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Westminster Hall

Volume 708: debated on Monday 31 January 2022

Westminster Hall

Monday 31 January 2022

[Sir Mark Hendrick in the Chair]

Stalking Advocates

Before I call the hon. Member for Gower (Tonia Antoniazzi) to open the debate, I wish to make a short statement about the sub judice resolution. I have been advised that the petition being debated today directly relates to the death of Gracie Spinks in June last year. An investigation by the Independent Office for Police Conduct is ongoing, and the inquest relating to the death of Gracie Spinks remains active. Mr Speaker has agreed to exercise the discretion given to the Chair in respect of the resolution on matters sub judice to allow limited reference to the death of Gracie Spinks. However, I ask that Members do not refer to the detailed speculation about the circumstances surrounding the death, including the conduct of the police in this case.

I remind Members to observe social distancing, and to wear masks. I invite Tonia Antoniazzi to move the motion.

I beg to move,

That this House has considered e-petition 593769, relating to funding for stalking advocates.

It is a pleasure to serve under your chairship, Sir Mark. As you say, this case is sub judice, so I will not go into details in my contribution. However, I pay heartfelt tribute to the parents of Gracie Spinks, who are here. I spoke to Richard and Alison last week, and was very moved by their story, but also angered. The trauma that they have gone through is unimaginable, and I hope that I am able to do them and Gracie proud today.

I also put on record my thanks to Jackie Barnett-Wheatcroft for starting this important petition, and for taking the time to speak to me last week. The petition, which has more than 105,000 signatures, states:

“The Government should provide more funding for stalking advocates for victims of stalking. This would help support victims, and should also help the police to investigate cases more thoroughly, potentially helping prevent threats to life.”

That seems a wholly appropriate way to deal with this issue, and there must be best practice that can be shared between police forces to make sure that the tragedy we are talking about cannot happen again. When I spoke to Richard and Alison, and to Jackie last week, one thing that struck me was their determination to find a solution to this issue.

Gracie’s case is a tragic reminder of what seems to be the ever-rising problem of violence against women and girls. Gracie had reported her stalker to the police, which, as we know, takes a huge amount of courage. What I am about to outline is not specifically about Gracie’s case, but there may be some similarities with it. Many women are dismissed by the police when they report violence perpetrated by men. Time and again, we have seen cases of women murdered by men who they have recently or previously complained about. Just this week, Yasmin Chkaifi was killed by her ex-husband. He had an interim stalking protection order against him, and was wanted by the police for breaking it, but despite this, he still found the opportunity to kill Yasmin in the street, just yards from her home—her safe place. In Swansea, we have seen the smirking face of Stephen Hill, who beat his girlfriend so badly that she needed a metal plate put in her head. He was given a sentence of just over two years—two years for life-changing injuries.

This is not the first time that I have spoken about violence against women. Just a few months ago, we were in this Chamber debating the rise in drink spiking, and over the past 12 months, we have been inundated with stories of serious attacks on, and murders of, women across the country. We have rightly been appalled by the murder of Sarah Everard at the hands of a policeman; the police’s taking photographs of sisters Bibaa Henry and Nicole Smallman after they were murdered in a park; and the killing of Sabina Nessa as she walked through her local park. It cannot go on like this. The Government must recognise that we have an epidemic on our hands.

When women approach the police for support, they are often turned away and made to feel as though they are wasting police time. If someone is mugged or burgled, they are not asked to provide evidence, but a victim of stalking is. The onus is put on the victim. Many stalkers are also guilty of other crimes against their victims. Affray, criminal damage, voyeurism and other offences are often recorded in stalking cases. If a stalking advocate were on a police force, a link between those offences could be established, and we could avoid such cases as those that we are talking about today.

Much is made of postcode lotteries, but we have a police force lottery when it comes to imposing stalking protection orders. It appears that some forces are using them to much better effect than others. We need to ensure that their use to good effect is replicated. A BBC investigation in March 2021 found that only two full orders had been granted in the whole of Wales since the introduction of stalking protection orders in January 2020, despite more than 3,000 stalking offences being reported to the four police forces. It is paramount that we find out how some forces are protecting women; that information then needs to be shared across the board. Much of this comes down to the training that officers receive. How are police forces learning from their mistakes and improving outcomes for all victims of stalking?

There are also issues with trivialising the crime of stalking. I know that I have used the verb to describe having a nose at somebody on social media, and that is not acceptable. It makes it a bit of a joke, when we know that it is not, and we must all recognise that. The dangers that social media can pose cannot continue to go unchecked. We have become so much more connected. That is great for staying in touch with family and friends, but it exposes us to the dangers of having our details available to the world. Posting photos, checking into places and keeping location services on are tools that can be used to find people. Where there are no checks on people setting up accounts, stalkers can create numerous accounts and use them to bombard victims with messages.

Just last week, stories were emerging about the new threat of people using Apple AirTags to follow women without their consent. Tracking devices such as AirTags and Tile are designed to be attached to things that we may lose, such as ours keys or bag, so that we can locate them from our phone, but in the wrong hands they are the ideal tools for stalking and locating someone. Stories emerged last week of that happening in America, and of women having to rely on a beep from the offending device. Even more worryingly, only 100,000 Android users out of a potential 3 million have downloaded an app that Android users are being asked to install that identifies such tracking devices.

Safety concerns about devices and technologies used in the home, such as smart speakers giving away someone’s location, or smart devices getting hacked and compromising home security, have not yet been addressed properly by the tech giants. They need to step up and take action. They have a duty of care to everyone using their products and services. I am not sure whether the Minister has had conversations with any of them, but I would welcome their engagement on the issue, and would be interested in hearing more about how she will approach that. I thank her for her engagement on the subject after I sent over questions earlier. We want and need a constructive discussion. I know that she has met the petitioner, Jackie, but I hope that she will agree to meet the family, and other families, to discuss the best way forward.

In the meantime, very simply there are a number of questions that I, and I am sure the family and friends of Gracie and many others, would appreciate the answers to. How many stalking prevention orders have been given out since they were introduced? Are they uniformly spread across all police forces, or are some doing better than others? What assessment has been made of the pilot scheme being run by West Midlands police? Has the Minister discussed with Government colleagues and police representatives the introduction of stalking advocates to police forces in order to deal with the issue? We would also like to know whether there has been an audit of other offences recorded against perpetrators who are later convicted of stalking. It is those red flags that could stop women such as Gracie being murdered.

The themes running through my research on this subject were that police forces need to share best practice in a much more structured and regulated way, and that training across all forces needs to be massively improved—although “massively” does not go far enough. The Minister needs to take a strong lead on these issues, and shadow Front-Bench Members and I are willing to help in any way we can. I echo the calls in the petition for an advocate on each police force to be made available to victims of stalking. Patterns of behaviour can be identified if someone is looking for them, but many police forces simply do not have the time to do that.

Women want to feel safe, but we do not. Just look at this case, and look at the number of women killed in the last 12 months. Every year, my hon. Friend the Member for Birmingham, Yardley (Jess Phillips) on the Front Bench reads out the number and names of the women killed at the hands of men that year. It is a stark reminder to all of us that we are not getting any better on this, and that we need to address the issue. Look at the conviction rates for rape that have just been released. Look at the Met’s response to the Sarah Everard vigil. As a country, we must do better, and I want to work with the Minister across the House to make sure that happens. Gracie’s parents have made it clear that they will not let this go; I will not let it go, either. Things must change. I will continue to fight for women everywhere who are suffering at the hands of men.

It is a pleasure to serve under your chairmanship, Sir Mark. It is an absolute pleasure to follow the hon. Member for Gower (Tonia Antoniazzi), who already knows that she is one of my favourite Members of the House. She gave an exceptional and incredibly powerful speech. I fully endorse her comments on best practice and advocates in police forces, and, indeed, the questions she raised. She opened the debate in a really suitable and fitting way.

This debate comes after a horrible event took place in the constituency of my neighbour, the hon. Member for Chesterfield (Mr Perkins), who is present. My hon. Friend the Member for North East Derbyshire (Lee Rowley) is in the Gallery; I know that this issue is very close to his heart, and that he wishes he could speak in the debate, although his role on the Front Bench prevents him from doing so. Hopefully, I will do him justice as well.

Victim support is important, and fostering an open and honest culture around stalking, domestic abuse and sexual violence, so that victims feel safe to come forward, is a massive challenge, particularly in areas that are a bit more rural and where education levels are perhaps not quite where we would like them to be. We need well-resourced, locally engaged police forces to protect communities such as those in Bolsover.

I offer my sincerest thanks to Jackie Barnett-Wheatcroft for setting up this petition. I know it must have been very difficult to speak so publicly, and it really demonstrates her courage and strength of character that she has brought about this debate with her activism. I should also say that I have met the Minister to discuss these issues, and I know that she takes them incredibly seriously. I know that she will be able to go only so far in her response, and that there is a big cultural issue that we need to address. She is incredibly committed to ensuring that we make progress in this field. The shadow Minister, the hon. Member for Birmingham, Yardley (Jess Phillips), is perhaps the most vocal and passionate Member of the House on a matter that we all care about very much.

The fact that Gracie Spinks’s death took place in a neighbouring constituency is reflected in the number of signatures—nearly 6,000—from my Bolsover constituency. That shows the strength of local feeling. I have been a Member of this House for two years and one month. The Petitions Committee has been functioning in various iterations during the covid pandemic, and every week I have watched on with envy as all the emails come through for different petitions, because Bolsover has never appeared in the list of most supportive constituencies. That number of signatures really shows how important this issue is to my constituents, so I thank the petitioners.

We are here to talk about the lessons learned and the need for further action. It is an incredibly difficult thing to talk about, and I appreciate that matters being sub judice means that we are unable to go into detail, but Gracie Spinks’s case is not the only high-profile case to have impacted my constituency. In another serious incident, in Tibshelf, the police were able to enforce a restraining order in a robust and effective response. Such incidents are harrowing ordeals for all involved, and effective intervention can and will save lives and protect our families, friends, neighbours and daughters.

I am a Conservative Back Bencher, so I want to make some defence of the Government, who are trying to take action on this matter. It is staggering, however, that 1.5 million people have suffered stalking in the past year; the number is almost unfathomable. I appreciate that it is not just men who engage in stalking—that is a perfectly fine caveat—but there is a challenge around masculinity and malehood, and a culture around being a man that can be deeply corrosive and that needs to be challenged. It is not a bad thing to be a man and sometimes not know the answers. I appreciate that I am a man, albeit a gay one, and some people will not like that, but hey.

There is challenge in being a man in a culture in which we are exposed to things on the internet that we were perhaps not exposed to before; in which we are challenged by culture from different sources; and in which we may not be as educated as we need to be. There is often a lack of role models, and a lack of people who can say, “No, that is not right.” There is a challenge around that. It is not impossible to overcome, but we must undoubtedly focus on and acknowledge it, and we must present pathways to ensure that it does not escalate to a point where women and girls are threatened.

Does the hon. Gentleman agree that education in our schools on consent and relationships is key? The best time to get the message across about good, healthy relationships and how to deal with everybody is the time between a person’s being a small child and their becoming an adult.

I agree wholeheartedly. Indeed, until not long ago, my husband worked for an organisation that used to go into schools to help spread tolerance and understanding—albeit in a slightly different field—to ensure that people were comfortable from a young age with those conversations, their rights, and people who may be a bit different. That is incredibly important.

This is an aside that I did not intend to make, but I visited Bolsover School only a couple of weeks ago, and I was absolutely blown away by the tolerance and understanding that I saw there. It was a sign of progress from when I was at school, and a sign that things were being challenged that I did not think would be in my adult life. The subject that we are discussing inevitably leads us to focus on the bad, but it is important that we highlight and praise progress, because that encourages other schools and people to step forward and learn.

I thank the hon. Member for being generous with his time. It is great to see progress in schools, and that progress should be celebrated. But is he concerned about the online harm to which children are being exposed—about what the web is offering them and the problems that that causes? And does he agree that that is why the online harms Bill will have to deal with those issues robustly?

I absolutely do. We seem to be in general agreement, which may be more worrying for my Whips than anybody else. Obviously, the shadow Minister who is responsible for the online harms Bill is very much a mutual friend of ours. The question of what is accessible on the internet is worrying in a variety of lights, but critical thought and being able to understand what is normal and what is right are also important. It is incredibly important for that to be taught in a variety of fields in the 21st century. That ranges from everything that we do and discuss here and everything that we see in the news, through to how we behave in relationships.

I find some of these issues incredibly difficult to discuss, because I grew up in an abusive household. I have spoken about it in the past. I was a victim of domestic abuse—I had an incredibly abusive stepfather—when I was younger. I perhaps come at the subject from the viewpoint that nobody is perfect. I have struggled to define myself as an adult male and, not wishing to make a huge thing of my sexuality, as an openly gay male in Doncaster as well and to find my place. I understand that some of those things are a great challenge for any person, but being a role model, encouraging people to be the best that they can be and, as the hon. Member for Gower rightly says, ensuring that the pathways are there and that the things that people are looking at online are challenged in the correct way is really important.

I got waylaid by the intervention. Fortunately, we have a 90-minute debate and not many speakers, so if I may, I will return to a point that I wanted to make as an aside. Quite recently, we had another event, in Langwith in my constituency, and it resulted in a very high-profile murder. Derbyshire police were incredibly impressive in how they handled that, how they dealt with the community and how they briefed individuals. There are moments when we are very proud of our local police force, and I think it is only right to highlight in this discussion the fact that there is good as well as bad.

It is also worth stating that the Government have, I think, open ears and are very determined to take whatever suggestions will work. That is really important. There is £151 million for victim and witness support, but the most important bit of money that is being spent is the £3 million to understand better the social causes of violence against women and girls, because there are underlying issues of education and culture, some of which have been alluded to both in the opening remarks and in our general discussion, that I think are really important to tackle.

Therefore I thank very much those who brought forward and signed the petition, and I look forward to future contributions—I am sure that that of the hon. Member for Chesterfield (Mr Perkins) will be in a similar vein. The issue definitely should not be party political, because our women and girls are far too important for us to toss it around as a political football. It should unite the nation and unite us as politicians, because this problem must end. Those of us who have been victims, in whichever form, know the importance of standing up, and of seeing people stand up collectively, so I very much look forward to hearing the Minister’s views as well. We need to work together to tackle a culture that must end.

It is a great pleasure to follow the hon. Member for Bolsover (Mark Fletcher), a constituency neighbour. It is a great shame that the debate coincides with the Prime Minister’s statement, because a number of other hon. Members would have liked to be in the Chamber and would have been in different circumstances. But these are the vagaries of the political calendar, as we all know.

I start by paying tribute to Richard, Alison and the whole family, because they have faced a grief and an anguish that is every parent’s worst nightmare. There is almost nothing worse for a parent than attending their child’s funeral, but to attend the funeral of their child in such circumstances, while thinking that steps might have been taken to prevent it, is an unspeakable anguish that no parent should have to tolerate. They have responded to that appalling chasm of grief by saying that they want to get something positive out of it. They know that they cannot bring Gracie back, but they want to support other families so that they do not suffer the same kind of grief. That is inspirational and it makes me very proud to have them as constituents and friends.

I would like to pay tribute to Jackie Barnett-Wheatcroft, who started the petition. Jackie leapt into action as soon as the funeral had passed, initially introducing a paper petition that was supported by the entire community and had over 17,000 signatures in a matter of weeks. Jackie counted them all, which was quite a performance. I will be presenting a paper petition later this evening that will also refer to that. Having being told that a debate in Parliament needed an e-petition, Jackie worked with the parliamentary authorities, assisted by the hon. Member for North East Derbyshire (Lee Rowley), to get a petition on the parliamentary system. That has led to today’s debate.

The funeral of Gracie Spinks was attended by thousands, and her murder sent shockwaves through the people of Chesterfield and beyond, as the hon. Member for Bolsover said. Many people in Chesterfield would have liked to have been here if covid restrictions had not prevented it. The outpouring of grief and anger that followed Gracie’s murder did not surface just because of the tragedy of a vibrant life cut needlessly short. There was also the sense that more could have been done to save her and that the support a victim of stalking receives is so often inadequate. That is what brings us to the debate today. Gracie’s family and the wider Gracie’s law campaigners are determined that some good must come from that appalling tragedy and that we should all do all we can to prevent other families suffering the same heartbreak that Gracie’s family endure daily. The petition is an important part of that campaign.

When the petition achieved 10,000 signatures, the Government responded and pointed out the contribution they have made to the stalking advocacy charity Paladin. They also referred to other stalking advocacy charities, such as the Suzy Lamplugh Trust. They referred to the tackling violence against women and girls strategy. I suspect that we will hear about those from the Minister today. Just like the hon. Member for Bolsover, I will hope that, in recognising the steps that Government have taken, there will also be a recognition that the experience of Gracie’s family and others tells us that far more needs to be done.

I entirely agree with what the hon. Member for Bolsover said about cultural change and the difficulties that some men experience in recognising their role in an everchanging world, but there needs to be a real focus within the debate on policing, justice, access to the courts and enforcement of the law, as well as measures to prevent people from stalking. In advance of the debate, I spoke to Paladin to understand more about the barriers that victims face and to hear more what it sees as the steps that would make a difference. Paladin explained that stalking is often misunderstood, both by the wider public and by police forces. It can be misrepresented as domestic violence, but in Gracie’s case, and indeed in many cases, there has never been a relationship between the stalker and the victim. Some victims have never even met their stalkers. The nature of the offence is often misunderstood and incorrectly recorded.

The nature of the stalking can often progress and change shape and increase in its intensity and obsession. It will also often be a series of acts, some of which are criminal offences and others of which are not. Offences such as vandalising a victim’s car or making malicious communications end up being recorded as a series of individual criminal damage offences, rather than being recognised as a collective campaign of stalking. In common with many other crimes that take place predominantly against women, stalking charities tell me that police often place a huge burden of proof on victims before they start investigating, in a way that is not expected with other crimes. When someone phones the police to complain that they have been a victim of a house burglary or have had their phone nicked, it is accepted as fact that the crime they are reporting has been committed, whereas with this sort of crime, there is an expectation that victims will turn up armed with evidence to get an investigation going. That frustration at the lack of investigation and detection is a common complaint of stalking victims and their families.

Alongside the physical manifestations of stalking, the majority of incidents often have an online aspect. That could be threats made online, posting things that are designed to be embarrassing or intimidatory, posting abusive messages or posting about doing harm to a victim. That leaves a footprint, and often if police followed up and investigated the online presence of accused stalkers, they would identify the evidence they need. However, because such events are often recorded as criminal damage, malicious communications or other lesser offences, the wider investigation simply does not happen. A lot of the evidence I have heard and seen in this case is that if only a number of different events had been pieced together in a single picture, there might have been greater support for Gracie.

The petition asks the Government to increase funding to ensure that there are people advocating for victims of stalking in every police force. That aspect of the petition is incredibly important, and I stress it to the Minister, because the response given when the petition reached 10,000 signatures was predominantly about supporting stalking advocacy charities. Charities such as Paladin do amazing work going into police forces and training up officers and providing a kit that officers can use. However, we need that culture within the police—not a junior person doing that but someone with the authority within the force to ensure that that culture changes and that every single police officer protects people in the ways that we should want for our own daughters if we were reporting the issue. The postcode lottery and inconsistency of service—both from force to force and even within forces, depending on which officer picks up the case—are entirely unacceptable. The need for all forces to have a specific case manager with an appropriately senior ranking to ensure that stalking is properly understood and appropriately policed is urgent. I stress that when we talk about stalking advocacy, we are talking about supporting charities, but we are also talking about having an advocate inside police forces who will make sure that the voices of victims are heard.

There are other aspects of the issue that we can deal with here in this place. My hon. Friend the Member for Gower (Tonia Antoniazzi) referred to the appallingly lenient sentences handed out in the case she mentioned, which we have all seen. I will speak a little more in a moment about the impact of stalking on victims, and it is imperative that the Government recognise the physical and mental torture of stalking on its victims, and that sentences should be appropriately severe. It is also crucial that the backlog in court cases is tackled, because we cannot underestimate the number of people who go to the police and then find 12, 18 or 24 months later that offences that have been reported have still not reached court. Often victims will say, “I simply can’t cope with waiting for this any longer. I want it over.” As a result, they will not go through with the process and the perpetrators will get away with it. Often they will hear about the appalling situation in our courts and decide not to pursue the case with the police.

For Gracie, it was very much a case of her wanting it to stop. She was not necessarily looking to pursue the legal aspects; she wanted appropriate support. A whole range of victims out there are being failed by our police, by our sentencing regime, and by the fact that they are unable to get into court to have their cases heard. Each is central to the question, as are all the important points raised within the strategy about the culture, tackling perpetrators, trying to discourage and other things. We need to make sure that we get the policing, sentencing and court availability right.

As I said a moment ago, there is a key role for stalking awareness charities such as Paladin. They do great work in improving the knowledge base of police forces, but the charitable sector is only part of the solution. I reiterate that the petition demands that the Government recognise the failure that the Spinks family experienced and take action to ensure that a culture of understanding and zero tolerance is endemic in every police force. A specific stalking advocate within the police force would be expected to have regular oversight of stalking cases and ensure that officers developed the understanding and skills that are too often lacking. Gracie Spinks’s case had the most appalling ending imaginable—the nightmare of every parent. Thankfully, most cases do not end in violent murder, but the impact on all victims of stalking is profound.

Stalking victims are not free. They are constantly looking over their shoulder and are forced, more than the rest of us, to be careful. They go out to their car in the morning, wondering whether it will have been attacked. They open their post, wondering whether they will be greeted by an abusive message. They turn on their computer, wondering what will have been posted to them or about them. Every time they answer their phones, they do not wonder whether it will be a payment protection insurance salesman, but whether the anonymous number will be spouting a torrent of hateful or disturbing abuse. They develop a habitat of looking out for a certain car; every red Ford Fiesta gives a victim a chill of fear if that is what they know their perpetrator drives, until they can assure themselves that it is not the same car. Not all victims of stalking end up in a graveyard, but they are all scarred and it is so important that we give them the support that they need. There are male victims and female perpetrators of stalking, but it is predominantly a crime committed by men against women. It is about power and control, and although it can take many forms, its effects are always debilitating.

The petition is of tremendous importance, as is the Minister’s response. I was asked in a TV interview today how important the debate was, and I had to say, “I don’t know. It’s all about the actions that the Government take.” We all know that we are in the process of discussing a huge number of issues in this place, and there is a widespread desire across the political spectrum to take action and prevent stalking. I am absolutely certain that the Minister takes the issue as seriously as I do, but it is a case of whether there are the necessary resources, legal backing, sentencing support and determination to address the court shortage, and whether we have taken all the steps that need to be taken for us to be able to look a family in the eye and say we have genuinely done all that we can. The petitioners demand that the Government recognise that the steps taken so far are not adequate, and that standards of policing must improve for stalking victims.

We are in the later stages of the Police, Crime, Sentencing and Courts Bill, and we are told that the Government also intend to introduce a victims Bill. Both those Bills seem to be appropriate vehicles to bring forward a Gracie’s law, to ensure that funding is provided for a stalking advocate in every police force, leading to better protection for victims of stalking, and that those obligations on police forces are written into law.

We can never say that Gracie Spinks will be the last victim of a stalker. Tragically, that is almost certainly not the case, but those of us in this place can resolve to do all we can to ensure that police forces understand the crime and have the resources to tackle it, so that more families like Gracie’s are not left asking, “Why wasn’t something done?”

It is a pleasure to serve under your chairmanship, Sir Mark, and to follow my hon. Friend the Member for Chesterfield (Mr Perkins) and all the Members who have spoken.

The hardest, but most rewarding, part of my job since becoming a Member of Parliament is getting to know the families of women and girls taken by male-perpetrated violence against women. It is always a total honour to meet the families. I am always totally bowled over by their resilience and desire to change the future for the better for other women; and Gracie’s family, and the case of Gracie’s law, is absolutely no exception. Gracie’s law is never going to bring people’s families back, but there is a desire to change things so that other families will not end up with their daughters’ names being read out on a list. I have yet to read out Gracie’s name on the list—I will do it in March—but we have to all do whatever we can to make sure that that list gets shorter, not longer.

On the point made by the hon. Member for Bolsover (Mark Fletcher)—with whom it is an honour to debate these matters—this is a totally cross-party issue. There was a time, perhaps even when I first got here, when I may have questioned some people’s views on these issues, and there was certainly a time, when I started working in violence against women and girls services, when I absolutely felt it was party political issue, whereby some political parties—not necessarily just the one that he is a member of—did not take it as seriously. I do not think for a second now that that is the case or that there is any political party in this building that does not care about this issue. I do not doubt for a second that the Minister cares very deeply about the issue, but it is my job—and will be my job for the rest of time—to point out where things are going wrong and what needs to be done about that.

Quite rightly, my hon. Friend the Member for Chesterfield pointed out that the case on which this petition hinges was not a domestic homicide; it was a case of an unrelated person, not an ex-partner, and—it is almost never that I think this—those cases can be even harder to prosecute and get action on, because there is now at least a base understanding in most police forces now around the idea that stalking is part of a pattern of domestic abuse. The role of stalking in domestic homicide must also be acknowledged, as well as the seriousness of the crime and what it can lead to.

Half of stalkers who make threats act on them, and some of these end in murder. Jane Monckton Smith has written extensively about what leads up to a fatal situation from stalking. Her study of 358 criminal homicides in the UK, all of which consisted of a female victim and a male perpetrator, revealed that stalking behaviour was an antecedent in 94% of all murders. So this is something very, very serious, and it is an alarm bell that should be being rung loudly, in order for us to end the most serious of crimes.

Between 2015 and 2017, a freedom of information request by news platform Vice and Paladin, the stalking charity that has already been mentioned, revealed that 60 women were murdered after they reported their partner, their ex-partner or a stalker to the police on grounds of domestic abuse and stalking. That is 60 women who had reported in just a two-year period. I stand here as a Birmingham Member, and I often outline that three women are murdered each week, on average, every year. In Birmingham, in the last nine days three women have been murdered—or killed, should I say. It just seems relentless. In those 60 cases in that two-year period, those men all had a history of harming other women, yet there was no proactive risk identification assessment or management of the perpetrators.

A previous history of stalking or abuse and a pattern of coercive control within a perpetrator’s relationship with his victim have both been identified as stages in the eight-stage domestic homicide timeline outlined by Jane Monckton Smith. In short, stalking is an identifiable precursor to killing. We must see it as a pattern of behaviour and it must be appropriately identified. An intervention can save a woman’s life, and we must ensure that reports are acted upon. The advocates that this petition calls for would undoubtedly help that.

Just last week, as my hon. Friend the Member for Gower (Tonia Antoniazzi) has already cited, there was the case of Yasmin Chkaifi. Without even having to go into the sub judice of Gracie’s case—I really wish this was not the case—there are hundreds of cases we can lean on to identify the same failures. In the case of Yasmin, she was stabbed to death in Maida Vale this month by Leon McCaskre. In the press it is reported that a friend of Yasmin had said that she had received text messages two years ago saying:

“He’s had cameras in my house recording me for months.”

Yasmin added:

“He’s stolen my mail, my phone, has access to all my personal data. I think he will kill me. I’ve tried everything.”

The press reports that McCaskre was wanted by the police when he killed Yasmin. The warrant saying that he should be held without bail was issued on 4 January after he failed to appear in court. McCaskre was accused of breaching an interim stalking protection order.

I will come to those orders, as they have been raised. I have worked in domestic abuse, sexual violence, stalking and human trafficking services for a good many years. We can make up as many good orders as we like, but an order is absolutely worthless unless the police act on breaches of it and unless there is a well-resourced police force that can, in that moment, go out, investigate the breach and make an arrest that leads to somebody being imprisoned—which, in the case of Yasmin, would have saved her life. In my experience, when I say, “Have you ever considered getting an order?”, this is the reaction I get: “Yeah, I’ve got about four.” I have personally got four restraining orders; I have been a victim of stalking and harassment. There are people in prison and sectioned for undertaking that abuse against me; and unsurprisingly their orders did not stop them.

There are other cases. Asher Maslin stalked and murdered Hollie Gazzard. Myself and the Minister met Hollie’s family. Maslin was involved in 24 violent offences, including three against Hollie, 12 against former partners, three against his mother and four against others. There was no proactive join-up of this information nor risk management. Ian Paton strangled Kayleigh Hanks to death in July 2018. He had strangled three other people, including his ex-partner, before he killed Kayleigh. There was no risk assessment or risk management of his behaviour.

Managing repeat offenders is a real concern. Research indicates that up to 56% of those charged with stalking go on to reoffend after prosecution. We already know that it is a tiny fraction who will have been prosecuted in the first place. Perpetrators’ histories are not checked, and links are not made.

Two inspections by Her Majesty’s inspectorate of constabulary revealed deeply troubling findings. Its 2014 inspection into police responses to domestic abuse revealed no risk management of perpetrators. In 2017, “Living in Fear”, a report specifically on stalking produced by Her Majesty’s inspectorate of constabulary and fire and rescue services—HMIC’s name changed in the intervening three years, and got a lot longer—revealed a 100% failure in every police service and the Crown Prosecution Service across the six areas it inspected. Out of 112 cases, not one case was properly investigated, and no stalker was proactively risk assessed or risk managed.

The most recent HMICFRS report was similarly damning. It identified that repeat offenders in the areas of stalking, harassment, abuse and violence against women were time and again not being monitored, with no offender management and no monitoring in the community of the most serious risk of harm perpetrators. Imagine if I was talking about terrorism—imagine if there were people like that living on your street and not being monitored by any intelligence agency. The trouble is that when the newspapers report these cases, the police say, “Don’t worry, nobody else is at risk”—as if all women are not at risk from the kind of hatred that killed Gracie.

Operation Soteria has been undertaken already at Avon and Somerset police, and recently at the Met—we await the findings of that when the Home Office decides that we should have them. What was found in Avon and Somerset, and I have absolutely no doubt also in the Met, was that when people were being accused of rape, abuse and stalking on the streets, as well as in relationships, police forces were routinely not even checking the accused on the system to find out if they were a repeat offender. Imagine that: “This man raped me.” “Maybe check it on the system.” That is a fundamental failing, and I cannot look at these failings across the board for every crime that women are victims of and just fall back on the idea that it is complex. It is not that complex. It is like burglary of a house: it is not that complex. Every woman who comes forward and says, “I feel scared by this,” should be listened to.

Victims have no faith in the system, and legal advocates would without question improve that. Out of 75 victim respondents surveyed, fewer than two thirds indicated that they had reported stalking to the police in the UK, citing a lack of trust in the police and the wider criminal justice system. The Suzy Lamplugh Trust’s survey of over 1,000 officers in the UK found that only 35% of police respondents had ever received stalking-specific training and that 10% of respondents received training over five years ago, with only 3% indicating that they were very confident in their knowledge of stalking legislation, while 13% were not confident at all. Imagine that is the one who you get, who is sent out to you—the one who is not confident in stalking legislation at all. We need better training on stalking: 82% of those respondents indicated that they wanted better training and that it was needed for the police to be better equipped.

In September 2020, the University of Central Lanc—Lancashire; sorry, I am from the midlands, not the north. I know everybody thinks it is the same place, but it is not. The University of Central Lancashire published “They speak for you when you can’t speak”, an academic review of the National Stalking Advocacy Service run by the charity Paladin. That report found that the support of an independent stalking advocacy caseworker—the specific kind of advocate that we are talking about—was critical in improving the responses of criminal justice agencies. Many victims explained how grateful they were for that advocacy and support. High-risk victims of stalking confirmed that an ISAC’s support increased their understanding of the nature and impact of stalking and the associated risk. The report also said that victims reported improved emotional wellbeing and enhanced safety as a result of the ISAC support. The advocacy improves victims’ experiences. It is vital.

My hon. Friend the Member for Chesterfield mentioned the Government’s response to the petition once it received 10,000 signatures. I pay massive tribute to people such as Jackie, who are the doers of changing the law. Every single change to the law was brought about by somebody sitting in a room saying, “This isn’t good enough.” It is people such as Jackie and Gracie’s family who will change the law—I have no doubt.

The £90,000 for extra stalking advocates is absolutely to be welcomed, but it would cover only what is necessary in Birmingham. It has been said that it is a postcode lottery across the board in terms of support for victims of violence against women and girls, and it is absolutely the case that in one place, people get a great service, while in another, people get a dreadful service.

The hon. Member for Bolsover made the point that nobody is perfect. I wrote down that I must point out that that is absolutely one of the best things I have ever heard a man in this place say about violence against women and girls. As a society, we have come to terms with the idea that we all know a victim. With #MeToo and the Sarah Everard case, women have poured their hearts out, with thousands more coming forward now than ever before. Women have stood up and said, “This happens to us.” As a society, we understand now that we all know a victim of abuse—such as the hon. Member, who spoke about what happened to him in childhood. It is deeply important.

However, the bit that we have not come to as a society—and we will not stop this unless we do—is this: we all know and love a perpetrator of violence and abuse. Statistically speaking, if we all know the victims, then we know the perpetrators—unless there is one very prolific, horrible man. We have to come to terms with the idea that these people, while they do those dreadful, monstrous things, are not necessarily the monsters they are described as. The people who stalk, abuse, rape and beat women and girls walk freely among us all the time. Until we can all come to terms with that as a society, whether through education or otherwise, cases such as Gracie’s will keep happening. We have to accept that those people exist and that they need monitoring and actioning. We need to listen to the voices of victims.

What my hon. Friend the Member for Chesterfield said about police reform is vital. I was an independent sexual violence adviser; advocates such as ISVAs have existed for 20 years and, for a good long spell, that advocacy massively improved the conviction rate. However, we have seen those rates tumble. Advocacy in and of itself, without proper police prioritisation—which needs to come from political prioritisation—is no longer enough.

As we continue to fail to monitor repeat offenders and to follow up on case after case where people come forward, it is no longer good enough for hon. Members to sit here and say, “We’re going to have a strategy. It’s up to police force areas what they decide to do.” With the greatest respect to Maggie Blyth—the officer put in charge of tackling violence against women and girls—when I had a meeting with her, she told me that, “I have to expect police force areas to take it on.” She has no teeth to say, “You have to do this, otherwise you’ll lose your job.” That has to come from the Home Secretary.

I agree entirely with my hon. Friend. I was reading in detail the Government’s response to the petition when it reached 10,000 signatures. It says that,

“the College of Policing provided a set of new advice products on stalking for police first responders and call handlers, and in November 2019 it released a new product for investigators.”

I have no doubt that they are very useful things. However, it needs to be compulsory and it requires real leadership from the very top of the police force that this is a priority. Instead of it being something that officers can avail themselves of, I want it to be something that every single officer is doing. I want to see the recommendations acted upon.

I 100% agree. I take my hon. Friend back to my terrorism analogy: imagine if we allowed the police to freestyle how they dealt with terrorism—that we did not have specific tasks that police force areas had to follow.

The same priority is never given to male violence against women. It is never, ever considered to be the most pressing issue. More than 20% of all police call-outs are cases of violence against women and girls. Do we think that those cases get 20% of the policing budget in any area? Can we all guess? I do not want to turn this into a pantomime, Sir Mark, but I think we can all guess that they do not get anywhere near that amount. The reality is that this support has to be driven with the political will shown by the 100,000 people who signed the petition. The hon. Member for Bolsover said that he was proud that this was the issue that mattered to his people. The country has spoken again and again in the last two years—more so than ever before—to say, “This issue matters to us.”

In my lifetime of working in this area, which now seems like many lifetimes, I have never known the country to push this as an issue of political will quite as much as it has in the wake of Sarah Everard’s death. These things will only change when every police force area knows that if it does not, the chief constable will be sacked. This proposal will only work if the issue is addressed when allocations of budgets come from the Government. Although I like the £151 million, the Minister and I both know—because it has been announced quite a few times over the years—that £125 million is going to refuge accommodation and has nothing to do with the police. It will go to local councils to offer refuge accommodation—not necessarily to the standard that I would like to see, but still better than nothing.

The reality is that we in this place have to say that, crime-wise, this issue is our priority and we are going to push it through to the bitter end, so that when a Prime Minister stands up and says that the single most important thing a leader can do—the first line of Government—is to ensure the safety and security of their citizens, in their head they are remembering that women and girls exist.

It is a pleasure to serve under your chairmanship, Sir Mark. I congratulate the hon. Member for Gower (Tonia Antoniazzi) on securing this debate and doing justice to this vital subject. It really is an honour to be here.

I thank the other Members who are present. I am sure that there would have been more had it not been for events in the main Chamber. Nevertheless, I thank my hon. Friend the Member for Bolsover (Mark Fletcher) and the hon. Member for Chesterfield (Mr Perkins) for doing an extraordinary job, as men advocating for the women and girls in their constituencies. The hon. Member for Birmingham, Yardley (Jess Phillips) and I may disagree on much, but I think we both agree that it is heartening and inspiring to see men coming together, because it is only when men stand up and demand change on behalf of women that we will see the change that we all want to see.

I also pay tribute to Jackie Barnett-Wheatcroft, who is with us today, for creating this petition. The amount of work that she has done to get this issue to the top of the agenda is not inconsiderable. It was a real pleasure and honour to speak to her and hear about her tireless efforts. She has taken this issue on because she cares about it, and that passion came across so clearly. It was wonderful to speak to her and my hon. Friend the Member for North East Derbyshire (Lee Rowley), who is also in the Gallery. As a Whip, he is not able to speak, but he was the conduit that allowed us to have that conversation. I pledge again that I will do everything in my power to help Jackie with her work to set up the charity, which I know will change people’s lives and be a massive source of support. To Jackie, I say thank you so much.

Of course, we must honour Gracie Spinks. Her name is not mentioned in the petition itself, but it is a tribute to her. You have enjoined me not to transgress and go beyond what I am allowed to say, Sir Mark, because the IOPC’s investigations mean this is a live case, but that does not prevent me from expressing my total shock and horror in reading about those awful events—I know that everybody shared that feeling. The issues goes wider than the area that Gracie comes from; constituents of mine in Redditch have signed the petition, as have people from across the country.

When we read about that tragic and senseless loss of life, we can all relate to it—whether or not we are parents does not matter. I extend my deepest sympathies and condolences to Richard and Alison, who are in the Public Gallery. I can only begin to imagine how terribly they must have suffered. I thank them for the tremendous amount of work they put into the petition, which has resulted in this hour-and-a-half discussion, and our dedication and effort. This is only the start of the change that they want to see.

I believe, Sir Mark, that I have enough time to set out what we are going to do, what we have already done, and what we will continue to do, as the petitioners have rightly requested.

Thank you for that reminder, Sir Mark; I will ensure that I leave enough time.

Stalking is at the heart of our “Tackling violence against women and girls” strategy, which we published in July. It is worth stepping back and reminding ourselves of why we needed that strategy, the consultation of which received the greatest number of responses to any Government consultation. That highlights that need, and we must all keep fighting and pushing—I include myself and the shadow Minister in that—to keep the issue at the top of the priority list for Government and for Members across the House.

We all have so many important things to focus on every day in our lives as parliamentarians but, as the shadow Minister said, the public care deeply about this topic, and that was reflected in the responses to the consultation. Of course, that was an immediate response following Sarah Everard’s death, but many other women have died—we all know about the work that the shadow Minister does every single year in Parliament to remind us of those deaths—and it is right that we continue to honour the victims in our work to take the strategy forward.

To reduce the risk of perpetrators committing further offences, as the strategy confirmed, we launched a fund for police and crime commissioners to run programmes to address the behaviour of domestic abuse and stalking perpetrators. The funds will provide programmes to cover a range of different methods for tackling stalking. It is right that we recognise that stalking only recently came on to the statute book in its current form. Our understanding is not quite as well developed as it is for many other crimes that involve serious violence against women and girls. That is why it is important that we have those programmes and evaluate the evidence so that we can understand what works. That work includes the development of a multi-agency stalking intervention project in Cambridgeshire, and the development of the compulsive and obsessive behaviour intervention programme in Surrey. The aim of all such programmes is to encourage behavioural changes to reduce the frequency and gravity of the abuse presented by the perpetrator, thereby improving the safety of and protection for the victim.

The strategy also refers to our commitments to improve the use of stalking protection orders. We introduced these orders just two years ago, and they can protect victims of stalking at the earliest possible opportunity and help to address the behaviour of perpetrators before they become entrenched or escalate. They have the flexibility to impose both restrictions and positive requirements on a perpetrator, and I am proud that the Government introduced them.

We know that there is more to do. We know that some forces have been applying for more of these orders than others. The violence against women and girls strategy confirmed that the Home Office would work with the police to ensure that all forces make proper use of the orders. That is why I have recently written to all chief constables whose forces have applied for fewer stalking protection orders than might have been expected to encourage them to always consider applying for one in stalking cases.

I did that in October, and I received responses from several forces setting out the measures they are taking to make sure these orders are being used appropriately. I am pleased that one of the responses I received was from Derbyshire police, which is rightly taking a number of actions, including the delivery of a force-wide training programme specifically for stalking offences.

Specifically on that point, it is my understanding that as of June 2021 stalking protection orders were used in response to around only 2% of stalking arrests. Is the Minister expecting any factor of increase after her letter and after the police forces have said they are going to do this? Will it go from 2% to 4%? Obviously, I would like to see it go higher. Is the Home Office putting a target on police forces?

Absolutely, we want to see the number go up. We will be publishing the figures as soon as we are able to.

This debate has rightly focused on the police response, not just in Gracie’s case—which I am not commenting on—but generally across the country. I want to talk about some of the things that the police have done. The hon. Lady referenced the 2017 inspection, which showed a number of failings, to put it that way, in the police response. Since then, forces have identified a number of improvements that have been taken forward, and they have published a national stalking and harassment improvement plan.

Every force must now have a single point of contact for stalking concerns. There is also a change in the Home Office’s crime counting, which was mentioned by the hon. Member for Chesterfield. Each force must ensure that stalking is recorded as the main crime before anything else—for example, criminal damage. I think that it is a very helpful point.

On the question of the single point of contact, is that for the victim or is there a single person managing the cases? If the latter, could she tell us about the seniority of the officer?

I will respond in writing to the hon. Gentleman, because I cannot do justice to that question in the time that I have left. I will come back to him on that.

I want to get on record some of the other vital protections and improvements in the police response across the country. It is vital that the police are provided with the correct materials and training to deal with stalking appropriately to ensure that they are confident in identifying stalking cases. That is why new advice and training products are being made available to police first responders, call handlers and investigators, making clear the key differences between stalking and harassment.

The hon. Member for Gower asked for information on the west midlands pilot. We have confirmed £11.3 million funding for PCCs to run programmes to address stalking and to evaluate the success of this work. The project is in its early stages, but we will provide her with an update from the west midlands police and crime commissioner when we are able to.

The violence against women and girls strategy also confirmed that the Home Office has this financial year tripled the funding that we provide to the Suzy Lamplugh Trust, which runs the national stalking helpline. That funding is enabling it, among other things, to expand its advocacy work. Since July, the trust has used the funding to provide advocacy support for 29 people who are particularly vulnerable or whose cases are particularly complex. I visited the helpline in November, and it was an incredible experience to see at first hand its vital work and how it is helping so many victims.

Hon. Members will be aware from our response to the petition last August of the additional funding for the national stalking helpline and of the almost £100,000 that we provided to Paladin, which many Members mentioned. I thank Paladin for what it does. We provided funding to it between April 2020 and March 2021 to provide additional independent stalking advocacy caseworkers during the height of the pandemic. The provision of ISACs trained by Paladin is also part of the Home Office’s funding to the Merseyside police and crime commissioner to address the behaviour of stalking perpetrators.

In the current financial year, the Ministry of Justice will have provided just over £150 million for victim and witness support services, including an extra £51 million to increase support for sexual violence and domestic abuse victims. That includes funding for independent domestic violence advisers. Domestic abuse funding can include stalking that takes place in a domestic context, where the stalker might be a former partner or a family member of the victim. It is open to police and crime commissioners to use their core, un-ringfenced funding to fund ISACs. The point has been made that stalking does not always take place in a domestic violence or abuse context. It is also correct to say that we do not ring fence funding for independent stalking advocacy caseworkers in the same way that we do for equivalent roles in domestic abuse and sexual violence, as the petition and many Members have referenced.

I will move on to the work that is being led by the Deputy Prime Minister on the victims Bill. A consultation that includes questions about advocacy services is open, and the consultation paper is clear that it focuses primarily on domestic abuse and sexual violence advocates. That is because we have a more developed understanding of those positions, Government funding for the roles and what is needed, but we appreciate that similar roles, such as ISACs, exist and are helpful. There are questions in the consultation that apply equally to all advocacy services. The consultation remains open until this Thursday, and I encourage anyone who is interested to submit their response.

Is it the Minister’s view that the proposal made in the Gracie’s law petition would be best applied to the victims Bill or to the Police, Crime, Sentencing and Courts Bill, or is her argument that we do not need legislation in this area?

If the hon. Gentleman will forgive me, I am making no such argument. On the victims Bill, I encourage him to continue his conversations via the consultation process with the Deputy Prime Minister and the Ministry of Justice. I am setting out the work that the Government are doing. If the hon. Member for Chesterfield will forgive me, I will come on to the response to the consultation, and work that is happening across Government.

I understand that the Minister is against the clock, but in relation to the question that the hon. Member for Chesterfield (Mr Perkins) just asked, will the Minister undertake to write to the Deputy Prime Minister to make him aware of today’s debate, and the recommendations that have been outlined by various Members? Perhaps whether they are appropriate can then be considered.

That is an excellent suggestion. If we have not already done so, I will ensure that that happens. In any case, the Ministry of Justice will look very closely at all the consultation responses received on this issue and many others.

I will briefly touch on what is happening in terms of the multi-agency public protection arrangements—MAPPA for short—because they are vital. They are specifically about how offenders are managed, which several Members have touched on. It is important that agencies make use of MAPPA to strengthen the effective management of serial and high-harm perpetrators of stalking and domestic abuse, and the national MAPPA team works closely with local strategic management boards to support implementation at a local level. This is about having the most appropriate arrangements in place to ensure that we keep people safe from harm.

We are also shortly due to publish a domestic abuse strategy that will seek to transform our response to domestic abuse in order to prevent offending—of course, stalking is a key part of the domestic abuse pattern of offending—support victims and pursue perpetrators. That will include a specific section on the risks associated with stalking. Some very good points have been raised about the pattern of offences and the escalation process. A couple of Members touched on education and what we are doing in schools, and we are already working with colleagues in the Department for Education.

I also want to let Members know that we will release a national education campaign about violence against women and girls. This will be quite a groundbreaking piece of work. We are talking about changing that misogynistic culture that everyone has spoken about, and making it absolutely clear that we probably all know a perpetrator—not necessarily a murderer, but someone who is not behaving in a respectful way to their female friends, associates, colleagues or partners. This communications campaign is specifically designed to make crystal clear what is and is not acceptable in the public and domestic sphere. I am really looking forward to the campaign and will pay close attention to it, as I am sure will all hon. Members here, and I encourage them to amplify it through their own communication channels, to get out the message out that this Government do not put up with those kinds of behaviours, whether they are on the street or whether they are serious crimes such as stalking, harassment and murder.

I once again thank the hon. Member for Gower for introducing the debate in order to raise this important issue. I will of course follow up on the points Members pressed me on. I could say a lot more, but unfortunately time is short, and I want to allow the hon. Lady the opportunity to respond to the debate.

I thank the hon. Gentleman.

I thank the Minister for her response, and all Members who have spoken. It was disappointing, as we have all said, that other Members were not able to join us in for what has been an important debate. I thank the petition maker, Jackie, Gracie’s family—it has been an absolute pleasure to meet you today—and everybody who signed the petition. The Minister spoke about the Suzy Lamplugh Trust, and my hon. Friend the Member for Chesterfield (Mr Perkins) spoke about charities such as Paladin that have given a lot of support. The Minister cannot respond now, but I really hope she will hold police forces’ feet to the fire, because we need to know that what she outlined as having been done since 2017 is being done. It cannot be, otherwise we would not be where we are today. It is integral that her role incorporates holding them to account and making them act on what they should act on.

In 1986, Suzy Lamplugh went missing. I was 15 years old at the time, and it really sticks in the memory, as a teenager, knowing that women are going missing. It is great to hear about the conference, and about National Stalking Awareness Week, from 25 to 29 April, but we have to do so much more.

The petition is so important, and speaking today has been an absolute honour. I also hope that Gracie’s sister, Abi, who I met today, will follow her dream, go on to study politics and join myself and other female Members in this place to fight for the memory of her sister, Gracie. As my hon. Friend the Member for Birmingham, Yardley (Jess Phillips) said, stalking is an identifiable precursor to murder. Minister, we cannot allow this not to be changed; we have to change it. She made the comparison to terrorism. We know where our terrorists are. We tag them. We look for them. We need to do the same as for terrorism.

I will end on this note—it is a nice note. The strength of the feeling of the family and the petitioners must be noted. Having two brothers myself, I was so pleased to hear Abi tell me earlier that her brothers are great, and what a great strength they are, because they look after her. Families are wonderful things, and theirs has been through hell. So many families have been through hell that it is our responsibility in the House to ensure that we do our best so that this is never repeated. I thank the Minister and everyone who has spoken, and I thank you, Chair.

Question put and agreed to.


That this House has considered e-petition 593769, relating to funding for stalking advocates.

Sitting suspended.

Future of the NHS

[James Gray in the Chair]

I beg to move,

That this House has considered e-petition 598732, relating to the future of the NHS.

It is an honour to serve under your chairmanship, Mr Gray. Today I have the privilege of bringing the petition to the House for debate. I congratulate Marcus Hynes, the writer of the petition and a proud Unite member, on achieving over 135,00 signatures. Marcus and other esteemed members of Unite shared their views ahead of the debate.

The NHS is a truly British innovation. It is there to help us in our hour of need, supporting us from cradle to grave. The NHS has an enormous role in the lives, health and welfare of British people. As a result, it is rightly at the centre of much debate in this place, as we constantly look at how it can be expanded, improved and made more efficient. I thank the NHS and all its amazing doctors, nurses, staff and volunteers for what they do. Throughout the past two years, they have been the crutch that has kept this country upright. No words will ever be able to articulate how thankful people across the UK are for the work that they do for us every day.

The NHS is a great British institution, founded in the wake of the war by a society that wanted better for everyone. It is, and always shall be, free at the point of use. The NHS carries the weight of our country’s health problems on its shoulders, which is why I am delighted to support the Government’s ongoing commitment to it.

The hon. Member referred to the NHS being free at the point of delivery, but NHS dentistry is on its knees. In my constituency, Rachael Elizabeth has been waiting over two years to see a dentist. It is the same in Runcorn, Frodsham and so forth. There is a similar situation in the neighbouring constituency of my hon. Friend the Member for City of Chester (Christian Matheson), in Ellesmere Port and right across the country. Does the hon. Member for Stockton South (Matt Vickers) agree that NHS dentistry is in crisis?

I have shared concerns about NHS dentistry from my own part of the world, and I am fairly confident that the Minister will fill us in and give a more extensive response.

The NHS carries the weight of our country’s health problems on its shoulders, which is why I am delighted to support the Government’s ongoing commitment to it. The biggest cash boost in the history of the NHS is allowing us to put thousands more doctors and nurses into our hospitals, coupled with major capital investment programmes that have already benefited my local hospitals. I know that the Minister is only too aware of my ongoing campaign to secure more sizeable improvements at the University Hospital of North Tees. That said, I know from my constituency that there remain huge challenges for the NHS and its role in improving the health of the nation.

In 2018, Stockton was labelled England’s “most unequal town” by the BBC. It is a town where people born in one area can be expected to live 18 years fewer than those living just a few miles up the road. Such health inequalities are not acceptable in modern Britain. The NHS rightly looks to prevention as well as cures, and furthering this cause requires not just more resources and improved efficiency, but joined-up co-operation with other agencies, which lies at the heart of the reform agenda.

Putting my experiences and observations aside, the lead petitioner, Mr Hynes, and those from Unite wanted to let me know that they are fundamentally opposed to the Health and Care Bill. As part of their reasoning, petitioners cited concerns about the staffing crisis, overwhelmed human resource departments and the backlog as core reasons for their belief that the Bill should not be brought on to our statute book. Petitioners shared their concerns about staff shortages and worker fatigue in an NHS that already stretches itself to meet the needs of the UK’s ageing population and the exponential growth in the public’s health needs. They talked of how the pandemic has compounded this problem.

Moreover, the pandemic paused elective surgery, leaving the NHS to deal with backlogs and extended waiting lists. The view of the petitioners was that the NHS should be given time to stabilise and respond to those challenges before taking on the challenges of reform. On a more institutional level, Unite said that it fears that this Bill would open the NHS up to deregulation, worsening staff shortages, and create a pay-for-use system akin to America’s.

The petition states that

“The Government has no democratic mandate to privatise the NHS”.

I agree: the Government have no democratic mandate to privatise the NHS, which is why they are doing no such thing. Access to NHS services will continue to be based on clinical need, not an individual’s ability to pay.

I congratulate the hon. Gentleman on having secured this debate. I put to him—this is perhaps a challenge to the Minister and the Government—that we need to be careful with the NHS as it is today. We all love the NHS—we love the workers and we love what it does—but if we are not careful, it could come to a point where if a person does not have the money, they cannot pay for their care. Does the hon. Gentleman agree that if that were to happen, the whole principle of the NHS would be knocked on the head?

This is a debate that we have in every election campaign, and other than the issues around dentistry, which I am sure we will come to, the NHS remains free at the point of use. I will fight the corner to keep it that way, and I am sure that the hon. Gentleman will do so as well.

I think everybody in this room would agree with the principle that the NHS was founded on—care that is free at the point of use—but the NHS has had many structural forms since its inception immediately after the second world war. My concern is that its current form and the proposals that the Government are bringing forward further centralise the NHS, and waste further money on bureaucracy, mimicking the private sector and creating an artificial market. Does the hon. Gentleman agree that that is a waste of money, and that the NHS should be decentralised in order to provide better services to local communities?

I am sure we are going to hear about the ways in which these structural reforms will take place with that very aim in mind. I am going to try to get through my speech, because I am sure that Members would prefer for everybody to get in and to hear from the Minister, who is wiser on this issue than I am.

In my view, the Health and Care Bill does not represent an attempt to create a “pay for play” system—quite the opposite. While I am sure the Minister will go into detail about this point in his response, my understanding is that the Bill is largely the work of the NHS itself, inspired by NHS England’s own desire to restructure its organisational system to be more efficient and effective. It builds on the NHS’s own long-term plan, as set out in 2019, and the NHS people plan, which was published in 2020. Many of my conversations with leaders from my local NHS trust suggest that the answers to improving health outcomes require multi-agency working and empowerment of local health agencies, and my understanding is that the reforms and structural changes in the Bill set out to do exactly that.

One point on which I strongly agree with the petitioners is the need to drive value for money within our NHS, reducing management costs and excessive use of consultants, so that the huge increases in funding for the NHS can actually reach the frontline, not just fund more fruitless layers of bureaucracy. I am hopeful that the Minister will update us on what is being done to drive efficiency in that regard. Another point that I fundamentally agree with is the petitioners’ view that private finance initiative contracts have no place in our NHS. I know all too well the debilitating effect they have on the ability of the NHS to administer care across our country. Nationally, PFI contracts cost our NHS £1 billion a year and restrict numerous hospitals across the breadth of Great Britain.

I have seen at first hand how PFIs have damaged our local services in the Tees Valley. South Tees Hospitals NHS Foundation Trust, in particular, has been plagued by a dodgy new Labour PFI contract. The James Cook University Hospital was completed in 2003, but its PFI contract does not run out until 2034, and will cost over £1.5 billion. The trust currently has to meet annual payments of £57 million a year—more than £1 million every week. Of course, hospital upgrades and rebuilds are expensive, but that trust is paying £17.5 million over and above what an equivalent Treasury-funded hospital would cost annually. Shockingly, that is enough to pay for more than 530 nurses. It is ludicrous.

Even if there were not an extra 530 nurses at South Tees, there is so much the hospital could do with this money, such as investing in its building, equipment and staff to help improve health outcomes and inequalities. Excessive costs from historic PFI contracts are listed as the largest single contributory factor to the hospital’s troublesome financial position. At time when retention is a huge issue for our NHS, this money would be crucial to making a substantial difference to the working lives of our NHS heroes. I am glad that in 2018 a Conservative Government decided that PFI contracts would be phased out. However, hospitals up and down the country are now stuck dealing with a Labour legacy that has damaged our NHS, our people and our ability to tackle health inequalities across this country.

I will carry on; I am sure that there will be a chance for the hon. Member to contribute. I look forward to hearing the rest of the debate and to listening to the input of Members from across the House.

Members will see from a glance around the room how many people intend to speak. I do not intend to impose a formal limit, which seems to sacrifice quality in favour of quantity, but I do suggest that, as a courtesy to one another, speeches are limited to around three minutes.

It is a pleasure to serve under your chairmanship, Mr Gray.

There are actually a couple of aspects of the speech of the hon. Member for Stockton South (Matt Vickers) that I agree with and congratulate him on. First, I do not support PFI either. History suggests that although that hospital was completed and perhaps started under a Labour Government, PFI was originally a Conservative initiative under the Major Government, so I would not be too confident about attacking it but I am pleased that it is gone.

I also profoundly agree with the hon. Member’s support for NHS staff; I think we will be hearing a lot of that this evening. The NHS is recognised and envied around the world. It is something that we should celebrate and admire, not chop up, neglect and sell off piecemeal at every opportunity. It is the NHS and its staff that are getting us through this pandemic. I would like to take this opportunity, as I am sure all hon. Members would, to once again thank the NHS and care staff who have worked so hard and sacrificed so much over the last two years.

The NHS cannot continue to look after us if we do not look after it. Tory mismanagement over the last decade and the pressures of the pandemic mean that the NHS is running on empty and surviving solely on the good will of its employees. Even before the pandemic, we were seeing record waiting lists and staffing shortages. Now the numbers are through the roof.

On that point, my hon. Friend mentions that the NHS is running on empty—of course it is. A Unite survey published in January 2022 showed that 77% of the NHS workforce believe that they are worse off than they were a year before, 55% are working during their lunch breaks, and more than 50% are working in excess of their contracted hours. Is it any wonder that the NHS is running on empty?

I could not have put it better myself. The NHS is running on empty, but also on the good will of the staff because they believe in the NHS and in what they are doing. There were 6 million people on the waiting list in England in November—the highest number ever recorded. In my constituency of City of Chester, the latest figures show that 36,000 people are waiting for care at the Countess of Chester Hospital.

Those record waiting lists are also true for NHS dentistry, as my constituency neighbour, my hon. Friend the Member for Weaver Vale (Mike Amesbury), has pointed out. Some people are being told that they may have to wait up to two years for a NHS dental appointment. Over the past few months, many of my constituents have told me the difficulties that they have had in finding and accessing an NHS dentist in my constituency and the surrounding areas. On average, there are only 4.4 dentists per 10,000 people in England, and the number is shrinking. With shortages of staff, a lack of funding, the pressures of the pandemic and dissatisfaction with NHS dentists’ contracts, the waiting lists are growing. Many dental practices are feeling pressure to turn private just to be able to cover wages and equipment costs, and to survive as a business.

Dr Simon Gallier, who owns a dental practice in my constituency, wrote to me with a heavy heart to say that earlier this month, he had to make the difficult decision to make his dental practice private; he had to inform over 7,500 patients that they will no longer be receiving NHS treatment. Practices around the country are doing this not through choice, but out of necessity and lack of funding. Dr Gallier just cannot make ends meet. Indeed, in the last year for which figures were available, 2018-19, the amount spent on dentistry fell in real terms, compared with the six years previously. While the £50 million announced recently by the Minster is welcome, only £7 million of that will go to dentistry in the north-west, which is clearly insufficient when the national budget for England was over £2 billion in 2019. With fewer NHS dental practices, many constituents have no choice but to go private—an option many will not be able to afford, especially given the cost-of-living crisis we face. I worry that the Tory masterplan all along has been to starve the NHS of funding, resulting in inevitable back-door privatisation—or perhaps there has been a more sinister scheme to monetise dentistry, as there has been in similar services, including some GP practices and many vets practices.

Dentists cannot afford to operate under the NHS, so they sell the practice to an umbrella company, which is the front for a finance company. That company then offers quasi-insurance or membership programmes, in which the patients pay an amount every month that entitles them to an annual check. That stream of money from numerous practices becomes a valuable commodity in the City of London, which the Conservative party exists to serve, along with Putin-linked Russian oligarchs, but we will not mention that now.

Talking of privatisation, what I fear is not the sale, lock, stock and barrel, in a public floatation, as happened in the 1980s, but sale bit by bit, behind the scenes, to private companies that extract money for their profit—money that should surely instead be spent on patient care. NHS dentistry is in crisis. I will not look that £50 million gift horse in the mouth, but let us be clear: much more is needed.

It is a pleasure to serve under your chairmanship, Mr Gray. I am proud that so many of my constituents in Hornsey and Wood Green signed this important petition about funding for the national health service, and about keeping it in the public sector.

There is no doubt that the national health service is the most popular public service in my constituency, but there is a basic lack of staff, whether we are talking about primary care, GPs and other practice staff—they always seem to be looking for more staff—the 40,000 nurses of whom we are in desperate need nationally, or the thousands more doctors who are needed. Compared to other European countries, we simply do not have the correct ratio of patients to doctors. For example, in psychiatry there are increasing numbers of patients, particularly following the stresses and strains of coronavirus, waiting days and days in a hospital bed to see a consultant. I heard a story this week about a patient who waited 10 days to be seen during doctors’ rounds. That is a very long time to use a bed without getting the correct medical attention.

Many Members have mentioned the insufficient funding for dentistry. Sadly, my constituency of Hornsey and Wood Green, and the London Borough of Haringey, has some of the worst rates of caries in children’s teeth in Europe.

As my hon. Friend the Member for Wansbeck (Ian Lavery) said, 77% of NHS staff believe that they are worse off this year than last year. We know that they are working in excess of their hours, and that since 2010, hourly pay has been frozen or increased by a tiny increment. That does nothing to help staff cope with the challenges of the Tory-driven cost-of-living crisis, be it domestic fuel bills, the cost of food, children’s clothing, basic travel to work, or petrol to drive to work.

The Health and Social Care Levy Act 2021 has recently passed through Parliament. Social care is crucial to fix bottlenecks in the health service. We need a properly funded care system in which the hourly rate is correct in the light of the needs of the people working in it, and we need better overall management to get people into the right sort of care as quickly as possible, so that we can free up the national health service to look after people coming into hospitals through accident and emergency. That is a basic point that every Member in Westminster Hall has made on a number of occasions, but it still seems as if this Government are sitting on their hands and failing to address the crucial question of how we get the flow through the system. The problem also comes down to the terrible cuts to local government. If local government was adequately funded, we would have a much better, more proportionate system. I will stop there, Mr Gray, as other Members wish to contribute.

It is, of course, a pleasure to serve under your chairmanship, Mr Gray. Time does not permit me to repeat the excellent points made by my hon. Friends the Members for City of Chester (Christian Matheson), and for Hornsey and Wood Green (Catherine West), but I certainly align myself with what they said.

I want to concentrate on two areas of huge concern to my constituents. The first, which has already been mentioned, is privatisation. Three years ago, in Bradford, I fought alongside trade unions and NHS staff to stop plans to introduce dangerous back-door privatisation into our local hospitals. Although we beat those plans to move key services out of the NHS and place them in the hands of private companies, the danger of the privatisation of our NHS in Bradford has not passed.

That threat has only grown as a result of this Government’s Health and Care Bill. While removing enforced competition, the Bill does nothing whatever to roll back the wave of privatisation that successive Tory Health Ministers have unleashed on our NHS over the last decade. Rather than improving patient care, the Bill allows private companies with a vested stake in driving greater privatisation in the NHS to sit on local health boards and make decisions about our health care; at the forefront of their mind are not patients, but profits. There is no greater threat to the future of our NHS—free at the point of use and in public hands—than the Health and Care Bill and this Tory Government. We must stop both before it is too late.

We also have to look at the future of our NHS for GPs, who are at the coalface of health care but are all too often overlooked. Each week, without fail, a worrying number of constituents tell me that they have been unable to get any form of appointment, let alone a face-to-face appointment with a GP; that they have been left on hold when calling, waiting for phones that are never answered; or that, when they are given an appointment, it is weeks away, even when it is an urgent issue that simply cannot wait.

I dealt with two such cases this week. I heard from a son whose 82-year-old mother went to accident and emergency, but was sent away and told to go see her GP the next morning. Her son began ringing the GP practice first thing next morning, but when he eventually got through, hours later, he was given an appointment in two weeks’ time. In the other case, involving very similar circumstances, my constituent was once again told to wait for weeks. It is unacceptable.

That level of service would be unacceptable anywhere. However, in Bradford—where we have higher rates of deprivation, where life expectancy is below the national average and where we have greater rates of preventable illnesses—it is beyond serious, and can even be fatal. No one should have to wait for more than a fortnight for an appointment, and certainly not for urgent cases, but as the inner city of Bradford has one of the worst GP-to-patient ratios in the country, that comes as little surprise.

Although fewer GPs being forced to see more patients explains the scarcity of appointments, it does not explain the poor service that patients in Bradford are reporting to me. I want to use this debate to put on notice those practices that are letting their patients down. I want to be clear: there should be a better service to ensure that urgent cases receive urgent appointments, and to help close the health inequality gap between the richest and the poorest in Bradford.

Finally, I listened to the hon. Member for Stockton South (Matt Vickers), who opened this debate. His speech implied that he was anti-privatisation. I say this to him and all those on the Government Benches: the reality is, over the last decade, we have seen an ideological, intentional attack on our NHS. Let us not beat around the bush: if the hon. Member for Stockton South and others wish to stop the back-door privatisation of our NHS, they should be opposing the Health and Care Bill. Any form of privatisation needs to be taken out of the Bill. We do not need the smoke and mirrors that we see in the current legislation.

It is a pleasure to serve under your chairmanship, Mr Gray. I speak in full support of the petition. I would like to make particular mention of the recent Health and Care Bill. The clearest example of what could happen to our NHS if this Bill goes ahead lies in NHS dentistry. Net Government spend on general dental practice in England has been cut by about one third in the last decade. The results of this are stark; there are reports of people resorting to pulling out their own teeth because they cannot afford private treatment.

The British Dental Association states worryingly that the Bill worsens the situation and

“does not ensure that the voice of three quarters of NHS primary care professionals is heard in the making of commissioning decisions”.

Whose voices will be heard, then? The Bill would put private companies right at the heart of NHS decision making and service delivery—on the new integrated care system boards, where they will be given power to make decisions about people’s care and how NHS money is spent. The Bill will allow private healthcare providers to award contracts for clinical care without considering any other bids. The doctor-led campaign organisation EveryDoctor states:

“This Bill will embed private companies in the NHS in England, and give them the power to decide who gets what treatment when.”

Members on the Government Benches might wax lyrical about the NHS being free at the point of use, but what happens when people cannot access the care that they need? It might be because of rationing, or because of lengthy waiting lists due to lack of funds. It might simply be because those with a seat at the integrated care system board table determine that a person’s care should not be available on the NHS, because it is just not profitable enough. The result is this: if a person cannot afford private medical cover, they do not receive treatment. That is already happening in NHS dentistry, where it has been normalised. The risk is that it will be normalised throughout the healthcare system.

This is not a Bill to tackle the crisis facing the NHS. It is not a Bill to tackle the care backlog, or to properly fund our NHS. It is a Bill to reduce our rights to access healthcare and to privatise our NHS. It must be scrapped.

I begin by praising all the staff in the NHS, who, often at enormous personal risk, have provided dedicated care to so many of us over the past two years. The Minister must know—and the Government should acknowledge—that they are exhausted. As a country, we must show that we care for all of them as they address the backlog of over 5 million people waiting for treatment.

That care must be more than warm words and clapping. It must be tangible and financial, and it must be realistic. That means expanding workforce capacity, both as regards beds and staffing, in order to reduce the pressures our NHS heroes are facing. It means meeting the capital maintenance backlog of more than £9 billion. It was dereliction by the Chancellor to entirely omit any funding for infrastructure and building repairs when announcing the NHS settlement. There are two futures for the NHS: the disastrous one contained in the Health and Care Bill, or one that integrates health and social care in an efficient, comprehensive service that is free to everyone, from cradle to grave, whatever their medical need. It would be delivered entirely by, and be accountable to, our public sector—staff who are fairly treated and properly rewarded. I want to pay tribute to all the unions, particularly my own, Unite the union, for the work they have done to ensure that that is the case for staff.

By “comprehensive”, I mean that the service should include mental health and public health. If the pandemic has taught us anything, it should be the importance of public health, yet the integrated care boards have no delegated places for directors of public health, mental health or adult social services. There is not even a place for the voice of the patient, around whom everything should be centred.

By “efficient”, I mean that the service must deal with the backlog of 5.3 million patients waiting for treatment. By “whatever their medical need”, I mean that it should definitely include dentistry, as we have heard from my hon. Friends. By “accountable public service”, I mean that there should be no conflict of interest that allows a private company to sit on the ICB and commission contracts from which it will then be able to benefit. In 2012, I railed against the imposition of section 75 because it put competition, rather than co-operation, at the heart of our health system. I thought—correctly, as it turned out—that this would give rise to increasing privatisation, the rationing of care and the lessening of patients’ access to the care they need. Putting competitive tendering at the heart of the service destroyed trust and introduced a profit motive, rather than allowing a focus on successful medical care outputs.

It may be wondered why the reversing of the Health and Social Care Act 2012, introduced by Andrew Lansley, would be of concern to me. In 2012, none of us could have conceived of the fact that doing away with competitive tendering might mean not less, but more privatisation, unregulated by the tendering process. In 2012, we would not have believed that we would see VIP commissioning routes, through which contracts for medical equipment worth billions—not millions—of pounds would be given out to friends of Ministers, but that is what we face in the Bill. It puts that ability into legislation, which is why the Bill should be stopped.

The impact of the Health and Care Bill on Wales is limited, but I have come to speak in the debate because over 150 of my constituents signed the petition, and because it is right for people from across the UK to defend the NHS as a service that is run publicly, in the way that the great Welsh hero Nye Bevan intended. I have real concerns about the situation faced by the health service and the care sector, both in England and in Wales.

The King’s Fund has estimated that NHS commissioners spend £9.7 billion on services delivered by the private sector, which represents around 7% of NHS revenue spending. While we are handing over NHS provision to the private sector, waiting lists are going up, waits for treatments are getting longer, NHS pay is going down, staff sickness is going up and staff vacancies are going up. The Health and Care Bill does nothing to address that—indeed, it will make things worse. Many of my colleagues have already set out concerns, particularly about the new integrated care boards and the private sector’s increasing role on them. The Bill will also reduce oversight of how contracts are awarded, and move the NHS from being a regulated market to a less regulated one.

The Bill will do nothing to improve social care. It has been two years since the Prime Minister stood on the steps of Downing Street and promised a plan for social care. When will we see that plan? Unison has found that more than two thirds of care staff said they were so busy at night that they managed to get only a couple of hours’ sleep, and staff are sleeping on makeshift beds in offices. A quarter of the workforce are on zero-hours contracts, and only about 10% are getting the real living wage. Why is this Tory Government continuing to fail our social care sector, its recipients and its workforce? In 2019, I stood on a manifesto that pledged to establish a national care service. That would have been a historic development along the lines of the establishment of the NHS in 1948, but regrettably, we are not in a position to implement it.

I want to make a few comments about the position in Wales. I suggest that people look at the Welsh Government, because in spite of Tory austerity Governments and years of underfunding, we have successfully managed to retain a largely public sector NHS. We have free prescriptions, and we are now proposing significant extra funding for local authorities to help with maintaining and developing the social care sector. Last year’s co-operation agreement and the programme for government in the Welsh Senedd committed to the implementation of the real living wage and to establishing a Welsh national care service, which will be implemented by the end of 2023. Before Christmas, the Welsh Social Services Minister, Julie Morgan, pledged that the Welsh Government would provide Welsh local authorities and health boards with £43 million so that they can implement the real living wage—not the living wage that the Tories are proposing—from April.

I reiterate my support for those campaigning to defend a publicly owned and run NHS and to deliver a similarly public national care service. We are trying to do it, and we will achieve it in Wales, despite the barriers put up against us by the Tory Government. I really hope that we will have a Labour-led Government in Westminster soon to do the same. Diolch yn fawr.

It is a pleasure to speak in the debate. I concur with the comments of others. Like the hon. Member for Stockton South (Matt Vickers), I acknowledge the incredible work of all healthcare workers across all spheres of the health system over the past two years, through the pandemic. The commitment and dedication that they have all demonstrated throughout the public health crisis is of course not unique to the pandemic but is a defining characteristic of all the staff our wonderful national health service produces. Each one of us present is here to say thank you to them from the bottom of our heart.

I commend the NHS staff who have been working hard day in and day out to ensure that their patients are looked after in the same caring way as they are in normal times. It is important that we acknowledge the sacrifices made by the families of nurses and doctors who have been called in at short notice when wards and A&Es have been short-staffed. Many of my constituents do that every day, and have done it almost every day through the crisis. Many do so having only just left a long overnight shift, and many saw very little of their families during those times. We tend to take it for granted that our NHS staff will go above and beyond to serve the public, which should make us even more proud of them. There is an onus on us in this House, and on the Minister and the Government, to ensure that we deliver for our staff for all that they have done.

The NHS is very different in the scope of the services that it delivers from how it was at its inception on 5 July 1948. I am certain that if Florence Nightingale walked its corridors today she would be more than impressed by how far the delivery of medical services has advanced, but she would also see the familiar aspects of local doctors delivering a first-rate service in community hospitals. The building blocks remain unchanged, and as our NHS looks to the future it is vital that the foundations never change. The NHS is central to our society. We do not want it to be Americanised. We all know what that means: that we would have to pay for it, which would be wrong. We have a duty to deliver for the people we represent, without having to gauge whether their wage packet can pay for treatment, or whether their wallet is big enough.

The future of our NHS will be supported by revolutionary technology, just as revolutionary as the first penicillins when they worked what seemed to be miracles. We do not have a crystal ball, but we can be certain that increased funding will be necessary to support the radical adoption of innovative technology, to improve resources and, without question, as the hon. Member for Cynon Valley (Beth Winter) said, to pay our NHS workers a wage that reflects the work that they do, have done, and will do in future.

I will conclude, as I am conscious of the three-minute limit, Mr Gray. Today, GPs and hospitals are under severe pressure, which I believe will not ease for the next generation of GPs and NHS workers. In order to ensure that the original building blocks of the NHS that we cherish remain in place, we need, as policy makers, to build firm bridges between now and then. Most importantly, the NHS of the future must have the same ethos of care and compassion at its core in 2050, when we may not be here, as it did at the beginning in 1948, when I was not here either.

It is a pleasure to serve under your chairmanship, Mr Gray. It is a truly extraordinary achievement that we have the national health service. We are so indebted to Nye Bevan and all those people who have fought for it. I pay tribute to everyone who signed the petition, which refers to the Health and Care Bill

“locking in privatisation and dividing the English NHS into Integrated Care Systems.”

If the Bill is enacted, we can expect to see the NHS split up into 42 locally managed health systems, which will be required to balance the books each year, rather than a national health service responding to patient need. Following intense pressure from the Labour party, campaign groups and other stakeholders, the Government have conceded that anyone who

“could reasonably be regarded as undermining the independence of the NHS because of their involvement in the private healthcare sector”

will not be able to sit on integrated care boards. Such individuals will still be able to have significant influence through a complex array of sub-committees, however, including place-based partnerships and provider collaboratives. It is there in black and white in NHS guidance:

“The Health and Care Bill, if enacted, will enable ICBs to delegate functions to providers including, for example, devolving budgets to provider collaboratives.”

That exposes the Government’s real intentions of increasing the involvement of private companies in the running of the NHS.

The Bill also includes measures to revoke the national tariff and replace it with an NHS payments scheme. As private providers would be consulted on the NHS payment scheme, it would effectively give the them the opportunity to undercut NHS providers. I am concerned that as a result, we will see more and more healthcare delivered by the private sector rather than by the NHS, with money going into shareholders’ pockets rather than being spent on patient care. If that happens, NHS staff could be forced out of jobs that are currently on the agenda for changed rates of pay and the NHS payments scheme, with only private sector jobs available—potentially with far worse pay and conditions.

I am also concerned that the Bill will lead to an increased rationing of services because ICBs would have strict financial limits each year. Once that money has been spent, patients would have to wait longer or go without treatment. Some may be tempted by the adverts for private healthcare, of which we are seeing more and more, but it is worth looking at where that path leads. According to Will Russell, a provider of international health, life and income-protection insurance, the average annual cost of health insurance in the US is an eye-watering $7,470 for an individual and $21,342 for a family. Employers typically fund roughly three quarters of those bills, so they also create a massive burden on businesses. The average cost for an individual of purchasing their own health insurance is $456 per month, according to a 2020 survey by eHealth.

In this country, we can only imagine just how devastating such costs would be to individuals, businesses and the economy. We cannot afford to let such a system take hold here. We must defend the NHS as a universal comprehensive national service that is there to treat us when we need it. Time is running out. I urge MPs across the House to appreciate just how fortunate we are to have the national health service, to join the campaign against NHS privatisation, and to oppose the Health and Care Bill.

It is a privilege to serve under your chairmanship, Mr Gray, and to follow the powerful contributions of my hon. Friends. I draw hon. Members to my entry in the Register of Members’ Financial Interests for my ongoing links with Unite the Union, which has played such a central role in the fight against privatisation of our health service.

I am enormously grateful to the hundreds of people in my constituency who put their names to the petition, and to the countless others who got in touch to ask me to speak in this incredibly important debate. They know what the Government so clearly do not know: the reforms are totally wrong and come at the worst time. Our NHS is in the midst of the darkest day of its long history. Exactly two years since the first covid patient was admitted to a UK hospital, morale is collapsing, staff are past the point of exhaustion, and many frontline services are at breaking point. For all the Government’s talk of life after covid, the virus continues to stalk hospital wards across the country—85 patients have died of covid in the last day alone.

Instead of doing anything in their power to tackle a catastrophic staffing shortage and a record-breaking backlog, Ministers instead seem intent on forging ahead with reforms that threaten to open the doors of our precious health service to ravenous multinationals that are interested only in making a quick buck, not in addressing the country’s health needs.

We should not be surprised that the Government have so cynically sought to exploit the crisis to advance an agenda of privatisation and fragmentation. After all, that is the logical next step of a project that has been consistently pushed forward by successive Prime Ministers and Health Secretaries since 2010. When the last Labour Government left office, they entrusted to the Conservatives the care of a health service that was world-beating by every conceivable metric. Despite the best efforts made by our healthcare heroes, the NHS entered the pandemic woefully unprepared and under-resourced, having had its resources and resilience sapped away since the passage of the Health and Social Care Act 2012.

I fear that the Government’s latest reforms, which include the introduction of integrated care systems and American-style healthcare management systems, will leave our NHS in a far worse state for confronting the public health challenges of the coming decades. I urge the Minister not only to listen to what has been said today, but to take heed of the public anger surrounding this issue. The British people are not in the least convinced by the claims that the Government have the NHS’s best interests at heart, and they look anxiously towards America as a sign of what might yet come to pass. They want an NHS that lives up to its founding principles—a public service that is free and accessible to all—which is why Ministers must return to the drawing board.

It is a real pleasure to serve under your chairship, Mr Gray, and it is wonderful to hear all these passionate speeches today. We need to be clear that whether they admit it or not, the Conservatives have always had a problem with the national health service. They might try to rewrite the history books, but the truth is recorded: they voted against the creation of our national health service on more than 20 occasions, and the reason is purely ideological. They see it as an unwelcome intervention into the market, a point I will return to in a second.

Some of the more vocal supporters of that neoliberal agenda see the NHS as a last bastion of socialism in our society. I am proud that our national health service was created by socialists, and I think it is the greatest example in this country’s history of socialist principles put into practice. What does that mean? It means that there are some things in life more important than the pursuit of profit. However, what we now see—what we have seen since 2010—is an increased drive for the Americanisation of our national health service. The Conservatives want to turn it into a system where they feel for a patient’s wallet before they feel for their pulse. The truth is that however the history books are rewritten, it was a struggle to create the NHS in the first place, and it is now a great struggle to maintain it in accordance with its founding principles.

There are two key issues for our health service—deep underfunding and greater use of the private sector—and they go hand in hand, with the national health service being underfunded so that people can supposedly be persuaded to stomach greater and greater private sector involvement. First, the Conservatives defund things so that people get frustrated, and then they say that there is no choice but to hand them over to the private sector—that is the plan. We hear from the Conservatives that the staffing crisis in our national health service was caused by omicron or by covid, but the truth is that the huge vacancies and understaffing in the NHS did not start with omicron or with covid: the vacancies have been there for a long time, and now there are nearly 100,000 of them. An unbelievable £100 billion has gone to non-NHS providers of healthcare over the past decade alone. Every pound spent bolstering the private companies means less spent on people’s healthcare, as the profits are creamed off.

People out there are right to be worried about what the Conservatives want to do with the NHS. I mentioned earlier the Conservatives’ historical and ongoing objection to interventions in the market, but the truth is they believe in free markets for the 99%—with all the harm it brings them in their lives, their pay packets and their health service—but believe in intervention in the market for the benefit of those at the top. That is what we saw during the covid crisis, with all those corrupt contracts, the VIP fast-track lane, and billions of pounds going to Serco for the failed test and trace system. What the Tories did with the corrupt covid contracts, they want to do right across our national health service. That is why the Health and Care Bill would be better renamed the corporate takeover Bill. We cannot allow that to happen. The Conservatives want to create a race to the bottom, and we know that cuts and privatisation go hand in hand.

Before I finish, I will say a word about our NHS staff. We saw the Prime Minister—who no one trusts anymore, and quite rightly so—standing outside Downing Street clapping for the NHS heroes, but claps do not pay the bills. If we have a Government that values NHS staff in the way they say they do, they need to pay those staff properly. I put on the record my support for the 15% pay increase for NHS staff, who have suffered a decade of real-terms pay cuts. We need to be clear about what that means: that 15% increase would bring their pay back in line with where it was a decade ago.

What is the way forward? It is for us to realise that no Prime Minister or Government will say to the public, “Do you know what? We’re going to privatise the NHS. Do you know what? We’re going to turn it into an American-style healthcare system.” Of course they will not do that. They will manufacture consent for those changes through underfunding and through creeping privatisation carrying on at ever greater pace. It was a struggle to create our NHS, and it will be a struggle to save it from this final Americanisation. Regardless of which party we are in, history will judge us poorly if we betray those who went before us and created our national health service—the greatest achievement in our country’s history, and the greatest example of socialist principles put into practice, which may be why this Government dislike it so much.

It is a pleasure to serve under your chairmanship, Mr Gray. The future of the NHS hangs in the balance, and the petition is entirely correct in calling on the Government to renationalise the NHS, scrap integrated care systems and end private finance contracts.

The Health and Care Bill threatens to open the floodgates to further privatisation by implementing a healthcare model that incentivises cuts and closures and rations funding to health boards while welcoming private profit-driven companies such as Virgin and Serco on to the boards of integrated care systems, giving them a say on where NHS money gets spent. The new legislation will further dilute the voice of patients and the public, with the new boards covering populations of up to 3 million people that will be remote and centralised, with no obligation to be open, transparent or accountable to ordinary people.

My hon. Friend is making an excellent speech. Does she agree that if we have that lack of transparency we might see a repetition of the Government’s wasting £4 billion during covid? There is a fear about related-party transactions, where people know exactly where the money is going—into their pockets.

I fully support what my hon. Friend says. The boards will be remote and centralised and will seriously restrict the power of local authorities to protect local services. With these changes, private healthcare giants will not only have a bigger say over the NHS but will be granted contracts with even less scrutiny than now.

By opening the door to private healthcare providers to take decisions on NHS budgets and services, the Bill makes it easier for public health contracts to be distributed to private providers, with less transparency and accountability. Safeguards in the Public Contracts Regulations 2015 will be excluded, watering down protections for employment and environmental provisions in procurement processes. There is no doubt that the Bill will put on steroids the cronyism we have seen during the pandemic while our NHS heroes have worked day and night, putting their lives on the line. The Government have cut real pay for nurses while handing out billions of pounds of contracts through an illegal VIP system to their mates and donors and to the failed track and trace system.

The NHS is the jewel in the crown of our public services—our proudest achievement. However, 12 years of Tory austerity, and now the pressures of the pandemic, have stripped it to the bone. An unbelievable £100 billion has gone to private healthcare providers in the last decade alone. The last thing the NHS needs right now is a dangerous overhaul that puts the private sector at its heart. We must take this and every opportunity to support amendments to the Bill that establish the NHS as the default option for all NHS contracts, to mitigate the worst parts of it. We must stand up to these new attacks or risk losing the NHS to privatisation by stealth. We must go further in our demands to roll back the damage done, reinstating the NHS as a truly national service and establishing a fully integrated national care service with staff and patients at its heart.

It is a pleasure to serve under your chairmanship, Mr Gray. The privatisation of the NHS has been a lengthy and well-documented process that started during Thatcher’s Conservative Government in the 1980s. It has shifted the responsibility for the long-term care of the elderly and the vulnerable from the NHS to local authorities, and allowed hotel-type charges for long-term care. This violated a key NHS principle that patients should not pay health charges. Charges became means tested, and homes had to be sold to pay for the bills. Local authorities were forced to pass on their responsibility for healthcare to outsourced private companies. That created a for-profit industry worth £6 billion a year.

Ninety per cent. of nursing home beds are now operated on a for-profit basis. Almost 400,000 elderly patients are now a source of income in an increasingly privatised sector. The staff in those nursing homes are an increasingly casualised and deskilled workforce. The privatisation of care for the elderly created such a mess that we are still trying to sort it out 40 years later. That is the shameful legacy of privatisation in one sector of healthcare. We can see clearly that the process of privatising the NHS itself will follow the same pattern. It will be run by private contractors who will de-professionalise and casualise a temporary workforce.

There has been a creeping privatisation of the NHS. In 2012, an Act was passed that, among other things, required all NHS contracts to be tendered to any qualified provider. Now we have ambulance services run by taxi firms, private companies that have taken over GP practices covering half a million patients in London, and a private company taking over an NHS hospital and cancelling the contract when there was no more money to be made. I have seen first hand, working for Unite and organising outsourced workers in the health sector, the damage that privatisation does to our essential care services.

If that tale of incompetence was not enough, the Government are now pushing through a new reorganisation, this time to establish what they call “integrated care”. It does the complete opposite, instead butchering our NHS into 42 separate areas. It should not be called integrated care but “disintegrated care”. Each area has a fixed budget that cannot be overspent. This will create a postcode lottery and force each area not to co-operate with each other to save cash. Each area board will allow private healthcare companies—another play on words: they are mostly private health insurance companies—to make decisions about the provision of healthcare.

Here we go again: the Government’s answer to underfunding our NHS is to let private companies run it. History has taught us that this is not the solution. NHS staff employed by 42 different organisations face a most uncertain future of casualisation, deskilling and the introduction of poorer terms and conditions. The people of England face a regional, not a national, health system, which will have different terms and conditions for its workforce and different provision of treatment. It is chaotic and irresponsible.

Every Government of the day have been entrusted to preserve and protect one of the country’s greatest achievements—to cherish, not cherry-pick and hive off to the private sector. I urge the Minister to listen to the calls of my constituents, campaigners and the trade unions and scrap the catastrophic Health and Care Bill, which destabilises, fractures and imperils our NHS.

It is a pleasure to serve under your chairmanship, Mr Gray. I thank all those who signed this petition. The position of the SNP on this matter is clear: the NHS was created to be free at the point of use and to treat all citizens equally from cradle to grave. That is the NHS we want to see back—an NHS for the people, by the people and firmly in the hands of the people. Despite the fact that the Government lack a democratic mandate to privatise the NHS, vast sums of public money are being wasted on business managers, private providers, PFI debts, multinational accounting firms, and corporate consultants. By enshrining privatisation in NHS England, the Tory Government continue to jeopardise access to care and universal standards.

Let us look at social care, for example. Scotland has successfully integrated health and social care services since 2014 and has put in record investment to allow continued quality improvements in services year on year, and that is without any privatisation. It has been achieved even with the culture of cuts to public services that has been forced on Scotland by Westminster’s austerity agendas. If Scotland can create a social care system that works with one hand tied behind our back, what is England’s excuse?

We have heard hon. Members refer to dental health and the lack of dental care in England. Of course, in Scotland we made provision for free NHS dental care for 18 to 25-year-olds in our last manifesto, and that is coming through the Scottish Parliament just now. That is on top of free annual and biennial eye tests for everybody, because those are the things that matter and they can have a better effect on the management of our NHS and address the clogging up of appointments.

For the UK Government, it seems that healthcare is a hassle; for the Scottish Government, it has been our priority. The covid crisis has demonstrated why the NHS is our most important public service, and Scotland has recognised that. We gave our NHS workers a bonus as we came out of the pandemic. The Scottish Government have also put record funding into our health and social care services of up to £18 billion, with resource funding up 90% under the Scottish Government. Frontline health spending is £111 higher per head in Scotland than it is in England. These figures speak for themselves.

The SNP Government in Holyrood have a history of making different parts of the health and social care system work together. They have used legislation to get these efforts under way. We also contributed to the betterment of the UK system by voting against the Health and Care Bill going through this House. That Bill gives the UK Health Secretary enormous powers over NHS England—over its structure, functions and budget—giving him more leeway during trade negotiations, with particular risks from American healthcare interests. Such ministerial control over NHS England is concerning, as there will be long-term consequences for the national health services in Scotland and the other devolved nations, particularly in terms of funding and what is included in any free trade agreements. The Bill eliminates the requirement for competitive bidding and allows NHS bodies to award some contracts directly. Can you imagine if the future care of your family and friends, your children and relatives, was all dependent on how much money was left in somebody’s locker, as opposed to whose expertise and resources were best to deliver it? The SNP has been clear that those in charge of services should have only the best interests of patients at heart, not the vested interests of private healthcare.

We appreciate our healthcare system and in particular its staff, who have been invaluable to every member of our society before and throughout the covid pandemic and will be after the pandemic has, thankfully, gone.

We heard what was said by Dr Pelle Gustafson, the chief medical officer of the Swedish patient insurer. When asked which country he would

“hold at the very top of the pillar”

with regard to patient safety, he replied:

“If you take all preventive work as regards patient safety, I would say that I am personally very impressed by Scotland. In Scotland, you have a long-standing tradition of working. You have development in the right direction. You have a system that is fairly equal all over the place and you also have improvement activities going on. I am very impressed by Scotland.”

If the Minister is listening to that, this is the NHS that the UK Government could and should be using as a basis to drive improvements for the health and social care sector across these nations, because if they do not, we are at a very real risk of doing citizens the greatest injustice that this country has ever seen.

It is a pleasure to serve under your chairmanship, Mr Gray. This has been a spirited and emotional debate, and one that captures the unique place that the NHS holds in the heart of this nation. On behalf of the Labour Front Bench, I want to personally thank the petitioners and the campaigners behind the petition, because the NHS is more than just an institution. It is an example of the difference that politics, society and individuals can make. It gives us hope that Governments can make real differences to people’s lives, so long as there is the requisite willpower and determination to do so.

Over the last 12 years, NHS staff have had to move heaven and earth just to keep the service on its feet. They have faced extraordinary upheaval, underfunding, neglect and Government mismanagement. I would like to place on record my thanks to all NHS staff, at every level, for the work they have done—not just over the last 12 years and before, but particularly in the last two years, when we were hit by the covid pandemic and the NHS was placed under enormous strain. I am in awe of the work that the staff have done, but I am angry that they have had to step up to try to mitigate the failures of this Government.

Even before the pandemic, the scale of the crisis in the NHS was stark. Covid has compounded the problems, but it did not cause them. Any attempt by the Government to blame covid for the state of our national health service is nothing more than an abdication of responsibility.

This debate is about the future of the NHS, but to understand the future, we must understand how we got here in the first place and how the steps we must take are informed by principles that have been too easily forgotten by the Conservative Government. The NHS is Labour’s finest moment: emerging from the tragedy and upheaval of world war two, the British public decided to put their faith in a Labour Government. British people suffered from endemic health inequalities and squalid living conditions, and were bearing the brunt of decades of public health neglect.

The NHS, spearheaded by the great Aneurin Bevan and Clement Attlee, aimed to change all of that. Many said it could not be done, but it was. It was done through courage of conviction and a belief in the necessity of a service based on need rather than income—a simple principle with revolutionary consequences.

We now find ourselves in 2022, almost 74 years on. If the Labour pioneers who built our health service were here today, what would they see? They would see record waiting lists, an acute staffing crisis, morale at its lowest ebb, health inequalities growing, and a Government fundamentally incapable of addressing their own failings. Yet if they twisted the dials of their time machine to 2010, they would see an NHS in a pretty healthy condition. Waiting times had dropped, public satisfaction was at the highest level ever, and hospitals were staffed at record numbers. In 12 years, that progress has been systematically undone.

The first priority of the next Labour Government will therefore be to sort out the immediate mess that the Tories have left our health service in—once more. That means throwing everything at slashing waiting times and reducing the care backlog, and it means recruiting, training and retaining the staff we need across the NHS and social care. The last Labour Government brought average waiting times down from 18 months to 18 weeks. We will have to do the same again as a matter of urgency. That must all come alongside a long-term plan for the care workforce and wider reforms to fix social care.

However, the Government are doing none of that. Instead, they are faffing around with an unnecessary and distracting top-down reorganisation of the NHS, in the form of the Health and Care Bill, while doing precious little to tackle waiting lists or address the staffing crisis. I would be grateful if the Minister recognised those concerns in his response and outlined what steps the Government will take to ensure that any NHS reorganisation comes alongside a proper plan to address soaring waiting times and critical staffing shortages.

However, the future of the NHS is about more than just addressing the immediate crisis; it is also about adapting to the needs of our population and recognising that health is about more than just surgeries and hospitals. Last week, here in Westminster Hall, I spoke about health inequalities and about how health is all too often viewed as an isolated issue, without considering the external factors that influence our wellbeing. Wellbeing is linked to our communities, our access to green spaces, our mental health, our opportunities and much more. If we fail to consider those influencing factors, our health service will always be geared to address the symptom, as opposed to the root cause of the symptom.

That is why the future of our NHS relies on prioritising preventive health measures. One example of that is Labour’s recent announcement that we would recruit more than 8,500 mental health professionals to support 1 million more people every year. That is exactly the kind of progressive, proactive and preventive policy that the Government should be driving. Such an investment in mental health would mean that every community had access to a mental health hub for young people, and every school specialist support. Wellbeing would be addressed beyond the clinical setting, and the health consequences of stress, depression and anxiety addressed before they reached the hospital waiting room.

So far, I have seen little evidence from the Government that they realise the importance of preventive health measures. In fact, I would go as far to say that the withdrawal of funding from community centres, green spaces and sports clubs over the past 12 years shows that the Government are not sensible and are not serious about preventive health policy. In his response, perhaps the Minister will correct me on that and advise how the Government intend to reverse their disastrous cuts to local services, which have had a calamitous impact on health outcomes.

Our NHS was built to provide security. It was built to recognise that our prosperity is innately linked to our health, and that we all deserve to live long, fulfilling lives—all of us, irrespective of our background or where we have come from. It is an issue of basic respect. To be healthy and have access to care is not a privilege; it is a fundamental right of every human being, a right that we expect the Government to protect and defend at all costs. The job of the Government of the day is to pass the national health service on in a better condition than they found it in when they came to office. I am afraid to say that this Government have failed in that obligation massively.

I am hopeful, however, that with the right support, the right investment, the right approach and the right values—values matter when it comes to our health and wellbeing—Labour can undo years of neglect and equip the NHS with the tools it needs to survive and then to thrive. That day cannot come quickly enough.

We have a few minutes in hand so, unusually—although I am told it is perfectly in order—I will call the hon. Member for Middlesbrough, Andy McDonald, to make a brief contribution.

Thank you, Mr Gray; I am grateful to you for accommodating me. I declare an interest as a private member of Unite the union.

The level of involvement of private interests that has built up in our NHS over decades is deeply troublesome. That concern has been expressed forcefully in the demands set out in the petition that we are debating. That petition has garnered more than 135,000 signatures.

In our manifesto at the last election, Labour stated:

“Our urgent priority is to end NHS privatisation”,


“Every penny spent on privatisation and outsourcing is a penny less spent on patient care.”

We committed to repealing the Health and Social Care Act 2012 and reinstating the responsibilities of the Secretary of State to provide a comprehensive and universal healthcare system. We also committed to ending the requirement on health authorities to put services out to competitive tender, to ensure that services are delivered in-house and that subsidiary companies are brought back in-house.

In the moments remaining to me, I will address the issue of the private finance initiative. The hon. Member for Stockton South (Matt Vickers) set out a lot of the detail very accurately. He told us about a hospital in my constituency, the James Cook University Hospital, and I pay tribute to the work of all its team, ably led by Sue Page, the chief executive. That hospital has performed marvels during this period, and offered services to other hospitals across the entire north of England.

I am appealing to the Minister for some help for my hospital, because the burden of PFI has been absolutely colossal: the hospital has cost £1.5 billion to build and maintain since it opened in 2003. The amounts paid by the trust increase every year until the final payment in 2034. I do not want to get into debate about how rotten the PFI deal was, quite frankly. All PFI deals were rotten. They were started in 1992 under John Major’s Government—please, let us not have any of that nonsense. The PFI deal costs an absolute fortune: £20 million more than an equivalent hospital would have to pay for maintenance.

What was missing is what we are going to do about it. As an initial solution, we could look at the decisive action of the Department of Health in 2012 to make £1.5 billion available in grants—not loans—to seven hospitals in England with some of the heaviest PFI debts through a stability fund. The seven trusts were able to use that money, rather than their usual budgets, to meet their PFI payments. It has been done elsewhere. I appeal to the Minister to look very carefully at providing assistance to get this PFI albatross from around our neck and let my hospital thrive and continue to do the wonderful work it has done for many years.

It is a pleasure to serve under your chairmanship, Mr Gray. I pay tribute to my hon. Friend the Member for Stockton South (Matt Vickers) for leading this debate on behalf of the Petitions Committee. I am pleased we were able to find time to hear from the hon. Member for Middlesbrough (Andy McDonald); I offered to take an intervention from him, which I suspect was a brave offer on my part given the intervention that might have come my way. I am pleased he got to give his speech.

I am grateful to the shadow Minister, the hon. Member for Denton and Reddish (Andrew Gwynne). I think this is the first time we have properly been opposite one another since his appointment to this role on the Opposition Front Bench. Although I did not agree with everything he said, he made a typically well-informed and well-argued speech. He is right to pay tribute to all hon. Members who have spoken today, regardless of whether one agrees with the positions advanced. This has been a passionate debate. At its heart is, perhaps, the most precious of our country’s institutions; understandably, right hon. and hon. Members and our constituents have very strong views on the subject.

Before turning to the substance of the debate, and although I may not agree with their position, I pay tribute in a broader context to the work of Unite, Unison and other trade unions. I do not always agree with the stance they adopt, but they play a hugely important role in our democracy and society. It is right to put that on the record. As always in these debates, and as the shadow Minister has done very clearly, I also put on the record our gratitude—from both sides of the Chamber equally—to all NHS staff and those working in social care, local government and other key workers across the country for what they have done across the past two years and, indeed, what they do every year, day in, day out.

As I have said before, the Health and Care Bill reflects evolution, not revolution. It supports improvements already under way in the NHS and, crucially, builds on what the NHS recommended and consulted on back in 2019.

I will make a little progress before giving way; I will always give way to the hon. Lady. The Bill is backed by not only the NHS but many others working across health and social care. In a joint statement, the NHS Confederation, NHS providers and the Local Government Association state that they

“believe that the direction of travel set by the bill is the right one”,

noting that local level partnership is the only way we can address the challenges of our time.

The Minister is talking about a consultation that, as I recall, took place over the Christmas period, when NHS staff are absolutely exhausted. He talks about these changes being requested by the NHS, but what percentage of NHS staff does he actually think took part in the consultation?

As the hon. Lady will know, the former chief executive of the NHS, Lord Stephens, was clearing in saying that the

“overwhelming majority of these proposals are changes that the health service has asked for.”

We should do the right thing by them and by patients. It is the right time for the Bill: it is the right prescription at the right time.

The substance of the petition, which has framed many speeches by hon. Members today, calls for the Government to renationalise the NHS. I have to say that it has never been denationalised. The NHS is and always will be free at the point of use. The Government are committed to safeguarding the principles on which the NHS was created. The hon. Member for Denton and Reddish set that out very clearly. We have no plans for privatisation.

I will make a little progress; if I have time, I will give way to the hon. Lady, with whom I sat on a committee of London councils when we were looking at social care reform way back in 2010.

We all recognise the importance of preserving this great national asset for the future and ensuring that the NHS remains comprehensive and free at the point of use, regardless of income, on the basis of need. The Government remain steadfast in their commitment that the NHS is not, and never will be, for sale to the private sector.

We are determined to embrace innovation and potential where we find it, but that is different from many of the accusations in the speeches we have heard today. I know it is tempting to scaremonger and set out accusations about what this Act does, even when people know better, as I know hon. Members do, but that reflects scaremongering rather than reality. There has always been an element of private provision in healthcare services in this country. Labour Members should know that because, as the Nuffield Trust said in 2019,

“the available evidence suggests the increase”—

in private provision—

“originally began under Labour governments before 2010”.

I will just finish this point and then give way to the hon. Lady. The hon. Member for Liverpool, West Derby (Ian Byrne) made the point, which the hon. Member for Middlesbrough touched on as well, that it is important to look at the extent of the involvement of private sector providers, which accelerated when the Labour party was in power. The hon. Member for Liverpool, West Derby talked about the 2012 legislation and “any qualified provider”, but that was not brought in by the 2012 legislation; it was brought in by the Gordon Brown Government in 2009-10, under the term “any willing provider.” The name was changed, but nothing substantive changed from what the Labour Government had introduced in terms of the ability to compete for contracts.

One more sentence and I will give way to the hon. Member for Hornsey and Wood Green (Catherine West); then I will try to bring in the hon. Gentleman.

One of the key changes allowing private sector organisations to compete for and run frontline health services came in 2004, again under a Labour Government, when the tendering for provision of out-of-hours services by private companies was allowed.

The Minister is being very gracious. How is the Act going to ensure that there is no conflict of interest between private providers who sit on integrated care boards and who then provide services? Are we going to end up with another Randox scandal?

The hon. Lady will know that when it comes to integrated care boards we, as a Government, introduced an amendment building on the already clear provisions in the Bill to prohibit conflicts of interest. I do not know whether she voted for the Government amendment, but it did exactly that, making it clear when the Bill was on Report that private providers and those with significant private interests could not sit on NHS integrated care boards.

The Minister is being generous with his time. Let us get the history right. The reason why the Labour Government increased the involvement of private sector bidders was simply to be able to increase capacity quickly—to get the waiting list and waiting time backlogs down, which they had inherited from the previous Conservative Government and that were massive. In terms of the 2009 Bill, I seem to remember that there was a provision in there that gave preference to NHS bidders.

I am grateful to the hon. Gentleman. Although we occasionally cross swords in the main Chamber or here, he knows I have a great deal of respect for him. All I would say gently on the point about the 2004 changes is that they came seven years into a Labour Government, so I do not know the reason why they had not been able to make progress before then.

We continue to work closely with the NHS to implement the changes that it has asked for, so that we can build back better and secure our NHS for future generations. As the shadow Minister, the hon. Member for Denton and Reddish, rightly said, the covid-19 pandemic has tested our NHS like never before, and all our NHS staff have risen to meet these tests in extraordinary new ways.

Hon. Members on both sides have rightly raised the point about the pressure that NHS staff have been under. Those who have been under pressure dealing with this pandemic are the people who will also be working flat out to deal with waiting lists and backlogs. We need to ensure that we are honest with the British people and that those staff have the time and space to recover, emotionally and physically, from the pressures they have been under. That is hugely important and we acknowledge the workforce.

I will not give way to the hon. Lady now. I have given way to her before. I will try to make progress, but if there is time I will try to give way to her.

We have seen innovative new ways of working: new teams forged, new technologies adopted and new approaches found to some old problems. There is no greater example of that than the phenomenal success of our vaccine roll-out. That would not have been possible without the staff, who are the golden thread that runs through our NHS. As we look to the future and a post-pandemic world, we know that, as the shadow Minister said, there is no shortage of challenges ahead of us: an ageing population, an increase in people with multiple health conditions and, as he rightly says, the challenge of deep-rooted inequalities in health outcomes and the need to look at the broader context. I do not know the shadow Minister as well as I knew his predecessor, but both his predecessor and I had a career in local government as councillors. I suspect that the shadow Minister may have had one too, so he may well know that I understand his point about the broader context.

I will make a little more progress. If I can, I will then try to give way to hon. Members.

More needs to be done, and we are giving the NHS the support that it needs and has asked for. In addition to our historic settlement for the NHS in 2018, which will see its budget rise by £33.9 billion a year by 2023-24, we have pledged a record £36 billion for investment in the health and care system over the next three years. The funding will ensure that the NHS has the long-term resources that it needs to tackle the covid backlogs and build back better from the pandemic.

The hon. Member for Stockton South referred to recruitment within the NHS. What is the Government’s response to that, to ensure that we have the recruitment and the staff in place?

As the hon. Gentleman will know, there are 1.2 million full-time equivalents in the NHS—a record number of staff. Take one example: our pledge for 50,000 more nurses by the time of the next scheduled general election in 2024. Last year alone, we saw the number of nurses in our NHS increase by 10,900. We have a plan in place, and we are recruiting and training more staff through increased numbers of places—at medical schools, for example.

I will not, because I have only two or three minutes left. If I make sufficient progress, I will try to give way, but I cannot promise the hon. Lady.

We know that different parts of the system want to work together and deliver joined-up services, and we know that when they do, it works; we have seen that with non-statutory integrated care systems over the past few years. The petition calls for the Government to “scrap integrated care systems”, but to do so would be to let down our NHS. The reforms have been developed by the NHS, and integrated care systems are already in place. The Health and Care Bill places them on a statutory footing to allow for that integration and joined-up working to continue.

In the minute or two I have left before I hand back to my hon. Friend the Member for Stockton South, I will touch on PFI contracts, which is an issue that he and other hon. Members have raised. In 2018, the Government announced that PFI and PF2 will not be used for any future public sector projects, including those in the NHS. The Government will honour existing PFI contracts, as wholesale termination would not necessarily represent good value for money. We need to look at each on its merits; many have clauses for early termination, which would cost a lot more than the life of the contract.

However, we have committed to undo the worst of the contracts inherited from the previous Government. The hon. Member for City of Chester (Christian Matheson)—I hope he will let me tweak his tail a little on this—chided my hon. Friend the Member for Stockton South by saying he should be careful about references to PFIs. Of the 124 significant PFIs currently in place, 122 were signed between 1997 and 2010.

Mr Gray, I think you want me to give my hon. Friend the Member for Stockton South some time to sum up, so I will conclude. We believe that this Government are doing everything necessary to ensure that the NHS remains free at the point of use. We are working with the NHS to deliver what it has asked for through the Health and Care Bill. There is huge support from those working in the system for the direction of travel. The Bill will create a more efficient and integrated healthcare system that is less bureaucratic, and allegations that this is privatisation by the back door are simply misleading. Through the legislation, we will ensure better and more joined-up services, improving health and care outcomes for all.

I thank the 135,000 petitioners for triggering this important debate on our most essential and treasured service. I thank Members for their valuable, emotional and passionate contributions, and I thank the Minister for what was a comprehensive response. The NHS is a great British institution, and we should be proud of it. From Borough to Burnley, our NHS staff are rightly celebrated as heroes. Their dedication got us through the pandemic and will help us reach the 6 million people on our waiting lists. We owe them a gratitude that cannot be expressed in words.

Dentistry remains an issue for constituents across the UK, and I look forward to the debate on NHS dentistry, which I understand is to take place in the near future. I am delighted that the NHS has the biggest cash boost in its history, and I am delighted to see thousands more doctors and nurses working in our amazing hospitals. I look forward to more debates on the NHS, so that we can continue to appreciate, extend and improve our great British NHS.

Question put and agreed to.


That this House has considered e-petition 598732, relating to the future of the NHS.

Sitting adjourned.