House of Commons
Monday 1 July 2019
The House met at half-past Two o’clock
[Mr Speaker in the Chair]
Oral Answers to Questions
Work and Pensions
Universal Credit: Roll-out
The national roll-out of universal credit was completed in December 2018. As of May 2019, there are now more than 2 million people claiming universal credit, and of those, 34% are in work. We now plan to begin “the move to UC” pilot later this month.
The right hon. Lady’s Government promised that
“universal credit should not leave councils out of pocket.”
Yet Highland Council has nearly £3 million of additional costs, including £640,000 of indisputable administration costs, directly as a result of universal credit. Despite letters, questions and meetings with officials and Ministers, where details and data have all been provided, there is still no settlement. When will this debt to highland households finally be repaid?
I am aware that the hon. Gentleman has raised this matter before and has had a number of meetings with the Minister for Employment. As a result of some of those meetings, we have already increased the additional funds available to councils such as the one to which he refers. There has been an increase in the total amount of new burdens money that has been paid out, but we have also said that we will investigate further. I want to reassure him that this is not finished yet, and that I will continue to look at it myself to ensure that there is satisfaction.
May I thank my right hon. Friend for her very successful visit to Stirling last Thursday and Friday? When we met the work coaches and the other staff of the Department of Work and Pensions team at Randolphfield, was she struck, as I was once again, with their degree of dedication and their genuine concern for the claimants with whom they work? They are a credit to themselves and to the DWP team. Does she agree that, rather than spread fear and scaremongering, Scottish National party Members should be encouraging the people who live in their constituencies to go to the DWP to get the help that they need, confident that they will be respected and treated with genuine dignity?
I thank my hon. Friend for his important question and for setting up the visit, which was so useful and purposeful. I do note that when I went to the jobcentre and met the work coaches, they were passionate about delivering the right outcomes for their constituents. When we asked them what they would change about universal credit, they said the publicity, because they are so committed to getting the right outcomes for the right people. These are people who are doing good work for good people.
Will the Secretary of State confirm for the record that any EU national who has been granted settled status in the United Kingdom is regarded as being habitually resident for the purposes of applying for and receiving universal credit?
That is largely correct. The only issue here is about the evidence that people now have to supply which they did not have to supply before. I know that there are a number of places where people were able to claim benefits and they now no longer qualify for universal credit. We are looking at those individually to see whether it is an issue with their application for settled status or something else.
In answer to the first part of the hon. Gentleman’s question, which is about assistance in getting the applications through, we announced in April this year the help-to-claim arrangements so that applicants who are struggling to apply for universal credit can have the additional support they need from citizens advice bureaux. I hope that he will find that that is working well in his local bureau. On the second part about getting money to people earlier, as he will be aware, we have made advances available and we are extending the amount of time over which people have to repay it and the amount that is deducted from their core amounts so that they do not feel it as badly as they would have previously.
With commendable brevity, I feel sure. Neil Gray.
Research released last week from the Child Poverty Action Group and the Church of England shows that women are being forced to choose between poverty and an abortion because of this Government’s two-child cap—that is the reality facing families with three or more children. It appears unlikely that the Secretary of State will face another Work and Pensions Question Time, so will she make it her legacy to scrap the two-child cap and avoid impoverishing half of all children in those families?
I will try not to be distracted by the hon. Gentleman’s slightly personal remarks. He might know that I visited Scotland last week, and the Scottish Government have taken their own steps on what they feel is the way to address child poverty. Those of us on the Government side of the House feel that the best way to address child poverty is to help more people into work. I am proud of the fact that there are now 1 million more people in work and that over 600,000 children are no longer in houses where no people work.
I note that the Secretary of State did not answer my question. I would like to compare and contrast, because CPAG has said of the two-child cap,
“you could not design a policy better to increase child poverty”,
but last week it described the new Scottish child benefit, to which the Secretary of State referred, as
“an absolute game changer in fight to end child poverty”.
Therefore, on the 20th anniversary of the reconvened Scottish Parliament, is this not yet another example of where Holyrood empowers, Westminster impoverishes?
Again, I point to the fact that there are different ways of addressing poverty, both child poverty and family poverty: one is to hand out money, which is what the Scottish Government have chosen to do; and another is to focus, with laser-like attention, on ensuring that we build the economy and create employment and that there are good jobs so that people can support their family.
There has been no such assessment. As one Department, we have rolled out universal credit, providing a holistic benefits system to ensure that everyone is given the support they need. As one Department, we have seen record levels of employment and the lowest unemployment rate since the 1970s.
I thank the Secretary of State for that answer. However, she will be aware that there is a significant difference between the benefits of universal credit, disability benefits and pensions. She will also be aware that certain newspapers are prone, when talking about the allegedly outrageous amounts of money that people on unemployment or disability benefits get, to look only at the Department’s overall spend. Of course, as she will be aware, 90% of that spend is on pensions. Would it not be simpler, easier and more straightforward simply to split DWP into two Departments, so that both can focus on what they should be focusing on?
Although I recognise the good work that the hon. Gentleman has done in many of these areas, I respectfully disagree. I think that it is right that those elements are held together in one Department. If we look at the results, we are seeing record levels of pensioner poverty—[Interruption.]
Yes, we are.
I say quickly to the hon. Lady on the Opposition Front Bench that we are seeing the lowest levels of pensioner poverty, as well as the highest levels of employment.
I very much welcome the recent decision to move the Office for Disability Issues into the Cabinet Office, creating a super-hub of all equalities work right across Government. Will the new hub be leading the reform to statutory sick pay so that it is better enforced, more flexible and covers the lowest-paid workers, and when will the consultation on this vital reform take place?
I thank my hon. Friend for that question, and may I take this opportunity to pay homage to the extraordinary work that she did to ensure that it took place? The point of having an equalities hub in the Cabinet Office is to ensure that we have strong enforcement to deliver on the disabilities changes across Government. With her help, following the work she put in, we are able to do that.
Ah yes, the man in the summer suit—splendid. Mr Barry Sheerman.
And my tie has whales on it, Mr Speaker—Japan comes to mind. The fact of the matter is that the Secretary of State knows that she has some really good people working in her Department—certainly the people working in my patch are very good—but the trouble is that they are not well managed or well led. Splitting is not the answer; the answer is to get in some managers who can tackle things such as the awful situation for people on universal credit who do not have a bank account, because she has still not tackled that.
I can reassure the hon. Gentleman that we are working with Lloyds, for instance, to ensure that basic bank accounts are more available. May I also take this opportunity to join him in praising the work of the staff at the jobcentre in Huddersfield to help people in his constituency?
Tackling poverty will always be a priority for this Government, and I take these numbers extremely seriously. In the latest low income statistics, child poverty increased in three of the four measures. The evidence shows that work is the best route out of poverty, and there are 667,000 fewer children in workless households compared with 2010.
Summer holidays are fast approaching, and far too many families will be struggling to feed their children. The Childhood Trust states that two thirds of London children living in poverty—that will be 2,000 in Kensington—could go hungry without access to charitable donations. While the Mayor’s Fund for London supports hungry children across the capital, what is the Minister doing, long term, to tackle the causes of child poverty, including in-work poverty?
As I have said, the latest statistics show that full-time work substantially reduces the chance of poverty. The absolute poverty rate of a child where both parents work full-time is only 4% compared with 44% where one or more parents are in part-time work. We are supporting people into full-time work where possible—for example, by offering 30 hours of free childcare to parents of three and four-year-olds. Over three quarters of the growth in employment since 2010 has been in full-time work.
In our country in 2019, what proportion of children live in poverty?
Without knowing the exact figure, it is too many. My role within the Department, and the role of the Department itself, is to address that. My hon. Friend will know too well that the best route out of poverty is work. That is why our focus is on universal credit. Universal credit is working in terms of getting more people into work, and more people are staying in work.
The best way out of poverty is probably properly paid work. The real problem for many of my constituents and their children is the fact that they have very low levels of savings, so when somebody loses their job, perhaps because a company closes, the real danger is that when they go on to universal credit they have to wait for five weeks for a payment and have nothing to fall back on. I really do beg the Government to reconsider the issue of the five weeks. The worst possible thing of all is saying, “You can borrow some money”, because suddenly a family ends up in debt, and that is when the children end up not having food unless it comes from a food bank.
I recognise the passion with which the hon. Gentleman raises his point, but, in terms of the five-week wait, nobody has to wait for their first payment of universal credit, as 100% of their indicative advance is available on day one. It is interest-free, repayable over 12 months—and, as the Secretary of State has said, that will in future be moving to 16 months. That is available and about 60% of people are currently taking it up.
Given that the majority of families affected by the two-child limit are working, why did the Department for Work and Pensions make the following statement in response to the recent report by the Child Poverty Action Group and the Church of England:
“This policy helps to ensure fairness by asking parents receiving benefits to face the same financial choices as those in work”?
Could the Minister clear up this confusion for the House?
The policy to provide support for a maximum of two children helps to ensure fairness by asking parents receiving benefits to face the same financial choices as those in work. Safeguards are in place and we have made changes this year to make the policy fairer. Tackling poverty remains a priority. We are spending over £95 billion a year on welfare and providing free school meals to more than 1 million children.
People with Disabilities: Employment
We support disabled people into work through initiatives like the Work and Health programme, the Personal Support Package, and the new Intensive Personalised Employment Support programme launching at the end of 2019. Access to Work approved support for nearly 34,000 disabled workers last year, and we engage with employers through the Disability Confident campaign.
The 19% disability employment gap in Cheadle highlights our untapped talent and the challenge facing the Government in getting a further 1 million disabled people into work over the next eight years. Greater flexibility in working hours, managing time and accommodating medical appointments are just some of the ways to close the gap, but there is clearly more to be done. Does my hon. Friend agree that employers should be encouraged to think creatively about how to make work more accommodating to disabled people?
My hon. Friend is spot on. I was at Employability Day on Friday, celebrating, meeting disabled people who had got into work and, crucially, meeting employers who had often made very small changes. The key message was that it is a win-win. The 950,000 more disabled people who we have got into work are making a real difference to businesses that have taken those steps.
I recently met the charity Root Experience at Chichester library, where it was launching a book called “Hidden Stories”. The book puts a spotlight on hidden disabilities such as epilepsy or autism and how they impact people on a day-to-day basis. Would my hon. Friend be happy to receive a copy of the book? What steps is the DWP taking to promote education and awareness of hidden disabilities in the workplace?
I thank my hon. Friend for highlighting that fantastic book. My hon. and learned Friend the Member for South Swindon (Robert Buckland) and I recently went to Swindon Council library and were handed a copy of this excellent book. It is currently sitting on the backseat of my car. It is a brilliant edition, and I hope that as many MPs as possible can see this proactive and constructive way to champion opportunities that people with hidden disabilities can offer.
I am sure the Minister will agree that we want all our pupils to stay in full-time education until they are 18, including those with special needs and disabilities. However, at 16 these pupils face the change of moving from disability living allowance to personal independence payment. That is out of step with changes faced by other children. For example, other children aged 16 in full-time education are able to continue to claim free prescriptions, free eye tests and free dental checks, but children with special needs and disabilities have to face this change in benefits at 16. This is extremely stressful—it is stressful enough for these children to be going on to college, let alone having to change benefits. Will the Minister look at changing that, so that children in full-time education at 16 do not change benefits until they finish?
I thank the hon. Lady for raising that important point. I recognise the points that she made, but it is a balance. The decision to do this has been in place for a long time, to allow for everything in be in place for when they get to 18, but I am happy to meet her to discuss this further.
Can the Minister explain the very long delays in the limited work capability assessment to qualify for the working element of universal credit, and why disabled people who are trying to work are being penalised because of the apparent inefficiency of the contractor, Maximus?
Under universal credit, from the initial conversation with a work coach, individual claimants—including those with disabilities—can get support. We continue to make improvements to the work capability assessment, following the five independent reviews. Over 100 different recommendations have been taken on board. I work very closely with stakeholders, as do all the ministerial team. We look to continue to improve the process.
Support for disabled people in work should be a top priority for this Government, but on several occasions I have raised with Ministers a fundamental flaw under universal credit for disabled people in work, which is that to qualify for in-work support, such as the work allowance, one must be found unfit for work under the work capability assessment. That contrasts with legacy social security, where someone qualifies for in-work support by being in receipt of DLA or PIP. Does the Minister agree that this is absurd, and will he commit today to rectifying this illogical and damaging policy?
I will commit to continuing to do everything we can to ensure that all people with disabilities and long-term health conditions have the maximum chance to get into work. I am very proud of the fact that over the last five years alone, 950,000 more disabled people are in work, and we continue to make good progress towards our target of a further 1 million disabled people in work by 2027.
Universal Credit: Food Banks
There are a range of reasons why people make use of food banks. The key for the DWP is to ensure that welfare claimants are able to access funds in a timely manner. That is why advances are available, so that no one has to wait five weeks for their first universal credit payment.
Even before universal credit was rolled out in Hull, the use of the Hull food bank was very high because we have widescale in-work poverty, and a third of the children in Hull are living in poverty. The Trussell Trust has said that nearly half of all food bank referrals are due to a delay in benefits being paid when universal credit is rolled out, which happened in Hull before Christmas. Does the Minister now accept that, and what is he going to do about it?
I thank the hon. Lady for her question. We continue to provide a strong safety net through the welfare system for those who need extra support and, as I have said, people use food banks for many and varied reasons. We review research carried out by organisations, including the Trussell Trust, to add to our understanding of food bank use. I intend to work far more closely with the Trussell Trust and other food bank providers, including other stakeholders in this area. I want food bank providers and jobcentres to work far more closely together so that we can better understand the issues and then put in place the interventions to make the situation better.
A few weeks ago, I and a colleague of mine visited a major food bank in Coventry. One of the lessons we learned from the food bank in Coventry—it has nine outlets throughout Coventry and Warwickshire—is that universal credit is forcing people to use food banks. What is the Minister going to do to sort out the problem that people have who are forced to use food banks? Surely we should have another look at universal credit and abolish it, because it is not working.
I am sorry to hear the hon. Gentleman’s example. If I get a chance to visit his local food bank, I will certainly do so, but I have to stress that no claimant needs to wait more than five weeks to receive their first regular universal credit payment. We have listened to feedback on how we can support our claimants and made improvements, such as extending advances, removing waiting days and introducing housing benefit run-on. I will continue to work with the Trussell Trust and others to improve our system in any way we can.
I am afraid to say to the Minister that the advance payment is missing the point. The biggest driver of people going to food banks is the five-week wait. Because of the benefit freeze, the basic amount people have to live on, particularly the very vulnerable, is not enough. We cannot then expect them to live on less by taking away their advance payment, which is a debt. There is a simple way to deal with this. Some 60% of claimants are already taking advance payment, which tells us they cannot wait. The money is already going out of the DWP’s door. Make it a grant. It should not be repayable for the most vulnerable people in society.
I respect the hon. Lady’s knowledge in this area on the Select Committee, but I would say that advances are not loans from a separate fund; they are the claimant’s benefit paid early, which is then recovered over an agreed period. So they are in place to ensure that those in genuine need are able to receive financial support and are not reliant on illegal or high-cost lenders. But if a claimant considers they are facing financial hardship because of the amount that is being deducted from their universal credit award, they can ask the Department to consider reducing their deductions. As of October this year, the maximum deduction goes down from 40% to 30%.
Universal Credit: Working People’s Incomes
One of the key transformations that universal credit provides is to support people who are in work, ensuring they can increase their earnings and develop in their career. It removes the 16-hour cliff edge, which held so many back on legacy benefits, and gives improved, tailored support through jobcentre work coaches.
Will the Minister join me in thanking the excellent DWP staff on the Isle of Wight, some of whom I met in Newport a few weeks ago? I am sure he and the team will seek to make further improvements to universal credit, but it was clear to me, talking to those staff, that universal credit enables them to do more good for more people than the inflexible system that preceded it.
I thank my hon. Friend for being a huge champion for the Isle of Wight and working so well with his local jobcentre. I am very pleased about that and he is absolutely right. As a result of universal credit, people are able to get the support—that one-to-one support—that is so vital. Since 2016, an extra £10 billion has gone into the system.
My constituent, Amanda, who is a single mum with significant mental health problems, had her UC claim closed—unknown to her—at the beginning of May. She was told by the DWP that this was a sanction because she failed to complete an online review. I should also mention that she was in the last few weeks of her pregnancy. Given that Amanda is clearly a vulnerable person, will the Secretary of State commit to ensure that all work coaches are aware of their obligations following last year’s High Court judgment, which demands that they should treat vulnerable claimants appropriately?
Of course. The Secretary of State, I and all colleagues want to ensure that absolutely every single person claiming universal credit gets the appropriate support and the right level of support. I would be very happy to look at that individual case with the hon. Lady. I would just say on sanctions that these are not just handed out; there is a clear process. I can tell her that, in February 2019, only 2.45% of those who were under conditionality requirements actually had a sanction and the average sanction’s length was 30 days. But I will look at that case for her.
My constituent, Craig Ferguson, has Asperger’s, but works in retail. He broke his leg, was not entitled to statutory sick pay and was advised to switch to UC. He then lost his severe disability premium. His UC has automatic deductions for an employment support allowance overpayment and, at times, he receives no UC award at all, which means that he has to depend on savings. How is that fair? Can his case be reviewed?
Of course, I am happy to look at that individual case. Perhaps the hon. Gentleman will get in touch with my office after this session.
Local Housing Allowance
Welfare reforms were designed to ensure a fair balance between public spending and supporting vulnerable people to meet their housing costs. LHA rates are not intended to meet all rents in all areas. However, the Secretary of State and I have committed to end the freeze to LHA in March 2020.
Local housing allowance is supposed to cover the lowest 30% of market rents, but research by Shelter found that that is not possible in 97% of England. For example, in south-east London, local housing allowance will cover only the bottom 10% of rents. We have a housing crisis across the country and local housing allowance is not fit for purpose. Does the Minister agree that it must be raised to reflect the true cost of renting?
I thank the hon. Lady for her question. As I said, LHA rates are not intended to meet all rents in all areas. Housing benefit claimants have to make the same decisions about where to live as people who do not receive benefit. In 2019-20, targeted affordability funding has been used to increase over 80% of rates in London. Nevertheless, we recognise that this is an issue. The Secretary of State and I are alive to it and we are looking at several options ahead of a spending review bid.
Does the Minister recognise that recent changes to the tax treatment of the private rented sector, particularly the buy-to-let sector, will mean an increase in rents across the board? That will have a very real read-across to the local housing allowance. Will he give some assessment of what allowance he will make for that increase?
That is, of course, a question for the Treasury. Any rise or potential rise in LHA rates has to go hand in hand with addressing supply. I urge my hon. Friend to address that issue with my counterparts in the Ministry of Housing, Communities and Local Government, and, indeed, the Chancellor and Chief Secretary to the Treasury.
I welcome what the Minister said the other day about reviewing how local housing allowance areas need to be redefined. Does he accept that, because Stroud is in the same area as Gloucester, we are now losing a significant number of people from the private sector because they cannot afford to top up? Will he therefore look at this as a matter of urgency?
I thank the hon. Gentleman for his question. He is right that the broad market rental areas have some anomalies. I have officials looking into this. It is a huge and complex piece of work, given that there are approximately 900 of those areas. It is therefore not something that can be done quickly, but I recognise the issue and I am working on it.
The overall trend in the percentage of pensioners living in poverty has fallen dramatically over recent decades. Relative pensioner poverty rates before housing costs have halved since 1990 and rates of material deprivation for pensioners are also at record lows. We want to maintain this achievement.
On Friday, I met constituents and campaigners from Women Against State Pension Inequality Campaign Scotland. Those women told me that they are suffering poverty, distress and significant inequality as a result of a pension decision taken in the name of equality. At a time when the Tory leadership candidates are promising billions of pounds of public spending, those women would like to know why the Government cannot find the cash to right the wrong done to the WASPI women.
It is not the Government’s intention to change the Pensions Act 1995, the Pensions Act 2007 or the Pensions Act 2011. There was a £1.1 billion concession in 2011. The policy was conceived in 1993, continued under the Labour Government for 13 years, continued under the coalition and will continue under this Government. I should also point out that a judicial review is pending. I cannot comment any further than that.
Does the Minister think it right that the UK has the lowest state pension in the developed world?
The reality of the state pension in this country is that it has risen by £1,600 in real terms through the triple lock. It also needs to be looked at in the context of the significant high private pensions that, thanks to automatic enrolment and other reforms, show that this is comparable to many other European countries.[Official Report, 9 July 2019, Vol. 663, c. 2MC.]
Free TV licences for older pensioners used to be a proud part of DWP policy. Ministers were warned that they would go under the Government’s TV licence plans, so please do not tell us that pension credits are the answer when thousands of pensioners in our area have small occupational or widows’ pensions, which mean that they are just above the threshold but are still on tight budgets. They will be hit by the free TV licence being taken away. What are the Government going to do to support those pensioners and to reverse this unfair plan?
The right hon. Lady will be aware that this is a matter for the Department for Digital, Culture, Media and Sport. In the 2015 funding settlement the Government agreed with the BBC that responsibility for the concession would transfer to the BBC after June 2020. I reassure the House that the Government recognise the importance of this, but we are very disappointed with the BBC and we expect it to continue the concession.
The hon. Member for Birmingham, Erdington (Jack Dromey), who is a keen young pup in the House, is perched as though he is about to expatiate. However, I had him down as coming in on the next question. [Interruption.] He wishes to expatiate now. Well, our delight is unanimous.
The pensioners who built Britain deserve nothing but the best in retirement, yet there are 1 million households in poverty because, according to research conducted by Independent Age, the Government have held on to a staggering £7 billion since the general election in unclaimed pension credit, increasing to over £17 billion by 2022— £10 million a day. What has been the Government’s response? An online toolkit used by 2,000 people last year. How do the Government begin to justify plunging 1 million pensioners into poverty? What will they do to ensure that all pensioners get the security and dignity they deserve?
The hon. Gentleman will know that, actually, pension credit applications are up significantly. It is also the case that successive Governments have attempted to promote pension credit. I share the frustration of colleagues that it is not higher than it presently is, but I want to emphasise that the DWP uses a variety of means to communicate and we urge all pensioners to apply for pension credit through the usual manner, whether through trusted third parties, jobcentres, local authorities or the like.
Due to automatic enrolment, 10 million workers have been automatically enrolled into a workplace pension, including 17,000 in my hon. Friend’s Walsall North constituency. In addition, the Government’s commitment to the triple lock has meant that the full basic state pension is now worth about £1,600 a year more in cash terms than it was in 2010.
I thank the Minister for that answer, but 3,440 households in my constituency will lose their free TV licence as a result of the BBC’s recent decision. Can he assure my constituents that pensioners with increased costs will be at the forefront of the Department’s decision making during the comprehensive spending review?
Clearly, I cannot comment on the specifics of the comprehensive spending review—I suspect that will be for the new Prime Minister—but the reality of the situation is that the triple lock and the various reforms we have introduced have meant that pensioners have done considerably better. We spend £120 billion on pensioners, of which £99 billion is on the state pension. That is a record sum.
Pensioners who apply for disability living allowance after the age of 65 are not eligible for the higher mobility component and are therefore not able to access the motability scheme. The regulations are not new—they date to 1991—but our understanding of what it is to live a good life in retirement has changed in the intervening three decades. Will Ministers reconsider the regulations, so that pensioners continue to have the opportunity for full social participation?
I will take the hon. Lady’s point on board and write to her.
The Department does not publish statistics on the number of people who receive a state pension below the full new state pension amount. As of November 2018, the average amount of the new state pension that people received, including any protected payments, was £154.91 per week.
I thank the Minister for that answer. While he may not have that figure, I can tell him that two of the people who do not receive that amount are Bob and Hilary Heyes from my Stoke-on-Trent constituency. Had they started to claim their state pension under the new state pension, they would have received the full amount because they had 35 qualifying years, but because they were born before 1951 and 1953 respectively, they receive considerably less. What would the Minister have me tell Mr and Mrs Heyes when they come to constituency surgery next?
It is hard for me to comment on the specifics of the particular case. If the hon. Gentleman writes to me in advance of the forthcoming constituency surgery, I will write back to him and he can hand over the letter.
Disability Confident is a very effective voluntary scheme, so compulsory options have not been discussed with Cabinet colleagues. Public bodies are already subject to the public sector equality duty. All main Government Departments are level 3 Disability Confident leaders, and 80% of local authorities are Disability Confident.
I hope I can be forgiven for saying—because I am going to say it anyway—that the House of Commons is a Disability Confident employer. It is absolutely right that we should be, but in case there are Members here who were not aware of that fact, they are now.
Thank you, Mr Speaker. My Harlow constituent, Lacey-Rose Saamanthy—a deaf lady—had a catering assistant job offer retracted by the Mid Essex Hospital Services NHS Trust on the basis that it could not mitigate against the so-called risks of her employment. This is despicable, so what steps are the Department taking to ensure that all employers, including the NHS, are signed up to the Disability Confident scheme and are aware of the funding available through the Access to Work scheme, as advocated by the National Deaf Children’s Society and others?
I know my right hon. Friend has championed the case of Miss Saamanthy and I understand that the trust has contacted her to discuss alternative roles in the organisation, including roles that staff with hearing disabilities have successfully been recruited into. I also encourage that particular NHS trust to sign up to the Disability Confident campaign.
I take this opportunity to pay tribute to the Speaker’s parliamentary placement scheme, which offers paid internships with training. The graduates graduated just last week. The one that I had the joy of hosting did very well out of that, and that was on the disability strand, hence my question. Will the Minister add his support to the disability strand of the scheme and also look at strengthening the learning from that scheme, so that we can help more employers in the public sector be better employers under Disability Confident?
Absolutely, and I am really encouraged to hear about that. Through the Disability Confident scheme and the Access to Work scheme, we want to do everything that we can to support these new opportunities being created, because ultimately, the employers benefit when disabled people’s talents are unlocked.
Ah yes, young Docherty-Hughes.
Thanks for the “young”, Mr Speaker.
The Minister seeks, in the Government’s proposal, to promote Disability Confident employers, but does he not recognise that, in April 2019, 85% of all mandatory reconsiderations for personal independence payment modified the original decision? Does he not agree that there seems to be rank hypocrisy in promoting Disability Confident employers while the Government are impoverishing my constituents in West Dunbartonshire and across the United Kingdom?
We have over 2 million claimants on PIP, and only 5% of the applications have been taken to appeal. I recognise that those who go through the independent appeal process will, more often than not, have a decision overturned, which is why we have been working extremely hard, through a series of pilots within PIP, on the mandatory reconsideration stage and the independent appeals stage, so that we can get hold of the additional oral and written evidence earlier, which is what is often used to get the decision changed. This is an absolute priority for the Secretary of State and we are making sure that we are doing everything we can, as quickly as we can.
Universal Credit: Vulnerable Claimants
Universal credit ensures that support goes to those who need it most by simplifying the previously complicated legacy system, allowing 700,000 more people to receive approximately £2.4 billion in unclaimed benefits. Since 1 April this year, the Citizens Advice and Citizens Advice Scotland Help to Claim service has been in place, providing free, confidential and impartial support to help people, including those who are vulnerable, to make a universal credit claim.
I acknowledge the work that the Minister and the Secretary of State have done to improve universal credit, though concern remains that the five-week wait for the first payment is presenting a serious challenge to many people. To address this, will he accept the recommendation of the Bright Blue think-tank for one-off, up-front helping hand payments?
Those moving to universal credit will get more than 25% of their award through two weeks of additional housing benefit and, as of next year, jobseeker’s allowance, employment and support allowance and income support. Advances are available to cover the interim period, but we recognise the concerns about the payments in arrears and would welcome further ideas.
Vulnerable universal credit claimants often need to travel, sometimes long distances, to regular hospital appointments. What can the Minister do to help give these people the financial security they need to attend those regular and important appointments?
Universal credit claimants may be able to claim a refund for the cost of travelling to a hospital for treatment through the NHS healthcare travel costs scheme. To claim travel costs, claimants should take travel receipts, as well as their appointment letter or card and proof they are receiving a qualifying benefit, to a nominated cashiers office, which will be located in the hospital or clinic that treats the claimant. I should advise my hon. Friend that costs can be claimed back up to three months after an appointment.
The requirement for explicit consent built into universal credit makes it difficult for organisations such as Macmillan to support claimants as they did those on legacy benefits. When will the Government meet their commitment to review this requirement with the Social Security Advisory Committee, how will they engage stakeholders and when do they expect to report their findings?
The hon. Gentleman raises a very good point—it concerns me too. We have agreed to work collaboratively with the Social Security Advisory Committee to consider how current practices could be enhanced, and to publish a report on our joint conclusions.
A constituent of mine, Claudette, lives with her son, who is disabled, in private rented accommodation. She is in receipt of universal credit, but she did not receive her April rent payment, and the Department is refusing to investigate. Prior to that and ever since, universal credit has covered her rent. Will the Minister meet me to review this case, as my constituent fears eviction?
I thank the hon. Lady for raising that individual issue. I would like her to raise Claudette’s case with me. My door is always open, as I know are those of other Ministers in the Department, and of course I would be delighted to meet her.
At the last oral questions, I raised the case of single parent Alicia in my constituency, who had seen fraudsters claim universal credit for her. The Minister promised to investigate but still has not. In the meantime, we have seen hundreds more cases across Greater Manchester, including that of my constituent Sarah, who has now, in spite of reporting the fraud, been asked to attend an interview under caution and been further victimised by the Department. Will the Secretary of State please make sure that victims of fraud and crime are not further victimised by her Department?
We take fraud incredibly seriously, and I believe that the matter in question is being investigated. If the hon. Lady has further cases, she can refer them to me or the Minister for Employment, and we will look at them very carefully.
The pilot of the Government’s ill-conceived managed migration of universal credit is meant to start this month, but the Government have been very slow in coming forward with details. Is this because the level of payment to severely disabled people who lost out when they transferred to universal credit was found to be unlawful by the High Court?
The Minister for Disabled People, Health and Work has been very clear on this. We are still considering it and will come back to the House in due course.
The Government have repeatedly responded to criticisms of social security cuts—and have done so today—by claiming that they are targeting those who need support the most. How does that accord with spending nearly £200,000 on legal battles with severely disabled people and single mothers who have lost out under universal credit?
Let me gently point out to the hon. Lady that we are spending more than £6 billion a year on the main disability benefits.
Personal Independence Payment
Let me answer the hon. Gentleman’s question and provide an important update on the Government’s work with Motability.
When PIP was first introduced, the Government worked with Motability to design a £175 million transitional support package to support Motability scheme customers who have not been awarded the enhanced mobility component on reassessment from DLA to PIP. Motability announced today that it would provide substantial additional financial support, including £1,000 for customers who lose eligibility for the scheme as a result of a PIP reassessment. It will also fund grants for personal contributions to the Access to Work scheme, and will accelerate the programme that is being undertaken with Family Fund to help many more families with severely disabled children under the age of three. I pay tribute to the proactive and constructive work done by Motability Operations in further supporting disabled people in society.
Notwithstanding what the Minister has said, some 52% of UK claimants who were claiming a mobility element under DLA found that it was either reduced or stopped altogether when they moved to PIP, and 2,370 people in the highlands have been hit in that way. Obviously, getting around in the highlands is not easy, and access to transport is not easy. Will the Government please look at this issue? My constituents are losing out, and it seems to me extremely unfair that those figures are so high.
Among those who have made the transition from DLA to PIP, an extra 144,000 who did not qualify for the enhanced mobility rate under DLA now do so under PIP. We have continued to work with Motability in respect of the additional transitional support that it has announced, and we will continue to keep a close eye on this important area.
Given the time constraints, it would be helpful to the House if the hon. Member for Mid Derbyshire (Mrs Latham) were to shoehorn her inquiry in the next question into this one.
I absolutely commend my hon. Friend’s constituent for the work that she does in her community. I also congratulate Ms Fennell on receiving the British Empire Medal in the Queen’s birthday honours, as well as a national citizenship award in recognition of her work: a true tribute.
Universal Credit: Access to Legal Aid
The Ministry of Justice is responsible for access to legal aid, and we will continue to work closely with it as it reviews the means test for entitlement. However, that is not the only initiative on which we have been working together. For instance, I recently announced an ex-offenders pilot scheme, which will provide enhanced employment support and help with access to universal credit in order to lift people out of the cycle of reoffending.
Solicitors in my constituency have told me that the DWP is refusing to supply written confirmation in the precise legal format that is required for legal aid applications made by people on universal credit. It is a case of one Government body refusing to comply with the rules of another. Is the Secretary of State aware of how deep these problems go, and will she ensure that no universal credit claimant misses out on legal aid because the DWP cannot follow the rules of the Ministry of Justice?
I am surprised to hear that question from the hon. Lady. According to my experience and the evidence that I have received during my conversations with the Ministry of Justice, there is no problem and it has been possible to passport in the same way. I hope that that will continue, but, as the hon. Lady knows, the Ministry of Justice is conducting a review. If she will write to me about that particular case, I will look at it myself.
Finally, on the matter of plumbing and pensions, Mr John Mann.
Pension Liabilities: Plumbing Industry
I met plumbing representatives from Lancashire recently, and those in Angus and Perth last year. We also debated this matter in the House last year. There are nearly 1,000 last man standing multi-employer schemes. Most respondents to the Green Paper on defined-benefit pensions felt that the current buy-out basis was a clear and fair way in which to calculate an employer debt.
My constituent Margaret Briggs, having paid £21,000 over 11 years with four employees into a pension scheme, has in the past four weeks received a demand for £331,000. How is she expected to pay this, and how can that possibly be rational and fair?
I cannot speak on the specifics of the individual scheme, but the majority of the employers in these schemes are incorporated and are not personally liable for any debt. The flexible apportionment arrangement can be used to help unincorporated employers who wish to incorporate, and the plumbing pension trustee has a streamlined flexible apportionment arrangement process that employers can use. Alternatively, where the employer debt arises in multi-employer schemes as a result of an employer cessation event, there are a number of mechanisms in the occupational pension schemes employer debt regulations that can be of assistance
I think that is the technical term.
Now that we have moved from the design to the implementation of universal credit we continue to seek ways to ensure that it is a fair, compassionate benefit that takes account of people’s circumstances. I know that there have been concerns across the House about how overpayments of benefits that result from fraud or error are recovered from claimants, and I pay tribute to the hon. Member for High Peak (Ruth George) and my hon. Friend the Member for South Ribble (Seema Kennedy) for alerting me to this issue.
I am able to announce today that in cases where a claimant has been convicted of defrauding the Department and their only considerable asset is their home, we will take account of this prior to instigating Crown court proceedings to recover assets under the Proceeds of Crime Act 2002. This ensures a proportional response that should not result in the claimant having to subsequently apply to the Department for housing benefit. We believe this provides the right balance between pursuing what is owed to the Department while acknowledging the deprivation debt recovery can cause some claimants.
I had intended to ask another question, but I want to refer to the answer given to me by the Minister for Disabled People, Health and Work; he is a very serious Minister but gave a very disappointing answer worthy of Sir Humphrey. The fact is that my constituent Lacey-Rose Samaanthy, who is deaf, was offered a job by the NHS in mid-Essex; I saw the letter. That job offer was then rescinded because they said it was too difficult. She then got another very similar job in another organisation and it was able to adapt to her needs. This sort of thing should not be happening; it is incredibly unjust, and I want to know what the Department is going to do about it by being humane and showing compassion to my constituent.
I thank my right hon. Friend for being such a great champion of people with disabilities and tackling the challenges they have in the workplace, and I must say that the example he has given is very disappointing, because we would always hope and expect employers to show compassion and support where they have applications and the opportunity to employ disabled people. The work that this Government are doing will always try to address that, and with my right hon. Friend’s help we will make sure we get it right.
The two men competing to be the next Prime Minister have both said they would be willing to push through a catastrophic no deal. That is despite long-running warnings that disabled people will be hit hard by a no deal, with risks to vital medical supplies and the recruitment of care workers and the loss of the European social fund. However, last week Ministers revealed that the Government have not carried out any assessment of the impact of no deal on disabled people, so will the Minister commit to carrying out such an assessment, and could he in good conscience be part of a Government who pushed through such a reckless act?
The hon. Lady may be aware that I have some concerns about no deal; I would much prefer that this country chooses to leave the European Union on the basis of a deal, and I am hopeful that when we have a new leader in place we will be able to arrive at that position, possibly even with the support of the hon. Lady, to try to ensure that we get an exit that supports disabled people as well as everyone else.
I thank my hon. Friend for the energy with which he is supporting his constituents on universal credit. One of the key performance indicators is, of course, payment timeliness, which has improved significantly over the past couple of years, and that progress is matched in Alloa jobcentre. His local jobcentre staff will be happy to interact with him and, of course, I am also happy to meet him.
I thank the hon. Gentleman for his work in this area, and I reassure him that there have been several meetings with Marie Curie on this subject. I will take an interest in the report that is coming out on Wednesday, and I can tell him that we are once more looking at this matter again.
As my hon. Friend knows, more people are in work now than ever before. Indeed, the employment rate is higher in every region of the country than in 2010, including in the Black Country. Specifically, he may already be aware that Willenhall jobcentre is working closely with major employers on employment opportunities and, of course, that our mentoring circles programme is being rolled out for 18 to 24-year-olds to help them increase their employability skills.
I am taking this case very seriously, and I have had the right hon. Gentleman’s letter. At the moment, we are doing an internal inquiry, and if the right hon Gentleman will leave that with me, I will come and talk to him if anything additional is required.
I thank my hon. Friend for highlighting such a fantastic proactive example that is making a real difference, and I support anything further that we can do. The number of applicants to the Access to Work programme with a learning disability increased by 22% in the last year alone. That is an encouraging trend, and we must do much more in this important area.
I saw the report, which was published last week, and noted the findings on page 15 and the four recommendations, many of which we are already doing. Whether through jobcentres, third parties, local authorities or our various other communications, we want more people to be claiming pension credit, and we are trying to do everything possible to make that happen.
Last week I had a meeting with a Parkinson’s support group in my constituency and was told about the many struggles that sufferers face. Will the Minister review the 20-metre rule, so that more people with Parkinson’s who have mobility problems can qualify for essential support, such as the blue badge scheme?
I thank my hon. Friend, and I would be happy to meet her to discuss this further. It is a rule of thumb, but we have to look at whether somebody can repeatedly, regularly and safely travel 20 metres. I welcome the fact that, under PIP, 55% of those with Parkinson’s qualify for the highest rate of support.
I understand why the hon. Lady raises that question but, under DLA, only 15% of claimants actually got the highest rate of support, whereas the rate under PIP is now 31%. One of the key things is that 70% of DLA claimants were on lifetime awards, yet one in three claimants’ condition had significantly changed within 12 months and they would have been entitled to a different rate—predominantly a higher rate, rather than a lower rate—and we do not want people to miss out. That is why, under PIP, we are now spending an additional £6 billion a year to support some of the most vulnerable people in society.
There has recently been a noticeable increase in the number of my constituents in receipt of personal independence payment who, on reassessment, have had it stopped or reduced. Will my right hon. Friend agree to meet me to discuss this worrying trend and to see what we can do to sort it out?
I would be happy to meet my hon. Friend. We work closely with stakeholders to look at how we can continue improving the system, but I repeat that we are now spending an additional £6 billion and that a significantly higher rate of claimants are now on the highest level of support, and rightly so.
I thank the hon. Lady for raising this question, and I am mindful of the Select Committee report that addressed some of it. We have now made changes so that women going into work for the first time from benefits—either universal credit or a legacy benefit—will be able to access advance payments for that first month so that they do not have to find the money themselves. I am making sure that work coaches have more independence to support people back into work; that is one of the changes I have made.
Can my hon. Friend tell me whether poverty has risen or fallen since 2010?
I thank my hon. Friend for that question. The Government remain committed to tackling poverty so that we can make a lasting difference to long-term outcomes. I am pleased to say that the Government have lifted 400,000 people out of absolute poverty since 2010, and income inequality has fallen.
We have made substantial responses to Philip Alston’s report. We have acknowledged some of his suggestions, and we will look at changing our assessments on poverty by using the Social Metrics Commission’s proposal. Otherwise, we are disappointed by the very political nature of his approach.
I would not want the hon. Gentleman to feel socially excluded.
Will the Secretary of State confirm that, when fully rolled out, spending on universal credit will actually be £2 billion a year higher than is currently spent on the equivalent legacy benefits, and that this will be worth some £300 a year to each recipient family?
I can confirm that, and it is refreshing to be able to point out that universal credit is, compared with the legacy benefits, a more generous, more effective and better-targeted system, and it is also better funded.
My 16-year-old constituent has a severe hearing impairment and has been on DLA since the age of three. My constituent has recently been reassessed and is now receiving no support whatsoever. How do the Government justify such decisions?
Without having the full facts of a case it is difficult to comment, but I am happy to look into that specific one. When we compare DLA with PIP, we are talking about an additional £15.04 of benefit support a week per claimant.
On a point of order, Mr Speaker.
Okay, I will take the point of order now. The hon. Gentleman has been jumping up and down like a veritable Zebedee, and so I shall accommodate him on this occasion, but I advise him that in the ordinary course of events points of order tend to be taken after statements. [Interruption.] It is not obligatory, and the Secretary of State for Health and Social Care can wait for his statement. I know he has all sorts of other activities in which he wishes to be busily engaged, but I am afraid he will have to wait.
On a point of order, Mr Speaker. Thank you very much for finding the time for this. I am standing next to the Leader of the Opposition, whose fitness is legendary. I wonder whether you have received an application by a Minister to make a statement to the House on the principle of civil service neutrality. I ask following the undemocratic and unconstitutional public intervention attributed to senior civil servants and based on a falsehood printed in Saturday’s The Times. No doubt you will agree that since the 1854 Northcote-Trevelyan reforms the professionalism and objectivity of our public servants has been admired throughout the world, and it is a cornerstone of our democracy. But there must be no hesitation at all in condemning the kind of behaviour reported, and I would hope that the Government will root out any miscreants who have behaved in this way. Finally, I wonder whether you can do anything to encourage Ministers, if they have not already approached you, to make a statement in the House or arrange time for a debate about this very important principle.
I am very grateful to the hon. Gentleman for his point of order. I have not received any indication that a Minister is planning to make an oral statement in the House on this matter, although it is perfectly open to a Minister to offer to do so. The Northcote-Trevelyan principles are of the utmost importance, and I hope they will be upheld by Governments indefinitely. They have existed for a long time because the principles involved—permanence, anonymity and neutrality—are absolutely sacred. I simply suggest that the hon. Gentleman pursues the matter with his characteristic persistence and vigour, and I feel sure that, using the Order Paper and the resources provided by the Table Office, he will be happy to do so.
On a point of order, I just want to reassure the House that we have complete confidence in the fairness and independence of the civil service. It has said that it will respond and I frankly question the good judgment of the shadow Minister for bringing this up in the House at this stage, before it has had the chance to do so.
I do not want to dwell on this matter. Suffice it to say that the Leader of the Opposition looks perfectly healthy to me; I have known him a long time and he is a very healthy-living fellow in my experience. On a serious note, I do think that the convention is sacred and it really should not brook of any dispute across the House. It might be best to leave it there. I gently suggest to the hon. Gentleman that he has made his point with considerable lucidity and let us leave it there.
We come now to the statement from the Health and Social Care Secretary, which he has been eagerly awaiting. I know that he will want to deliver his own words with every ounce of aplomb at his disposal. I call Secretary Matt Hancock.
NHS Long-Term Plan: Implementation
Mr Speaker, I would like to update the House on the implementation of the NHS long-term plan and the delivery of improvements to the health service. Today marks the 100th anniversary of the Ministry of Health, founded under the Liberal and Conservative coalition of Lloyd George, and the Department has been staffed by brilliant, impartial civil servants ever since, and is today.
I can tell the House that on Thursday last the boards of NHS England and NHS Improvement agreed the long-term plan implementation framework. Alongside the clinical review of standards, and the interim workforce plan, published last month, this framework is a critical step in delivering on our 10-year vision for the NHS, and in transforming our health service with the record funding that this Government are putting in. The document sets out the framework within which each of the 300 commitments in the long-term plan will be delivered, and it also sets out the 20 headline commitments and how we will monitor the delivery of the plan. In the past, there have been criticisms that NHS plans have not led to full delivery. We are determined to ensure that the long-term plan fulfils its potential to transform the health service for the better, and I am placing a copy of the implementation framework in the Libraries of both Houses.
I wish to draw attention to three particular areas, the first of which is cancer care. I thank my hon. Friend the Member for Basildon and Billericay (Mr Baron) for his efforts to ensure that we focus on the vital indicator of cancer survival. The Prime Minister set out the ambition that by 2028 three quarters of all stageable cancers are detected at stage 1 or stage 2. Early detection and diagnosis are essential to the enhancement of people’s chances of surviving cancer.
Since 2010, rates of cancer survival have increased year on year. However, historically our survival rates in the UK have lagged behind the best-performing countries in Europe. The implementation framework sets out our goal of measuring the one-year cancer survival rates as one of the core metrics for the long-term plan. The one-year survival rate is how we measure our progress in achieving the ambitions set out in the plan. To realise those ambitions and ensure that we do everything we can to give people diagnosed with cancer the best chance of survival, the framework sets out: first, a radical overhaul of screening programmes; secondly, new state-of-the-art technology to make diagnosis faster and more accurate; and thirdly, more investment in research and innovation.
From this year, we will start the roll-out of rapid diagnostic centres throughout the country, building on the success of a pilot with Cancer Research UK, so that we can catch cancer much earlier. NHS England is further extending lung health checks, targeting areas with the lowest survival rates, and Health Education England is increasing the cancer workforce, which will lead to 400 more clinical endoscopists and 300 more reporting radiographers by 2021. With these steps, our ambition is that 55,000 more people will survive cancer for five years, each year from 2028. Improving the one-year survival rate is how we ensure that the NHS remains at the forefront of cancer diagnosis and treatment and continues to deliver world-class care.
The second area is mental health. The Prime Minister and her predecessor rightly prioritised the treatment of mental health so that we can ensure that mental health finally gets parity with physical health. The £33.9 billion cash-terms settlement, which is the longest and largest cash settlement in the history of the NHS, includes a record £2.3 billion extra in real terms for the expansion of mental health services. The framework sets out how 380,000 more adults and 345,000 more children and young people will get access to mental health support. I pay tribute to the mental health Minister, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Thurrock (Jackie Doyle-Price), who has done so much work to put the issue on the agenda.
We are introducing four-week waiting-time targets for children and young people and testing four-week community mental health targets for adults. The implementation framework refers specifically to the vital improvements to community mental health services that we all know are needed. Those improvements include services for adults living with serious mental disorders, including eating disorders, and for those coping with substance misuse. The framework also sets out how we will create a new workforce of mental health support teams to work with schools and colleges to help to identify young people who need help and reach them faster. In all, it is a fundamental shift in how we treat mental illness and how the NHS will prioritise mental health services.
The third area that I wish to touch on is people. Three quarters of the NHS budget goes on staff, because people are the most valuable resource that we have in the NHS. We need not only the right numbers but to ensure that staff have the right support. The long-term plan sets out our ambition to recruit, train and retrain the right numbers of staff over the next decade. Last month, Baroness Dido Harding set out the interim people plan, which sets out how we will build the workforce we need and create the right culture, so that doctors, nurses and other NHS staff have the time to care for patients and for themselves.
Last week, the British Medical Association accepted in a referendum the new agreement with junior doctors that will improve both pay and working conditions. Thanks to the hard work of my predecessor, we are already taking steps to increase the number of clinical training places by opening five new medical schools and increasing the number of routes into nursing through apprenticeships and nursing associates. Last year, more than 5,000 nursing associates started training through apprenticeships. This year, it will be up to 7,500.
Those are just three of the most vital areas from the 10-year vision for the NHS set out in the long-term plan. Across England, based on the implementation framework, local strategic plans are now being developed and will be brought together as part of a national implementation plan by the end of the year, and all of this will be underpinned by technology. Today sees the official opening of NHSX, the new part of the NHS, which will drive digital transformation to give citizens and clinicians the technology they need and save and improve lives. I am delighted that NHSX has received such a warm welcome across the NHS because it has so much potential to transform every part of health and social care for patients and staff.
The forthcoming spending review will settle budgets for health education, public health and NHS capital investment, and the settlements will feed into the final implementation of this plan. As part of the spending review, we will also review the current functioning and structure of the better care fund, which is rising in line with NHS revenue growth.
On this the 100th anniversary of the foundation of the Ministry of Health, this framework sets out how we will go about securing the foundations of the national health service into the next century and the creation of an NHS that delivers world-class care for generations to come. I commend this statement to the House.
I am grateful to the Secretary of State for an advance copy of his statement. I had hoped for a greater sense of urgency from him. He talks about the 100-year anniversary of the Ministry of Health, but this year is the first time in 100 years that the advances in life expectancy have begun to stall, and even go backwards in the poorest areas. Just the other week, we saw that infant mortality rates have risen now for the third year in a row. As this is the first time that they have risen since the second world war, I would have hoped for a greater focus on health inequalities in his statement today, not least because public health services—the services that, in many ways, lead the charge against health inequalities—are being cut by £700 million. Now he says that we should wait for the spending review for the future of public health services, but we do not know when the spending review is. The Chief Secretary to the Treasury has said that it will be delayed, so it could be next year.
In the past, the Secretary of State has talked about a prevention Green Paper. Will that prevention Green Paper be before the spending review or after the spending review? Will he also tell us whether it is still the intention of the Department to insist that local authorities fund their public health obligations through the business rates?
At the time of the publication of the long-term plan last year, the then Secretary of State for Health said that we cannot have one plan for the NHS without a plan for social care, yet we still have no plan for social care. We have been promised a social care Green Paper umpteen times. We are more likely to see the Secretary of State riding Shergar at Newmarket than see the social care Green Paper. Where is it?
The Secretary of State talks about the better care fund revenue increase. May I press him further on that? Is he saying that the clinical commissioning group allocations to the better care fund, which tend to be the bulk of the better care fund, will increase in line with the NHS revenue increase, or is he saying that there will be new money available for the better care fund? Adult social care has been cut by £7 billion since 2010 under this Tory Government, which is why hundreds of thousands of elderly and vulnerable people are going without the social care support that they need. Presumably, we will have to wait for the spending review for proposals on social care.
The Secretary of State talks about the workforce. We have 100,000 vacancies across the NHS. We have heard about the interim people plan, but of course we have seen the bursary cut, the pay restraint, and the continuing professional development cut. That plan is all good and fine, but when will it be backed up by actual cash?
The Secretary of State talks about IT systems and apps—we know that he is very fond of that—but again he gives us no certainty on capital investment. Hospitals are facing a £6 billion repair bill—ceilings are falling in and pipes are bursting. The repair bill designated as serious risk has doubled to £3 billion. When will we have clarity on NHS capital?
We broadly welcome what the Secretary of State said about mental health, but 100,000 children are currently denied mental health treatment each year because their problems are not designated as serious enough, and over 500 children and young people wait more than a year for specialist mental health treatment. He talks of a fundamental shift, so can he guarantee that clinical commissioning groups will no longer be allowed to raid their child and adolescent mental health services budgets in order to fill wider gaps in health expenditure? On mental health resilience and prevention, only 1.6% of public health budgets is currently spent on mental health, so will he mandate local authorities, when setting their public health budgets, to increase the money they spend on mental health?
On cancer, we broadly welcome what the Secretary of State has said, but patients are waiting longer for treatment because of vacancies and out-of-date equipment. Today we learned that consultant oncologists with shares in private hospitals are referring growing numbers of patients to those hospitals. Is that not a conflict of interest? When will we see tougher regulation of the private healthcare sector?
The Secretary of State talked about the clinical review of standards that is being piloted in 14 hospitals, yet those hospitals are not publishing the data. If he wants to abandon the four-hour A&E target, will he insist that those pilot hospitals publish all the data? He did not mention waiting lists. We have seen CCGs rationing treatment because of the finances. We have seen 3,000 elderly people refused cataract removals. We have seen CCGs refusing applications for hip and knee replacements. We have even seen a hospital that until last week was inviting patients to pay up to £18,000 for a hip or knee replacement—procedures that used to be available on the NHS. When is he going to intervene to stop that rationing of treatment, which we are seeing expand across the country because of the finances?
Finally, there are many laudable things in the long-term plan that we welcome. Alcohol care teams were a Labour idea. Perinatal mental health services were a Labour idea. Gambling addiction clinics, which the Secretary of State announced last year, were a Labour idea. Today he is talking about bringing catering back in-house, which is also a Labour idea. Why does he not just let me be Heath Secretary, and then he could carry on being the press secretary for the right hon. Member for Uxbridge and South Ruislip (Boris Johnson)?
Well, it is great that by the end of his questions the hon. Gentleman finally got to the future of the NHS, which is what we are here to discuss. However, what I did not hear—unless I missed it—was a welcome for the extra £33.9 billion that we are putting into the NHS. I did not hear him welcome the fact that life expectancies are rising, or our plan to drive up healthy life expectancy still further. I did not hear him say whether the Labour party supports our efforts to ensure that the NHS is properly funded and supported not only now but into the future, because that is what this Government are delivering.
I will go through some of the questions that the hon. Gentleman did raise. He asked about the prevention Green Paper. Indeed, he will know that preventing people getting ill in the first place is a central objective of mine, and it will be forthcoming shortly. He mentioned the better care fund. I was very precise in what I said about the better care fund, because its funding is rising in line with NHS revenue growth. In fact, the overall funding available to deliver social care in this country has risen by 11% over the past three years. Of course there is more to do to ensure that we have a social care system that is properly funded and structured to ensure that everybody can have the dignity of the care they need in older age, and that people of working age get the social care they need, but the Labour party ought to welcome the increase in funding, as well as the aim of ensuring that we get the best possible value for every pound.
The hon. Gentleman mentioned the clinical review of standards, which he welcomed when it was announced recently. The pilots that he mentioned started just four weeks ago, and of course we will be assessing the results and ensuring that we get the right structures in place in future. I am glad that he welcomed it, but in relation to publishing data, after just four weeks it is unsurprising that we are still in the early stages.
The hon. Gentleman asked me to ensure that the increase in funding for mental health will happen and that CCGs will be required to see that increase flowing through to make sure that patients get better service. I can confirm that NHS England is already intervening. The £2.3 billion increase that we have set out in the long-term plan will be required to flow through to the frontline. This implementation framework is part of the system that we are putting in place to make sure that that happens.
I very much welcome the Secretary of State’s announcement on putting the one-year cancer metric at the very heart of cancer services as a means of encouraging earlier diagnosis. You will be well aware, Mr Speaker, that the all-party parliamentary group on cancer has long championed the need to put this metric at the very heart of our services in order to encourage earlier diagnosis. The inconvenient truth is that despite the best will of those on both sides of this debate on the need to focus on process targets, we have failed to close the gap on international averages in our cancer survival rates. I chaired the APPG for 10 years, and I know that the current chair, the hon. Member for Scunthorpe (Nic Dakin), is waiting to speak as well. Will the Secretary of State ensure that sufficient funds are allocated to the one-year metric, because history would suggest that this metric has been there, or thereabouts, in the mix before, but because the money has been attached to the process targets, local NHS systems have ignored it?
I pay tribute to the work that the APPG, so ably led, has done in putting the measurement of improvements of cancer at the forefront of the debate. I particularly acknowledge the point about early diagnosis. Here in the UK, we are one of the best countries in the world at treating cancer once it is diagnosed, but we are behind the curve on early diagnosis. Putting a one-year cancer diagnosis metric at the heart of the implementation of the long-term plan is a critical step in making that happen. What is going to happen now is that each of the local systems will feed into the framework in terms of how they will be putting this into action. The full implementation plan, which will be published shortly after the spending review, will take that into account, as well as all the budgets that need to be settled in the spending review. I would recommend to my right hon. Friend—my hon. Friend—[Interruption.] Just for now. I recommend that he keep up this campaign, because we have made significant progress in the implementation framework but there is still more to do.
The hon. Gentleman was temporarily elevated to the Privy Council by his right hon. Friend on the Treasury Bench. He might—who knows?—regard that as an earnest of what is to come.
There is no reference to GPs in the statement—I have just been looking through it. This comes at a time when my constituents are telling me that they are having to wait three weeks to get a GP appointment. Faith House GP surgery on Beverley Road, which I have raised with the Secretary of State directly, is now due to close. It is all very well training doctors for the future, but what is he going to do about the crisis in primary care now?
I picked out three of the 20 areas that we are particularly focused on in this implementation framework, one of which is the number of GPs and the broader primary care workforce, because it is not just about GPs but about all those who also support primary care across the board. We have a clear target of 5,000 more GPs, based on the 2015 baseline. We have a record number of GPs in training. Last month, the Minister for Health, my hon. Friend the Member for Wimbledon (Stephen Hammond), announced the consultation on changes to the pension to remove some of the unintended consequences of pension tax changes for GPs to ensure that we retain our highly trained, highly qualified GPs. There is a whole load of work in the people plan being led by Baroness Dido Harding to make sure that we have the number of GPs that we need and the wider primary care health workforce that is necessary.
As my right hon. Friend said, the first Minister of Health was Christopher Addison, then a Liberal, who abolished his position as President of the Local Government Board to succeed himself as the first Minister of Health in 1919, but the first Secretary of State to hold up a White Paper saying “national health service” was the Conservative Sir Henry Willink in 1944. We must give credit to the Labour party for bringing in the health service, agreed by the coalition Government, in 1948, although we have to recognise that Aneurin Bevan decided to nationalise the hospitals and not the GPs, when most people expected it to be the other way round.
In the experience of my wife, who did five years as Minister for Health and Secretary of State for Health, we should be praising all those who support the clinicians—the support workers, administrators and others who help doctors, nurses and other professionals—to look after us at all stages of our lives. We must have the extra money. I am glad that we have gone beyond the Labour party’s ambitious targets to meet our own ambitious targets, and that we can look forward to doing more, because we have to recognise that health will require a greater proportion of our wealth as we live longer and want better services.
I wholeheartedly agree with the entirety of what my hon. Friend said. It is true that for the majority of its 71-year history—71 this week—the NHS has been run by Conservative Secretaries of State, and the largest cash injections have come from this party. It is a truly national institution that we should all support, and we have to support not only the doctors, who lead many parts of the NHS, and the nurses, but all the health service staff, because it is a true team effort.
The Secretary of State may remember that I brought a group of mental health reformers to see him, to make the case for culture change in mental health services to address clear human rights abuses such as locking people up when they do not need to be locked up, often for a long period, shunting people around the country in ways that would never happen with physical health and the endemic use of force in mental health services. We argued that ending inappropriate institutional care would free up money for better prevention and early intervention. He said he loved that approach. Is he doing anything to actually implement it?
Yes. First, in terms of the review led by Simon Wessely of the legal powers set by the Mental Health Act 1983, there will be a Government response and then legislation in due course. We want to get that legislation right and bring it forward on an open basis, to ensure that we get a consensus behind it before introducing it formally to the House. On the administrative side, a programme of work is under way to deliver exactly what the right hon. Gentleman mentioned. In my statement, I specifically referenced the expansion in community mental health services that must happen, which will be good value for money and, of course, much better for many patients.
Ah, a veritable galaxy of parliamentary celebrities from whom to choose.
I felt that my right hon. Friend’s announcement deserved a more enthusiastic response than the uncharacteristically churlish one it received from the shadow Health Secretary. In terms of mental health, I particularly welcome the introduction of four-week waiting time targets for children and young people, because I know how much distress has been caused to many of my constituents by undue delays in the assessment and treatment of young people with mental health problems. Can he tell the House when he plans to implement those new waiting time targets and how he will keep pressure on CCGs, so that the benefits are seen on the ground as soon as possible?
I thank my right hon. Friend for his question. The shadow Secretary of State is so nice behind the scenes that he sometimes has to get a bit spiky in public, just to prove to his masters in the Leader of the Opposition’s office that he is on their side.
Over the rest of this year, we will deliver the plan to ensure that these targets are put in place. The truth is that we can only manage what we measure, and having a target for access to mental health services and pilots on how we do that for children’s health services is an incredibly important part of ensuring that the system lines up behind the rapid availability of mental health services, which, as I imagine every Member knows from constituency casework, is critical.
I very much welcome the ambition of this plan, the recognition that it will need appropriate resources—it very much needs appropriate staffing, because the human resource is most important—and the emphasis on cancer and early diagnosis. May I ask the Secretary of State how he will ensure that improvements in early diagnosis for less survivable cancers are central to the target to diagnose 75% of cancers at stage 1 and stage 2? There is a concern that the less survivable cancers will get neglected, given the nature of the plan at the moment.
I am grateful to the hon. Gentleman for the tone that he takes, and he is absolutely right in his analysis. I know he met the cancer Minister, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for South Ribble (Seema Kennedy), last week on this point. We absolutely will address it, and we will not miss the less survivable cancers. Indeed, the focus on early diagnosis will of course help survivability, but it is also a focus across all cancers equally, rather than just on those where survivability has improved so much.
This long-term plan for the NHS has been developed by the NHS, not imposed by Government. Does my right hon. Friend agree that this sets the plan apart and means it is much more likely to work for staff and patients alike?
Yes, my hon. Friend is absolutely right. The plan is of the NHS by the NHS for the NHS. We in Government will absolutely facilitate it and support it, and of course we are putting in the money, but the NHS as a whole should be very proud of what this plan proposes and the way the implementation is being done in such a rigorous fashion.
May I press the Secretary of State a little further on the section of the plan that relates to prevention and early intervention? We are all waiting still for the prevention Green Paper. In particular, there are some diseases and illnesses, such as stroke, where apparently four out of five cases could be prevented by such early action, whether it is diagnosis of atrial fibrillation, or blood pressure and cholesterol testing devices. What more can be done for this Government to show they are serious about preventing ill health, such as stroke?
I completely agree with the hon. Gentleman. The whole plan—the whole NHS long-term plan—is about prevention as well as cure. The focus of the NHS needs to switch more towards prevention as well as, of course, helping people get better when they get ill. Taking the example of stroke, there is a lot on the prevention of stroke in the draft prevention Green Paper—just to give him a bit of a teaser for that. At the core of improving prevention of stroke is both behaviour change but also better use of data, because being able to spot people who have symptoms that are likely to lead to stroke can then help much more targeted interventions. I find it striking that with the big stroke charities, as with the big heart charities, their big ask is for better and more access to data.
May I thank my right hon. Friend for his statement and his commitment to this implementation plan, alongside the commitment to increase clinical standards? That is not a criticism of the medical professions; it is just a determination to make sure that the NHS is an infinite learning organisation and can learn from its mistakes. In that respect, will he recommit to HSIB—the healthcare safety investigation branch of his Department—which is devoted to doing clinical investigations without finding blame, so that these problems can be surfaced and the learning can be implemented across the NHS? In particular, will he recommit to the legislation, which has been through prelegislative scrutiny and is still waiting to be introduced?
Yes, I am looking forward to that legislation being introduced. The work that my hon. Friend’s Select Committee—the Joint Committee on the Draft Health Service Safety Investigations Bill—did in the prelegislative scrutiny was incredibly important. The HSIB Bill promises to improve patient safety, which is an important part of the agenda, and I look forward to its being brought forward to the House.
I have recently become the vice-chair of the all-party parliamentary group on sickle cell and thalassaemia. Sickle cell is very much a hidden disability which is lifelong. Some people take up to five medications a day, which is very costly. If they have a relapse, they can be hospitalised, but it is more cost-effective and preventive to have free prescriptions than to end up in hospital. Will the Secretary of State review the matter and do what is both best for those patients and in the public interest?
I will certainly look at the matter. When I was on a night shift with a London ambulance crew, we attended a patient who suffered from sickle cell, and it was horrific to see the degree of pain that they were in. I have therefore seen at first hand exactly how horrific the condition can be and I will look into the hon. Lady’s suggestion.
I was delighted to be able to show the Secretary of State the health and wellbeing hub in Budleigh Salterton and the opportunities at Ottery St Mary community hospital, and that he confirmed that both places had a role to play in the future of health provision in East Devon. However, last week, the National Audit Office found that community hospitals and GP surgeries were struggling to pay the rents charged by NHS Property Services and that, nationally, outstanding debt has almost tripled since 2014 to £576 million. If my right hon. Friend is interested in securing a legacy before he moves on to even higher political office, will he please look at that, particularly in advance of the review planned for 2021?
I certainly will. I also draw my right hon. Friend’s attention to an announcement, which we made last month, to allow local hospital trusts to request property from NHS Property Services so that it can be transferred to the trusts if it can be used better and more flexibly locally, in the way that the hub I saw at Budleigh Salterton absolutely delivers. I can also see such an opportunity for the potential hub at Ottery St Mary, which was a community hospital and has enormous promise for delivering services closer to the community.
I thank the Secretary of State for the statement and the substantial moneys that the Government have committed to the NHS long-term plan, particularly given the need for the cancer strategy to be fully implemented. On rare diseases, will he confirm that drugs such as Orkambi, Spinraza and medicinal cannabis will be simple to apply for and accessible for those who desperately need them now, when time is not on their side?
I understand the importance of those drugs. Each one is in a slightly different part of the process. We have opened up availability of medicinal cannabis. Indeed, I was talking this morning to the head of NHS England to ensure that our plans to normalise access to medicinal cannabis for those with a clinical need for it can be brought forward. The hon. Gentleman should expect to hear more news soon on the progress that NHS England and the National Institute for Health and Care Excellence have made. On Orkambi, we are still engaged with the company, Vertex, to try to bring that to patients in a cost-effective way. I greatly hope that Vertex will make some progress.
It has been great to hear my right hon. Friend mentioning the new medical schools. The one in Chelmsford is fantastic. It is 12 times oversubscribed for next year—we would love an increase in places. It was lovely to meet three of the medical students last week, when they raced across the high street to have selfies taken with my right hon. Friend’s predecessor.
We are also doing well on nurse apprenticeships, but there is an issue, especially with mature students coming in to study adult nursing. Will my right hon. Friend look again at how to give them financial assistance?
I thoroughly enjoyed visiting my hon. Friend’s local medical school and seeing the expansion that has taken place. The two of us walked into a room occupied almost entirely by dead bodies, which was quite an experience. [Interruption.] It was nothing like this place. On the specific and substantive questions she asks, we are looking at the funding for both the expansion of medical schools and how we ensure that we get the nurses we need into the profession. That will be part of the spending review process with the settlement of the budget for Health Education England.
Having been diagnosed earlier this year with a stage 3B melanoma, I always get a bit sweaty when people start talking about how important it is to have early diagnosis to ensure survival rates, but of course they are absolutely right. The number of people, in particular men, with melanoma is rising and people are still dying. I have heard horrific tales of people going to GPs five, six or seven times before a GP was able to send them on to see a dermatologist. I have heard about dermatologists saying, “I’ll look at this mole here, but I’m not going to look at that one because you haven’t been referred for that one. That will have to be a separate referral.” I have heard of people waiting six or seven weeks for histopathology to come back. All those things delay the process. Do we not need to have a wholesale approach to melanoma to ensure that we save more people’s lives?
Yes, the hon. Gentleman is absolutely right. I agree with what he says. There is a need for the whole medical profession to be constantly up to date with the latest treatment and diagnostic science. I am determined that part of the drive for early diagnosis is about not just diagnosis once referred, but better referral. We all have a part to play in that—wider society, as well as primary care.
Many people in my constituency find it difficult to obtain NHS dentistry. While that is part of the short-term plan, on the ambitions outlined in the plan for long-term improvements to oral health, what assurance can the Secretary of State give that NHS dentists will be in place to deliver them?
NHS dentistry is incredibly important. Ultimately, dentistry is part of prevention; it prevents oral ill health. We are doing a lot of work on what further we can do to support oral health. In fact, I had a meeting with the Minister with responsibility for public health on that subject this morning. I would love to meet my hon. Friend to discuss it further.
The Secretary of State clearly identified three critical areas for improvement to cancer survival rates. He is absolutely right about early diagnosis. I do not want to make my hon. Friend the Member for Rhondda (Chris Bryant) any more sweaty than he already is, but it cannot be repeated enough times that spotting these issues early on is critical to improving survival rates. The Secretary of State is also right about the importance of mental health. The third point he touched on was that the workforce is key to underpinning all this. In that regard, does he know how many specialist mental health and specialist cancer nurses we will have at the end of the 10-year period?
The answer to that question is being worked on as part of the people plan, which Baroness Dido Harding is putting together. We published the interim plan last month. The full people plan will be available after we have settled, in the spending review, the budget of Health Education England. The hon. Gentleman raises an incredibly important point.
I very much welcome the plan, with £33.9 billion being committed by 2022-23. My concern is slightly where the money is going to come from. I wonder whether my right hon. Friend has had assurances from the Treasury that that will indeed be the case. With all the other pressures on spending and revenues in the coming years, that might be a little difficult. We have to find ways to ensure that the revenue is there because this money must be spent.
Yes, it will in all circumstances. This is a firm commitment, supported right across this House and right across our party, and it will be delivered. There is absolutely no question about that.
We know that areas of greater deprivation have greater health needs than other areas. Will the Secretary of State tell us what more there is in the long-term plan specifically about increasing the resources for GP practices that serve areas of greater deprivation? They have longer waiting times and greater vacancy lists and we need specific action to support those practices.
Making sure that we have the right allocations for CCGs across the country that reflect the needs of the local population is a very important responsibility for NHS England—as the commissioner of those services—to make sure that the money follows need. After all, the principle of the NHS is that it is available to everybody according to need, not ability to pay.
We all know that the Secretary of State is a great fan of technology and of improving the mental health of young people, and all people across the country. In my constituency, a man called Richard Lucas has set up a new online system called govox, which is a revolutionary, technologically enabled way of improving mental health among young people. Will the Secretary of State advise the House how innovative new technological solutions at a local level can best get into CCGs and the local NHS, so that we can improve mental health for everybody?
My hon. Friend has raised with me before the new technology developed by Mr Lucas. A new technology such as this can be picked up by all sorts of different parts of the NHS—by different CCGs or mental health trusts—which can then use it. One of the reasons that we have brought in NHSX, which opens today, is to make sure that there is a central place to which people with a good idea for how to improve the health of the nation by using technology can go to find a way into the NHS, so that great practice and good technology can be promulgated across the NHS as quickly as possible.
Speaking of revenue, what is the Secretary of State’s attitude to NHS trusts that set up subsidiary companies, if one of the main motives is clearly seen to be VAT avoidance, as in the case of Bradford trusts where nearly half the extra revenue of setting up a company in the first five years would be VAT-related?
If the hon. Gentleman writes to me with the specifics of the case, I will be very happy to look into it. The use of subsidiaries in the way that he described in principle has been available to NHS organisations for some time, and I am very happy to take up the case that he asked about.
I strongly welcome the 10-year plan and particularly what the Secretary of State said about apprenticeships, and I urge him to push more degree apprenticeships in the NHS. If it is right to have a 10-year long-term plan for the NHS in England, does he agree that we also need a long-term NHS plan for my constituency of Harlow? The only way that we can achieve that is by having a new hospital health campus. He has visited our hospital and realises that it is not fit for purpose.
Few people make the case for their constituencies better than my right hon. Friend, and nobody makes the case for Harlow better than him. He invited me around Harlow hospital. I went into the basement to see some of the work that is needed, and the basement of Harlow hospital is in a worse state of disrepair than the basement of this building. That means that it needs work, so I am considering his proposal. The future NHS capital budget will be settled in the spending review, so I suggest that he has a conversation with Treasury Ministers as well. I look forward to seeing the case progress.
My right hon. Friend is also right about how important degree apprenticeships are. Both of us are former Skills Ministers and have heralded the arrival of degree apprenticeships as a route for people into high-paid, high-quality jobs without them having to go to university.
Delayed discharge has a knock-on effect on the whole NHS. The fact that the Secretary of State has said today that all he will do is review the better care fund and that he will not publish a White Paper on social care shows what a low priority this is. When will we see the White Paper on social care for which we have been waiting not just months, but years?
The statement was about the implementation of the NHS long-term plan, to which of course the future of social care is vital, which is one reason why the spending power available within social care has risen by more than 10% over the past three years. We continue to work on the long-term future of social care. We will have to wait for a new Prime Minister before publishing the Green Paper—I think that is fairly obvious—but it would also be good to get a bit of cross-party collaboration. When my right hon. Friend the Member for Ashford (Damian Green) made some proposals that were in line with the cross-party work of two Select Committees of this House, within half an hour the shadow Secretary of State’s friend, the shadow Chancellor, had rubbished the idea—I do not think he took the time even to read it. We could do with a bit of cross-party work on the future of social care in this country.
Thanks to the record funding boost for the NHS, Cheltenham General Hospital can plan for the future with confidence, but local trust managers consistently cite difficulties with recruiting emergency medicine doctors as a reason for not being able to expand A&E provision. Does the Secretary of State agree that some of the additional resources must go into training additional A&E doctors so that we can give Cheltenham General Hospital the resources it requires?
Yes, I agree very strongly with that. When I said that my right hon. Friend the Member for Harlow (Robert Halfon) was one of the best constituency advocates, I forgot my hon. Friend the Member for Cheltenham (Alex Chalk), who is also one of the best, and certainly the best advocate for Cheltenham, that the House has ever seen. He is absolutely right in the substance of his question, which is that we must have the support for the workforce we need, including in emergency medicine, to ensure high-quality emergency facilities near to people—where they are needed—and he makes that case with respect to the expansion of services at Cheltenham Hospital, which he supports incredibly strongly.
Is the privatisation of the urgent care centre in the Runcorn-Halton part of my constituency part of the Secretary of State’s NHS plan?
I am not sure what specific case the hon. Gentleman is referring to, but I will tell him this about privatisation: I support the NHS being free at the point of delivery so that everybody can use it, and the most important principle at stake is how to deliver the best possible services for our constituents. That is what I will keep doing.
The success of the NHS long-term plan in Northamptonshire will depend on urgent short-term reform of the combined health and social care system in the county. There are 1,400 hospital beds in the two hospitals in Northamptonshire; 900 are occupied today by stranded and super-stranded patients as a result of delayed transfers of care. This is the worst situation in the country. The number of patients staying more than seven days in a hospital bed is twice the national average. Northamptonshire’s over-65 population is the fastest growing in the county. We need to take advantage of local government reform to establish an integrated health and social care pilot, but this requires the personal attention of the Secretary of State. Without that, we will not make any progress. Will he meet Members of Parliament from the county this month to get this under way?
Yes, and I suggest we meet also with the Secretary of State for Communities and Local Government. I have met the Northants MPs to progress this, and I have also meet the Communities Secretary about it. My hon. Friend is dead right. There is a serious problem, but there is also an opportunity for much more integrated health and social care. If Northants MPs, the Communities Secretary and I can find an opportunity to meet, perhaps we will be able to crack through this one.
I thank the Secretary of State for his announcement. I have two questions. First, do he and his Department accept that there are additional costs in providing healthcare on an Island that is of an equal standard to that provided elsewhere? Secondly, will he and his officials agree to meet Island officials to discuss plans for a pilot scheme to help integrate healthcare, adult social care and other local government services to ensure maximum efficiency in the delivery of services, as my hon. Friend the Member for Kettering (Mr Hollobone) just talked about, and to ensure that as much money as possible goes to frontline services?
Yes, I shall be happy to ensure that that meeting happens. As for Island healthcare costs, my hon. Friend is right to say that the Isle of Wight is unique in its health geography, and that there are places in this country—almost certainly including the Isle of Wight—where healthcare costs are higher because of the geography. There is a programme for smaller hospitals that are necessarily smaller because of the local geography, as they need special attention.
As I have said, I shall be happy to ensure that the meeting goes ahead, and I shall continue to talk to my hon. Friend, who makes the case for the Isle of Wight better than any other.
Tomorrow I shall attend the funeral of my Auntie Bib, who has just died of cancer. It was discovered at quite a late stage. May I press my right hon. Friend to ensure that rapid access diagnosis centres are rolled out as quickly as humanly possible, and to give the House more details? May I also—as is my job—remind him that he is, of course, the Secretary of State for Health and Social Care for this entire United Kingdom, and ask him how he intends to engage with devolved authorities when targets are being missed to ensure that standards are maintained across the island? Our constituents are all British citizens, and they all require and deserve the same level of support.
I am sure that the whole House will want to pass our condolences to my hon. Friend, to his family, and to friends of his aunt. In a way, it is fitting to end this session with a very personal example of why early diagnosis matters.
As for my hon. Friend’s second point, ensuring that we have high-quality health services throughout the UK is, of course, vital. It is true that there has been a smaller increase in funding for the NHS in Scotland, and a consequent smaller increase in the number of healthcare professionals there. We need an improvement right across this country. We are delivering that in England, and I am sure that my hon. Friend will continue to make the case for better health services in Scotland from the Scottish National party Government, who receive the money from the UK Treasury but do not put all of it towards the NHS.
On a point of order, Mr Speaker.
Order. I will come to points of order in a moment. We now come to—or we will come to, after the points of order, so I should more accurately say that we shall shortly come to—the motion on the estimate for the Department for International Development. The debate will led by Mr Laurence Robertson. I inform the House that I have not selected the amendment in the name of Margaret Beckett. It may also be helpful if I inform the House that I have not selected either of the amendments to the second motion. After the points of order, I will call the Minister to move the motion, but first we will treat of points of order.
Points of Order
On a point of order, Mr Speaker. Long-suffering rail travellers in the north of England were promised for many years that Pacer trains, described by the Transport Secretary himself as “knackered”, would be replaced by new trains by December 2018. Before the end of 2018, the deadline became December 2019. In the weekend press, news emerged that Pacer trains would not now be replaced by then, and would be in use well into 2020.
Given the billions of pounds spent on rail investment in London and the south-east and the £1 billion-worth of new Crossrail trains sitting idle in London, this latest broken promise is extremely galling to Members of Parliament and passengers throughout the north. Have you received any indication from the Department for Transport, Mr Speaker, that it intends to make a statement on why there is to be this further delay—or does it simply not believe that people in the north deserve such an explanation?
I am bound to say to the hon. Lady that I am not aware of any intention on the part of a Minister to make a statement on the matter in the Chamber. Certainly I have received no approach, to the best of my knowledge. I think that if I had been written to about it, I would know, and I don’t, so I haven’t. Let me say to the hon. Lady, however, that if she wishes to give voice further to her concern about this matter—as the indefatigable representative of Kingston upon Hull North constituents that the House knows her to be—there will be plenty of opportunities for her to do so. I have a feeling that she will be troubling the scorers on the matter for some time to come, irked and aggravated by the decision as she palpably is.
On a point of order, Mr Speaker. As you will have noticed, the sun has actually been out over the last few days, and you will know that one of the major causes of skin cancer is exposure to the sun. You might have noticed that Glastonbury has been giving out free high-factor sunscreen to everybody at the festival. Those in the armed forces get given free sunscreen because it is a chargeable offence to suffer from sunburn, yet our police officers and the security staff who stand outside this building, often for many long hours in the blazing sun, get no free sunscreen from the Palace authorities. Can you, Mr Speaker, make sure that that is now available in your capacity as Chairman of the House of Commons Commission? If you were thinking of going to Wimbledon at any point in the next fortnight, I wonder whether you might have a word with the authorities there to make sure that people there too do not end up with burnt faces and burnt ears and that there is free high-factor, high-quality sunscreen available to all.
That is a very useful public information notice as well as a request by the hon. Gentleman. I shall always profit by his counsels; I am always grateful to him for his advice, and he speaks on this subject with a passion, knowledge and authenticity that are respected across the House. All levity aside, he makes a very serious point, and I am particularly preoccupied with the situation of the staff here. I may or may not make my way to SW19 over the next fortnight, and if I do I will bear in mind his advice, although I am not sure mine will be especially welcome. But as far as the House is concerned the hon. Gentleman makes a good point, and I would like to reflect on that. Of course people should take proper precautions to protect themselves from exposure; it is possible to enjoy the sun, but to do so safely, and that does require appropriate factor cream regularly applied as the hon. Gentleman knows. I will come back to the hon. Gentleman on the point relating to the staff, but it will have been heard by officials, with whom I will discuss the matter.
[6th Allotted Day]
Department for International Development
Motion made, and Question proposed,
That, for the year ending with 31 March 2020, for expenditure by the Department for International Development:
(1) further resources, not exceeding £3,631,122,000 be authorised for use for current purposes as set out in HC 2154 of Session 2017–19,
(2) further resources, not exceeding £1,923,101,000 be authorised for use for capital purposes as so set out, and
(3) a further sum, not exceeding £5,760,680,000 be granted to Her Majesty to be issued by the Treasury out of the Consolidated Fund and applied for expenditure on the use of resources authorised by Parliament.—(Rebecca Harris.)
I thank the Backbench Business Committee for approving this debate today. I would also like to put on record my thanks to my right hon. Friends the Members for Sutton Coldfield (Mr Mitchell) and for Witham (Priti Patel) and the Chairman of the Select Committee, the hon. Member for Liverpool, West Derby (Stephen Twigg), for helping me to prepare for this debate; the experience they have and the work they have done is admirable.
I have long had an interest in international development, and I think probably it comes from the fact that I certainly feel very lucky to have been born in this country. I did nothing to deserve to be born in this country. We have food, we have clean water, we have medical services, and we have education, which very many people across the world do not have; in other words, we have the building blocks to be able to progress in our lives and to normally live beyond childhood, while many in the world do not have that opportunity.
I would go as far as to say that my interest in international development and in trying to help the world’s poorest people was one of my main motivations for wanting to enter the House of Commons in the first place, and I have had the privilege of being able to witness the effects of the aid that the United Kingdom has provided. I am aware it goes across the world, but my particular interest has been in Africa and I have the honour of being chairman of the all-party group on Ethiopia and Djibouti. I have been to some very rural areas in Ethiopia as well as the cities and have seen the benefits our aid brings to so very many people.
We should look at the achievements we have made in this country through our official development assistance fund, which is now, I am very proud to say, 0.7% of our gross national income. We have donated more than £77 billion since 2013, when we set that target.
I am glad that my hon. Friend has introduced the debate in this way. He has mentioned the 0.7%, and if anyone says that we cannot afford 70p out of every £100 of our wealth, they are wrong. We should be able to look after our own people and make this contribution to meet the United Nations target, which we have started to meet rather late but before most other countries.
My hon. Friend is absolutely right. For a prosperous country—we are supposed to be the fifth largest economy in the world—that is a small amount to be asked to pay, but it has an enormous impact across the world.
I wholeheartedly agree with what has just been said. Our aid has made a huge impact. Under both Labour and Conservative Governments, there has been cross-party consensus on this. It is one of the few issues on which we have consensus in this House, and it is a good job we do, because it has made a huge difference. I chair the all-party parliamentary group on HIV/AIDS, and our aid through institutions such as the Global Fund has made a huge difference. I want to commend the Government for their fantastic announcement of £1.4 billion for the Global Fund in recent days. In 2000, when I was starting to work on these issues, there were only 2 million people globally receiving antiretroviral treatment for HIV; today, that figure is 22 million. This is literally life-saving treatment that we have been able to provide through our aid.
The hon. Gentleman is right to talk about the cross-party support for this issue in the House. The 0.7% target goes back a very long time, and I am pleased that it was a Conservative-led Government who actually reached it, but it would be churlish not to recognise the work that Tony Blair did, for example, in highlighting the issue, and I am pleased to do so. Many other leading politicians have also done work on this. I am grateful to the hon. Gentleman for making that point, and I will come back to it in just a minute.
I mentioned the fact that we had given that £77 billion in aid since 2013, but what does that actually mean? It means that we have helped more than 1 billion children across the world to get an education, as well as helping more than 37 million children to be immunised and more than 40 million people to have access to clean water. These are things that we in this country take for granted, but our aid has helped people in those ways across the world and I am very proud of that.
Does the hon. Gentleman also agree that a particularly important facet of our investment in children’s education has been the investment in the education of girls? If we invest in girls’ futures, we invest in the future of the whole community and the whole country. Does he agree that the efforts we have made in that regard have been admirable and must be sustained and indeed increased?
I entirely agree with the hon. Lady on that point; I am glad that she has raised it. In rural areas in Ethiopia, I have witnessed situations in which girls have had to walk a number of miles every day to collect water to bring back to their families. That is neither sustainable nor efficient. It keeps the girls away from school, it prevents any progress from being made in the neighbourhood and it is wrong. We have to do a lot more to help in those situations. I absolutely agree with the hon. Lady on that. Of course it is important that boys and girls attend school, and there are distractions to keep boys and girls from attending school in such countries, but we really have to address that and get over it; otherwise, we will not make the kind of progress that we want to make.
The hon. Gentleman is making an excellent speech, particularly in his focus on education. I am the chair of the all-party parliamentary group on disability. Does he agree that in many developing countries, children with disabilities still find it too challenging to get to school and that we must focus on those extremely vulnerable children, who are often kept behind closed doors and never seen? We must ensure that they get every opportunity in life and that, in line with the sustainable development goals, we leave no one behind.
Absolutely. The hon. Lady makes an extremely good and useful intervention. As many hon. Members have done, I have seen the disabilities that some children have that prevent them from attending school or from doing very much in life, really. For example, we see children who cannot stand up because their limbs are damaged, and children with cataracts who are blind because they cannot get a simple operation. That situation really is unacceptable. So, if our aid can help reduce such incidents, it really is worth doing. We have to increase aid, and we have to improve so much.
It is a sad fact that we are one of the only eight countries that actually meet the aid target. Other countries do give a lot of money, but few actually meet the target, and we need to work with and encourage others to do so. The situation is a bit like reducing emissions in this country, because we produce only 2% of the world’s emissions, but if other countries are not going to play their part, we are not going to get the progress that we need. The situation is exactly the same with aid.
It is appropriate to follow up on the contribution from the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron), because our international aid and development programmes are largely centred in East Kilbride. That is yet more evidence of the strength and vitality of this Union that we enjoy and the blessing that it is across the face of the earth.
Absolutely. I am sure that Madam Deputy Speaker would not want me to go too far down that road, but it is a good point.
Does my hon. Friend agree that it is also in our national interests to keep up our investment in international aid? By making poorer countries more stable, we improve the world’s stability. By tackling diseases, we stop them spreading to our own country. If we are to fight climate change, we need to fight it globally. Aid is not just the right thing to do morally, but it is in our interests to continue it.
My hon. Friend is absolutely right. We could take things even further because, in the commercial sense, if countries across the world are richer, that affords us new markets as well, which is in addition to the humanitarian reasons for aid that she rightly outlines.
DFID’s budget is around the £14 billion mark. While it is certainly a small part of our overall income, as was raised earlier, it is still a considerable amount of money. The aid budget has its critics and criticisms, of course, and I will come on to one or two of them, because some may be valid. Perhaps we can improve matters, and we should certainly never be satisfied with where we are, because we can always do better. We all have constituents who point out that some of our schools and our police are short of money, so if we are going to spend money abroad, helping people who are not from this country, then we must ensure that we spend it wisely and effectively, and this estimates day debate is about addressing the budget in the wider sense.
It is worth touching on exactly how aid works. This may come as a surprise to some, but DFID itself spends around 75% of the aid budget, with the other 25% being spent by other Departments, such as the Department for Business, Energy and Industrial Strategy, the Foreign and Commonwealth Office, the Department for Health and Social Care and the Home Office, and other outside organisations. Some of the aid that we provide is bilateral and some is multilateral, and I will come on to the difference in a minute.
The National Audit Office report, which came out just a few days ago, says that most of our aid is going to the right places and having a great effect, but it did point out that there is room for improvement. As I go through one or two areas in which we can improve, the observations that I will make are not in any way a criticism of our approach of our aid policy because, as the House has heard, I am supportive of it.
I thank the hon. Gentleman for being so generous in giving way. He is making a good point, but does he not agree that part of the reason why DFID is so good at focusing its share of the aid is because it is a discrete Department and not just part of another bigger Department? Does he share my concern that some right hon. and hon. Members have talked about amalgamating DFID into the FCO? Will he perhaps commit on the House’s behalf to talk to the candidates for the leader of the Conservative party to assure the House that DFID will continue no matter who wins the upcoming contest?
The hon. Lady raises a good point. I think it was Tony Blair who set up the separate Department, which provided it with focus. Thinking back before that, however, most right hon. and hon. Members would acknowledge the excellent work carried out by Baroness Chalker, even though the Department was then within the Foreign and Commonwealth Office.
I suppose there are two ways of looking at it. When I travel and meet DFID officials abroad, I often meet officials from the FCO, and maybe also from other Departments linked to it. Overall, I agree with the hon. Lady that this is such an important subject, and it obviously should have close ties to the Foreign Office, and probably to other Departments, too. As I say, 25% of the overseas aid budget is spent by other Departments, so there has to be a close link. I am probably persuaded that that should be the case. I will talk to the successful leadership candidate, whoever they are, about this issue in due course.
I mentioned that other Departments spend about 25% of the aid budget, and that proportion has increased significantly—it was 11.4% in 2013. That spending can be a good thing, because it draws on the expertise of those other Departments. In certain cases, money is provided that might not have been so quickly forthcoming if those Departments had to queue outside the Treasury for it.
However, the spending raises the question of whether these other Departments quite have DFID’s experience and expertise in delivering aid. The Department of Health and Social Care, for example, might be expert in handling health-related issues—I am sure it is—but DFID has that experience of delivering projects abroad. There is a question mark over whether we have got to the right level. Hopefully the Minister will give us some guidance.
The hon. Gentleman is generous in giving way again. Does he agree that that underlines the point made by my hon. Friend the Member for Bristol West (Thangam Debbonaire) on the importance of having DFID leading on this? DFID has that expertise and experience as a separate Department and, actually, some of the criticisms levelled by the National Audit Office and others—I am not an aid purist, and some important aid spending needs to be done in conjunction with other Departments, such as through the Stabilisation Unit, International Climate Finance and other institutions —have been levelled at spending when it has been done well but without the remit of DFID. We need to see DFID in a leading role, using its expertise to ensure our money is spent effectively.
The hon. Gentleman makes a good point, and I look forward to hearing whether the Minister thinks that 25% of the budget being spent by other Departments is about right, too high or too low. I have not necessarily come with answers. I am asking as many questions as I am giving answers, but that is the nature of this debate.
This spending also raises the question of transparency, because the other Departments do not have the same legislative requirements. For example, the International Development (Reporting and Transparency) Act 2006 requires DFID to report to Parliament on where the money is spent, but other Departments are not covered by the Act.
The targeting of aid is something else that concerns some people. In 2017, the last year for which figures are available, DFID spent 66% of its bilateral aid budget on the world’s poorest countries, but the other Departments spent only 25% of their bilateral budgets on the least developed countries. There are always explanations and more details behind these figures but, on the face of it, we need to look at it and ask questions.
Through bilateral aid, we have complete control of the projects we fund; and through multilateral aid, we work with other agencies and do not have the same control, and the priorities of those other agencies might be slightly different from ours. There are different nuances within each of those headings, too. This is never a simple subject.
Before the hon. Gentleman launches into multilateral aid, may I take him back to the point raised by my hon. Friends the Members for Bristol West (Thangam Debbonaire) and for Cardiff South and Penarth (Stephen Doughty)? In my experience, since 2010 it is the Treasury that has been the principal driver of other Departments increasingly being allowed to count some of their spending as international development spend. To what extent has the hon. Member for Tewkesbury (Mr Robertson) already had conversations with Treasury Ministers about the comprehensive spending review they are preparing for the next Conservative Prime Minister? I suspect the Treasury has already done work to try to identify ways to get that 25% figure even higher.
The hon. Gentleman raises a good point. I have not had those discussions with the Treasury, but they are certainly discussions we will need to have. I raise this with the Minister to find out her view, because this is increasing quite a lot—it has more than doubled in the past few years, so the hon. Gentleman is right to raise the point. This is why I make the point about spending in the countries that most need it and targeting it at the poorest people in the world. That is what most people would want us to do. There can be knock-on effects that come to this country, but the primary concern must be about helping the world’s poorest people.
On the comment just made by the former International Development Minister from the Opposition, surely the issue is not just the 0.7% but the rules. Any expenditure undertaken by other Departments must of course be within the rules; otherwise, the Treasury would have a fit, as it would have to find the additional money if spending were undertaken outside those rules. The important thing is that this expenditure should be well spent—a point I hope to make if I catch your eye, Madam Deputy Speaker. It does not matter which Department is spending any expenditure that falls within the rules that Britain has accepted so long as it is spent well.
I am grateful to my right hon. Friend for that intervention. He has expert knowledge of this issue. We had a meeting before this debate and it could have gone on a lot longer because we discussed so very many things. Where this spending goes does matter, and it does matter that there is accountability and transparency. That is the important point.
What concerns me is the issue of which partners we use to deliver our aid. DFID has great relationships with large trusted partners, but I am always concerned that smaller, more effective organisations operating in the most dangerous places, such as the Hands Up Foundation, do not get the funding and support from DFID that they need. Does my hon. Friend agree on that?
My hon. Friend raises a good point. It is very important to consider the partners we use. Accusations are made that some of the partners—the intermediaries—might take too big a chunk of the money before that money gets to ground level, and there are concerns about that. With multilateral aid, who we deal with is certainly one of the issues. Sometimes these bodies do not have the same priorities as we have.
If my hon. Friend will allow me, I will deal with this immediately. The bilateral aid of DFID was 62.6%, as against multilateral aid of 37.4%, and this has remained steady over the past few years. However, that is still a lot of money going on aid that we do not fully control. There are some good projects out there. The World Food Programme is an excellent example of multilateral aid that saves lives. The hon. Member for Cardiff South and Penarth (Stephen Doughty) mentioned the money going to the Global Fund to Fight AIDS, Tuberculosis and Malaria, and today we had the announcement of this being £467 million a year. As I understand it, that is multilateral aid, so there are some excellent projects we are involved in, but there are delays in reporting by the multilateral agencies, which impedes our ability to analyse the work they do.
The hon. Gentleman, an old friend, knows of my passion for cutting road deaths worldwide; this is the biggest killer, especially of children and young people, and mainly of poorer ones. He knows of my role as chair of the World Health Organisation’s Global Network for Road Safety Legislators. Does he agree that bilateral and multilateral approaches are both good in the right contexts and with the right partners? We are doing work in the real target countries, and in some countries this can be bilateral but often we are looking for a number of partners.
I absolutely agree with the hon. Gentleman, to whom I pay tribute for all his work in that respect. I shall come back to that issue in a moment.
Let me turn to the Independent Commission for Aid Impact, which was set up by my right hon. Friend the Member for Sutton Coldfield. It has identified some spending by, for example—this is only an example, and it is not the only one—the Newton Fund, which the commission said
“is not promoting the best use of ODA and some projects appear not to be within the ODA definition.”
That is of some concern. The commission lists some of the projects about which it is concerned. Sometimes when one looks into the projects and gets into the details, one finds they actually do help people who need help, but the headlines that they receive do not necessarily suggest that. Nevertheless, we have to be careful, because we all have constituents who want to see that their hard-earned money they pay in taxes goes to the right target.
My hon. Friend has just made an important point. It is absolutely right that we fund multilateral projects, and some of the organisations involved, such as the UN, are huge. In respect of the big multilateral projects it is easy to pick on the tiniest point about where some aid might go and blow that up into a huge headline, and that is what our constituents hear. We are not going to change that in the press—the newspapers will not print a headline that says, “All the planes took off on time yesterday”—but it is the House’s responsibility to emphasise exactly what my hon. Friend is talking about.
I am grateful to my hon. Friend for that intervention, which enables me to move to another point. Contrary to what is sometimes said, we do not actually finance corrupt dictators in other countries. Another point raised—I have taken so many interventions that I cannot remember who made it—was that it can be difficult to get aid to the people who need it most. For example, people who live in war-torn countries are going to be desperate and will need help of one form or another. The people who live in countries with very poor Governments that have dictatorships need help. It is not the dictator who needs it, but the people who live in those countries certainly do need help. The trick is to get under the radar to help those people, but that should not be confused with the financing of wicked dictators. The two situations are different.
Is not another benefit of multilateral aid that it enables a country such as Britain to help by combining with other countries to get significant sums of money to the poorest people, with a minimum impact on that country? I think of a country such as Ghana, which has lots of poor people and a civil service with nothing like the capacity that our great civil service has. Imagine if all 27 EU countries that give money through the European development fund suddenly decided that they wanted not to give money to Ghana through Europe but to do it themselves. The Ghanaian civil service would suddenly have to deal with all those 27-plus reporting lines. Is not one of the benefits of multilateral aid that it minimises the administrative burden of getting aid to the very poorest in the country in question?
The hon. Gentleman makes a good point. Of course, countries working together has to be the way forward, but the system really does have to be accountable, transparent and delivered efficiently and effectively. When it is those things, it is obvious that countries working together is a good thing.
All that takes me to another point: we all want humanitarian assistance to be provided—I certainly do, and we certainly do provide it—and it is easy to justify that, but we also want to see countries being given the building blocks and facilities to develop. The hon. Member for Harrow West (Gareth Thomas) gave the example of the civil servants in Ghana. Tax-raising and collecting authorities in such countries are important. The problem is that it is sometimes difficult to explain to our constituents the difference between development aid as opposed to humanitarian aid. It is not always easily understood. It is important that we help countries to build the capacity to move forward. The old adage about giving a man or woman a fish and feeding them for a day or teaching them how to fish so that they can feed themselves for a lifetime is absolutely right. We have to find ways to do that, or we will never make the progress in the world that we all want to see.
On that important aim, let me say that, like me, the hon. Gentleman probably attended the Fairtrade Fortnight event, which looked at the impact that DFID has when it works with developing countries to ensure that producers receive fair prices for cocoa through the She Deserves campaign. Does he agree that that kind of intervention is vital not just at a governmental level but at an individual level, ensuring that families, and women in particular, are able to support and sustain their families?
I totally agree with the hon. Lady. We have had campaigns in this country to get fair milk prices for our farmers, so it is certainly right that we should ensure that farmers and traders in other countries get fair trade as well as fair prices. It is very, very important indeed.
The hon. Gentleman is being very kind in giving way. He will know the sterling work that my hon. Friend the Member for Halifax (Holly Lynch) has done in this area. She, like all of us here, absolutely believes not only in tackling world poverty but in the absolute scrutiny and accountability that go with it. For all of us in this field, they are our watchwords, our doctrine. When the newspapers accuse us of being do-gooders who do not care, it is just not true. My hon. Friend is a champion of that sort of scrutiny.
It is right that we do scrutinise things and that we do demand transparency, but it is also right that we put things in perspective as well. I certainly agree with the hon. Member for Huddersfield.
I want to try to draw my remarks to a close, because, presumably, lots of hon. and right hon. Members wish to speak. In summary, I want to see an increase in the amounts going to the least developed countries and an increase in transparency, certainly in non-DFID and multilateral spending. I also want us to have a bit more control over, and understanding of, where the multi- lateral aid actually goes. We need to be aware that when we leave the European Union—and I will say “when”—we will get something like 10% of our budget back. We then have to decide where that goes. I am sure that there is no shortage of places or projects for which we want to provide.
In conclusion, I am very proud of our aid budget and of the fact that we have saved and transformed so many lives. The suggestions that I have made and the queries that I have raised today in no way challenge my commitment to our aid budget, but I want to make sure that we help even more people even more effectively than we already are. Most people want to see the United Kingdom, one of the richest countries in the world, helping the poorest people in the world, but they do have a right to make sure that their hard-earned money—it is not our money, it is theirs—actually goes to the people who need it the most. Much of it already does, but I think that all of it needs to do so. Thank you, Madam Deputy Speaker, for allowing me to speak in this debate.
It is a great pleasure to follow the hon. Member for Tewkesbury (Mr Robertson). I congratulate him on securing this opportunity to scrutinise in the main Chamber DFID and its work. I agreed with every single word that he said. His speech demonstrated that there is strong cross-party support for this commitment.
It is opportune that we debate the Department’s estimates this year because we are in the 50th anniversary year of the Pearson Commission, which was under- taken by the World Bank and which first suggested a commitment of 0.7% of gross national income for countries to follow. The United Kingdom met that target in 2013. As the hon. Gentleman rightly reminded us, we are alone among the major economies in the world in achieving that target and one of just eight countries to have done so.
The cross-party commitment is incredibly important. I agree with what the hon. Gentleman said about the importance of the 0.7% commitment and the importance of DFID as a stand-alone Department—a voice for development in the British Cabinet, but also a strong British voice in international institutions. DFID has earned, rightly, enormous praise in international institutions as a strong leader on development. I also agree with him that those of us who support the 0.7% target and DFID have an added responsibility to demonstrate value for money, to call to task when there is not value for money, and to ensure that every penny of taxpayers’ money that goes to international development is spent wisely and efficiently.
Another point that we should make, although it is not a focus for today, is that if we are to achieve the sustainable development goals—the ambitious Agenda 2030 programme to which the world is committed—aid alone will not get us there. Aid will be a fraction of the resources required to achieve those goals around the world, but especially in the poorest countries. Mobilising other forms of capital, including private sector investment, will be vital. I strongly agree with the hon. Gentleman that it is vital that we assist those countries to develop strong tax collection systems so that they can collect taxes from domestic taxpayers and international companies operating there.
The hon. Gentleman makes an extremely important point. Does he agree—this has been brought up by the International Development Committee, which he so ably chairs—that what the UK needs in addition to DFID, or perhaps inside or alongside DFID, is a development bank, which so many other major economies have but we do not?
I am delighted to take that intervention from my friend the hon. Member for Stafford (Jeremy Lefroy), whom we miss on the Committee. He is an extremely eloquent and powerful voice for international development in this House and beyond, not least through his role in the World Bank parliamentary network. I am very sympathetic to his point about having our own development bank. I have just come from an event with the Commonwealth Development Corporation, which performs some of those functions, but I know that he argues for a distinctive UK development bank, and I hope that he will have an opportunity to elaborate on that later in the debate.
I will comment briefly on five areas, all of which were covered by the hon. Member for Tewkesbury: humanitarian versus development; multilateral versus bilateral; localisation and small organisations; scrutiny; and addressing some of the issues with non-DFID official development assistance.
We know that the world is facing some huge crises. Some of them are global, such as climate change, and some are a consequence of natural disasters, but many of them are man-made—person-made—and often a consequence of conflict. We look at Syria, Yemen, the Democratic Republic of the Congo, South Sudan and the crisis affecting the Rohingya people of Burma, most of whom now live in neighbouring Bangladesh. In that context, the distinction between what is a response to a humanitarian situation and what is development is increasingly irrelevant. People are escaping conflict and living as refugees or internally displaced people for large parts of their lives. Children are spending their entire childhoods displaced. They need humanitarian assistance, but they and their communities also need development support.
That is why the International Development Committee has focused so much on the importance of investing in global education. As the Minister well knows, we have consistently called on the Government to devote a larger part of the UK’s development assistance to education. I welcome the commitment that she made recently—at the last but one DFID Question Time—to the UK increasing our commitment to Education Cannot Wait, the multilateral fund aimed at supporting children and young people in emergency situations. I encourage her to put today, or quite soon, a figure on that commitment—and for it to be a high figure—because the earlier we make a pledge on Education Cannot Wait, the more likely other donors are to follow so that we can ensure that that excellent fund can play its part to support education in emergencies.
That brings me on to the broader issues around multilaterals and bilaterals that the hon. Member for Tewkesbury set out fully. First, let me strongly echo my hon. Friend the Member for Cardiff South and Penarth (Stephen Doughty): we hugely welcome the commitment that was made on the Global Fund over the weekend. It is really excellent news that the Government have made that commitment to replenishment, and have made it early, which has lessons for replenishments in other areas and again demonstrates strong leadership in this field. The last-but-one Secretary of State—I think we are on the fourth Secretary of State since I took over the Chair of the Committee four years ago—oversaw the multilateral development review. That was a very thorough piece of work by the Department looking at the relative strengths of different multilateral institutions and showing that some of those working in the health field, notably the Global Fund, came out very strongly.
Interestingly, other institutions that came out very strongly—the right hon. Member for Witham (Priti Patel) oversaw the review—were the European ones, including the European Commission. I have been encouraged by the responses that we have had from Ministers about the issues that we will face in the event of Brexit and about ensuring that the excellent programmes that are provided through European institutions, like the European development fund, do not suffer as a result of Brexit. What we should have uppermost in our minds is the needs of those who are benefiting from those programmes. I urge the Minister, and the Government more generally, in deciding whether to continue to work closely with and fund European development programmes after Brexit, to follow the best evidence as to what is good for the beneficiaries. I hope that whoever the Prime Minister is, the Government will not be guided by an ideology that says, “We can’t work with European institutions.”
The hon. Gentleman is making an important point. Would he also urge those on the EU side of the debate to leave their ideology aside and, where there are fantastic non-governmental organisations from the UK that could deliver some of these programmes, to ensure that they can continue to do so?
I absolutely agree with the Minister on that. It is very important that, if we are no longer in the European Union, British NGOs are still able to apply for these sorts of programmes. If they are best suited to deliver them, it is absolutely right that they should have that opportunity.
The hon. Gentleman is making an excellent speech. Further to the point that the Minister made, are we not in a very strong position, when we leave the European Union, to decide for ourselves—in the same way that the multilateral aid review takes place—which of the programmes that the European Union is delivering are worthy of our support, and support them? Then, where there are programmes that we perhaps do not choose to support, we can use our money in a different way, giving us the flexibility always to go where the money is best spent.
I agree. I am keen to emphasise that the Government’s own reviews suggest that most of these European-run programmes are good, so there is a strong likelihood that we would, if given the opportunity, volunteer to remain part of them, but the right hon. Gentleman is absolutely right that we would have more flexibility in terms of any programme that we might not want to support, and that would free up some money.
I very much hope that, whatever happens on Brexit, we will be contributing to those European programmes that have been so well regarded.
Does my hon. Friend agree that one of the crucial things about having DFID as a separate Department with a Cabinet-rank Secretary of State has been our ability to influence and shape global institutions? Having a Secretary of State going to World Bank board meetings, attending sessions of the Global Fund and attending crucial UN meetings has given us greater influence, not just through our money but through political investment. That is why we need to ensure that we have a strong, separate Department with a Cabinet-rank Secretary of State.
I absolutely agree. When DFID was created in 1997, the UK governorship of the World Bank shifted from the Chancellor of the Exchequer to the Secretary of State for International Development. That was absolutely the right thing to do. It has given us a strong voice in these multilateral organisations, including the World Bank.
Let me comment briefly on the three other areas that I identified—first, localisation. The hon. Member for Banbury (Victoria Prentis) made this point earlier, and it is very important. We frequently take evidence from organisations that say that it can be hard for a smaller company or smaller non-governmental organisation to get access to some of DFID’s contracts and programmes. That applies whether those companies and NGOs are in this country or in other countries. Greater opportunity for those smaller organisations to access programmes is important.
Alongside that, it is important that we see more autonomy for DFID’s country offices. I was interested to listen to the Secretary of State when he came to the Committee last week, because he was proposing something quite radical in terms of greater autonomy for the country offices. He made an important point—it is something we said in one of our reports—about the concern that, in recent years, DFID has lost some of its in-house expertise in certain areas and made itself much more reliant on contracting for that expertise. Indeed, many of the people now getting the contracts used to be the in-house experts. The Secretary of State contrasted how much DFID spends on specialist country advisers on education or climate change with some of the other donors who spend a lot more. I welcomed him saying to us that he would look at that again, and all power to his elbow.
My hon. Friend knows that I have boundless admiration for him as Chair of the Select Committee. He mentioned localism and smaller groups. There are a lot of fashions. Something less fashionable but none the less effective is cutting road deaths. In the developing world, the loss of a breadwinner or the breadwinner becoming injured or an invalid for life is a sure path to poverty. I have lobbied him to look at road deaths and casualties. Rather than the bigger, more glamorous issues, will he look again at something like that, which is very effective?
I thank my hon. Friend. He is tireless. He has lobbied me privately to do that and I do not blame him for lobbying me publicly. There are other members of the Committee here who can bear witness, so we will consider that. We have been looking at the global goals, which make reference to cutting road deaths, and we have the voluntary national review later this month. I can give an undertaking that my good friend, the hon. Member for Mid Derbyshire (Mrs Latham), the hon. Member for Dundee West (Chris Law) and my hon. Friend the Member for Brighton, Kemptown (Lloyd Russell-Moyle) and I will raise that when we are in New York later this month—Whips permitting—to attend the voluntary national review.
As the hon. Member for Tewkesbury said, aid spending is quite widely and deeply scrutinised, and rightly so. It is scrutinised in the media and by the public. Like all other areas of Government spending, it is scrutinised by the National Audit Office. We also have the Independent Commission for Aid Impact, established when the right hon. Member for Sutton Coldfield (Mr Mitchell) was Secretary of State, which is a very powerful lever for improvement in our system.
Alongside that scrutiny—this is something we are focusing on more as a Committee—we need to get better at hearing the voices of those who are beneficiaries of aid and those who are working in the field. That was brought into sharp focus by the issues around sexual exploitation and abuse that arose last year. I pay tribute to the hon. Member for Mid Derbyshire, who has been raising that issue for years, well before The Times coverage began last February. It brought to light the failure of the aid sector, including those of us who scrutinise it, to hear and to create opportunities for those who live in some of the poorest countries in the world to have their voices heard about the impact of aid—hopefully when it is positive, but also, in this extreme case, when it is negative.
I thank the hon. Gentleman for giving way; this is the second speech I have heard by him today, having been at his CDC speech. On that issue, and particularly sexual exploitation, we are clearly out of touch—having served twice on the Committee, I include myself in this—with what is going on on the frontline. I understand that Voluntary Service Overseas, which I associate more with students and what is now called gap years, offers opportunities for more mature people. Instead of going on a typical Committee visit where everyone goes to one place, would it be possible to starburst out and use an organisation such as VSO to be in the ditches, in the huts and at the delivery units and warehouses, keeping our ear to the ground—not with any fixed purpose, but genuinely to listen and engage? As we all know from our constituency visits, that is sometimes when we get the most powerful evidence.
I thank the hon. Gentleman, who served with distinction on the Committee until relatively recently. This is always a challenge when we undertake visits, because we are there to scrutinise how the money is being spent, so we are often somewhat in the hands of DFID about where we go, but there is a case to separate ourselves from that sometimes to get to hear those voices and to work with organisations such as VSO, so I thank him for that suggestion.
The final thing I want to address is what the hon. Member for Tewkesbury focused on, which is the fact that roughly 25% of official development assistance now goes not through DFID, but through other Government Departments. He made the case well. He asked whether it is too high or too low. I think the test is not so much whether it is too high or too low. For me, the test is whether it is as effective as the money spent through DFID. The current DFID permanent secretary, Matthew Rycroft, when he was before us a few months ago, said he felt that the DFID share should not go below 75%. That sounds about right to me and I think that is about where it is at the moment.
DFID has an important role to play as a driver of all the spending, and we have said as a Select Committee that DFID should sign off all ODA spending, including what goes through other Government Departments. We were supported in that in a recent report by the TaxPayers Alliance, which recognises that DFID has a stronger record than the other Government Departments. For me, it comes down to this. When we look at the Newton Fund, which the hon. Gentleman referred to; the prosperity fund; the conflict, stabilisation and security fund; or individual programmes by other Government Departments, is it absolutely focused on poverty reduction and, in particular, on creating jobs and livelihoods in the poorest parts of the world? Those programmes are perfectly capable of delivering that, and some of them do, but I do not think that is yet in the DNA of those other Government Departments in the way that it is in the DNA of DFID. By putting DFID in the driving seat, we can ensure that that is the case.
I am really pleased to have had the opportunity to speak in this debate. I congratulate the hon. Gentleman again. I finish by mentioning again the sustainable development goals and the voluntary national review that we will undertake this month. There is an opportunity here for us to ensure that we take these important issues out there and engage and re-engage with the great British public. I think there is a huge generosity in the British public—that is seen in the charitable donations when there are appeals during emergencies—but there is a scepticism about whether we are really getting value for money in aid spending. I believe, based on the evidence, that in most cases we are, but we have an opportunity as parliamentarians, on a cross-party basis, to get out there and persuade our constituents and the wider public that some fantastic things really are being done in their name.
I am most grateful to have an opportunity to contribute to this debate, and indeed to follow the Chairman of the International Development Committee, the hon. Member for Liverpool, West Derby (Stephen Twigg), who does the job so very well and in such an open and transparent way. I draw the House’s attention to my interests, which are documented in the Register of Members’ Financial Interests.
In discussing these estimates, I want to make the point that DFID is one of the most transparent Departments of State. Almost all its expenditure, from a very low level, is in the public domain. When it comes to transparency and the ability really to scrutinise where money is going, DFID is not surpassed by many, if any, Departments in Whitehall. I am particularly pleased about the level of agreement, although we must be wary when the House of Commons appears to agree in almost every corner—we must remember the words of the late Harold Macmillan, who said that when the House of Commons is in complete agreement, there is probably something wrong—so we must maintain self-criticism in spite of such agreement. I congratulate my hon. Friend the Member for Tewkesbury (Mr Robertson) on launching this debate, and doing it with his customary efficiency, good sense and judgment.
I am very pleased that the issue of development has not been caught up in the leadership election that my party is going through, and that what I would call the David Cameron development consensus continues to motivate and define British policy in this very important area. With all the Brexit distractions, global Britain is something that, across the House, we are very keen to see driven forward in the post-Brexit era. In many ways, the progress being made at the moment in respect of global Britain is almost entirely in this area, as I will come on, I hope, to demonstrate.
The Department for International Development contains many leading international experts who are respected around the world. It is important to underline just how respected this relatively new Department is. Hon. Members of all parties have emphasised this afternoon the importance of its remaining a separate Department. I do not think that anyone is suggesting that it should not be a separate Department, but let us be clear that it does not need to be part of another Department because of the National Security Council. That is the link between diplomacy, development and defence. The policy is beaten out and agreed there, and that provides the right level of co-ordination and underlines the importance of keeping DFID as its own area of expertise, which makes such a large contribution internationally.
United Kingdom leadership is about not just DFID, good though the Department is, but many of the academic institutions throughout the UK, which, through their academic work and thought leadership, lead on development policies around the world. Development is of huge interest to the younger generation. I am able to do a little bit of work at Cambridge University, Birmingham University and Harvard on the matter, and I am struck by how many of the next generation are united in a determination to tackle the appalling inequalities of wealth and opportunity that disfigure our world, about