minutes, at which point she became so distressed that she had to leave the centre and cancel the appointment. That is a callous and uncaring way to treat someone. When one of my constituents rang up two days before her assessment to give notice that she would not be well enough to attend, she was told that it was too late for the assessment to be rescheduled and she would be recorded as a no show. It is double standards of the highest order.
In conclusion, people with long-term conditions deserve compassion, respect and support. They should not be made to feel they are on trial because they are ill.
I congratulate the hon. Member for North West Durham (Laura Pidcock) on securing this debate and on the tone that she set at the beginning.
I was first elected in 2015 and I have spoken out repeatedly about the damage that the assessments and the way in which they are carried out do to my constituents and constituents across the United Kingdom. Although I am glad to speak in this debate, I am really annoyed that it is necessary, because it should not be. The Minister is not hearing anything today of which he is not aware. He knows exactly what is going on and it is not acceptable that we come back time after time to say the same things over and over. I know the Minister will tell us about changes that have been made and about people who are not reassessed if they have got a severe disability or a lifelong illness. He will tell us that people with progressive conditions requiring a high level of support will be assessed only every 10 years. I say to him that that is all very well and good, but it simply is not good enough.
The Disability Benefits Consortium, made up of 80 different charities and organisations, has stated that it did not think assessors had sufficient expertise to carry out assessments. Respondents who had seen a copy of their paperwork following assessment said that it “badly” or “very badly” reflected the answers that they gave. We all know that to be true when we speak to our constituents. Citizens Advice has told us that 81% of its advisers report inaccuracies in work capability assessments, so the information is out there. It is in our constituencies and in our surgeries, and I know it will be in the Minister’s inbox as well.
Constituents in a state of extreme distress have told me that they felt the questions they were being asked at the assessments were extremely intimate, invasive and inappropriate. Discussing very intimate details of your medical challenges with a panel of strangers in a context that causes the claimant distress and nervousness very often sets back the claimant’s health, exacerbating their condition, and all of that is before they are told, often incorrectly, that they are fit for work, with the paperwork not accurately reflecting the answers that the claimant gave at the assessment.
Some 51% of ESA claimants are recorded as having a mental or behavioural disorder as their main disabling condition. Rethink Mental Illness has published a report that states:
“Assessments can be traumatising and anxiety-inducing”
in a system that requires claimants to
“collect their own medical evidence”,
“inherently discriminates against people with mental illnesses”.
Often a false sense of security is created where assessors appear friendly and ask questions supposedly by way of a preamble to the formal interview: “Do you have pets?” “Do you have a dog?” “Do you walk it?” “What lovely weather we’re having.” “Do you like to sit in the garden?” All the questions are asked as if it is casual conversation, only for the claimant to subsequently discover, upon receiving his or her paperwork, that their assessment decision has been reached on the basis of answers to the so-called casual questions instead of on the medical evidence presented. I think that is sinister.
The hon. Lady is making an important point. I have a constituent who was asked if they could get a pen out of their bag, and they did, and then that was put down in the assessment. She was in floods of tears at my surgery because she felt she had been tricked. It is just awful.
A false sense is presented to the people, some very vulnerable, when they go to the assessments, and it is simply not good enough. The simple fact is that the system—the Minister knows this—which is a partnership with the private sector that has been in place since 2008, brought in under Labour, opened the gates, but the Minister has to understand that it has opened the gates to a place where folk who are sick and disabled are commodified, and it is not working.
Nearly half of women involved in work capability benefit tests have attempted suicide. We have seen the reports of claimants being asked, “Why haven’t you killed yourself?”, and even a double amputee being told he was no longer eligible for the mobility aspect of his disability living allowance. Sadly, such stories continue to emerge, and we have heard today about the very sad case of Stephen Smith, with which I am sure the Minister is familiar.
I have heard DWP Ministers say—I cannot remember whether this includes the Minister here today—the number of successful appeals against decisions shows that the system is working. I must confess I have never heard such stuff and nonsense. The number of successful appeals shows that too many incorrect decisions are made, which deny the most vulnerable in society, the sick and infirm, the support that they need and deserve. That is why the Scottish Government are committed to taking a lead on obtaining medical evidence so that claimants are not burdened with it. That is why there will be no private sector involvement in assessments, so that there will be no profit motive for it to declare claimants fit for work when it is not in a payment-by-results system. That is why the Scottish Government say that claimants will be offered a location and time and date that suits them for assessment, with home visits for those with travel difficulties, and that is why they have said audio recordings of assessments will be standard to ensure accuracy and transparency.
I urge the Minister and the Government to step up and admit that the current system punishes those who are unfit to work and those who are sick, and cruelly strips them of their dignity. I hope that the Minister will admit that it does not work. I urge him to look at the measures that the Scottish Government will implement and take a leaf out of that particular book. The current system does not work for my constituents in North Ayrshire and Arran. It does not work for anyone’s constituents. I ask the Minister to do the right thing: reach out a compassionate hand to those living with a disability. Anyone who is a Minister for Disabled People should do no less.
I congratulate my hon. Friend the Member for North West Durham (Laura Pidcock) on securing this important debate. The work capability assessment was introduced for employment and support allowance claimants in 2008. It has also been used to reassess incapacity benefit claimants and determine eligibility for additional universal credit support. It is now more than a decade since the introduction of the assessment: a good time to reflect on the impact that it has had on the lives of claimants across the country.
From 2008 to 2017, 48% of all work capability assessment outcomes were successfully appealed in Scotland and nearly half of all fit-for-work outcomes reached through work capability assessments were also overturned. In my constituency, 47% of appeals were successful in overturning the outcomes of such assessments and almost half of all fit-for-work outcomes reached through them were successfully appealed. The most recent national figures released by the DWP highlight the fact that 65% of fit-for-work outcomes were overturned in the period from December 2017 to January 2019.
Those figures illustrate the negative impact of work capability assessments on claimants, and the fact that they are failing, because they find people fit to work when they are clearly incapable of working. Claimants in that situation have to go through the appeals process with no access to their ESA payments, which means that they face poverty or destitution, or making a claim for jobseeker’s allowance or universal credit while waiting for their appeal to be processed. Considering the problems that there have been with universal credit, such as the five-week wait for the first payment, that is unacceptable. Many people face financial hardship and further uncertainty simply because they have challenged a work capability assessment outcome. Another thing to reflect on is the fact that ESA appeals are currently subject to a clearance time of 30 weeks.
Work capability assessments have also led to a situation where vulnerable claimants are denied the support that they need. The latest DWP figures show that 68% of those suffering from injury were found fit for work; 59% of those living with connective tissue diseases and 40% of those with mental or behaviour disorders were also found fit for work. How can the Government claim to be building a fairer society when work capability assessments are pushing the most vulnerable people into work in spite of their disabilities and medical conditions? It is clear that the assessments are not fit for purpose.
That view is shared by disability charities and the Work and Pensions Committee, whose 2017 inquiry received more than 3,000 letters from individuals who shared their experiences of the assessment process. More than 100 people reported that they or someone they cared for had experienced suicidal feelings as a result of the assessment process. We have heard today that people have taken their own lives. Shame!
Others highlighted a mismatch between what they had told assessors about their conditions and the content included in the assessor’s written report. In response, the Work and Pensions Committee made recommendations designed to improve the assessment process, including recording face-to-face assessments and providing clearer guidance to claimants about submitting evidence to support their claims. Similar recommendations have also been made by organisations such as Citizens Advice. The Government’s response was to ignore the recommendations.
The Secretary of State might be striking the right tone, but actions speak louder than words, and the problem with work capability assessments cannot be hidden through merging them with PIP assessments. Disability Rights UK summed up the shortcomings of the Government’s approach:
“You can’t merge two badly constructed processes and expect to come up with one fit-for-purpose approach”.
How right that is. For as long as the Government refuse to make real changes to the assessment process, vulnerable people will continue to be denied the help that they need.
It is shameful that this Government have extended Maximus’s contract to carry out work capability assessments until 2021. The company has maximised its profits through work capability assessments despite the clear evidence that claimants have been denied access to the support they need. I am glad that private companies will be banned from carrying out assessments in the new Scottish devolved social security system, thanks to pressure from Scottish Labour. It is about time that claimants were treated with dignity and respect by the Government.
It is a pleasure to serve under your chairmanship, Sir Henry. I congratulate my hon. Friend the Member for North West Durham (Laura Pidcock) on securing the debate, and on her excellent speech.
My office was involved in a work capability tribunal case last Wednesday and I have obtained permission from the person involved to discuss publicly what she has gone through because of such assessments. Sophie is the daughter of a friend of mine. Her mum and I trained 20 years ago as nurses and we worked all those years together on a ward at Lincoln County Hospital, so I know her really well. I provided Sophie with a letter for her tribunal, as her MP, as a qualified nurse and as someone who has known her for 20 years, before and after her diagnosis of multiple sclerosis.
Sophie tries hard to live as normal a life as she can, but I have seen how her illness affects her ability to do that day to day. She is just 30 years old and she was diagnosed with relapsing remitting multiple sclerosis at the age of 16 when she first developed balance difficulties. Over the following years she has developed problems with weakness, particularly on the right side of her body, as well as urinary difficulties, pain, fatigue and visual problems. She uses a wheelchair and struggles with mobility.
We went on a hen weekend in February; Sophie is my friend’s best friend, and we were in Boston. Everywhere we went she was in a wheelchair, and she simply cannot get out and about on her own. Whereas some patients with relapsing MS are unaffected between attacks, Sophie has chronic symptoms and is affected by her MS every day. The symptoms fluctuate markedly, and even mild infections and changes in temperature can make things much worse. There were complications during a trial treatment—I remember Alison and I and a few of us looked really hard to try to get her on trials to control what she had. There was a drug called alemtuzumab. Sophie now has an overactive thyroid and has to have regular blood tests to monitor her blood levels of thyroxine.
Sophie left school at 18 and trained as a nursery nurse. She worked at a nursery. She loved that job; it was one of her bits of normal. Eventually, though, she had to give up her job because of her MS, and after being forced by her disability to do that she applied for employment and support allowance benefits.
Recently, after a medical review, Sophie was deemed fit to work. The reasons given were that she has no problem with balance, uses public transport on her own and takes herself places independently. The truth is that she wears a support on one of her legs at all times, as I saw when we stayed for the weekend in February, because she drags the leg as she walks. She has to use a wheelchair every time she goes out of the house. She cannot walk any but short distances indoors, so how she is supposed to use public transport is totally beyond me.
The person who completed the assessment was allegedly competent to do it. Yet at the tribunal last week, those hearing the evidence seemed surprised that the case ever got as far as a tribunal and dismissed it in less than 10 minutes. They said something about a level 2 out of 3; I do not understand the terminology—but that is how ill Sophie is, although she had been deemed fit to work.
When someone is deemed fit to work, the process is that they have to appeal the decision if they feel it is wrong. Sophie appealed, but her appeal was dismissed because, I am told, the only evidence that the DWP will consider is the examination on the day, which came to such worryingly inaccurate conclusions. Sophie was therefore forced to take her case to a tribunal. That was eventually successful, but she should never have been put through such an anxiety-inducing ordeal. She is pregnant—she has a little boy of two and is about eight months pregnant, and the assessment came on top of all those other things in her life. I am sorry—it gets really upsetting, because I know her and what has happened to her is disgusting.
For people like Sophie it feels as if the DUP—[Interruption.]—I am sorry. That was a Freudian slip, and I meant no offence. It feels as if the DWP is working backwards from the conclusion that they are fit to work, regardless of the severity of their disability. That practice must end. Support must be given to the most vulnerable in society.
It has become popular in recent years to demonise those who are forced to claim benefits—to label them as somehow being scroungers or as faking their disability. Just after Christmas, I watched “I, Daniel Blake” on TV, and a prominent Conservative MP said on Twitter that it is only a film, but actually it mirrors real life, and people need to realise that. It is high time that the Government woke up to the fact that the vulnerable in society are suffering because of what they have done to our welfare system. It is meant to be the safety net for those who need it. People say that the mark of a decent society is how it looks after its vulnerable people. I am sorry, Sir Henry, but at present the reality is that the system is broken.
It is a pleasure to serve under your chairmanship, Sir Henry. I congratulate the hon. Member for North West Durham (Laura Pidcock) on securing this important debate, and on her consistent opposition to measures introduced by this Government that are calculated to push people in financial hardship further into poverty. She has been a genuinely welcome Member of the House; we need more people who are as passionate and who have that integrity to stand up for their constituents. I stand with her in opposition to the work capability assessment, and agree that the whole system needs to be redrawn.
I welcome the Minister to his new post, and I hope he will continue—as he has done—to listen to views from across the House, including suggestions about how to reshape the system so that it works better for people. I appreciate that that is a tall order because, with all due respect to the civil servants, his Department has probably had the fastest revolving door for Ministers of any Government Department, although they have all had a fairly mixed tenure. Without the work of the civil servants to keep things running, this Government would come to a standstill.
The hon. Lady highlighted the impact of work capability assessments and their tragic, life-ending consequences. That gets to the heart of today’s debate, and that is why the Government must take action—the consequences are too significant. The hon. Member for Strangford (Jim Shannon) and my hon. Friend the Member for Glasgow South West (Chris Stephens) rightly paid tribute to our parliamentary and constituency staff, as well as to Money Matters, Citizens Advice, and all those charities and organisations that work with people on a daily basis. These vulnerable people in our society require our support. The hon. Member for Lincoln (Karen Lee), who I had not heard speak before, made an emotional speech that went to the heart of this debate and reminded us of the emotion and humanity surrounding this issue. We do our jobs day in, day out, but this issue is affecting people’s lives.
The hon. Member for Coatbridge, Chryston and Bellshill (Hugh Gaffney) rightly said that a Labour Government introduced this policy, but he should not take all the credit for the social security system in Scotland, as a few other people had a hand in it as well. The hon. Member for Ellesmere Port and Neston (Justin Madders) highlighted the damaging impact of this system, and the hon. Member for Cheltenham (Alex Chalk)—he is no longer in his place—said that we need to get this right first time. My hon. Friend the Member for North Ayrshire and Arran (Patricia Gibson) said that by using the private sector we are simply passing the buck, but it is our responsibility to get this right.
The number of appeals against decisions made during work capability assessments is testament to the fact that the system does not work. I could recount the statistics, but the Minister will then stand up and tell me contrary figures, and I do not want to swap statistics any more on this matter. This is about real people’s lives, and unlike the revolving door of Ministers, and unlike the different Governments who have presided over this policy, it is time that we took responsibility and got the issue right, rather than kicking it even further down the road.
MPs have supported constituents through the mandatory reconsideration process, and our staff have had to deal with that consuming and emotionally draining process. Ultimately, however, this is about the people affected, and the devastating impact that the process has on individual lives when we get it wrong. It takes such a long time to overturn a decision that we fail to recognise the significant consequences of that decision on individuals.
The Work and Pensions Committee made a number of suggestions in 2017, and noted the flaws in the assessment process. People were being asked “medically inappropriate questions”, and there was a mismatch between what assessors heard and what was written in their reports. Some assessors overlooked certain aspects of disabilities or illnesses, including mental illness and conditions such as fibromyalgia or ME. Such conditions can be deceptive, and medical professionals who have not seen them before can often miss them, and we must therefore consider those severe flaws in the process.
As I said in a previous debate, I was invited to witness an acted out version of an assessment. If I am honest, I found the whole thing a bit ridiculous because it took an hour and a half, although I was told at the start that it would take 40 minutes. It felt as if I was having a wee play performed for me about how the process would work in an ideal world, but in reality that is not how things work. That is not the experience of my constituents or those people we have heard about today.
The hon. Member for Oldham East and Saddleworth (Debbie Abrahams) named many individual cases. Tragically, there are many more examples of people who have ended their lives as a result of this process. These are vulnerable people, and we have a responsibility to do more. With all due respect to the Minister, I know he will stand up and restate the Government line. That is fine, but it does nothing for people who are sitting at home right now and going through this process.
The Government have announced plans to combine the assessment processes, but I am not sure how much comfort that will bring to my constituents, or any of the people we have heard about today. It is true that they might not have to go through repeated questions and the needless extra stress of multiple examinations, but they will still have to go through the assessment process and the devil will be in the detail. Many disabled people receive only one kind of benefit, so I see no real benefit to that solution, which is the only one on the table right now.
I call on the Minister to get this right. I am tired of coming to Westminster Hall, on any given day of the week or time, to hear another new Minister who will not last very long and has not really managed to get any further down the road. I hope this Minister will be different, and I call on him to listen to the voices in this House, take action and do something.
It is a pleasure to serve under your chairmanship, Sir Henry. I congratulate my hon. Friend the Member for North West Durham (Laura Pidcock) on securing this debate. I thank all organisations that have provided briefings for it, and commend the excellent campaigning work of so many disabled activists, including those from Disabled People Against Cuts, who have shown that through direct action, our voices can be heard. I welcome the Minister to his new post, and I, too, hope he lasts longer than his predecessors. I look forward to working with him to try to make a difference.
My hon. Friend the Member for North West Durham made an excellent opening speech that highlighted the flaws in the unfit-for-purpose assessment framework, and the inadequacies of the assessment. She eloquently described the impact of poor decision making, and the flaws in the process that so many individuals have to go through. These ill and disabled people have to endure weeks, if not months on end, of waiting to receive the vital social security support to which they are entitled. She rightly highlighted the damning report from the UN Committee on the Rights of Persons with Disabilities, which stated that this Government have caused a systematic violation of the rights of disabled people. She also highlighted the harrowing experiences of so many people, which I will come on to later in my speech.
This afternoon hon. Members from across the House have shared their testimonies and paid tribute to their casework teams. We MPs are picking up a lot of this casework. We heard from my hon. Friends the Members for Ellesmere Port and Neston (Justin Madders), for Oldham East and Saddleworth (Debbie Abrahams), for Lincoln (Karen Lee), and for Coatbridge, Chryston and Bellshill (Hugh Gaffney), and from the hon. Members for Strangford (Jim Shannon), and for Glasgow South West (Chris Stephens), to name just a few.
Ten years on from its introduction, the unfit-for-purpose assessment continues to cause unnecessary harm. I admit that the work capability assessment was flawed from its inception, in that it fails to assess a person’s ability to work, instead relying on a series of functional descriptors that do not reflect the real world of work or the barriers to it. Under the coalition Government in 2012, WCA criteria were revised and the descriptors changed, making the test more restrictive. Once assessed, a person was placed in one of two groups: limited capability for work, or limited capability for work and work-related activity. In 2017, however, the Government did the unthinkable and abolished the work-related activity group component for employment and support allowance and universal credit. That denied nearly 500,000 ill and disabled people almost £30 per week, and chose to ignore the additional costs and distance from the labour market that are faced by ill and disabled people.
All hon. Members here have mentioned the outsourcing of assessments. Since 2010, more than £1 billion has been paid to private contractors, including Atos and Maximus, which have repeatedly failed, even by the DWP’s own performance standards. Despite those failures, the DWP recently announced that it will be extending the contract for Maximus until 2021. Does the Minister not agree that instead of extending the contract for a further 16 months, it is about time that we ended the privatisation of the assessments and brought them back in-house? I also ask the Minister to publish the contract and its terms, and how much it is going to cost, as his predecessor promised.
Members have told heartbreaking stories about the failures of the outsourced assessments, such as that of Larry Newman, who was assessed by Atos, was awarded zero points, and died of lung problems soon after. Healthcare professionals are asking inappropriate and offensive questions, and are compiling inaccurate reports. Citizens Advice says that 81% of its advisers have seen assessment reports that contain inaccuracies.
I am sorry; I have to keep going.
The flawed WCA has led to inaccurate and poor decision making. Some 74% of decisions on ESA are overturned at appeal, but less than a quarter of ESA cases are overturned at mandatory reconsideration. As a result, many are forced to go to appeal tribunals, which, according to Citizens Advice, have an average waiting time of 30 weeks. That is 30 weeks without vital social security support. In 2017, the DWP spent £120 million challenging the cases at appeal tribunals. When will the Minister act to address the failure of the mandatory reconsideration stage?
My hon. Friend the Member for North West Durham mentioned all the cases that drop out of the system before even getting to mandatory reconsideration or appeal stage. Do we record that information? If not, does the Minister not agree that it is time to start recording and calculating the number of people who are falling out of the system? Will the Minister also share how much it costs to administer ESA appeals?
It is good that the ESA65B letter will be revised for the summer. Will the Minister pause any further distribution of those letters to GPs?
Perhaps the biggest failure of the work capability assessment lies in its role as a cause of and contributor to mental distress for ill and disabled people. My hon. Friend the Member for Oldham East and Saddleworth listed all the people who took their life in 2017. This is just not good enough. The Government recently revealed that 5,690 people died six months after being found fit for work. That is unacceptable. These are people like Stephen Smith, who was found fit for work, despite having multiple illnesses. He died last week, and we send our condolences to his family and friends, because this is not an acceptable situation. There is no stronger indictment of a failing system than thousands dying months after being denied vital social security support—the support that is supposed to be the safety net for the most vulnerable in our society.
It is time to scrap the failing system. It is not time to merge or integrate ESA, universal credit and personal independence payments. As long as two assessments are deeply flawed, combining them will only expose individuals to the risk of two adverse decisions as opposed to one.
This is a cruel and callous assessment framework, which has created a hostile environment for disabled people. Labour, disabled people and disabled people’s organisations are clear that we need to scrap the work capability assessment immediately and replace it with an assessment framework that treats disabled people with the dignity and respect that they deserve. We need to end this hostile environment.
It is a pleasure to serve under your chairmanship, Sir Henry; you have expertly managed the timekeeping. I pay tribute to the hon. Member for North West Durham (Laura Pidcock). I know this is an area that she has campaigned on since she was first elected, and she does so with real passion and a determination to see improvements right across the system. That was echoed by all speakers. I might not have agreed with absolutely every point—hon. Members would not expect me to—but it is clear that there is a real desire to see continued improvement and an emphasis on how important that improvement is to people who are going through the process.
The hon. Member for Lincoln (Karen Lee) highlighted a particular story, which I was very touched by. I would like to meet her to discuss it further, as I think there are lessons to be learned from that case. I am certainly sorry for the experience that person has gone through.
This area is a real priority for me. I have been the Minister for Disabled People before, when I was a Parliamentary Under-Secretary. I have been an elected representative for 19 years, so I recognise the comments—we see first-hand through our casework instances where things have not gone right. I have spent my parliamentary career being proactive, working with MPs across the House, and stakeholders, charities and experts in this area. I listen to what is said, I try to do my best to make improvements and I certainly hope that that was reflected in my record as Minister for Disabled People last time. I will continue in the same vein.
The Government are focused on this area, and we have rightly increased funding for those with disabilities and long-term health conditions. This year, we are expected to spend £55 billion, which is a £10 billion increase in real terms since we came to office. It is a record high and it is 2.5% of GDP, which is higher than the spend of any other G7 country. It is 6% of total Government spending, and I think every penny is rightly supported by the wider public.
The debate today is focused on the 10-year anniversary of the work capability assessment, which I note a few speakers did acknowledge was introduced by the last Labour Government. Clearly, it was not perfect and there has been much-needed improvement since its introduction. We are all committed to playing our part in improving the process and to taking account of the developments in healthcare, modern workplaces and flexible working arrangements.
Backing up those improvements were the five independent reviews. The first three were carried out by Professor Harrington and the final two were carried out by Dr Litchfield. More than 100 recommendations were made that we have accepted and delivered. As the Secretary of State set out in her recent speech, we need to do more, and that is a real priority.
Many people have highlighted concerns with the frontline staff and process. Since 2015, the Centre for Health and Disability Assessments has taken over the delivery of the work capability assessment, and the focus has been on improving the operational process. It has increased the number of healthcare professionals by 82% and 1,300 staff are now directly involved in supporting assessments. It has increased the number of assessment rooms and significantly improved the training programme—many speakers highlighted these issues, in particular in relation to individual conditions. There is broad training on disability analysis and on specific conditions, including multiple and complex conditions, which covers three distinct areas—principles and professional standards; the assessment process; and scrutiny and file work, with an emphasis on quality. Training is predominantly modular, with competency testing at every stage. The healthcare professional must then undergo the continuing medical education programme and is subject to regular case reviews and audits. For complex cases, we expect the healthcare professional to refresh knowledge prior to the assessment.
One very important and welcome addition that has begun to be rolled out is the introduction of customer champions. I absolutely recognise just how anxious and nervous people can be when going for assessment. I absolutely get that. The customer champion can assist those claimants, before and after assessments, to ensure that they receive the best service. We have had good feedback on that, and the intention is that there will be one in every single assessment centre.
I also recognise the comments about communication—the brown envelopes coming through. There is a commitment from me to work further with stakeholders to improve the letters that come out. I have seen this as a constituency MP; I have taken a deep breath at the poor quality of some communications. We need to improve that.
I cannot give a broad-brush answer. I know what the hon. Lady is saying and I am coming on to the use of evidence and how we can do more earlier and, potentially, then with paper-based assessments. I will come on to that. I understand, but I cannot give a definitive answer, because every claimant has their own unique challenges that have to be addressed.
In addition, SMS text message reminders about appointments have been welcomed, and there has been a lot of work on the website, which includes mock assessment videos so that people can get an idea of the sort of things to expect. Those things are all looking to remove some of the anxiety and worry about assessments. There is more to be done in that area, but we recognise that.
The improvements in the training and the extra healthcare professionals have meant that median clearance time halved from 25 weeks in March 2015 to 10 weeks in 2018, and customer satisfaction has exceeded the 92% target since that point. However, that does not mean that we are getting it right every time, and that is what I want to turn to now in focusing on MR and appeals.
All of us as Members are frustrated when what seem to be clear-cut cases come to our constituency surgeries asking for our help. There are times when we think, “How on earth can this have happened?”, and ultimately the person could have a very long appeal process to go through to get the right decision. In the majority of cases, appeals are successful because of additional oral and written evidence. That has to be addressed. We rightly are going to tackle it and will do so in two stages—first, with the MR process. We have started doing this with PIP. We are seeking to contact the claimant who is disputing a decision and talk to them directly to get the additional oral and, potentially, written evidence at that stage to see whether we can improve decisions at that point, rather than waiting for the evidence to come at the end of the appeal process.
Does the Minister think that it is unacceptable that any Government policy should cause their citizens to take their own life or to die? If he does, should there not be a moratorium on this policy until it is got right? Surely one death is one too many.
We all recognise that suicide is a tragic and complex issue, and we take it extremely seriously. We take the death of any claimant seriously and, where we are made aware that a person has died and it is suggested that that might be associated with the DWP directly, a review will be undertaken to identify whether any lessons can be learned and can be actioned.
Let me make some progress, because this is a very important point about the MR process. We are in the early stages with a new way of looking at MRs, but there have been very positive results, and we will now roll this out to all the PIP dispute sites. We intend to do the same for the ESA sites as well.
The second stage has to do with the appeal process. Again, we recognise that people will submit additional, late written and oral evidence.
Let me just make this point. I want to explain one of the challenges. The shadow Minister, the hon. Member for Battersea (Marsha De Cordova), talked about a 30-week wait, in some cases, for an appeal. The person may have got the additional evidence in week six, but then the system is saying, “I’m sorry, but you’re going to have wait another 24 weeks until we can actually take that into account.” That is clearly not an ideal situation, so we are looking at how we can lapse appeals, where there is new evidence, to reconsider the decision with the additional evidence and be able then to give them a different decision. If we do not think that that should change the decision, they have the right to carry on right through to the final appeal process, but if it is something that is clearly going to change the decision, we should act as quickly as possible.
In a second. Over the past five years, only 4% of work capability assessment ESA decisions have been revised at appeal, but we recognise that it is in no one’s interest that things should be picked up only after a lengthy appeal process, so we are absolutely committed to being proactive in this area, and this issue will be a real priority.
I thank the Minister for giving way. I just wanted to ask for clarification on one point that he made, which was about appeals being successful because of new or additional information. How does he respond, then, to the fact that people who go on to appeal do so on the basis that the information that they see about themselves is badly or very badly expressed and incorrect, and to Citizens Advice saying that 81% of the customers it sees have inaccurate information recorded about them, which leads to a wrong decision?
I am coming on to how we can do more to ensure that the right evidence is put into the system at the earliest possible moment and in the right way. We do not want people who should be getting support to have to go through a lengthy process unnecessarily. We all agree on that, and I hope that hon. Members can see that what I am describing is an important improvement. It is still at an early stage, but as I have seen in previous debates, it is the sort of thing that stakeholders want us to do, and we are rightly going to take it forward.
Let me come on to the point about evidence. It is referring to the integrated service. There is a bit of confusion in terms of what people thought that this would be. The view was that it ultimately would be a panacea whereby people would go for one single assessment for PIP and for the work capability assessment. The reality is that very few people apply for both benefits at a similar point in time. However, for the very few people who do, it might make sense for them to have, if they wish, both of the assessments on the same day instead of having to come in on the Monday and then again on the Wednesday. That may be what people want to do, but we are talking about very small numbers.
The thrust of this is to share evidence if the claimant wishes that to be done. One point that many hon. Members made was about the challenge that often arises of getting the evidence, whether from the GP, the physiotherapist or the hospitals, in a timely manner and in a way that is helpful for their assessment. If they have managed to do that once and they would like us to use that evidence again, with their consent, that is something that we would seek to do as part of building the new digital system and ensuring that the claimant has consistent, better information. Being able to share evidence will reduce the burden of providing the same evidence multiple times. It could potentially lead to fewer face-to-face assessments if we can gather crucial, vital, clear-cut evidence earlier in the claim.
I want to pay tribute to all the stakeholders, the medical experts, the charities and all the MPs across the House who regularly engage on this issue. Over the coming months, we will be doing a series of roundtables and regional events to gather further evidence, with a real emphasis on those with real experience of this area, so that we can further improve the system. We want to build trust, transparency and consistency and we want to improve the claimant’s experience through a more personalised and tailored approach. As a returning Minister, I am committed to supporting disabled people and those with long-term health conditions to claim and receive the benefits to which they are entitled and to ensuring that people are treated fairly and with dignity. I thank all the Members across the House who have contributed today.
I thank all the hon. Members who came to the Chamber today to share the painful experiences of their constituents. I pay tribute to my excellent caseworkers, who work day in and day out to try to get justice for people who are subject to the abuses of the state. I express solidarity also with all the disability rights campaign groups and advice services.
It is a real shame that not one Conservative Member came to the debate or prepared a speech and showed their constituents that they cared. They will have people who are subject to the work capability assessment, and I think that their absence is symbolic of their complicity in the system. This Minister is now in control of the system, so warm words and sympathy are not enough. The Minister has control, so action is necessary.
I want to stress this point in the 30 seconds that I have left. It is just not true that additional evidence is what wins at appeal. It is often evidence that the DWP could have had, and the evidence that people go and give in the initial assessment is the same as that at the appeal stage, so this is not about blaming advice and support agencies or the person for not giving the evidence in the first place. The evidence is there; it is the system that is flawed. The language is also an issue. They are not claimants or customers; they are people who are entitled to this support by the state.
Question put and agreed to.
That this House has considered 10 years of the work capability assessment in relation to employment and support allowance and universal credit.
NHS: North-West London
[Sir Christopher Chope in the Chair]
I beg to move,
That this House has considered the NHS in north west London.
It is a pleasure to serve under your chairmanship, Sir Christopher, and to see so many of my Labour colleagues from north-west London here to support this debate. It will be a relatively short debate on a rather lengthy subject, so I will try to keep my remarks concise, or at least as well ordered and structured as I can. To that end, I will touch on two subjects, and perhaps mention one or two other issues. The first subject is the collapse or withdrawal of the “Shaping a healthier future” programme, which was principally around the reorganisation of acute care; the second is the commercial Babylon GP at Hand service, which is distorting the primary care market, and not just in Hammersmith and Fulham, or indeed in north-west London.
I will begin by reflecting on how we got to where we are. In 2012, “Shaping a healthier future” was heralded as the biggest hospital reorganisation programme in the history of the NHS, but was quickly called the biggest closure programme in its history. It was a scheme for closing four of the nine type 1 A&Es across north-west London, and completely restructuring, demolishing and—in common parlance—closing two of its major hospitals, Ealing and Charing Cross, which is in my constituency. When the scheme was announced, it was unambiguous that it was about saving money. It was part of a programme to save about £1 billion, and we were told that if it did not happen, the NHS in that area would go bankrupt. Those were literally the words that were used. Much water has flowed under the bridge over the past seven years, until almost exactly a month ago, when the scheme was withdrawn wholesale in a rather hole-in-the-corner way.
This is something of a bittersweet debate. I do not know anybody in north-west London who is not delighted that the scheme for hospital closures has been withdrawn, yet because of the way those seven years have been wasted and how the scheme has been dealt with over that time, we are left with as many questions as have been answered. I do not have time to go through the whole history of those seven years. Suffice it to say that Charing Cross Hospital is the second-largest hospital of the nine in its sub-region; it has 360 beds, almost all acute. It was to be demolished. It was to lose more than 300 of those beds—more than 90%. It was to lose all of its major emergency services and its A&E, and effectively be replaced by what was called a local hospital, with primary care and treatment facilities. In other words, it would have been a very radical shake-up.
Throughout the process, there was a frustrating lack of honesty; there was no admission of what the scheme was, certainly not at a political level. If someone drilled down into the business plan or clinical strategy, it was clear what was being advocated. We were told that in some way, the increase in community services and primary care that was also part of the “Shaping a healthier future” scheme would make up for the loss of those hundreds of acute beds and those A&E facilities. It is now commonly accepted that this was always an entirely misconceived plan, as the King’s Fund—to give just one example—has said. Given the rise in demand, the best that could be hoped for was that if the increases in primary and other care services took place, we would be able to cope with the current amount of acute capacity.
The idea that we could dramatically reduce capacity was entirely misconceived. That is not conjecture; it was proven in 2014, when stage 1 of “Shaping a healthier future” went ahead, with the closure of the A&Es at Hammersmith Hospital and Central Middlesex Hospital. We were told that as those were not two of the main A&E departments, those closures would easily be coped with. However, demand at St Mary’s, Northwick Park and Charing Cross went up to such an extent that they had some of the worst waiting time figures of anywhere in the country. Since then, those figures have come down only slowly and gradually.
I hope that the Government and the health service will learn lessons from this scheme—that is probably the best gloss I can put on this. It has taken a huge amount of time and effort, and a huge amount of money wasted by the health service, to get to where we are today, which is effectively back to where we were seven years ago. In 2012, it looked as though the situation was hopeless, and I have to praise Ealing Council, which was then Labour-controlled. At that stage, Hammersmith and Fulham Council was under Conservative control, and from 2013 onwards it fully backed the closure strategy. Ealing Council stood absolutely solid and firm; it mounted a judicial review, and opposed those proposals from day one.
When there was a change of political control in 2014, that council was joined by Hammersmith and Fulham Council, which, together with surrounding Labour councils, set up the Mansfield commission under Michael Mansfield. That independent commission looked at the “Shaping a healthier future” proposals, and when it reported, it said that those proposals would be a health disaster for the area. By that stage, the sustainability and transformation plans had been introduced. In a way, it is regrettable—although it was the right thing to do—that both Hammersmith and Ealing councils refused to participate, because they knew how damaging “Shaping a healthier future” and the hospital closures would be for the area.
Over all that time, I do not think a week went by in which I did not deal with this issue, both here and in the constituency. There was a sustained campaign of what I can only call disinformation. A lot of money—£72 million is a conservative estimate—was spent on consultants, preparing for the “Shaping a healthier future” programme. All of that money was wasted. Despite the fact that we relied entirely on internal health service documents to prove what was being planned, I was constantly told by everyone from the then Prime Minister down that we were scaremongering, and that the proposals were sensible and helpful.
It is curious that when the Health Secretary announced the withdrawal of “Shaping a healthier future” a month ago, the Government withdrew support from the scheme, as if somebody else had thought it up. Until that point, we had been told every day and every week for seven years that it was a sensible scheme, which would only improve resources and services within the health service. It is to be regretted that the Government did not sit down with politicians, campaigners, local residents and the local health service to talk through where we were and where we were going. Instead, in a rather hole-in-the-corner way, they used the contrived trick of using a planted question from a Conservative Back Bencher to announce withdrawing from the scheme. That does not bode well for the future.
Although we are extremely pleased that the programme has been cancelled, and that both Ealing Hospital and Charing Cross Hospital will stay open, where do we go now? First, Charing Cross Hospital has the largest maintenance backlog—£300 million—of any hospital in the country. That was clearly not under consideration, because it was intended that the structure would be demolished. In actual fact, the capital moneys are simply not there to have done that in any event.
The other hospitals in the area, including West Middlesex, Chelsea and Westminster and St Mary’s, were promised that they would benefit from the closures, and that there would be substantial investment. My question to the Minister is: what is the plan going forward? For political expediency, the Government have bailed out of “Shaping a healthier future”, and we are grateful for that, but where do we go now? Certainly the clinicians and the managers in west London cannot answer those questions. This thing has been entirely derived and supported by the Conservative party and this Government. It is for them to answer that question, rather than simply leaving our local health service to stew in that way.
Before I move on, I want to say that some of the staunchest campaigners have turned up to listen to this debate. I last saw them at the victory party at Hammersmith town hall a couple of weeks ago. Without their contribution, we would not be here. They countered well funded, well resourced and entirely disingenuous statements about what would happen to the health service. Every week, rain or shine, they were out talking to and converting the local population. One could say that the local population might not need much conversion to preserve a much-loved, major local hospital that has just celebrated its 200th anniversary, but the reality is that that needed to be done, because millions were being spent on spinning the yarn that the changes would be good for local health services. The campaign was not based simply on sentiment or popular feeling. It was well researched, and well supported with independent clinical evidence. The campaign was based on the day-to-day, week-to-week, absolute dedication of people who worked for nothing, and had nothing in common other than their love of the national health service and their feeling that Government at all levels had got it wrong.
With that, I will move to another topic, GP at Hand, which the Minister probably does know something about. We have become increasingly alarmed at its trajectory. For those who do not know, GP at Hand is a digital app provided by a private company called Babylon Health. The service has raised an enormous amount of concern at different levels; I will narrow that to four points.
The first and most obvious concern is how GP at Hand works. It attaches itself to a particular bricks-and-mortar GP practice—in this case, a particular surgery in Fulham. It was an orthodox GP surgery with a list of around 4,000 patients before that association began. As of today, it is approaching 50,000 patients, and is one of the largest GP practices in the country. That distortion has a cost implication for the clinical commissioning group, initially in Hammersmith and Fulham. It is estimated that over the two years from 2018 to 2020, that distortion alone will cost the CCG about £26 million. There is no provision for that at the moment, and that has to be addressed. I would like to hear from the Minister that there is a scheme for addressing that, and that there will be full reimbursement of those costs.
For those who are not aware of how the system works, it is very straightforward. When patients sign up to a GP practice, the money effectively goes with them. What is not anticipated is that there will suddenly be a tenfold increase in a patient list over one or two years. Why is that money not simply redirected? It has been, to some extent, to the CCGs in west and north-west London, but the money is not provided to the much wider catchment area—GP at Hand now serves not only Greater London and a wider travel area, but has expanded to Birmingham—because those other CCGs are saying, “Hang on.” A digital app of this kind attracts a certain type of patient: younger, fitter patients—effectively those without complex medical conditions or co-morbidities. They do not take up a lot of the GP’s time, as their issues are relatively simple and straightforward to deal with. Often they do not contact the GP at all for long periods.
Those patients effectively subsidise older and sicker patients. There is a perfectly understandable resistance from local GPs and CCGs to allowing those patients to escape, leaving them only with the most demanding and least cost-effective patients. If the issue is not addressed, the problem that results for my CCG is an annually increasing bill, going from £10 million to £16 million and who knows what beyond that, with no provision for that in any way.
The second concern, which has been expressed by clinicians and those who have simply tested out the app, is whether the app—like other apps, it is based on algorithms and diagnostic tools—is accurate and good enough. Has it been sufficiently tested? It is growing logarithmically across the country. It is not a question of it perhaps being tested in a small area and got absolutely right before it moves on. It could be in your constituency tomorrow, Sir Christopher, and it could be across the entire country in a year or two.
The third issue is that GP at Hand is driven entirely by a single commercial provider. It is a way of doing digitisation, but it is the way of the wild west to simply allow one particular firm to start from one location and expand across the country at a rate that it determines, controlled only by its advertising budget and its ability to attract customers. In my submission, there is no thought behind how that is done. The NHS is jumping to the tune that is being played by GP at Hand. One might suggest that it should be the other way around.
The fourth and perhaps most contentious issue is the fact that this particular private provider has had the support of the Secretary of State for Health from the beginning. He is a subscriber and has written about it in glowing terms. Whenever the matter is raised in the House and he is responding, at Health questions or wherever else, he has only praise to give it, but he is parti pris to this. Not only is that of concern in itself, but it means that when one is talking to local, regional and even national organisations within the NHS—this is now a national issue—they are looking over their shoulder, because their boss or their boss’s boss is saying, “This is the future and this is what is going to happen.”
With the support of a number of colleagues, I have written today to the Chair of the Health and Social Care Committee, asking the Committee to undertake an investigation into GP at Hand. I know that she shares a lot of my concerns, so I am hopeful that that investigation will follow. I ask the Minister to give what assurances she can on those four points that I have raised.
Sir Christopher, I can see you are looking at the clock, and my colleagues are looking at me with daggers drawn, so I will speak for one more minute and then sit down. That means that I cannot go into detail about the other local health service issues, which will have to wait for another day. Suffice it to say—I will give a lightning portrait—that in Hammersmith and Fulham, we have a number of failing GP practices that are either suspended or require improvement. We have planned substantial cuts to our CCGs of £30 million. We have cuts planned to palliative care, community care and the hospital sector, including a proposal to close the hydrotherapy pool at Charing Cross Hospital. Everybody who has been involved in that has told me that it provides an invaluable service.
The overall picture is one of declining and reducing services. Only yesterday, a letter informed us that the “Beyond places of safety” scheme, which is very good, has been suspended because the funding is not there. There is no pretence any more that we are restructuring services, or reducing such things as management costs—that has all been done. What is being cut now are basic and essential services from the community, primary and indeed acute sectors.
I will conclude, as colleagues want to contribute to the debate. I hope that the Minister appreciates the seriousness, complexity and universality of the cuts that are happening across the health service. I hope that she will be more magnanimous than some of her colleagues in admitting the mistake that was made over “Shaping a healthier future”. We can turn the page and move on. We all want to work together for improved health, but first, some of these issues have to be addressed.
It is a pleasure to serve under your chairmanship, Sir Christopher. I thank my hon. Friend the Member for Hammersmith (Andy Slaughter) and congratulate him on securing this important debate.
North-west London has been a guinea pig—unloved and uncared for in the testing of a failed experiment. It has taken our local NHS trust and the Secretary of State all this time to recognise what we have been saying for years. When I say “us”, I mean not just Members of this House, but doctors, nurses, clinicians and, most importantly, patients and the local community. The “Shaping a healthier future” programme was not fit for purpose. It did not work, and it did not deliver for those who needed it most.
Two weeks ago, I attended a party in Ealing—my hon. Friend mentioned that he had one in Hammersmith—celebrating the end of “Shaping a healthier future”. My constituents were ecstatic. I have rarely seen more strongly held convictions than those they had that lives were being put at risk by the scheme. The cancellation of the programme is the greatest gift that we could have been given. It was almost an Easter miracle. Ealing Hospital, Charing Cross Hospital and others in the area can now rise from the dead and continue to serve our constituents.
However, those hospitals remain broken—not yet whole again. Ealing Hospital has lost full A&E services, which we badly need. We have lost our maternity ward and in-patient paediatric care. I remember, only a few years ago, spending time with volunteers in that area helping to raise funds for a publicly paid-for refurbishment of that children’s ward. It now lies empty. The garden we built is un-played in, and the swings are still. Its closure was a slap in the face to hospital users and the patients’ group. Parents felt un-consulted—a theme that runs throughout the “Shaping a healthier future” programme. It always seemed to be a top-down programme: a project put on local people and led by Whitehall that was not what patients needed.
Thankfully, the scheme is now only a failed experiment, not an ongoing disaster, but the clearing and cleaning up still need time and effort. Local residents want to feel listened to. They want to feel that their needs are being placed at the centre of their care, not treated as a peripheral concern. I hope that the Minister can commit to restoring services to all our hospitals in north-west London, but—I would say, selfishly—particularly to Ealing Hospital, which is in my constituency.
The London Borough of Ealing has a very high number of young people, but suffers from one of the highest levels of lifestyle-led premature death. The widely reported Mansfield commission into the programme roundly condemned the “Shaping a healthier future” plans, and found that cuts were falling disproportionately on the poorest in society. Minister, please reverse the cuts and give my worst-off constituents a fair chance at healthy and full lives, unblighted by ill health.
It is a pleasure to serve under your chairmanship, Sir Christopher. I, too, congratulate my hon. Friend the Member for Hammersmith (Andy Slaughter) on introducing this timely debate. Before I say any more, I need to declare an interest: my husband is a non-executive director of the Chelsea and Westminster Hospital Trust.
I congratulate the key people who have made this possible: the campaigners. They have worked tirelessly and, as my hon. Friend said, for no money for, I think, seven years now, to wake the community up about the implications of the loss of, initially, four hospitals. We have since lived through the closure of many services, the downgrading of Charing Cross Hospital and, as my hon. Friend the Member for Ealing, Southall (Mr Sharma) said, the downgrading and withdrawal of services at Ealing Hospital.
The issue is important to my constituents in a number of ways. First, for the residents of Chiswick, in the east side of my constituency, Charing Cross is their nearest hospital. It is the hospital that they look to for all the basic services, particularly A&E. It is the nearest and easiest to get to. They have rightly been really angry and worried about the loss of that hospital, as have residents in Hammersmith and other parts of west London—the places for which Charing Cross is the nearest and easiest hospital to get to. We have had many campaigners and many campaign days, signing petitions at public meetings and so on, in Chiswick over the last seven years.
The impact of the cuts to services, and the threat of cuts to services, in Charing Cross and Ealing in particular, have affected all residents across my constituency; for many of my constituents, Ealing is their nearest hospital. The other concern surrounds the impact on the general hospital in my constituency, the West Middlesex University Hospital, part of the Chelsea and Westminster Hospital Trust. It has been very difficult for staff there to plan properly, and for patients to know what their future will be in terms of potential services.
The recent announcement on the ending of “Shaping a healthier future” was not entirely a surprise. We have heard nothing for months, if not years—no new information, and no new developments. However, A&E attendance has increased—by 11%, I think, at Charing Cross in recent years. The increasing pressure on Ealing and Charing Cross hospitals is not entirely surprising. Hon. Members for constituencies not only in London but throughout the country have said in debate after debate on the NHS that we are seeing more and more pressure on accident and emergency services as a result of our rising population, the withdrawal of basic primary care, and the cutbacks in adult social care and mental health services, as well as a whole host of other issues.
There is no way that the loss of significant accident and emergency services in west London could fail to cause incredible pressure on the remaining services and long journey times, given the levels of congestion in London. Another problem, as I know from many constituents who work at Charing Cross and Ealing hospitals, is the effect on staff morale: will people apply for a job in those hospitals, where they do not know how long their post will be available, or will they try for a vacancy in another hospital? The impact on morale, team building and team continuity is bound to have an effect—admittedly one difficult to measure—on patient care.
What we want to know from the Minister, given the ending of the “Shaping a healthier future” programme, is how the NHS estate, particularly the acute estate in north-west London, will be planned and financed in future. It feels as if we are in a strategic vacuum. When will we know whether there will be sufficient acute beds? The original plan was that the “Shaping a healthier future” programme would free up a load of capital to be spent in other hospitals around west London, including St Mary’s in Paddington, West Mid and so on, but where are the acute beds that are so desperately needed as A&E attendances rise? How will they be funded? What does all this mean for the future of integrated care organisations?
I share the concern of colleagues across west London about the shambles of the “Shaping a healthier future” programme’s initiation, continuation and end. I also share their concern about what will happen next.
Six months ago, at the beginning of November, the walk-in centre at Alexandra Avenue in my constituency closed its doors for the last time. If there was ever a much-loved and vital service that told the story of the NHS funding crisis in north-west London, it was Alexandra Avenue. Its opening 10 years ago was strongly opposed by the Harrow West Conservative party and its then parliamentary candidate. She and the Harrow West Conservatives were not immediately successful in getting it closed, but in 2013 it was closed during weekdays; it was kept open at weekends, although only as a result of local campaigning. In November, the Conservatives finally got their way: a service that, at its height, provided a valuable walk-in service from 8 am to 8 pm, 365 days a year, to 40,000 people in my constituency and the surrounding constituencies, finally shut its doors.
Bluntly, the centre’s closure was a result of the clinical commissioning group’s lack of funding. The CCG has been put into special measures because its forecast deficit is £40 million, according to a written answer that I received in February from the then Minister, the hon. Member for Winchester (Steve Brine). Not surprisingly, it is under pressure to make a huge range of cuts, so not only is there no prospect that the Alexandra Avenue walk-in centre will be reopened, but other walk-in centres that serve Harrow are vulnerable to the threat of closure at a moment’s notice.
Nor is it surprising that the situation has had an impact on Northwick Park Hospital, which serves my constituency. It has not met the A&E waiting target for some considerable time: over the past five years, 25% of patients in A&E have not been seen within four hours, which gives a further indication of the decline in quality across the national health service in north-west London.
I am grateful to my hon. Friend the Member for Hammersmith (Andy Slaughter) for securing this debate and allowing me to ask the Minister a number of questions. When will the north-west London NHS be properly funded? When will there be an end to the sorry tale of the clinical commissioning group always finding itself in deficit? It is not that it cannot manage its books. It has had excellent chairs and an excellent board; I pay tribute to the outgoing chair, Dr Amol Kelshiker, and the new chair, Dr Genevieve Small, for their willingness and commitment, but they deserve to know that their CCG will be properly funded.
When will Northwick Park Hospital no longer have to face inadequate funding, like the other hospitals in the trust? When will those hospitals get the support that they need to get the consultants and nurses in place to meet their A&E targets? My hon. Friend mentioned the closure of Central Middlesex Hospital’s A&E service, which has had a huge impact on services in north-west London, including the services at Northwick Park Hospital that my constituents depend on. Frankly, it should be reopened, because we need that acute capacity. It would be good to hear whether the Minister could ever foresee such a scenario.
It is now clear that cancer waiting times are also under pressure in our community. For the first time, the maximum two-week wait for a first consultant appointment after an urgent GP referral is not being met, according to the latest data on our area.
Harrow clinical commissioning group needs to be properly funded, funding for the NHS in north-west London needs to be significantly increased, and—in my view—England’s national health service needs a dedicated national fund for walk-in services in communities, such as my own, in which there is strong evidence of demand. I look forward to some positive reassurance from the Minister that the Conservative party has changed its attitude to walk-in services such as those at Alexandra Avenue in Rayners Lane.
It is a pleasure to speak under your chairmanship for the second time today, Sir Christopher. I congratulate my hon. Friend the Member for Hammersmith (Andy Slaughter) on securing this short but important debate. He was quite right to use the word “bittersweet” in the context of the collapse of the “Shaping a healthier future” strategy. It was sweet, in that it lifted a shadow from Charing Cross Hospital. There has been a continuing surge in A&E admissions over many years, during which we have consistently been told that a strategic approach to health services should be about reducing such admissions and replacing them with services in the community. That is a principle that I think everyone would agree with, and the lifting of the shadow is a good thing, but as we have heard from other hon. Members, it is clear that the strategic shaping of healthcare in north-west London remains very much in doubt.
I will focus on St Mary’s Hospital in Paddington, which is just outside my constituency but is the main hospital for it. It is the major acute provider for north-west London, and one of the four major trauma centres in London, with a 24/7 A&E department. It is a hospital very dear to my heart—it saved my life once, and I gave birth there—and it is held in very high regard among my constituents. Quite rightly, it has a terrific reputation for clinical care; we should never miss an opportunity to record our admiration for the staff, who deliver healthcare so superbly to the public.
None of that should blind us to a very grim reality, which is that St. Mary’s Hospital is very old. In some instances, it is quite literally falling down. It is now 14 years since the Paddington health campus proposal finally collapsed, which was the first vision of the redevelopment of St. Mary’s Hospital. Here we are in 2019, with the collapse of “Shaping a healthier future”, and we are still frozen in terms of a major redevelopment for St Mary’s.
In January 2018, Imperial College Healthcare NHS Trust gained full planning permission for the first phase of the redevelopment of St. Mary’s, which is a new eight-story out-patient and ambulatory service building on the site. The trust submitted the outline business case for the investment required to NHS Improvement, NHS England and the local commissioning groups. Under those plans, the trust is looking to house most of the St Mary’s out-patient and ambulatory services in the new building, but this has been on hold since January 2018. It is not an academic issue; the failure to gain funding and approval from key stakeholders for the redevelopment programme is a key risk on the trust’s corporate risk register, because the conditions of St Mary’s Hospital have deteriorated so much. Planning permission has only two years left.
While we are waiting for the funding to be put together for the redevelopment of the hospital within that timescale, the structural issues in the hospital have become absolutely and imminently challenging. The structural problems in the Cambridge wing at St Mary’s resulted in two wards being out of use, with no possible value-for-money structural solution. There is a £1.3 billion backlog maintenance liability across the five hospitals, including St Mary’s. As we have heard, the backlog is the biggest in the country, and St Mary’s has the largest in the trust. In fact, 30% of all high-risk backlog maintenance in the NHS in England is at Imperial College Healthcare.
I just mentioned one of the wards that has been out of action, and St Mary’s maternity services had to be temporarily relocated due to a lift fault in September 2018. The Grafton ward closed due to significant structural concerns, with the loss of 32 beds in May 2018 and no possible structural solution. A ceiling collapsed in the Thistlethwaite ward. The Paterson Centre was flooded and closed for two weeks, with the loss of activity and 20 surgical beds in 2017. Floods, electrical issues and drainage problems are commonplace across the buildings and services at St Mary’s. The hospital simply cannot wait, yet everything is now frozen.
We urgently need advice from the Minister on how we will proceed. Should there be a further structural problem of the kind that we have already seen, it would not only be an imminent risk to patients, but would take out chunks of capacity from an already highly stretched hospital, which will have repercussions across the whole of north-west London. We simply cannot go on like this. I hope the Minister will give us an indication of how the St Mary’s maintenance backlog, structural programme and redevelopment will proceed.
Good news for a change from this Government, who have admitted that the crackpot “Shaping a healthier future” plan to cut the nine major hospitals in north-west London to five is not workable and has been killed off. It was always a David and Goliath battle.
I pay tribute to, on the one side, Ealing Save our NHS, which works shoulder to shoulder with Save our Hospitals Charing Cross and our two Labour councils, as my hon. Friend the Member for Hammersmith (Andy Slaughter) mentioned. They are people like Ollie, Eve, Arthur and Judy Breens, Aysha, Raj and Gill, who held protests and popped up at every carnival. They organised parties, lobbies and petitions, and distributed a quarter of a million leaflets, all of which were paid for out of rattling buckets and their own pockets.
On the other side, we had “Shaping a healthier future”, with its swanky offices in upmarket Marylebone. Tens of millions of pounds of NHS cash from the public purse was spent on private management consultants, who all mysteriously alleged that if they junked departments, A&Es and hundreds of beds, health outcomes would somehow improve. In the end, the figures did not work. Quelle surprise! They never worked.
As early as 2012, John Lister pointed out in his report that the whole thing was a pile of nonsense, as did reports from the two councils, which involved the forensic skills of Sir Michael Mansfield, QC. Even then, seven years into a five-year-long failing plan, local health bosses were still carrying on as if the emperor were fully clothed. There was a heavy-handed threat of legal action against me, because my 2017 general election leaflets pointed out that it did not work. That arrived days after my mother passed away at Ealing Hospital—I know every bit of the hospital, right down to the morgue.
Where next? These disastrous Frankenstein plans have seen the two A&Es nearest to Acton Central—Middlesex and Hammersmith—completely shut their doors. I congratulate the Minister on her appointment, and my question to her is: can we have them back, as well as the stroke unit, paediatrics, maternity services and A&E admissions for children at Ealing? All these things mean that the figures for type 1 A&E urgent visits are going through the roof. No more babies are to be born at Ealing. As a mum, I recently had to schlep out of the borough for a paediatric appointment at the West Middlesex Hospital, which is in the constituency of my hon. Friend the Member for Brentford and Isleworth (Ruth Cadbury).
As my hon. Friend the Member for Hammersmith said, we need a serious exercise in lessons learned from this whole sorry episode, rather than clinging on to defend the indefensible and denying that there are serious problems. Ealing Hospital remains perilously underfunded and in crisis. Staff morale has been sapped, as was pointed out, by all the uncertainty. We could go on and on about the Brexit effects—the EU nurses exiting in droves and the social care sector being hollowed out by this Government, who are obsessed with their £30,000 skills target.
The slaying of the beast that was “Shaping a healthier future,” which was always known locally as “Shafting a healthier future,” is not before time and has raised eyebrows, such is the cynicism of politics in our time. As we did at the Drayton Court Hotel in my constituency last week, let us eat, drink and be merry, because tomorrow there might be another election.
It is a pleasure to serve under your chairmanship, Sir Christopher. I thank my hon. Friend the Member for Hammersmith (Andy Slaughter) for securing this debate. I know that he is a passionate advocate for the NHS in his area. Although I am pleased to respond on behalf of Labour, it is with sadness that hon. Members have to come here over and over to explain the impact on their constituents of the crisis in the NHS.
We have heard a mixed message of plans made and abandoned. It is a story of a shambles, and declining and reducing services, including the loss of services for children, maternity and stroke care. It is no secret that the NHS is under extreme pressure. After nearly a decade of stagnant investment, coupled with a recruitment crisis and a retention time-bomb, the cracks are really starting to show, as we have just heard. The King’s Fund notes that during the Labour Government, budget growth in the NHS was an average of 3.7% a year. It has dropped to an average of 1% a year during the Conservatives’ time in office. The recent announcements of additional funding are of course welcome. However, the British Medical Association and the King’s Fund acknowledge that the promised £20.5 billion, which equates to an increase of 3.4%, is simply not enough after nine years of severe underfunding. It is not even enough to wipe out hospital deficits.
Where is the funding to guarantee sustainable health services in the face of ever-increasing demand from a complex and changing demographic? Where is the funding to renew NHS infrastructure or outdated hospital equipment? Just repairing the dilapidated hospital buildings will cost in excess of £3 billion. We have heard from my hon. Friend the Member for Westminster North (Ms Buck) about the state of the buildings at St Mary’s Hospital and the urgent work that is needed. My hon. Friend the Member for Ealing, Southall (Mr Sharma) outlined the refurbishment work that is urgently needed.
Of course, it is not all about money. I was brought up to believe that you get what you pay for. It is clear that if we do not invest much, we will not get much. Is it any wonder that we have a staffing crisis in the NHS? The Conservative Government’s failure to provide adequate resource and support has created problems in both staff recruitment and retention. The Government continue to exploit the good will of dedicated NHS staff, many of whom are pushed to breaking point. As my hon. Friend the Member for Brentford and Isleworth (Ruth Cadbury) pointed out, staff morale is at an all-time low.
It is inconceivable that more and more hospitals should constantly face the threat of closure. I commend my hon. Friend the Member for Hammersmith and the committed grassroots campaigners for their extensive work over many years to save these vital hospitals. These victories are really welcome, but the Hammersmith and Fulham CCG faces cuts of £30 million. Is it not disgraceful to hear, in the light of that, that £72 million was wasted on private consultants? It is astonishingly incompetent, above all else.
Of course, the cuts to the CCG forced it to reduce urgent care, local GP hours and access to primary care, which is short-sighted as it causes suffering for constituents and often leads to more expensive or hospital treatments. It seems that the Health Secretary’s only answer is to focus on technology. I agree that technology has a role to play in the future delivery of NHS services, but we must proceed with caution. Patients’ needs are paramount, and we must ensure that their safety is never compromised.
I share my hon. Friend’s concern about the use of online GPs. It is clear that the app providing access to such services, GP at Hand, will be very convenient for some people, and is likely to appeal to younger patients. Indeed, Ipsos MORI found that 87% of all GP at Hand patients are aged between 20 and 39. It is also likely that online GPs will prove attractive to patients with less complex medical needs, leaving the providers open to the accusation of cherry-picking. They are undoubtedly delivering a service for which there is demand, but the fact remains that many patients need to attend a traditional GP consultation.
Of course, many patients do not know when they register with an online GP that they are deregistered from their GP surgery. That has serious consequences for the financial viability of the traditional surgery. Hammersmith and Fulham CCG has paid £10 million to GP at Hand. That money is no longer paid to local surgeries, which are as busy as ever catering for patients with multiple complex needs, and their overheads are still as great as they ever were. It is imperative that the funding model for the delivery of GP services is adjusted to reflect the fact—
I will sum up, Sir Christopher.
Patients are suffering. We want assurances from the Minister about future hospital closures, sustainable funding and the role of technology in the modern NHS. We want to know the direction of travel of the NHS in north-west London and the country as a whole.
It is a pleasure to serve under your chairmanship, Sir Christopher. I thank the hon. Member for Hammersmith (Andy Slaughter) for securing this important debate, and all hon. Members for speaking so passionately. I welcome the campaigners, who have been following our deliberations this afternoon. Everybody has spoken passionately about NHS services in north-west London, and the hon. Gentleman spoke about his area of Hammersmith and Fulham. I am under considerable time pressure, and if I do not answer all the questions that hon. Members raised, which ranged over primary and acute care, I am happy to write to them later.
I would like to start by thanking everybody who works in the NHS—in primary, secondary and community care—for everything they do, particularly in north-west London, which is a busy area with a lot of demand on services. It is exposed to unique pressures, but there are also unique opportunities. It has some of the country’s busiest services and is used by an increasing, complex and dynamic population. Our capital city challenges our NHS, but it is also home to transformation and innovation that has delivered important benefits for patients.
“Shaping a healthier future” looked at the pressures on the NHS in and around the hon. Gentleman’s constituency. It achieved significant benefits for patients in north-west London. It delivered 24/7 urgent care centres in every local borough and improvements in maternity and emergency paediatric care, and introduced a range of initiatives to help people obtain the specialist care they need closer to home. The NHS in north-west London is now in agreement to move on from the “Shaping a healthier future” programme. The hon. Gentleman asked specifically what the future will hold. In January, the Government announced that there will be an extra £20 billion a year for the NHS by 2024. As part of that, every area in the country will need to develop its own local plan for the next five years for how to spend the extra money. The north-west London sustainability and transformation partnership, working with clinicians and the public, will develop a new long-term, five-year plan for how best to spend that money, working together as a single health system.
I want quickly to address the points that the hon. Gentleman made about the lack of honesty in the north-west London process. Reconfiguration processes are, by their very nature, contentious, and raise many passions locally and nationally. His passion was evident from his contribution. The consultation process in north-west London involved extensive public consultation and clinical engagement throughout. It is important to recognise the high level of clinical engagement. It was never a political exercise or a fait accompli. Its underpinning principle was what was best for patients with the available resources. We need to support NHS staff and managers as they face the challenges before us. We must help them to manage service change responsibly. General practice primary care is the front door to and the cornerstone of the NHS, which is why the long-term plan addressed it when it was published in January.
I want to speak about Babylon GP at Hand. The hon. Gentleman raised a number of issues, and I will do my best to answer them. He spoke about the cost to the CCG. I wrote to one of his council colleagues this morning about the issues he raised. I understand that the CCG has reported that it overspent by £10 million in 2018-19, specifically in relation to GP at Hand. NHS England will of course have to look at the year’s final accounts and any overspend in more detail to understand better the precise financial impact of changes in the borough. For 2019-20, the CCG’s target allocation has increased, all else being equal, in line with the growth in its overall registered population up to the 12-month average for November 2017 to October 2018. NHS England does not believe that the CCG has had to scale back services because of any extra financial burden from GP at Hand, but we will continue to work with the CCG and other partners to explore options for maintaining the robustness of the commissioning system, both now, while GP at Hand is focused in London, and in the future.
I just want to address the hon. Gentleman’s point about safety.
I suspect the Minister was referring to my colleague, Councillor Ben Coleman, the cabinet member for health and adult social care, who wrote to the Secretary of State on 15 April specifically asking for the money spent—£10 million—to be refunded, and for a commitment to reimburse the CCG fully for the cost of GP at Hand. I did not hear the Minister say that, so will she give that assurance?
I cannot give that reassurance, and I would only reiterate what I have just said to the hon. Gentleman.
On the safety of the app, all NHS providers are held to account through a robust network of systems, including, and not limited to, the inspections of the Care Quality Commission. Any apps providing video consultations must be evaluated and regulated to ensure that the patients who access those services can be confident that they receive safe, effective and high-quality care. Hammersmith and Fulham CCG, along with NHS England, has commissioned an independent evaluation of GP at Hand, which will report shortly.
I question what the shadow Minister said. Digital technology is part of the solution, but the Department is looking at other ways of transforming primary care. We are looking at how we look at partnership models and at how we pivot to primary in future. All patients will have a right to digital-first primary care, including web and video consultations, from April ’21. All patients will be able to have digital access to their full records from 2020. They can, from this month, order repeat prescriptions electronically as the default.
By the end of the next decade, digital innovations are likely to have transformed the NHS. They will allow clinicians to work more efficiently and flexibly so they have more time to spend caring for patients. Every pound spent will go further. That will allow for greater responsiveness and personalisation for patients. We need to design services for patients and things that are available for people when they want them and at times that are convenient for them. I am pleased that the Government have committed to saying that all patients will have access to digital-first primary care from April 2021.
I acknowledge the hon. Gentleman’s concerns about the effect of GP at Hand on primary care as a whole in his constituency. The challenge for the Government and NHS England is to ensure that the way we commission, contract and pay for care keeps up with the opportunities digital innovation offers, ensuring that the new technology is safely integrated into existing pathways without unduly destabilising the services it works alongside. Two important principles within the NHS are that a patient can choose which practice they register with, and that funding follows the patient. The emergence of digital-first providers, which register patients who may live some distance from the practice, raises the question of whether these funding arrangements are fair. This year, NHS England is analysing and reviewing the out-of-area registration.
Motion lapsed, and sitting adjourned without Question put (Standing Order No. 10(14)).