Thursday 8 October 2020
[Caroline Nokes in the Chair]
No Recourse to Public Funds
I would like to remind hon. Members that there have been some changes to normal practice in order to support the new call list system and to ensure that social distancing can be respected. Members should sanitise their microphones before they use them, and please respect the one-way system around the room as you leave. Members should speak only from the horseshoe, and they can speak only if they are on the call list. This applies even if debates are undersubscribed. Members cannot join the debate if they are not on the call list. Members are not expected to remain for the wind-ups. I remind hon. Members that there is less of an expectation that they stay for the next two speeches once they have spoken; this is to help manage attendance in the room. Members may wish to stay beyond their speech, but they should be aware that doing so might prevent Members in seats in the Public Gallery—there are none there today, so fret not on that front—from moving to a seat on the horseshoe.
I beg to move,
That this House has considered No Recourse to Public Funds.
I begin by thanking the Backbench Business Committee for facilitating the debate in our first week back in Westminster Hall. It is great to be back, and it is very good to see you in the chair, Ms Nokes. I am very pleased to see the Members who have come to take part in the debate, and I am pleased to see the Minister in his place as well. I particularly want to thank the hon. Members for Ruislip, Northwood and Pinner (David Simmonds) and for Glasgow South West (Chris Stephens) for their help in applying for the debate.
In a Liaison Committee hearing on 27 May, I told the Prime Minister about a couple in my constituency. Both of them work and they have two children, both born in the UK and holding British passports. The husband’s employer did not put him on the job retention scheme, so he had no income. His wife was still working, but her income was less than their rent. They have leave to remain in the UK but no recourse to public funds, so they could not get any help at all—a hard-working, law- abiding family being forced into destitution. I explained that to the Prime Minister, and he responded:
“Clearly people who have worked hard for this country, who live and work here, should have support of one kind or another”.
In my view, the Prime Minister is absolutely right: they should have support of some kind. Unfortunately, however, the Prime Minister’s view is not the policy of the Government.
May I ask my right hon. Friend whether that suggests to him that the Prime Minister has probably not an advice surgery in a very long time? Does my right hon. Friend think that any London MP would be unacquainted with the facts of no recourse to public funds?
My hon. Friend is absolutely right. Any London MP who has done an advice surgery in the recent past would be very familiar with this issue. Under the “no recourse to public funds” policy, the family I spoke of and thousands of others were getting no help at all.
Last Friday I visited the Deptford warehouse of the remarkable charity FareShare, which gathers surplus food from farms and supermarkets and distributes it to food banks and other charities. Before the pandemic, they were sending 1 tonne of food to my borough, Newham, every week. Now, they are sending 20 tonnes every week. Around a third of that increase, from 1 tonne to 20, is about no recourse to public funds. A large number of hard-working, law-abiding families have no income, cannot afford to buy food and are therefore dependent on those charities.
I am full of admiration for all the organisations in our borough that have risen to the enormous challenge, including Bonny Downs Baptist church, Bonny Downs community association, City chapel, Ibrahim mosque in Plaistow, Mana Park Christian centre, Highway Vineyard church, Newham Community Project, the Magpie Project and Alternatives Trust East London—all of them supported extremely ably by Andy Gold and the Newham public health team.
Some people in Government have done the right thing. The Ministry of Housing, Communities and Local Government agreed at the start to accommodate street homeless people at public expense on public health grounds, although it is being reported now that they are starting to receive eviction notices. The Department for Education agreed that children in families with no recourse to public funds would be eligible for free school meals, contrary to previous policy. That has been a lifeline, especially since, thanks to Marcus Rashford, those families received meal vouchers for their children throughout the summer holiday. I commend that Department for doing the right thing.
The Home Office, however, has not done the right thing. The Home Affairs Committee and the Work and Pensions Committee, which I chair, both unanimously called for the no recourse to public funds restriction to be suspended for the duration of the pandemic, but the Home Office has not budged. It insists that families must be facing destitution before they can apply for an exemption from the restriction. Previously, families had to be actually destitute, rather than facing destitution. A Court of Appeal case about an eight-year-old boy who had been sleeping rough because of the “no recourse to public funds” policy forced the Home Office, greatly against its wishes, to make the policy less draconian than it previously was, although it remains pretty draconian. Those who apply for an exemption have to wait for a month on average for the Home Office to get around to granting it. I spoke to a family that the Home Office had kept waiting for four months. The whole set-up is a disgrace.
In May, the Prime Minister said to me:
“I will find out how many there are in that position”.
That was a helpful offer. Unfortunately, he has not been able to keep that promise because the Home Office will not tell him. There is extraordinary unwillingness on the part of the Home Office to answer straightforward parliamentary questions on no recourse to public funds. I always thought, perhaps naively, that Departments have an obligation to answer straightforward parliamentary questions. That is clearly not the Home Office view.
The Home Office says that it does not know how many people have leave to remain with no recourse to public funds. I understand that it does not know how many people have left the country after having that condition attached to their status. Hon. Members might think that the Home Office could produce an estimate, but it is not willing to do so. Fortunately, others have. Based on work by the Migration Observatory at the University of Oxford, Citizens Advice recently estimated that 1.4 million people in the UK have leave to remain but no recourse to public funds, including families and 175,000 children.
Of course, the Home Office does know how many people it applies no recourse to public funds to each year. I asked a series of questions before summer about that, but the Minister refused to provide a substantive answer to any of them. His colleague, the Immigration Minister, answered a whole series of questions with a single meaningless answer. On 20 May, I asked:
“how many people were given leave to remain in the UK subject to the no recourse to public funds condition in 2019.”
I asked for a number. On 2 June, the Minister’s colleague replied:
“The information you have requested is not assured to the standard required by ONS for publication and as it would be too costly to do so, we are unable to provide it.”
In other words, “We’re not interested in answering your question.”
I complained about that answer to the UK Statistics Authority, and it upheld my complaint. The correspondence is on its website. The Home Office head of statistics responded on 3 July. His letter accepted that that answer was inadequate, and he said that the reason that it was inadequate because no statistician had cleared it. Well, I suppose that clears the statisticians of guilt, but the Immigration Minister saw it and put his name to it. How on earth was he prepared to put his name to such a hopeless answer to a straightforward parliamentary question?
I say this to the Minister: Ministers have constitutional responsibilities to Parliament. It is not good enough for a Minister of the Crown to sign off a completely hopeless answer like that simply because—I don’t know—somebody answering to Dominic Cummings has instructed him to do so. Ministers in the Home Office need to start fulfilling their responsibilities and providing answers to straightforward questions.
The letter from the Home Office head of statistics said they could not answer how many people were given leave to remain in the UK subject to NRPF in 2019, because
“Home Office administrative data only captures information on whether visas are subject to NRPF conditions for in-country extensions.”
I have since asked twice in how many in-country extensions in 2019 people were given leave to remain with no recourse to public funds. From the head of statistics who had the information, answer came there none.
In response to the Windrush scandal, the Home Office has just published its comprehensive improvement plan. Theme number four of five is openness to scrutiny— that will be the day. Can we at least dare to hope that Home Office Ministers might at least stop refusing to answer basic, straightforward parliamentary questions? On how many people were in such a situation, the Prime Minister eventually said that the Home Secretary would write to the Liaison Committee with an answer. She did so but provided no useful information. As such, I am grateful to the Chair of the Liaison Committee, the hon. Member for Harwich and North Essex (Sir Bernard Jenkin), for writing the Home Secretary a letter yesterday, also signed by myself as Chair of the Select Committee on Work and Pensions, the Chair of the Select Committee on Home Affairs, my right hon. Friend the Member for Normanton, Pontefract and Castleford (Yvette Cooper) and the Chair of the Public Accounts Committee, my hon. Friend the Member for Hackney South and Shoreditch (Meg Hillier), who I am delighted to see in her place this afternoon. In it, we asked to meet the Home Secretary to discuss her failure to provide basic information that the Home Office head of statistics has confirmed the Department holds, but that for some completely unknown reason Ministers are unwilling to provide. Not having the data means not being able to evaluate the policy. That is, as the Windrush lessons learned review pointed out, a large part of the problem of why the Windrush scandal occurred. Now, we are heading down exactly the same tracks with this.
I will make two final points. Among 1.4 million or so people with leave to remain but no recourse to public funds is a large group of overseas students. Many among them were working to support themselves through their studies. The pandemic has ended their work, or their families back home have also been affected by the pandemic, so support from them has dried up. People from overseas studying in the UK do not expect to claim benefits. However, I do not believe it is in Britain’s long-term interests to force into utter destitution such a large number of those who have chosen Britain of all the countries they could have chosen in which to study, often investing their family life savings to do so. Certainly, we need the universities to be flexible and supportive to students struggling to pay fees in this academic year. We want those students to be friends of Britain for life in their own countries. The way we support or fail to support them now will be key. At the moment, we are giving them no support at all.
The Government line over the past six months has been that no recourse to public funds is okay because people could apply to the job retention scheme or the self-employed income support scheme. Of course, millions of UK citizens have been ineligible for those two schemes, which is why 3 million people have had to apply for universal credit in the past six months. People with no recourse to public funds are barred from doing that. There is no safety net for them at all. It is true, though, that some with no recourse to public funds have been supported by one of the Government pandemic schemes. In fact, the family I told the Prime Minister about in May was eventually able to benefit from the job retention scheme. However, those schemes finish at the end of this month. A whole new cohort of working people will have no job, and if no recourse to public funds is attached to their immigration status, there will be no safety net for those hard-working, law-abiding families. Banned from universal credit, foodbanks will be their only option to survive. If they do find work, they cannot claim the £500 track and trace support payment, so if they get covid they will be forced to carry on working and will be a risk to public health.
Now, more than ever, the Government need to deliver what the Prime Minister said. Those hard-working, law-abiding families who have been contributing to the UK should have support of one kind or another. Suspend no recourse to public funds.
It is a pleasure to serve under a chairman with such experience of this issue. I know, Ms Nokes, that you have done a great deal of work on asylum migration in the United Kingdom over the years.
It was my pleasure to support the bid for this debate today. My experience with no recourse to public funds starts with recognising that it is an extremely complex issue. I have no dispute with the estimates, made by the Migration Observatory at the University of Oxford, of 1.4 million people and up to 175,000 children living in households where there are adults with no recourse to public funds. For many of those households, that is not necessarily an issue of destitution, because for some time NRPF status has been used as a kind of migration amnesty. People are told that while there may be some question mark over their eligibility, they are able to remain in the United Kingdom provided they are not a charge on the funds of the state.
I am a constituent of the Prime Minister. One of the members of the household next door is a lady from India, who is married to a British man of Indian heritage and who has two children who were born in the United Kingdom. She has NRPF status. If the Prime Minister is not aware of that, I am certainly happy to bring it to his attention. It is evidence that in many households this condition has been imposed as a consequence of the person’s presence in the United Kingdom, but for many people that is not something that will cause them a problem in their day-to-day life.
Although there is a valid debate to be had about the morality of saying to people, “You can be in the UK but you are excluded from the British safety net,” I will focus on some of the practical issues that NRPF status creates for those families who find themselves getting into difficulty. I agree with what has been said about the numbers. One of the challenges in this debate is that because those numbers are not widely available, they are not easily analysed. Understanding what proportion of the estimated 1.4 million people find themselves in difficulty and require intervention is a major challenge.
Starting in 2005, the Government introduced, through the Home Office, a programme of asylum dispersal. I had the pleasure of giving evidence to the Home Affairs Committee, alongside the Mayor of Greater Manchester, Andy Burnham. Part way into his evidence he said, “I have just realised that I was the Minister who signed this into law, in the mid-2000s, when we introduced this policy of dispersing people through this mechanism around the country.” A lot of the issues we see arising in local authorities are iterations of that policy, which exists to this day. The simple principle behind it is that people should be placed in parts of the country where accommodation is inexpensive and where they can be housed in a way that does not introduce competition with other local families that may be in need. It is a policy that has worked in different forms, with varying degrees of success, over the years.
The challenge seems to arise when the result of those people’s journeys through the asylum dispersal system is a decision that they are not supposed to be in the United Kingdom and that they do not have a future here. At that point the NRPF status is imposed on them and they find themselves at risk of destitution. That is where there is a major challenge for Governments of all parties, which is that NRPF is something of a myth, as a status. It is a list of things that are paid for out of central Government funds, which cannot be accessed, at which point the duties of local authorities, dating back to the National Assistance Act 1948 and the Children Act 1989, then come into effect.
What we see, in fact, is a cost shunt from central Government to local government. Those who understandably wish to see a robust policy in respect of migration, and in respect of those who do not have a right to be in our country, have the comfort of thinking, “At least we are not paying for the subsistence costs of those families,” but in fact local council tax payers are picking up the bill for that. I know that the Public Accounts Committee has given the matter some consideration over the years. When we look at the information provided by a number of different sources—I pay particular tribute to the No Recourse to Public Funds Network—we see that they identify that that costs the authorities responsible about £44 million per annum of council tax payers’ money. Some 82% of the households that are supported under those arrangements are on what is termed the exit pathway, so they are people whom the Home Office does not view as having any long-term future in the United Kingdom, and they are on their way to deportation or leaving under their own steam but have not yet left.
It seems to me that it is not justifiable to say that we have a tough and robust policy around migration, and that people who should not be here are required to leave, when in fact the consequence of our policy is that they are staying at a cost to local council tax payers. The underlying assumption is that NRPF will result in people who do not have the long-term right to be in the United Kingdom leaving. The reality is that, in many cases, that is not what happens, and families who do not have a long-term future in the United Kingdom none the less become a cost to local council tax payers.
I therefore urge consideration of this issue, not just from the perspective of compassion—I think that that is very important, and it is very much the perspective that we have heard already—but because, if we wish to develop and build confidence in our communities that, in practice, we have the robust and rigorous asylum, refugee and migration policies that we say we do, we need to demonstrate that the ambitions that are set out in policy are being fulfilled at local level. In my view, NRPF simply does not meet that test at the moment.
I congratulate my right hon. Friend the Member for East Ham (Stephen Timms), my constituency neighbour, on securing the debate. I will be brief, because I have no choice.
I have been dealing with the consequences of this policy since I was elected as the MP for Leyton and Wanstead a decade ago, and during that time the situation has become much worse than I remember in my early days. Like my right hon. Friend’s constituency, Leyton and Wanstead is one of the most diverse constituencies in the country. That means that I have a very high proportion of migrant constituents. That means that I have a very high proportion of people with no recourse to public funds, and the situation will undoubtedly get worse because of the consequences of covid. I will say more about that in a minute.
Even before covid, almost half of all children with foreign-born parents living in Britain were living below the poverty line. That is 100,000 children. Again, a lot of that is because of no recourse to public funds. As the hon. Member for Ruislip, Northwood and Pinner (David Simmonds) mentioned, councils are clearly dealing with an awful lot of the consequences—for which they are ill prepared because of the financial cutbacks over the last decade—through social services, because of course social services are not designated as a public fund. The hon. Gentleman mentioned £44 million a year. The last figure that I saw, for 2018-19, was nearer £48 million. We do not have the figures for the period with the virus, but we can guess that, after covid, the figure will be much higher than £48 million. We can only guess at the moment how much it will be. As the previous speaker said, there is a cost shunt. That does not involve any saving to the taxpayer, because the taxpayer is still paying for the consequences of what is a pretty disreputable policy.
Legally, court cases are very difficult. Court cases are now slightly easier to bring than they were. At one point—my right hon. Friend mentioned this—someone had to be actually in destitution before they could bring a court case. Now, someone can bring a court case when they are facing destitution. However, it is still pretty desperate stuff when someone is facing destitution. Only then can someone bring a court case and try to overturn the decision, but overturning the decision is very rare and very complicated, and it is very difficult to find legal specialists who can take on those sorts of cases.
I will give just two brief examples from my constituency that illustrate the effects of no recourse. The first involves a woman separated from her husband and stuck in one-bedroom accommodation with three children, one of whom is autistic. Following the break-up of her relationship, she applied to the Home Office for a change of circumstance, but the form asked for details of her legal representative. She had no legal representative, so she could not complete the form and could not change her circumstance. The second is the case of a woman threatened with homelessness because of rent arrears and unable to approach the council for emergency accommodation. She was working in a betting shop in Leyton, but of course on minimum wage and therefore very low paid. She was unable to meet the rent and fell into arrears, and children’s services could not assist because she was not considered destitute. That brings me on to working conditions.
With covid, a very high proportion of migrants who face having no recourse to public funds will have been on, and in some cases still are on, zero-hours contracts, so their employers have no real incentive to furlough them. There is no real mechanism for furloughing them. From one day to the next, they go from being employed to not being employed—literally overnight. They are then in the position of having no recourse to public funds and rapidly facing destitution.
I agree with my right hon. Friend the Member for East Ham. We live in the sixth biggest economy in the world, and the notion that we have tens of thousands of people facing destitution is disgraceful. What is also disgraceful is that the Prime Minister, apparently, is blissfully unaware of the situation out there, despite the fact that he is a London MP.
It is a pleasure to serve under your chairmanship, Ms Nokes. I congratulate my right hon. Friend the Member for East Ham (Stephen Timms) on securing this debate, and I thank the Backbench Business Committee for tabling it.
I want to make it clear that this matter is urgent for families in my constituency, and indeed across the country, as we are hearing today. It is urgent particularly for hard-working parents who are struggling to make ends meet and who, through no fault of their own, now face huge uncertainty over their homes and their futures, with their family and children being pushed into poverty.
No recourse to public funds impacts on most non-EEA national migrants with temporary permission to remain in the UK. As we have heard, the visa condition prevents them from accessing most state-funded benefits, tax credits and housing assistance. The Institute for Public Policy Research think-tank warns that the covid-19 pandemic could have particular financial and health consequences for such migrant households, with migrants more likely to be working in industries affected by the crisis, to be in temporary work or self-employed, and to be living in private rented and overcrowded accommodation.
The Joint Council for the Welfare of Immigrants has said that the NRPF restrictions have pushed working families into abject poverty, forcing them into unsustainable debt and into homelessness or overcrowded and insecure housing. Right now, it matters more than ever, because covid-19 has made the situation much worse, particularly for those in insecure employment or on zero-hours contracts, which are at a record high of 1.05 million in this country. Many others have had their hours cut or lost their jobs completely.
A significant number of migrants are from BAME communities. We know that members of BAME communities are more likely to be in insecure employment, and they are being hit harder on two fronts. First, they are more likely to have lost income or work, and secondly, they are at a higher health risk from the virus. There are serious concerns about whether our welfare state is fit for purpose, certainly for the circumstances that we find ourselves in.
Today we are looking at the facts relating to those with the status of NRPF, who are often in the toughest of conditions and who are now struggling to fend for themselves. That is why the Labour party, cross-party committees and charities have called on the Government to suspend the “no recourse to public funds” conditions in response to the pandemic. That is also why, back in March, I raised this matter in the House of Commons. I was told that the Government were looking at a range of measures to support this group, which may include the self-employed, business owners and those who work in our public services, as well as students and many others. Along with my right hon. Friend the Member for East Ham, I then wrote to the Home Secretary to ask for advice that we could pass on to our constituents to reassure them that by staying at home in line with Government guidance, they would not be forced into extreme financial hardship. We received no reply to our letter.
Later, the Government did bring in some concessions, which have been referred to. They allowed local authorities to provide some basic safety net support. Food banks have taken up some of the challenges, and there was also the temporary extension of free school meals to families with no recourse to public funds. Quite clearly, it has not been enough.
There have been all too many occasions when all we could do was to refer people with no recourse to public funds to a local authority hub, to get the most basic of support. As family savings dry up and as people struggle to find work, the strain and stress is having an enormous impact on our fellow citizens and neighbours, who want to do nothing other than continue to support themselves, their families, their communities and, indeed, this country.
To illustrate what it has all meant, let me share just one heartbreaking story from my constituency. A constituent with three children, one of whom has special needs, has been receiving only £345 per month of income through furlough to survive on, and that is now uncertain. Her husband lost his job because of covid; they are unable to pay their rent or afford food and are now at risk of homelessness. Just think about the impact on those children. As well as having a disrupted year of education, they are worrying about where their food will come from and where their home might be in six months’ time.
Crisis has talked about marriages breaking up and the rise of rough sleeping. We cannot wait any longer. Winter is coming. Times are getting tougher, with rising cases of coronavirus and increased local lockdowns and restrictions. Casual or temporary work that has kept people going is drying up. Constituents are telling me that their other sources of income—family and friends who they may have been able to draw on in hard times—are themselves facing hard times, and that route is now not available to our constituents.
This is about fairness, compassion and humanity. It is about a Government’s responsibility. I urge the Government to suspend the “no recourse to public funds” conditions in response to the pandemic, so that families are not forced to choose between their health and food on the table, and so that they have the support they need to keep themselves and their communities safe at this incredibly difficult time.
It is a pleasure to serve under your chairmanship, Ms Nokes. It is a privilege to listen to my right hon. Friend the Member for East Ham (Stephen Timms). I thank him for the way in which he has conducted the debate. I almost feel sorry—no, in fact I do feel sorry for the Minister. He is caught between the Scylla of the Prime Minister and the Charybdis of the Home Secretary. In that passage, he has been absolutely smashed on to the rocks by my right hon. Friend.
I want to try to give an example that shows the inhumanity of what is happening. On 6 May this year, I received an email from a woman about her husband. She says he was a very healthy man with no underlying medical conditions. He was only 45 and had just celebrated his 45th birthday—she says he was her childhood sweetheart. She goes on, “Sadly, my husband drifted away forever while my children and I were watching him on screen and screaming and begging him not to leave us. The whole experience has left us shell shocked.”
Her husband was a construction worker who died from covid. They came to this country in 2004. They obtained a visa with limited leave to remain and no recourse to public funds and were on the discretionary 10-year path. She has been working, but has nowhere near enough income to pay the rent for their home. As I say, on 6 May, she wrote in desperation. Within 24 hours, we had acted and appealed to the Home Office to give her recourse to public funds. It did, and for that, I am incredibly grateful, but it took five weeks. For this family, with one child who is a British citizen, that meant five weeks in destitution.
That was the good outcome. I have another piece of correspondence, which relates to a gentleman who had lived here for many years with his European economic area spouse. He had always worked hard as her dependant in the UK. They have a daughter who was born here. His wife has abandoned the family and returned to her home in continental Europe and, as he is originally from Pakistan, he is now trying to establish his right to remain in the country, but he has no recourse to public funds. They first contacted me in January of this year. Without the help and support of Brent Council’s no recourse team, I do not know what would have happened to that man and his seven-year-old daughter.
It is incumbent on the Minister to answer a number of questions, some of which were asked by my right hon. Friend. The Minister needs to explain—not to us, but to the public—how he expects a single parent like my constituent to pay his rent and look after his daughter, alongside having to deal with covid, with no recourse to public funds. He needs explain how people who are now no longer in employment will be able to survive the five weeks for which, in a good situation, his Department comes back and provides.
The Minister needs to make the commitment that any change of condition to which the Home Office agrees—when we, as Members of Parliament, apply to the Home Office to change a condition, or when a council does—will be done within 48 hours. If someone is at risk of destitution, it is no good saying, “Oh, yes, it is at the bottom of a pile somewhere, and we will get to it in five weeks.” We are talking about children and vulnerable people, so speed is of the essence. I hope that the Minister will at least agree to review that so that those decisions can be taken expeditiously.
It is a pleasure to see you in the Chair, Ms Nokes. I congratulate the Chair of the Select Committee, my right hon. Friend the Member for East Ham (Stephen Timms) on securing the debate.
It seems to me that covid has brought into sharp focus the stark reality of the inhumane nature of no recourse to public funds. Not only has it exposed the suffering to which we are subjecting people and their children, but it carries with it an in-built additional health risk. It must be obvious that those with no other source of income will continue to try to work, even while they are unwell, inevitably exposing others to the virus because of their desperate need to make ends meet. That is not only hitting them, at one level, but creating another health risk.
As we have heard, the policy applies largely to those who have not been granted indefinite leave to remain, including victims of trafficking and torture, and women fleeing abusive partners. Until recently, as my right hon. Friend said, it also barred their children from receiving free school meals. This is placing an intolerable burden on local authorities. Birmingham, like many authorities, is battling with a huge increase in homelessness and buckling under the strain. As we know, local councils do not receive any specific funding from central Government to support these people. There may be some slight dispute about the total figure, but the latest data I have seen, for 2018-19, showed that 59 councils were spending £47.5 million a year on NRPF service provision—that is before coronavirus.
As we know, the High Court recently described the system as a breach of article 3, which prohibits inhuman or degrading treatment. As my hon. Friend the Member for Leyton and Wanstead (John Cryer) indicated, the court found it particularly problematic that a person must prove they are destitute before the conditions can be lifted; it ordered that their showing they were about to become destitute should be sufficient. I am not sure how either can be proved, to be perfectly honest, but I think most reasonable people could make that judgment quite quickly and without too much investigation.
I find myself in agreement with much of what the hon. Member for Ruislip, Northwood and Pinner (David Simmonds) said, particularly towards the end of his remarks. At its core, this is a Home Office problem; its inability to deal with outstanding immigration cases is causing much of the difficulty. To my mind, the best way to resolve the problem would be to allow those currently subject to the restriction to claim the equivalent of universal credit and charge the cost of that to the Home Office. Ministers and officials would soon be incentivised to produce a rather more efficient immigration system—one that actually sets out to resolve cases rather than leaving people in limbo for years on end.
There cannot be a Member in the Chamber who has not got a backlog of cases of people who have been trying for years to get their situation resolved. That is the problem. We are penalising these poor folk because of the Home Office’s inability to do its job. If we were to give them access to the equivalent of universal credit and charge that to the Home Office, we would at a stroke address our article 3 failings—perhaps enabling this country to lift its head a bit higher—and tackle the root cause of the problem at the same time.
I want to pursue the problem that what looks like a resolution—offering status on the basis of no recourse to public funds—has instead created an industry of people involved in trying to help families in those circumstances, and increased the workload of the Home Office when that is the very last thing it needs.
Every Friday at my advice surgery, in my pack of papers I bring applications to remove a “no recourse to public funds” restriction on a visa. The people I meet are principally women whose children have British citizenship or women whose children were born here and are now over the age of seven. In the main, those women work. They are the carers; they do the jobs that we do not want to do, mostly on zero-hours contracts. They can manage to get by as long as their relationships stay more or less stable, but once those relationships break down and the men go, they can no longer afford their housing and to support their children; they lose the support network that allows them to be able to work antisocial hours, evening and weekends, because there is nobody to look after their children.
It is interesting that most of the MPs present represent London constituencies that have really hard-pressed children’s services departments. We Members get in touch with children’s social services, and then they get involved and do the assessments. They pay for the housing, support and continuing care out of the money that they get to look after children who are in the gravest need in our country, whose safety, security and health are threatened. A local authority strapped for cash, such as mine, can spend half a million pounds a year, which is dwarfed into insignificance by comparison with a Hackney, a Haringey or an Islington, or any of the councils represented in the room. That money does not go to the children who are most in need because we are supporting families who have the “no recourse to public funds” restriction on their visas, which is something that the Home Office introduced. Then, we develop another industry of voluntary sector organisations that do their best to get the restriction removed. I thank Jenny Allison and her team from Commonside Community Development Trust, and Gillian Thicke and James Saville from Christian Care, who spend most of their time trying to get the restrictions removed.
The policy of no recourse to public funds is not cheap, because it simply shunts the spending to another public body that is unable or ill equipped to give help and support. We are also stimulating the industry that allows landlords to rent out individual rooms in houses to families, because these people cannot afford anything else. Once they are in those circumstances, it is impossible to get out of them. I can tell legions of stories about mums with three or four children living in tiny rooms. If we took a photograph of them and put them in the national papers, nobody would believe that people in our country are living in those circumstances. No matter how privileged we are—we are all privileged people—we know families who live in such circumstances. We must have all had this experience with people who work with us or do work experience with us: we show them the way that people live in our country, and they cannot believe it.
This policy is not a cheap option. I understand that there has been an increase of 600% in applications to the Home Office to have the restriction removed. It costs civil servants, it costs time and it costs crises. I would argue that we are not saving the taxpayer any money by doing this. We are humiliating people who work hard and putting their children in circumstances that we would not wish on anybody’s children. Desperate people and desperate women will do desperate things to support their families if they have no other means of doing so. We are fuelling some pretty terrible practices and some pretty terrible crimes, and we should stop doing it.
It is a pleasure to serve under your chairmanship, Ms Nokes. It is worth highlighting that we talk a lot about this issue, but quite a lot of people are affected, as others have highlighted. There are 285,000 people living in my borough of Hackney. Of that population, 31,000 are non-EEA citizens. Those are people who have never acquired British citizenship; it is not the total number of foreign-born people, which is just over 10% of the total population. A significant number of them are going through the immigration system, and of those a number will be under “no recourse to public funds” restrictions.
As my right hon. Friend the Member for East Ham (Stephen Timms) highlighted, however, the Home Office does not know how many people are under the restriction of no recourse to public funds, because it either does not collect the data or does not wish to publish the data. We know there are issues with the Home Office databases, and perhaps the Minister can provide some illumination. I will try to be brief in order to allow the Minister extra time to respond, and I hope our Front-Bench spokesperson will do so as well, because we need answers to why the figures are not available.
We cannot make policy without decent data. As I will touch on later and as my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh) highlighted, there are big, cost-shunting issues. If we have the numbers and can work out the cost, we can make better and—dare I dangle this in front of the Minister at this difficult time for all Departments?—cheaper policy. As Chair of the Public Accounts Committee, I spend a lot of time looking at this question.
I have served as an MP for 15 years, and no recourse to public funds was not talked about much 15 years ago. I am sure colleagues in the Chamber recognise that. We know it has been extended in the past decade. When I was first elected, people would apply for discretionary leave to remain, they would get five years, and then they would get citizenship. Then it was split into two periods of three years, so they would have to apply twice to get their five years for citizenship. Now it is two years, so it is three applications, three fees, and often at some point in that process, if they did not start out with no recourse to public funds, that is added on.
Absolutely, and I will touch on that at the end. That is a very significant issue. We have talked a lot about children today, and we are in danger of putting a whole generation on the wrong side of everything. They were often born here, or arrived here as young people, and all they want to do is contribute.
On the face of it, it does not sound wrong. People who come to this country should pay their way; we would expect that if we went to visit other countries—but life is not as simple as that. Many of my constituents are in very low-paid work. As my hon. Friend the Member for Feltham and Heston (Seema Malhotra) said, they are often in low-paid, zero-hours contract jobs. Actually, in my constituency, they are often in good, well-paid jobs. I have nurses, teachers and others who are in jobs that pay well but not enough to live in London. It is very difficult. In my constituency, and probably across the whole of the south-east of England—I do not have up-to-date figures—people cannot rent a three or four-bedroom property under the housing benefit cap. Those people are not necessarily claiming housing benefit, but the costs of renting are too high to pay for out of their wage packet.
What happens is that people live with family and friends, and I have many constituents who do that. As my hon. Friend the Member for Mitcham and Morden said, if these pictures were shown in the media, people would not believe it. People are living in one room with another family member living in the other room, because they just cannot afford the housing costs. They have no recourse to public funds, and they cannot get a penny of housing benefit to help towards that. Let us not forget that most housing benefit goes to people in work. That is another issue, but it is a systemic sign that the whole housing system is bust. That is a debate for another day—possibly the same Members might wish to contribute.
Overcrowding is a big health risk at the best of times, and we are not in the best of times. A concern of mine during the covid pandemic is that those double households are trapped. I had a very distressed grandmother come to see me at a surgery. I had been to visit the family, and they had been to see me before. She loves her daughter and granddaughter, but they cannot move out of their one-bedroom flat because they have no recourse to public funds, and mum is a nurse. The grandmother came to see me and said, “When will we get housing? How will we get housing?” She came to see me privately because she did not want to tell her daughter how hard it was for her to share her small home with her beloved family. These are small flats, and they are often very overcrowded.
As others have highlighted, councils are spending a lot of money on this. In 2018-19, 59 councils were spending £47.5 million a year on service provision to people with no recourse to public funds. That was before coronavirus, and some of those people are being affected now. I want to highlight an individual case—we all have so many. One of my constituents has two children, and her late father was British. She is working, but because she has no recourse to public funds, she cannot claim tax credits, child benefit or housing benefit. That has had a very big effect on her, and is having an impact on her children. She is not sure, and nor am I, how much longer she will be able to cope.
My hon. Friend the Member for Mitcham and Morden highlighted the issue of cost-shunting, which the Public Accounts Committee talks about all the time. There are costs to society, the taxpayer and, of course, individuals. I want to highlight the taxpayer costs to the Minister, because that should bite if nothing else does. So much of the system is having to pay for people who cannot pay their own way because they have no recourse to public funds. They are working people for the most part. They want to work, and they might just have hit a rocky time.
My hon. Friend made a point in passing that I want to highlight. I do not know whether it is well known, but we are talking about a large number of British-born children whose parents cannot claim child benefit for them. I do not think most people know that is the case, but it is.
I am grateful to my right hon. Friend, the Chair of the Work and Pensions Committee, for that intervention, because that is correct. People assume that there is a safety net there—we all assume a lot of things about other people’s lives in a general way, because people do not always live that path themselves—but many of our constituents do not have a penny coming in, even though their children are British. It is the main householder who affected. There is a really big cost and those children are growing up in increased poverty as a result.
If we want to invest in the future of our country, we must consider these young people with their driven parents—parents who came here, who are working, who want to work and want to contribute, and anyone would say that they have the right work ethic to ensure that their children will also achieve—because they are living in much more difficult circumstances than they need to. The cost of any public funding will not suddenly fund their lifestyles; it is just going to help them to keep afloat, to keep their housing and to keep playing their active role as working members of society.
I will touch on the point that my hon. Friend the Member for Brent North (Barry Gardiner) made about people who cannot afford the fees; we talked a bit about that. I pay tribute to my constituent, Chrisann Jarrett, and to We Belong, which is a group of young people who are taking the long route for citizenship; some are from families with no recourse to public funds, but there is a wider point that I raise here, too. These people are young, gifted and talented, and they came here as young children. They want to contribute to this society; they are not going to live anywhere else. The countries that their parents were born in are of interest to them, but usually they cannot visit them because they do not have citizenship. However, they have to pay these repeated fees. Often, they never got citizenship early on because their parents simply could not afford even to start them on that process. Then they find that they cannot go to university and they are left sitting around, kicking their heels.
In July, the Home Secretary said—very genuinely, I feel, and I say that to the Minister—when she made her latest statement on Windrush that she wanted to root out any unequal treatment in her Department, and that she wanted to see a root-and-branch review of how it treated people. I took her at her word on that; she stood there, said that, and I believed that she meant it. If she really means it, this group that I have talked about—We Belong, which I believe she has met or is about to meet—are really good advocates for this. Surely, however, if she really believes what she said, she needs to look at no recourse to public funds, because if we look at the profile of the people who are affected by that, we see that it does not meet the equality standards that she professes to support.
In summary, I hope that the Minister will answer the detailed questions on the Home Office statistics. Does he have the statistics? If they are available, why can we not see them? If he does not have those statistics, can he tell us how he will get hold of them, so that he can make sure that he and the Home Office are making policy decisions based on proper evidence and data?
It is a pleasure to see you in the Chair, Ms Nokes. Obviously, with this debate being a home affairs-style debate, you must have your own reflections on it. I certainly reflect that all too often in the last Parliament, it was your good self who had to defend the indefensible in terms of Home Office actions. We will see whether the Minister who is here today reaches the same standard.
I thank the Backbench Business Committee for granting this debate, and I pay particular tribute to my good friend the right hon. Member for East Ham (Stephen Timms), the Chair of the Work and Pensions Committee, which I sit on. He is chairing it with distinction. During his contribution to this debate, I remembered what was for me one of the political television moments of the year: the right hon. Gentleman having to explain to the Prime Minister what “no recourse to public funds” actually means. It was an almost “Playschool”-like exchange, as he had to explain to the Prime Minister what those words mean.
In his speech, the right hon. Gentleman also explained his extraordinary exchanges while putting parliamentary questions to the Home Office. I have to say that was very familiar. I think that it is something that we have all experienced with some of the parliamentary answers that we get back, particularly the one that says that “due to disproportionate cost”, an answer cannot be provided. I have often thought that I should perhaps table a question asking just how many answers are couched in those words: “The answer cannot be provided due to disproportionate cost”. I wonder whether the answer will indeed be that they will not be able to provide the answer, because of disproportionate cost.
[Ian Paisley in the Chair-]
Mr Paisley, I want to give the clear view of the Scottish National party, which is that the coronavirus does not respect borders or immigration status, and that everyone in these islands, including those with no recourse to public funds, deserves help to get through the crisis without facing destitution. The SNP, like other political parties, has been clear that the policy must be suspended, so that we can support people through this unprecedented public health crisis. Both the Select Committee on Home Affairs and the Select Committee on Work and Pensions have called for it to be lifted temporarily, as has been alluded to. It was incredible to see the most recent updates from the Home Office, stating that it had no plans to change they approach. The economic impacts of the pandemic are pushing thousands of people further into poverty and harming their employment opportunities.
In April we saw what can be possible when the political will is there, as thousands of vulnerable people in the UK were given support and shelter during the first wave of the pandemic. As the charity St Mungo’s said at the time,
“People say it’s not possible to end rough sleeping, but we’ve always maintained that it is, with the right attitude and money.”
Yet six months on, homelessness is again on the rise, with a 33% increase in the number rough sleeping on London streets between April and June this year.
Our other concern is that no recourse to public funds is a racially discriminatory policy, and we believe it should be scrapped without delay. It is more likely to affect black and minority ethnic British children than white British children. It only contributes to the ongoing hostile environment that we believe the Government are intent on creating. Scrapping the policy would be a concrete step towards tackling inequality in these islands, particularly in the light of the findings of Public Health England and Scotland’s independent expert reference group about the disproportionate impact that the covid pandemic has had on BAME communities. We come from the view that everyone in these islands should have the right to get access to support, which is particularly vital during the pandemic, regardless of their status. However, owing to the policy, many people have been left behind because of the lack of support, which has led them to being pushed further into hardship through no fault of their own.
We certainly come from the view that the UK Government’s refusal to do the right thing and immediately lift the restrictions on those with no recourse to public funds for the duration of the public crisis is appalling. The unreasonable and heartless restriction also affects women and children fleeing domestic abuse who have had to leave their little resources and belongings, and non-EEA nationals who lost their incomes and found themselves far from their families and homes as a result of the pandemic. We received an excellent briefing from the Unity Project, based in London, and I received a similar one from the Unity centre based in Govan, in Glasgow. Who is affected? The impact is severe. The briefing tells us that 52% did not have a bed to sleep in; a third share their bedroom with their children, and 6% of single women have experienced street homelessness with their children.
Can the condition be removed, as we have heard in the debate? First, it can take too long. People suffer every day they have to wait. Organisations provide support to people to try to get restrictions lifted but they have had to wait four months for a decision. Many people do not know that they are eligible to apply for the restrictions to be lifted in the first place. It is a 20-page form and often requires hundreds of pages of evidence, which can be utility bills, evidence that has to be got from an informal landlord, or a letter from an exploitative employer, so there are real problems. The other problem, of course, is the whole system. Applicants can be unlawfully refused. In many cases support organisations have successfully challenged the decisions of the Home Office through judicial review and the national success rate for applications was 62% before the pandemic. There are real concerns about the policy under which people try to secure the lifting of a restriction.
The effects on women, children, people with disabilities, Commonwealth citizens and those who are subjected to domestic abuse are a real concern, but so is the fact that the policy has been ruled unlawful in the past. The whole operation of the policy has been brought into disrepute in court cases in 2014 and 2019 and during lockdown in 2020. In the most recent hearing, the High Court ruled that the policy was unlawful, because it did not prevent destitution and left the claimant, an eight-year-old boy, street homeless with his mother. The policy has since been adjusted, but continues to be subject to legal challenge. That is a real concern.
I have a couple of questions. Will the Minister explain specifically how single parents affected by no recourse to public funds are expected to pay rent and feed their family in scenarios in which they test positive for covid and have to self-isolate, are laid off and unable to find employment, or have health conditions that put them at particular risk from the virus?
Will the Minister also tell us if he will launch an inquiry into the impact of the “no recourse to public funds” policy? According to the Government’s 2012 policy statement, the policy was introduced to
“reduce burdens on the taxpayer, promote integration and tackle abuse”,
within an immigration system that is
“transparent, clear, consistent and fair.”
I can only say to the Minister that, since I arrived in this place in 2015, I have not regarded the immigration system to be transparent, clear, consistent or fair. What concrete evidence will the Minister provide to show that the policy is meeting those stated objectives?
We have heard some real life examples. My fellow Glaswegian, the hon. Member for Brent North (Barry Gardiner), gave some horrific examples of the policy, and many more have been covered. I will close on the Prime Minister’s response to the right hon. Member for East Ham on television. People affected by the “no recourse to public funds” policy often pay income tax, national insurance and council tax, but they face those exorbitant immigration charges that have been referred to. If they are taxpayers in need, they should be entitled to public funds. I support those who believe that the policy should be scrapped.
It is a pleasure to welcome you to the Chair for this important debate, Mr Paisley.
I start, as so many others have done, by congratulating my right hon. Friend the Member for East Ham (Stephen Timms), the Chair of the Work and Pensions Committee, on not just securing this important debate and making a powerful opening contribution, but his leadership on no recourse to public funds throughout the coronavirus crisis. As he made clear, his Committee and the Home Affairs Committee, on a cross-party basis, unanimously called for the suspension of the “no recourse to public funds” restrictions for the duration of the pandemic. His questioning of the Prime Minister at the Liaison Committee gave us what we later learned to be false hope that the Prime Minister himself was in agreement that they should be lifted.
My right hon. Friend spoke of his extensive efforts—as did my hon. Friend the Member for Hackney South and Shoreditch (Meg Hillier), the Chair of the Public Accounts Committee—and the difficulty of ascertaining exactly the information that we need about just how many people are affected by having no recourse to public funds. The latest figures produced by the Migration Observatory at the University of Oxford, which others used during the debate, estimate that by the end of 2019, at least 175,000 children under the age of 18 in families were expected to have no recourse to public funds, and more than 1.4 million adults.
The Labour party has consistently asked the Government to lift NRPF as a condition on a person’s migration status to ensure that no one is left behind in the public health effort against the coronavirus. Writing to the Government on 21 April, I asked them to lift the “no recourse to public funds” condition for the duration of the pandemic, stressing that thousands of people could face impossible choices between staying safe and securing an income for themselves and their families. My hon. Friends the Members for Birmingham, Selly Oak (Steve McCabe) and for Mitcham and Morden (Siobhain McDonagh) spoke powerfully about how the length of time it takes to determine a person’s immigration status is at the heart of this debate.
The Minister will say that those with no recourse to public funds were eligible for furlough but, as we all know, not all types of work or employment conditions were eligible for the furlough scheme, which comes to an end on 31 October. My hon. Friend the Member for Leyton and Wanstead (John Cryer) spoke about those he represents—it is the same in my constituency—who are on zero-hours contracts and were not eligible for that support as a result.
Labour has pressed this issue throughout the passage of the Immigration and Social Security Co-ordination (EU Withdrawal) Bill, both in Committee and on Report. The tight framing of the law changes in that Bill did not allow us to table amendments that would have lifted NRPF with immediate effect, but we did make the case again for why lifting the condition for the duration of the pandemic would be the appropriate and responsible thing to do in the circumstances. The Minister might remember that we pushed that to a vote on Report, as we felt so strongly about it.
As others have commented, it has been frustrating that the Home Office has dug in on the issue. Other Departments have simply circumvented Home Office obstinance. On 26 March, Ministers from the Ministry of Housing, Communities and Local Government wrote to all councils asking them to
“utilise alternative powers and funding to assist those with no recourse to public funds who require shelter and other forms of support due to the COVID-19 pandemic.”
It seems that the Government have understood in principle that NRPF is counterproductive during the pandemic.
My hon. Friend makes a similar point to the one made by the hon. Member for Ruislip, Northwood and Pinner (David Simmonds) in his detailed and articulate speech. The point about cost shunting is exactly right. We have asked local councils to use “alternative powers” to do something, but they are essentially being asked to fudge it.
A lack of clarity from the Home Office means that, in practice, people now face a postcode lottery, at the discretion of their local authority, in the absence of a clear steer from the Home Office. The Local Government Association has called for NRPF to be suspended on behalf of councils, giving them the best chance of delivering on their responsibilities to protect those vulnerable people. As we are sadly now well into a second wave of infections, I urge the Government to once again consider lifting NRPF. If the Minister cannot make that commitment this afternoon, I ask him to seriously reflect on some mitigations for this cohort of people.
As the Minister knows, people are now required by law to self-isolate if they are contacted by NHS Test and Trace, and they will be offered a test and trace support payment of £500 if they are on lower incomes, cannot work from home or have lost income as a result. As the Government guidance states, just under 4 million people who are in receipt of benefits in England will be eligible for this payment. It is not clear if those with no recourse to public funds will be eligible for that payment, but I suspect, in some cases, they would be those people most in need of it. I hope the Minister will clarify the situation and confirm that they will be eligible for that payment, should it be necessary.
As we have discussed, it is possible for individuals and families to apply for NRPF conditions to be lifted if their circumstances change and they face destitution. That can be a complicated and lengthy process, with families fearing that their application will be unsuccessful unless they turn to paid immigration advice. My hon. Friend the Member for Brent North (Barry Gardiner) shared powerful stories from his constituency about the barriers to having those restrictions lifted.
In the first quarter of 2020, 843 applications were made to the Home Office but in the second quarter, 5,565 were made. The Government’s own figures show that thousands of people’s circumstances have changed and that they are facing destitution. I hope the Minister will give us a clearer answer to the question of how many people have no recourse to public funds. If he does, can he give an indication of what percentage of that group these applicants represent?
The latest data published by the Home Office covers quarters 1 and 2 of this year. Can the Minister give us an early indication of what the data says for the third quarter of the year, in terms of both the numbers who are applying to have their condition lifted and the time taken to process the applications? In the latest publication, there are early signs that the time taken to arrive at a decision is starting to slide, so I hope he will give us an indication of the average time and the longest time taken to determine those applications. Others this afternoon have talked about everything from five weeks to four months.
We know that children can be denied access to public funds because of their parents’ immigration status. However, an audit of families with NRPF undertaken between 2015 and 2018 found that 68% had a child or multiple children born here in the UK. These children have only ever known the UK, but they are not protected by the safeguards we put in place to ensure children do not face the types of poverty we are seeing.
The Child Poverty Action Group published a report last April that predates the pressures of covid-19, but it has shone a harrowing light on what life is like for low-income families when there is just no safety net due to NRPF. My right hon. Friend the Member for East Ham told us about the eight-year-old boy who was sleeping rough due to having no recourse to public funds. The study also found that some children, who came from the most severely deprived families with NRPF simply did not eat at all during the school day. One child interviewed as part of the study said:
“Sometimes you don’t have enough energy, you cannot cope in the classroom so you have to like try and rest a bit. You just put your head on the table and you end up falling asleep in the classroom”.
Children in families with NRPF are not routinely entitled to free school meals. While the Department for Education has extended eligibility for free school meals temporarily to include some groups with NRPF, when it is compounded with the existing pressures on those families brought about by the virus, the consequences of not extending the safety net to those children is surely not something we are prepared to tolerate.
It is worth reminding ourselves, as the hon. Member for Glasgow South West (Chris Stephens) did, that those with NRPF pay the same taxes as every other in-work person in the UK—income tax, national insurance and council tax—in addition to ongoing immigration charges and the immigration health surcharge. Like everybody who has spoken in the debate, I have some brilliant organisations, such as St Augustine’s Centre in Halifax, WomenCentre and Halifax Opportunities Trust, which dedicate so much time to working with people in desperate positions due to having no recourse to public funds. I wish to put on the record how grateful I am for their service.
I appreciate that it was the Minister’s colleague, the Under-Secretary of State for the Home Department, the hon. Member for Torbay (Kevin Foster), who led on the passing of the Immigration and Social Security Co-ordination (EU Withdrawal) Bill. In Committee, our amendment asked the Government to produce an analysis of the impact of no recourse to public funds, with a particular focus on those with children, those with pre-settled status and victims of domestic abuse. Further to the points made by the hon. Member for Glasgow South West, it would be enormously beneficial to everybody if we had that analysis. It would allow us to shape better policy and give us the information we need to ensure we are not leaving anyone behind in our efforts to protect people over the course of this crisis and beyond.
It is a pleasure to serve under your chairmanship, Mr Paisley. I only narrowly avoided serving under the chairmanship of Ms Nokes, one of my predecessors in this role, as several Members have mentioned this afternoon.
I congratulate the right hon. Member for East Ham (Stephen Timms), my hon. Friend the Member for Ruislip, Northwood and Pinner (David Simmonds) and, of course, the hon. Member for Glasgow South West (Chris Stephens) on securing this afternoon’s important debate. Everybody who has spoken has contributed with great sincerity and passion, and I have been listening carefully to everything Members have said. Where I have, occasionally, been on the phone, I have been texting officials asking various questions in follow up on points that have been raised.
I will start by laying out some of the historical context to the “no recourse to public funds” policy. It has existed since the Immigration Act 1971, and the principle that underpins it is that it would not be reasonable for people who have arrived here very recently or on a temporary basis to be able to access the full range of benefits available to somebody who is settled here or a citizen. If we look at the categories of people to whom the NRPF condition applies, it is people such as visitors, those who are here on a holiday visa, students, people who come here to study, and workers who are here for a short time or, in some cases, a longer time. There would be an inherent unfairness if, having literally just arrived, people were able to fully access public funds.
I was going to come to that point. It is a very reasonable question to raise. Let me just finish my point, and I will come on to address the point that the hon. Lady has raised, entirely understandably and rightly.
It is worth mentioning that, of course, refugees are not subject to the NRPF condition. A couple of hon. Members, including the hon. Member for Birmingham, Selly Oak (Steve McCabe), talked about the time it takes to make decisions. I am not sure if he was referring to asylum decisions or another kind of decision, but I make it clear that anyone claiming asylum or anyone granted asylum is not subject to the NRPF condition, and neither are people who are granted indefinite leave to remain.
The hon. Gentleman has made it very clear. I am grateful for that clarification. As he has just alluded to, people who have indefinite leave to remain—people who are here permanently—do not have the NRPF condition applied to them. The path to getting to ILR can take five years for many people, if they are on a relevant qualifying route. Even if they are not on a relevant qualifying route, 10 years’ continuous residency gets people ILR. The majority get it after five years.
That brings us to the question that the hon. Member for Mitcham and Morden (Siobhain McDonagh) raised. I was going to address that point later, but since she raised it in an intervention, I shall turn to it now. It is the question of families. Almost every case raised this afternoon has involved children. No one can listen to stories involving children experiencing hardship without feeling extremely moved, but of course the NRPF condition, as many Members have mentioned, can be lifted where the parent is on a family route. Where there are children who are British citizens, that will typically be the case—it certainly should be the case. The hon. Member for Brent North (Barry Gardiner) gave an example where an application was made to have the condition lifted and the application was granted. In cases where there are British citizen children whose parents have the NRPF condition, people can apply and do apply to have that li-fted.
Let me finish the point and I will give way in a moment. The success rate for those applications is very high. The most recent figures, which I think the hon. Member for Halifax (Holly Lynch) has seen, show a success rate of 89% for those applications. That has increased in the last year. It was 79% and it is now 89%, and the time taken to make those decisions on average is 30 days—not quite five weeks, but 30 days.
The hon. Member for Brent North said, “Well, these are often quite pressing circumstances. What can be done to make that decision, which is successful in 89% of cases, faster?”. That is an entirely reasonable question. One of the actions I will take away from this afternoon’s session is to probe a little further on the question of speed. Someone mentioned 48 hours. Clearly, we have to make sure that people qualify for the condition to be lifted, and I would suspect 48 hours would not afford time to do that, but I will certainly see if anything can be done to expedite it, for the reasons the hon. Gentleman mentioned.
On the topic of children, the shadow Minister talked about free school meals, and I entirely sympathise with her point. I know that the Department for Education is conducting a review into the interaction of NRPF and free school meals. I hope it will report back on the result of that review as quickly as possible, because I understand entirely the hon. Lady’s point.
I am conscious of time, so perhaps I ought to say a quick word about data. I should congratulate the right hon. Member for East Ham on his terrier-like tenacity on the question of data. In relation to the total number of people who are subject to the NRPF condition, we do not hold that data, as has been explained previously. There are a couple of issues. First, in relation to visa applications made out of country, the data is not recorded.
Secondly, there is obviously a continual coming and going of people—it includes people who are here on holiday visas and so on, who come and go the whole time. Some come and go via the common travel area, or via Ireland, so we do not have an exit check. That number is a moving feast. It includes people who come here on holiday for two weeks and then go. The right hon. Gentleman said that in relation to people who had made an in-country visa application, he had received a reply saying that that data was collected and held, but he had not received any further information.
The letter from the Home Office chief statistician dated 3 July, which is on the UK Statistics Authority website, states:
“Home Office administrative data only captures information on whether visas are subject to NRPF conditions for in-country extensions.”
I have asked how many there are, but received no answer.
I was about to come to that point. I heard the right hon. Gentleman make that point in his speech. He had seen evidence saying that the data was held, but it had not been provided. That is another action for me to take away from this afternoon’s proceedings. I will go and ask that question about the data relating to in-country visa applications. According to the letter that he referred to, the data is held, so I will endeavour to ferret it out. It might sit in the portfolio of the Under-Secretary of State for the Home Department, my hon. Friend the Member for Torbay (Kevin Foster), but I will certainly make inquiries in that part of the Home Office. If I am able to ferret out the information, I will certainly get back to the right hon. Gentleman. I will take that away as an action from this afternoon as well.
Finally, quite a few comments were made about coronavirus and our response to it. Clearly, everybody has access to the health service for coronavirus-related treatment. The shadow Minister asked whether the NRPF cohort are eligible for the payment if they have to self-isolate. I believe it is £500?
I do not know the answer to that question, but I will go away and find out because it is a very reasonable question to ask. More generally, people who are subject to NRPF are eligible for things such as the coronavirus job retention scheme, the self-employed income support scheme, and the support given to people on zero-hours contracts, based on their previous income. Those funds are not classed as public funds. Those are available to everybody, including the cohort mentioned today.
Local authority funding has been referred to a great deal. It has been denigrated as “cost shunting” and as being a small amount, but it is £4.3 billion, which, even by the standards of public spending, is a pretty significant amount of money. It covers more than just NRPF cases—I understand that—but it is none the less a very large amount of money, much of which has found its way to supporting NRPF cases. A case mentioned by one Opposition Member ended up being helped in that way. We can debate whether it is cost shunting or whether that is the best way of administering it, but local authorities often have the best knowledge about how to help people in their local areas. We might debate the nature of that safety net, but what cannot be gainsaid is that that safety net—that £4.3 billion to local authorities—does exist. It is there and it does help people. For those with children, which applies in all of the cases we have heard about this afternoon, there is a route to lifting—
I must finish to allow time for the right hon. Member for East Ham to wind up.
There is a clear route to having the conditions lifted for people with children, quite rightly. It can be done without a lawyer. Somebody suggested earlier that a lawyer is needed, but that is not the case. Somebody said people need to produce hundreds of pages of evidence, but they do not. They simply need to provide basic evidence of the risk of destitution, and I believe the service is now available online as well.
I hope I have explained the principles of NRPF, but also the safety nets and exceptions that have been set up. There are at least three points that I will take away from this afternoon’s proceedings, and I will get back to the three Members concerned. I hope that I have provided an adequate response to this afternoon’s queries.
We have had an excellent debate. I am grateful to everyone who has contributed to it and to the Minister for listening and for the offers that he has made.
The big expansion of no recourse to public funds came in 2012. It was an integral part of the hostile environment, or the “compliant environment” as it is now called, and the families we are talking about are, as others have said, largely on a 10-year route to indefinite leave. Frequently, they have been here for years beforehand. Nobody is suggesting that they are ever going to leave. The children have British citizenship. The people are working and pay taxes, yet they have no recourse to public funds throughout those 10 years.
I am grateful to the Minister for his offer to answer my question. I tabled it this morning for the fourth time, so now he has the perfect opportunity to go away, do the job he is expected to do, fulfil his responsibilities and answer the question.
Question put and agreed to.
That this House has considered No Recourse to Public Funds.
Mental Health Support: Frontline Staff
I beg to move,
That this House has considered mental health support for frontline staff.
It is an honour to move the motion with you in the Chair, Mr Paisley, now that Westminster Hall is once again available for our purposes. In this unique time of pandemic, the mental health of frontline and key workers should be fully supported. I declare an interest as a former psychologist in the NHS for 20-plus years—I am showing my age—before I came to this House, and as chair of the all-party parliamentary health group and the all-party parliamentary group on psychology.
No one should underestimate the severity of the mental health crisis that engulfs us all as a direct result of the advent and ongoing havoc wreaked by covid-19 across the UK, and indeed worldwide. I thank the organisations that have been involved on the frontline, supporting mental health strategy and the delivery of services, including: the child mental health charter and, in particular, Helen Clark, a former Member of this House; the British Psychological Society; the British Medical Association; the Royal College of Psychiatrists; Mind; the Centre for Mental Health; and EveryDoctor—that is to name but a few. I thank all the other parliamentarians who have taken the time on a Thursday afternoon to speak on this vital issue.
On 5 October, Dr Tedros Ghebreyesus of the World Health Organisation introduced the first global dataset on covid-19 access to mental health services. He said:
“COVID-19 has interrupted essential mental health services around the world just when they’re needed most.”
There were some devastating findings. Before the pandemic, countries were spending less than 2% of their national health budgets on mental health. More than 120 countries —93%—reported that mental health services had been stopped or disrupted during the pandemic, 72% said that mental health services to children and adolescents had been disrupted, and 75% had seen a disruption to mental health services in the workplace. Despite the fact that 89% of the countries surveyed said that mental health and psychosocial supports were included in their national coronavirus response plans, only a shocking 17% had full additional funding to cover the cost of those services. Together, those figures show that there is likely to be an international tsunami of mental health morbidity like no other seen in our time.
The Centre for Mental Health, a UK charity, estimates that in England alone up to 10 million people may need mental health support—including long-term support—for the foreseeable future as a result of covid-19, and that 1.5 million children may require support. Those numbers are a stark warning that the impact of the pandemic will have severe long-term repercussions for the mental health of the UK as a whole.
Those affected will need support for depression, anxiety, post-traumatic stress disorder and other mental health difficulties in the coming months and years. Of course, some groups are disproportionately affected, including those with disabilities, those from minority ethnic communities and those with pre-existing mental health conditions who have experienced increased morbidity during the pandemic. Responding to increased mental health needs must therefore be a priority when a recovery plan is drawn up for both NHS and social care sectors for the future of our public health and in fiscal planning across Governments.
On the impact on frontline staff, the national forecast for adults is that more than 200,000 NHS workers may need treatment for post-traumatic stress disorder, psychological distress and burnout. Although less data has been collected, it is likely that a similar pattern will affect those who work across social care settings such as nursing homes. Research is badly needed. Those staff must not be excluded from or let down by the data collection and resourcing that is required. I would be grateful if the Minister looked specifically at the resourcing of data on the psychological impact of covid-19 in the community, nursing and social care sectors.
The International Council of Nurses reminds us that the effects of covid-19 on the mental health of nurses and the wider health social care workforce is a ticking time bomb. Every Thursday, across the UK, we were glad to show our support for key workers on the frontline, who risk themselves daily as they confront the pandemic on our behalf, but we owe them much more than weekly applause, and Governments across the UK owe them that duty of care.
Data from previous pandemics analysed by the British Medical Journal shows that post pandemic, healthcare workers are at high risk of both psychological illnesses and physical outcomes. For frontline staff, decisions made during the pandemic have regularly determined who to prioritise for care, but they have also felt a lack of control, especially when patients are care home residents who are dying and no treatment has been available for them. Emotionally and physically, having to be there day in, day out for patients as well as their families, who often could not visit relatives in their time of need, has been unduly toiling. That has come alongside the use of personal protective equipment for long periods; times when PPE has not been provided to the extent that it should have been; and long periods of excess working hours, stress and exhaustion.
A study by Kisley and colleagues has identified risk factors for psychological distress for staff in the time of covid-19. Personal care and socioeconomic stressors included personal childcare needs, having an infected family member at one point during the pandemic, and having a lower household income, with fewer choices in how to cope. Trauma is triggered when trusted bodies act in a way that can harm their safety at work, such as the failure to obtain correct or sufficient PPE, or by the breakdown or absence of testing and systems. The study also identified enforced redeployment to care for covid-19 patients, a failure to screen and triage healthcare workers for mental health needs prior to the pandemic, and a reliance on crisis intervention when symptoms develop.
Prior to the pandemic, the British Medical Association set out in a 2019 NHS staff survey that 40.3% of healthcare staff reported feeling unwell due to work-related stress. With the onset of covid-19, the workload for healthcare workers has increased radically. Four in 10 psychiatrists have reported an increase in people requiring emergency healthcare, including new patients, in the aftermath of lockdown. NHS and social care jobs obviously involve exposure to a huge range of potential stressors, including competing demands, interpersonal conflict, complex and life-changing decision making, moral injury, shift work and long hours. Added to that in the past six months is the pausing of the working time directive, the limited scope for time off or holiday periods, the increasing morbidity of patients, and losing colleagues. As someone who has worked in the NHS for many years, I have to say that the loss of colleagues is a terrible shock, and not something that people expect in their day-to-day working lives. That is something that frontline staff have had to cope with in addition to their care roles.
People join the caring professions to make a difference and make others better, but coronavirus has created an overwhelming feeling of helplessness in the midst of this trauma. It should be noted that previous coping strategies that those on the frontline utilised may play out differently if they have to cope with a second or third wave. The adrenaline with which they coped in those vital months so that they could be there to support those in need may be replaced by the dread of going through it all again and the fear of being retraumatised.
I have referred to some of the facts and figures impacting the mental health of care workers, but here are some voices from the frontline, expressed in letters sent to The Guardian and the nationwide EveryDoctor organisation, which has been in touch. One said: “The mental health exhaustion that comes from changing everything about the way you work on a weekly or sometimes daily basis for months is immense. All the while, you can see a light at the end of the tunnel, but then you are bracing yourself for the next disaster: a second wave or winter crisis, alongside mass staff absence.”
Another said: “There is the effect of not only seeing patients die, but losing colleagues. Everyone is struggling with this pandemic, but doctors are responsible for the decision making clinically. We can see that this is not going away. There is no respite in sight.”
“I am employed on mental health wards as a support worker, helping people recover from acute problems… Covid-19 has not only affected general hospitals but has also had a huge impact on mental health facilities, which are more often run by a skeleton staff… On top of this we are also dealing with mental health patients infected with Covid-19… As we are not considered to be on the frontline, we are not equipped with proper personal protective equipment. We get a basic face mask, gloves and a flimsy apron.”
It should not be forgotten that school staff are also on the frontline, as they have to deal with the effects of the pandemic on children in their care. The mental health issues incurred by lockdown in the children they teach everyday are present upon return to schools. Anxiety and stress among a large group of pupils, alongside the experience of bereavement and a lack of community adolescent mental health services for those with acute problems, has been a feature of the recent past. That is alongside reduced assessment and diagnosis possibilities, due to staff having to change their working patterns, often from face-to-face to virtual sessions, after a period during which sessions were not offered.
Innovation will be key in ensuring that we can address the needs not only in the population but among the frontline staff who desperately need support. Using technology and ensuring that there is the capacity and technical knowledge to support the transition to other methods of care will be fundamental. Meeting the mental health needs that arise from coronavirus is a huge challenge, but it is not optional. Just as responding to the threat of the virus itself has tested our resources and resilience, so too will addressing the psychological and emotional consequences.
I am extremely grateful to the British Psychological Society, which has provided specialist guidance. I know that it has also been working with the Scientific Advisory Group for Emergencies and with the Minister’s office. It wants to see the planning of psychological support and resourcing of the psychological workforce to meet demands in the NHS and care homes and also in schools and the community. It also wants to see increased access to an in-house employee wellbeing service, which it believes will be critical, particularly if unemployment issues face the population in the coming months. It wants to see the employment of psychologists to focus specifically on staff. It tells me that it is not feasible, in the long term, to ask psychologists to work with patients in their work time and then to work with NHS staff in their spare time to meet psychological needs. The society would like to see more use of psychologists not just in supporting patients, but in a strategy to support staff over the long term.
My hon. Friend the Member for Midlothian (Owen Thompson) will be covering in depth the work of the Scottish Government in relation to mental health strategies during the pandemic, so I will focus on the issues that have been raised with me in my capacity as chair of the all-party parliamentary health group and the all-party parliamentary group on psychology.
These are some of the questions that I have been asked to raise with the Minister. What steps is the Department of Health and Social Care taking to model and plan for demand for mental health support as a result of coronavirus and the consequent impact on the economy and employment? What additional funding will be made available to mental health providers to ensure that services are covid-19 safe and that they can meet increased demand for support and deliver on existing pledges in the NHS long-term plan for mental health? What resources will be made available for local initiatives that provide early mental health support in our communities, especially for those people who have been bereaved? What proportion of schoolchildren will benefit from the wellbeing for education return funding? How will children’s mental health be supported moving forward?
What resources will be made available to support health and care staff in the NHS, social care and voluntary sectors who are experiencing post-traumatic stress disorder, high levels of psychological distress or burnout? What specialist support will be made available? What resources will be made available to ensure that research and funding are provided for those working in social care settings so that we adequately address their mental health needs alongside the NHS staff population?
What plans are being put in place to protect NHS staff from a potential onslaught of claims against them because of the pressures that they have worked under during the pandemic? That may give rise to a number of negligence suits in the future. That issue has particularly been raised by the Medical Defence Union, which is concerned that staff have often been placed on the frontline with a lack of resources and with a lack of support medically or clinically themselves.
Now is the time when I feel that I and other hon. Members should be responding in the main Chamber to a detailed statement from the Government about their proposals for mental health directly arising from the devastating impact and ongoing effect of covid-19. Such a statement could include ways in which the Government propose to protect and sustain the mental health and wellbeing of key workers and that will be distinctly and separately resourced, rather than relying on any money from pots designed for other purposes. I look forward to the Minister’s reply today. I hope, on behalf of the key workers for whom I have been given the privilege to speak, that she will tell us that the Government have set a date for the announcement of a properly and realistically resourced mental health strategy that will be both integral and central to the overall covid-19 recovery plan.
It is a pleasure to serve under your chairmanship, Mr Paisley. I congratulate my hon. Friend the Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) on securing the debate. It is important to focus on mental health, and today we have a great opportunity to do that. I know that my hon. Friend brings a wealth of invaluable professional experience to the topic, which I cannot begin to understand.
In mental health, as with other aspects of health, time needs to be dedicated to caring for and looking after people, to reduce the chances of someone becoming seriously unwell. If we relentlessly push our bodies every day we soon pick up physical ailments, stresses and strains, and they can develop into something more serious if they are not given time to recover. Our bodies will send signals telling us to stop before we collapse, and the same goes for our minds. Downtime is not a luxury. It is essential, and we all need to be able to read the signs before reaching breaking point. The brain is an unbelievably complex organ, and is constantly processing something even more complex—human experiences and emotions. I am amazed that it does not go down, and that something does not go wrong with it, more often.
On the frontline, our carers and health staff have faced the brunt of the pandemic response. We may moan about working from home, or not being able to go to the pub or to see friends, but they see people scared, alone and in pain, gasping for breath. They see families unable to get close enough to offer their loved ones the most basic human comfort—a hug. Dealing with that every day takes its toll.
[Siobhain McDonagh in the Chair]
The World Health Organisation reported a recent review of healthcare professionals finding that one in four was suffering from depression and anxiety and one in three had insomnia during the coronavirus outbreak. There was also an appalling rise in verbal harassment and discrimination and physical violence. No wonder they are battle-scarred.
Switching off from work is made even harder by the fear of being a spreader, which leads to increased isolation when what we need is social comfort and community. Like all of us, frontline staff cannot access the habitual escape routes that we used to take for granted, whether that might be going out for a drink with friends, to the theatre or to live music, or experiencing the warmth and excitement of the crowd at a football match. Those things just are not possible just now. With NHS resources cut by years of austerity, staff were already working at or beyond capacity before the pandemic, so they had to find a whole new superhuman reserve of energy when the crisis struck. Sheer willpower, determination and dedication keep the staff going and I cannot thank them enough for that, but after eight months with no end in sight more and more of our critical staff are getting to breaking point, traumatised, running on empty, and mentally as well as physically exhausted.
In those serious circumstances it is essentially the responsibility of Government to make sure that there are adequate levels of professional mental health support in place. We need more than a website, an app and a few choicely worded paragraphs in a staff handbook, although all sources of information are very welcome. Any port in a storm, I suppose we could say. We need more trained psychologists and counsellors available to provide tailored support—human faces with experience and expertise in their field. We need to make sure that people are able to talk and share experiences with others, to be listened to, get a bit of breathing space, and be guided to get more help and treatment whenever they cannot cope.
I know that NHS England, like the Scottish Government, brought in helplines to help staff dealing with covid-19. I welcome those efforts. The Scottish Government also established the national wellbeing hub in May for health and social care staff, which takes a psychological first-aid approach, with resources on self-care and 1,000 hours of coaching for staff to maintain health, wellbeing and resilience. I believe that it is the first of its kind in the UK and I know from the feedback that I have had that it has been a welcome move.
I am pleased to see that the national wellbeing hub includes a section for unpaid carers, because the Carers Trust found that 68% of young adult carers in Scotland said their mental health was worse as a result of coronavirus, and 85% were worried about their own future. Those 12 to 17-year-olds, who already have responsibilities beyond their years, are living in an age of anxiety unimaginable when all of us in the Chamber were their age. I recently hosted a virtual meeting with young people in Midlothian to talk about their lockdown experiences and concerns, and it was deeply worrying to hear how many issues they raised, including those related to their mental health, and how little they felt listened to by many of those in power.
Health & Safety Matters reports that a survey
“into the mental health of frontline staff and healthcare professionals has revealed that over 90% believe there is not enough mental health support available for the general public to deal with the aftermath of the pandemic and 66% felt there is not enough workplace support for healthcare professionals and frontline staff.”
We rightly call our frontline workers heroes, and we admire their courage and dedication, but those in Government need to look after them and not just praise them.
It is good to see carers, who have insultingly been called “low-skilled” by some in the Government, getting the recognition they deserve, but most key workers do not have a choice but to keep going. They would rather not risk their mental or physical health for a care badge or a clap. They should be proud of their jobs, but pride does not pay the bills or keep them and their loved ones safe. I suggest the best thing the Government could do is to find an appropriate way of honouring those heroes in our NHS, care sector and essential services who work tirelessly day after day to defeat coronavirus and look after all the rest of us.
It is indeed a pleasure to speak for the Opposition with you in the Chair, Ms McDonagh. I thank the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) for securing this extremely important debate and other hon. Members for their thoughtful contributions. I pay tribute to all staff on the frontline, far too many of whom have made the ultimate sacrifice while trying to keep us safe and well. Their unwavering courage in standing up to the virus, knowing full well the risks to themselves and their families, has been inspirational and truly deserving of the gratitude of Members across the House.
From the very beginning of the pandemic, health and care staff have made immense sacrifices. When we were asked to stay home to avoid the virus, they were going to work and facing it head-on anyway. They were sadly left unprepared, with PPE problems and no access to testing that lasted for months. Ahead of World Mental Health Day on Saturday, this is a fitting time to acknowledge that frontline staff have a unique need. Everyone across the country has had their life disrupted, but our frontline health and care staff have had to deal with patients, colleagues and friends dying on their watch. As the hon. Member for East Kilbride, Strathaven and Lesmahagow said, nothing prepares you for losing a colleague, particularly when you think it could have been avoided. Frontline staff are trained to deal with high-pressure scenarios, but even then, they were not trained to tell people that their loved ones had died via phone calls. Covid-19 has stripped the humanity out of grieving.
The additional pressure has undoubtedly had a significant impact on the emotional wellbeing of frontline health and care staff. They have had no break, no support and no relief from the Government. Fatigue and burn-out are setting in on an already exhausted workforce, who are in desperate need of respite. We need only look at the latest NHS staff absence figures to grasp the true magnitude of the hidden crisis. Over half a million sick days were taken by NHS staff in England because of mental ill health in May alone—one month. Half a million days in just one month.
For context, those absences account for almost a third of all NHS absences for the month of May. In comparison, 200,000 fewer sick days were taken for covid-related illness during the same time period. Let us remember that it was around that time that the virus was causing the most damage to our country, when hospital admissions were still high and transmission was rampant. Even then, for NHS staff, mental ill health still accounted for more time away from the frontline than any other reason. A survey conducted by NHS Providers of its membership at the tail end of June showed that 92% of NHS trusts were concerned about staff wellbeing, stress and burn-out following the pandemic.
The evidence is clear. If we are to expect NHS and care staff to deal effectively with an impending second spike in addition to the care backlog while approaching winter flu season, they must receive mental health support. They need it tailored for them. All health and care staff have given their all. Many have been redeployed, have been working in fear without adequate PPE, have lost colleagues or members of their own family, and have never been trained for something like this. The Government need to act. They cannot simply cherry-pick who they are going to support.
Just as Ministers have an obligation to protect the physical wellbeing of frontline staff by providing them with PPE and ensuring that their work environments are as safe as possible, they also have an obligation to protect the mental wellbeing of frontline staff, guaranteeing them access to psychological therapy if and when they need it, and need it they certainly do. It should be a moral imperative for this Government to ensure health and care staff have the practical and emotional support they need to do their jobs. Based on what little support they have been offered so far, it does not seem like it is.
It is not as if the Government have not had ample opportunities to address the growing need. Labour recognise it and we have put forward our own plans to support the mental health of the entire health and care workforce. Our care for carers package, which we launched in June, would have guaranteed access to counselling and psychotherapy to all 3.1 million health and social care workers. It would be offered nationally and completely confidentially. Currently, that is not available to the majority of the workforce. The package was designed in consultation with those on the ground—nurses, paramedics and porters—who are leading the fight against coronavirus. The Labour party has said that not a single frontline worker in our NHS or care workforce will be left behind. Everybody is equally valuable.
I want to share a couple of testimonies. During our consultation, an ambulance worker and member of the GMB trade union said:
“My team of ambulance staff have lost a close colleague to Covid, as many have in the nursing and care sectors. Every death is tragic. The stress on the team, the issues of grief and loss, the fact that it could have been them, for some survivors guilt, it has had a big mental health impact…I worry about my colleagues and future patient care.”
Care home workers were just as fraught. One told me:
“It has been really emotionally hard supporting residents when they are dying without their loved ones close by. Then we have had to support and reassure their family members and provide information about their last moments. There’s a lot of questioning going on—could I have done more, could anyone have done more, were the residents’ lives valued in the way we would want them to be?”
“I am a really strong positive person and I have been a carer for over 15 years. But at the moment I really don’t think I could mentally carry on if there is another wave of Covid, I just don’t think I would have the strength to go through it again. There is definitely going to be a mental health crisis in the care sector.”
Those types of testimonies are sadly far too common. Staff are desperate for help, yet nothing has been forthcoming from this Government. Care for carers would have given the workforce the support they need, yet in June, when I requested a meeting to discuss the proposal, the Health Secretary and the Minister responding today refused to meet me. Given the sheer scale of the problem, I ask the Minister whether she will meet me to discuss the care for carers package, so that together, with a cross-party, conciliatory approach, we can give our frontline care and NHS workers the mental health support that they need. I hope she will reconsider the offer.
Ahead of winter and a second spike, the Government must learn the lessons of the spring. We must fight for the mental health of those who have supported us so courageously during this crisis. Just last week, the Centre for Mental Health predicted that 10 million people across the UK will need mental health support as a consequence of covid—8.5 million adults and 1.5 million children. If we are ever going to be in a position to match that need, we need to first protect the mental wellbeing of our healthcare workers. Only then, if we do that thoroughly and fairly, can we expect them to protect the physical and mental health of the nation. I hope the Minister agrees that without the proper resources being made available to our frontline staff, we risk further damaging the health of our country.
I echo the sentiments of the hon. Member for Tooting (Dr Allin-Khan): it is an absolute pleasure to see you in the Chair, Ms McDonagh. I thank the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) for securing the debate. I have heard her speak many times in Westminster Hall, including when I have been in the Chair. She always speaks with passion, particularly on this subject, and she always bring her experience as a consultant psychologist. We are the better and the richer for it.
The onset of the covid-19 pandemic in March was the beginning of a hugely challenging time for all our frontline staff, who have so brilliantly supported our essential frontline workers. I echo everything that has been said in praise of our frontline workers. They have been beyond exceptional—beyond words. I spoke to some of them this week. When they were going into work in March and April, every day it got a bit worse. Every day they had no idea what they would face that day, but they did it, sometimes working 12 hours without a break. Those staff in ICU went on a hugely emotional journey with their patients. As we know, the pathology of covid once someone is in ICU changes very rapidly. That took some getting used to for the staff who were nursing those patients—one moment they thought they were doing fine, and the next their condition fell off a cliff. That was hugely challenging emotionally for the staff who were nursing those patients.
I endorse everything that has been said in the debate, and I give my thanks and praise to staff. They worked long hours doing emotional and draining work, which is why it was important to ensure that support was put in place. We know that staff resilience has been tested to the nth degree, and the Government recognised early on that this would be a difficult situation and that we had to prioritise the mental health of the staff who were working in those very challenging conditions—not just staff in ICU and in hospitals, but staff who were working in care homes and social workers, too. That is why, at the beginning of covid-19, we commissioned NHS England and NHS Improvement to develop a comprehensive package of emotional, psychological and practical support for NHS workers. We ensured that the same offer was in place for all social care staff and their colleagues in the NHS, wherever possible.
Throughout the pandemic, NHS and social care workers have been able to access a dedicated and confidential staff support line operated by Samaritans, which is open from 7 am to 11 pm. It is there for people if they have had a tough day, if they feel worried or overwhelmed about what they are facing at work, or if they have a lot on their mind that they need to talk through. Trained advisers are available and can help with signposting to further services, or they can simply listen in confidence. A text helpline runs parallel to the phoneline and is open 24/7 to all NHS workers, social workers and care staff. A separate bereavement helpline has also been established by Hospice UK; it is manned by a team of fully qualified and trained bereavement specialists. So we had one-to-one care, the helpline, the text service and the Hospice UK bereavement line available for frontline staff.
Alongside the helplines, workers were given free access to a range of mental health and wellbeing apps, including Daylight, Sleepio and SilverCloud, and there have been over 150,000 downloads of these apps by key workers. For NHS workers, virtual staff common rooms have been established in partnership with NHS Practitioner Health. It has given staff the opportunity to reflect, share experiences and find ways to cope with how covid-19 is affecting their life at home and at work. Line managers have also been given the tools that they need to effectively support their teams through covid-19. For example, mental health conversation training has helped to equip NHS managers, supervisors and those with caring responsibilities for NHS staff to confidentially hold local, supportive and compassionate mental health and wellbeing conversations.
In addition to everything we have done through the NHS and the Department of Health and Social Care to provide a complete safety net and blanket of support around our NHS staff, the trusts went further. There are amazing stories of what some trust managers put in place straight away for their staff, including making space in the hospital where staff could go and download, and talk about their day; putting in place a practice of buddying up with another NHS worker; and putting into practice the process of staff not just finishing shifts and giving a handover report, as they used to, but then having a coffee session afterwards to debrief and go through what had happened that day. NHS trust managers also need to be praised for the huge package of care that they put in place for their staff, going over and above what the NHS supplied. NHS England and NHS Improvement also launched a new framework that enables employers to buy in additional occupational health and support for their staff.
Additionally, in partnership with the trusts, chief social workers published guidance for social workers and social care professionals, which can be accessed via Skills for Care. It explains the need to support the emotional wellbeing of employees during and after the pandemic, what managers can do to support that and what social care professionals should do to support themselves. To support our frontline workers more widely, NHS mental health services have remained open for business throughout the pandemic; no mental health services closed or ceased to look after patients during the pandemic.
In fact, during the pandemic we were able to accelerate parts of the long-term plan. For instance, 24-hour mental health crisis helplines opened across our trusts throughout the pandemic. Every one has been established and every one is now open. They have not been open long enough for us to gather data on how many people have used them and how they have been accessed, but I have heard anecdotally from ambulance support services, who are aware that the helplines are being used, that they know the helplines are working because there are fewer call-outs for mental health crisis.
To increase support throughout the covid-19 pandemic, we provided £5 million to national and local mental health charities, through MIND and the mental health consortia. On 22 May, the Chancellor announced a further £4.2 million for mental health charities as part of the Government’s UK-wide £750 million package of support for the voluntary sector. These additional moneys for mental health charities will support adults and children, including frontline and key workers. However, we still have to go further. We continue to learn from our experience during covid-19.
On 18 September, we published, “Adult Social Care—our COVID-19 Winter Plan 2020/21”, for adult social care settings outside the range of support we are making available, to ensure we support the workforce throughout the winter. A tough winter is coming, so as well as everything we have put in place, we need to go further to ensure that those services continue to be provided throughout the winter and that we have well-established support for our frontline workers.
As part of what we are doing throughout the winter, the NHS is in the process of setting up a first wave of staff mental health hubs, which will provide proactive outreach and engagement; overcome barriers to seeking help for frontline staff; build capacity in local employer organisations or teams; provide rapid clinical assessment; and provide care co-ordination and supported onward referral to deliver rapid access to mental health treatment. These hubs will be particularly useful and successful because we can focus mental health services into the infrastructure of the hubs. That will be of huge additional benefit, along with everything else that we have been providing to frontline staff. We are committed to providing essential mental health support to our frontline workers as they continue their work in response to the covid-19 pandemic. Ensuring that the health and adult social care sectors are well staffed with colleagues, to look after patients and prevent the pressures from becoming too great, is an absolute top priority for the Government.
The hon. Member for East Kilbride, Strathaven and Lesmahagow asked a question about clinical negligence claims against staff. There is a clinical negligence scheme for trusts that provides indemnity cover for all staff. I knew that was in place, because I signed it off at the beginning of the pandemic; I just could not remember what it was called. No staff member or frontline worker needs to worry. This is, I believe—I will be corrected if I am wrong—aside from what is provided by the Medical Defence Union and what normally applies. This package, which I believe came about as part of the emergency coronavirus regulations, is available to all staff, and all staff are covered.
We are committed to continuing to provide services to staff. If I went through every trust and listed every measure and initiative that has been put in place to support staff, I would be here for quite a long time. As well as the helplines, the apps, the one-to-one psychological care sessions provided to frontline staff, the trust support, the download rooms, the buddying up and the coffee debriefs, additional trust-by-trust measures have been put in place. As we know, staff were also provided with free meals. A huge package went in, and rightly so. This was not just a job during the recent pandemic, and it will not be in the future.
The hon. Member for East Kilbride, Strathaven and Lesmahagow mentioned post-traumatic stress disorder. We are going into a difficult winter, so I made inquiries this week as to what evidence we have about the rise in mental health issues that she spoke about, and other things. At the moment, we are seeing that the pandemic has had an impact on those with pre-existing mental health issues, as we would expect. Somebody who already suffers from bipolar, schizophrenia or a medically diagnosed mental illness will have found the pandemic challenging, and they will still find it challenging. The same is true for people with eating disorders—I think the hon. Lady has spoken about this—which I regard as the most serious of all mental health issues, because they are linked with morbidity. One in five people with eating disorders dies, and that is the highest morbidity rate of all mental illnesses. There is support here. That is why we have provided funding to increase the capacity to deal with those who have eating disorders and who need quick access to someone they can talk to.
We know that those with pre-existing mental health conditions are going to suffer. It is really important that we unpack wellbeing from mental health. There is some very unhelpful dialogue taking place that does not help people at all. We may see in the newspapers or hear people saying that suicide rates are going up, but they are not. We have no evidence of that; in fact, the recorded suicide rate from April to June was down. That could be for a variety of reasons, and we will not know what the true rate is until next year. However, we know that writing and talking in such a way has an impact out there, and that is why we ask the media to be careful about how they discuss suicides. We all need to be careful about how we talk about mental health. As for whether there is going to be a tsunami of mental health problems, I asked the clinical lead director of NHS England about that yesterday, and there is no evidence of that either.
We know that the other group of people who will be impacted are the frontline workers who have gone through the pandemic. As we know, post-traumatic stress disorder takes a long time to manifest, so those people may not even be presenting. We are expecting a problem, but it has not manifested itself yet. I do not have to tell a clinical psychologist how long it can take for the impact to fall out, but apparently it can be some time. We have prepared for that and we expect to see it in the future, but it has not happened yet.
I say that we should unpack wellbeing and mental health because a lot of what people are experiencing now—anxiety, apprehension, fear of the unknown and fear of covid—is a wellbeing issue, and it is normal to feel like that. Nobody ever goes into an adverse situation without experiencing such emotions. It is okay, and very normal, to feel anxious and fearful in an adverse and quite frightening situation, and people will develop their resilience. We want people—particularly frontline workers and students—to reach out and talk to their friends and their family, and to use the support networks that they would normally use to get through a difficult situation.
The problem arises if those feelings persist over a long period, and if that happens, we then urge people to seek help. However, we are not at that point, and we are not seeing that manifest yet in referrals or people seeking help. What we know is that people are going through a phase of anxiety. We therefore launched Every Mind Matters, because we need to provide people with the tools to get themselves through a difficult situation of anxiety and fear. Every Mind Matters launched for adults and, on 8 September, for children. It is now launching for students, too, alongside Student Minds.
Interestingly, when we talk about mental health, there is almost no such illness that cannot be helped in some way, and no experience of wellbeing that cannot be assisted, but people need the tools. They need improving access to psychological therapies services, 70% of which are available online, and tools to get them through such difficult situations. Those tools are available on Every Mind Matters, which I believe has had 2 million downloads for adults. They are there to help people get through. It is amazing that people do not know what they should do—I did not, until I looked into this—and how they should help themselves to get through a difficult situation now.
I caution everyone that we need to be careful about the language we use, such as “falling off a cliff edge”, or the “tsunami” of mental health issues. According to the clinical lead at the NHS yesterday, there is no evidence to support any of that yet. Hundreds of surveys are going on, some of which are showing that some people’s mental health has been improved—some people are enjoying working from home and do not ever want to go back to doing the commute, which they now realise was making them feel pretty miserable. They are welcoming the social change that has occurred. It is not at all a case of one size fits all, and that is why we need to be careful.
Hopefully, we are prepared, particularly when it comes to frontline workers. The services that they require have been put in place, after consultation with frontline workers, and we will have even more ready as we move forward into the winter.
Thank you, Ms McDonagh, and I thank everyone who has spoken. It is vital that we continue to raise awareness of mental health, particularly for frontline workers. Saturday is World Mental Health Day, so it is apt that we have spoken about the issues today. The fact that 2 million people have downloaded the Every Mind Matters app shows that the population are reaching out for mental health support, that mental health is at the front of their minds and that they want support to build their resilience.
It is absolutely correct to view mental health as a continuum, but something such as a pandemic can push people who were perhaps coping well previously towards the end of the continuum where they need additional support. Those supports have to be stepped and matched to their clinical needs. Some will have acute clinical needs, and others will be able to cope with the support of family and friends or colleagues, and in different ways. Support needs to be matched. We need to ensure, right across the UK, that best practice is shared; that people work together so that when something is rolled out, it works extremely well; and that there is dialogue and sharing for all staff in the NHS of the four nations.
Before I finish, I want to mention that next year—when we have events back, which I hope will be towards the summer—the all-party parliamentary health group will host awards for staff who have shown themselves to have supported others, whether patients or their communities. I would be so pleased if the Minister and the shadow Minister were able to attend. I can let them know about it well in advance.
I also want to bring up something that I wrote to the Prime Minister about, which I hope to hear about at some point in the near future and which can perhaps gain cross-party support. That is to have a national memorial for those who served on the frontline and lost their lives during this pandemic. I hope that is another discussion that can be taken forward from today.
I thank everyone who took part. I know it is late afternoon on a Thursday, but it is so vital to pay tribute to all those on the frontline who have been there to support our needs in this time of crisis. We must always be mindful of supporting their needs, too.
Question put and agreed to.
That this House has considered mental health support for frontline staff.