House of Commons
Tuesday 19 April 2022
The House met at half-past Two o’clock
[Mr Speaker in the Chair]
Before we come to today’s business, I wish to make a short statement. I have received letters from a number of hon. and right hon. Members, including the right hon. and learned Member for Holborn and St Pancras (Keir Starmer), the Leader of the Opposition, requesting that I give precedence to a matter as an issue of privilege. The matter is the Prime Minister’s statements to the House regarding gatherings held at Downing Street and Whitehall during lockdown. The procedure for dealing with such a request is set out in “Erskine May” at paragraph 15.32.
I want to be clear about my role. First, as Members will appreciate, it is not for me to police the ministerial code. I have no jurisdiction over the ministerial code, even though a lot of people seem to think that I have. That is not the case. Secondly, it is not for me to determine whether or not the Prime Minister has committed a contempt. My role is to decide whether there is an arguable case to be examined.
Having considered the issue, and having taken advice from the Clerks of the House, I have decided that this is a matter that I should allow the precedence accorded to issues of privilege. Therefore, the right hon. and learned Member for Holborn and St Pancras may table a motion for debate on Thursday. Scheduling the debate for Thursday will, I hope, give Members an opportunity to consider the motion and their response to it. The motion will appear on Thursday’s Order Paper, to be taken after any urgent questions or statements—hopefully, there will not be any. I hope that this is helpful to the House.
Oral Answers to Questions
Health and Social Care
The Secretary of State was asked—
Smoke-free 2030 Target
I know that my hon. Friend has long been a passionate advocate for a smoke-free England, and I read his recent Westminster Hall debate with interest. Some 64,000 deaths a year are attributed to smoking and it is one of the greatest drivers of health disparities in our country. I am personally determined that we should do everything we can to reach the Government’s ambition of a smoke-free 2030. That is why, in January, I asked Javed Khan to lead an independent review into tobacco control. Once that review is complete, the Government will set out their next steps.
To get to a smoke-free 2030, for every 100 people smoking today we need to reduce that figure by eight, because “smoke-free” actually means 5% or less of the adult population smoking. Can I ask the Secretary of State to ruthlessly target the barriers that stop people stubbing out their last cigarette? We need to get the numbers of smokers down; otherwise, 2030 will be an ambition that is not achieved.
My hon. Friend is absolutely right. The smoking rate is currently 13.5%, which is the lowest on record. However, smoking remains the largest driver of health disparities in our country. The new tobacco control plan, which will be informed by the new independent review, will be looking to do exactly what my hon. Friend says.
As one of the original campaigners for a ban on smoking in public places, I fully support what has just been suggested, but can I go further and beg the Secretary of State to come up very soon with a plan so that every child, every person and every family in this country can breathe clean, fresh air away from the pollution coming from diesel vehicles and other sources?
The hon. Gentleman has long been a campaigner on this issue and I commend him for that. He is right to continue pushing. I do not want to pre-empt the outcome of the independent review because it is just that, a review fully independent of Government. However, once it is complete—I hope to publish it in May—we can set out our plans.
Health and Care Integration
The past few years have shown that we are strongest when we work together. Earlier this year we published the integration White Paper, drawing on our experience of the pandemic to develop a plan that will bring together the NHS and local government to deliver jointly for local communities. We have also created integrated care partnerships, such as the programmes in mid-Nottinghamshire and Northamptonshire, through which we are already showing how we can bring together health and local social care services.
As covid regulations come to an end, I understand that the discharge fund is also set to end. This could leave local government vulnerable where there are no formal procedures locally to pass funding from the NHS to local government services and local authorities. Particularly as we seek to reduce hospital backlogs, it is vital that we get people out of hospital and into appropriate care settings. Will my right hon. Friend assure me that, where local authorities seek to tackle such backlogs, they will have access to appropriate funding?
I can give my hon. Friend that assurance. Of course, we are already putting in record funding for local authorities and the NHS to deal with backlogs. I believe the plan we set out earlier this month for the integration of NHS and local authority care services will make a real difference.
I thank the Secretary of State for referring to the work in Northamptonshire to integrate health and social care. Can he assure me that the central role of local government in ensuring that health and social care services work together to make the most efficient use of local resources will continue? And will he give me a clear guarantee that adult social care will not be taken over by the NHS?
I am pleased to give my hon. Friend the assurance he seeks. The integration White Paper signals our intention to go further and faster on health and care integration, building on the work already being done by the NHS, adult social care and local government to deliver services jointly. The plan will lead to better collaboration, and we want to make sure that overall responsibility is still shared between local authorities and the NHS.
The Secretary of State will know that Walsall Manor has been merged with the Royal Wolverhampton—they share a chief executive and chairman—without consultation with local people. How on earth can integration take place when Walsall Manor does not have a full-time chief executive to ensure that it happens? Will the Secretary of State please ensure that Walsall Manor gets its own chief executive?
I understand the right hon. Lady’s point, but it is about what works on the ground. My understanding is that what is happening in her area is about a shared management team that shares best practice and tries to address challenges together, rather than any kind of formal merger.
Across the country, tens of thousands of people sitting in hospital are medically fit to go home but cannot do so due to a lack of social care. The Health and Care Bill should have addressed that, but it does not. Rather than making us wait for more legislation, will the Secretary of State at least concede that local health leaders, be they in clinical commissioning groups or in integrated care systems in shadow form, should be driving this locally as a matter of urgency?
Thank you, Mr Speaker. You have clearly had a happy Easter.
The fact is that the Government’s failure to fix the social care crisis is causing huge pressures on the NHS. As of last week, more than 20,000 patients were fit to leave hospital but could not be discharged because the care was not available, which means that 22,000 patients each month are waiting more than 12 hours in A&E and that heart attack and stroke victims have to wait more than an hour for an ambulance. We are used to hearing about winter crises, but is it not the case that, after more than a decade of underinvestment in the NHS, a failure to fix social care and the absence of a plan even to address the staffing challenge in the NHS and social care, we have not just a winter crisis but a permanent crisis in the NHS?<
That is not the case at all. The hon. Gentleman knows, although he pretends not to, that the NHS and social care are facing unprecedented pressure because of the pandemic. He will know that as a result of the pandemic, both in NHS settings and in adult social care there has been a necessity for infection and protection controls. He will know that, sadly, staff absences are higher than they have been in normal times. But the NHS is stepping forward, with its colleagues in adult social care, to provide whatever support it can bring, especially with the record funding the Government are providing, both to the NHS and to adult social care.
My hon. Friend the Member for Hyndburn (Sara Britcliffe) and I have been working with east Lancashire local authorities and our GP services to see whether we can increase the number of face-to-face GP appointments. Will the Secretary of State say what action he and the Government are taking to ensure that people in east Lancashire can see their general practitioner face to face?
My right hon. Friend is absolutely right to raise this issue. We have heard time and time again in this Chamber about the pressures our constituents are facing in order to get that kind of face-to-face access to their GPs. We all know why the situation was particularly bad at the height of the pandemic, but we expect it to improve rapidly. The percentage of people being seen face to face is increasing substantially, in large part because of the measures the Government have taken, including the £250 million access fund that was announced a few months ago.
Thank you, Mr Speaker.
Integration and service improvement cannot be delivered without sufficient staff, and the only way to attract people to a career in social care is by valuing them. In Scotland, they are already paid better than those in England and Wales, and through the national care service the Scottish Government will improve terms and conditions for care workers, through the introduction of national pay bargaining. Have the UK Government considered following the Scottish Government’s approach and commitments?
Integration between the NHS and social care requires the right level and quality of workforce, both in the NHS and in adult social care. In the NHS in England, we have more doctors and nurses—more people working than ever before. In adult social care, we are recruiting at high levels, not least because of the huge recruitment campaign we ran with the sector, and some of the other changes we made, including the £400 million- plus of retention funding over the winter period. In addition, the support for the workforce more generally is making a real difference.
In north Northamptonshire, integration is getting on very well, with Councillor Helen Harrison heading the adult social services. However, going back to what my hon. Friend the Member for Northampton South (Andrew Lewer) said, there is the worry that because the NHS is so big it will overwhelm local government. I have told the Secretary of State that they do not want to mess with Helen Harrison, but can he ensure that there is a mechanism for reviewing that?
I know that my hon. Friend knows Helen Harrison extremely well, but he is right to talk about the importance of the NHS and the adult social care sector and local authorities working together. We must make sure that it is a true partnership, where one does not overwhelm the other and they work together towards their shared interests.
One key cause of the urgent care crisis in Shropshire, in the Shrewsbury and Telford Hospital NHS Trust, is the inability to discharge patients who are medically fit to go home into social care in the community. Shropshire Council’s resource challenges in that area are well known. Will the Secretary of State commit to putting extra resource into social care in Shropshire so that the medically fit can be discharged into the community when they are ready?
The hon. Lady is absolutely right to raise this issue, and the whole House heard just before the recess the results of the independent work done by Donna Ockenden. The hon. Lady is right to talk about that and the pressure that has been faced locally. I understand that she has already reached out to my hon. Friend the Minister for Health and that he will be meeting her to discuss just that.
NHS Dentistry Backlog
The dental activity threshold has recently been raised to 95% of usual activity. That is another quarter-on-quarter increase to get us towards 100% of pre-pandemic activity. I fully recognise, though, that access to NHS dentistry before the pandemic was patchy and that the crux of the problem is the current NHS dental contract, so work is under way to reform that contract. As negotiations have started, I am limited in what further I can say, but I will update the House as soon as possible.
A number of my constituents are finding it impossible to access NHS dental care. They include Alison, one of my constituents who worked as a midwife in Ipswich Hospital for 40 years. Some of them have contacted 40 different practices and have not got anywhere. My understanding is that there has been a 30% drop in the number of dentists taking on NHS work in Suffolk. Will the Minister explain what local work is going on between the Department and the local NHS bodies to try to ensure that this issue is addressed?
My hon. Friend is quite right in his question and is campaigning hard to increase dental activity in his constituency. One of the key pieces of work is being done through Health Education England, which set out a range of recommendations in its “Advancing Dental Care” review. That will do a number of things, such as increase the skill mix and scope of practitioners across dental teams, and we may well require legislation to bring some of that work forward. Health Education England is also introducing more flexible routes into dental training and doing some workforce modelling to identify the parts of the country with the biggest gaps in provision, so that we can establish centres of dental development in those areas. I will look at Ipswich in particular.
My constituent contacted me to tell me that when she broke her canine and went to contact her NHS dentist, she found she had been kicked off the list and was facing a bill of £4,000, which she simply does not have, to have the work done privately. Will the Minister speak to some of the dental practices about the possibility of relaxing their rules on kicking people off their dental lists, especially as covid has meant that patients might have had legitimate reasons for missing appointments?
I am sorry to hear about the hon. Lady’s constituent’s experience. There is not actually a list system for dentists as there is for GPs, so patients can see any dentist when they have a dental issue. With that said, we have asked dental practices to update their availability for NHS patients on the website. This morning, I looked at the website to see what availability there was throughout the country and saw that many dentists still have not updated their availability, so I will ask officials—particularly in her constituency—to update the lists so that patients can access NHS dentistry more easily.
I join the Minister in thanking dentists and their associates for getting so much of the service back. Does she agree that in places such as the Arun parts of my constituency, where people cannot find a dentist and have not been able to for two or three years, there must be a way for people to get on a dentist’s list and get treated, and for dentists to be properly rewarded? Dentists and patients would be grateful for a change in the contract.
The Father of the House is quite right that the crux of the problem is that there is a shortage throughout the country not of dentists but of dentists taking on NHS work. The contract is the nub of the problem, which is why work is under way to reform it. We will shortly announce some short-term changes and some longer-term reforms, which will hopefully help my hon. Friend’s constituents.
Bearing in mind that dentists are now determined to turn their practices wholly private as they cannot make ends meet with NHS prices, will the Minister pledge to review NHS payments to stop the haemorrhaging of NHS dentistry provision?
The hon. Gentleman is correct that the units of dental activity payments are a perverse disincentive. Sometimes, when someone needs more extensive work, their dentist is paid the same as they would be for, say, one or two simple fillings. That is the nub of the problem and we are currently in negotiations on the matter.
My hon. Friend the Minister is right to talk about the contracts with dentists, but should she not also look at how dentistry is structured and the regional nature of the contracting? It sits outside our clinical commissioning groups, which reduces co-ordination and accountability in respect of something that is central to our health. Should this not change?
My right hon. Friend is right. Health Education England is addressing the overall system of where dentists are training and where the gaps in provision are filled in its “Advancing Dental Care” review. It is also working with commissioners at a local level to develop more opportunities in those places that we term dental deserts, where there is currently a lack of provision.
NHS dentistry is in crisis. Patients are stuck with either a never-ending wait for an NHS appointment or footing the bill for going private, which is simply not an option for most families suffering rising bills and taxes. With a third of the population experiencing untreated tooth decay, when will this Government, who have had 12 years to do so, finally come up with some practical solutions that put patients’ needs first, rather than the half-baked, unworkable ideas we have heard to date?
I am sorry to the hear that tone from the hon. Lady. We are working under Labour’s 2006 dental contract, and she may have missed that dentists were unable to offer any routine care during the pandemic over the last two years, which we have slowly worked up to 95% of usual activity. She may want to play politics with this issue, but perhaps she should speak to her Labour colleagues who run the NHS in Wales, where 6% of dental posts were lost last year. She should get her own side in order before lecturing this side of the House.
With the exception of the previous question, I do not think that anybody on either side of the House who has raised this issue is playing politics, because a pattern is emerging of a backlog and problems in accessing NHS dentistry. An increasing number of constituents are contacting me having gone to their NHS dentist with an acute dental problem only to be told either that NHS patients are no longer being seen or that they have fallen off the list, as the hon. Member for Kingston upon Hull West and Hessle (Emma Hardy) mentioned. How can Ministers help in the short term? I know the long-term answer is around the contract—I used to give that answer when I was in her seat—but will the Minister please meet me over a cup of tea so that we can try, as a starter for 10, get to the bottom of this?
I thank my hon. Friend for his question. We have had many cross-party meetings with colleagues about dentistry, with many raising constituency issues that we have followed up. He could speak to his local commissioners, because there can sometimes be local problems with the commissioning of dental services. However, now that we are moving towards 95% of usual activity—a significant change compared with last year— I hope that his constituents will be able to access services more easily.
NHS Ear Irrigation and Microsuction
Ear wax services are the responsibility of local commissioners, who are responsible for meeting local healthcare needs. Depending on a local area’s arrangements, services should be undertaken either at local primary care practices or through referrals to appropriate local NHS services.
Well, I obviously want to thank the Minister for that answer, but I was recently contacted by a constituent who complained that she was told by her GP surgery that such services were no longer available on the NHS and that she should consider obtaining them privately. This is happening despite recent studies that link the effect of impacted cerumen with cognitive decline and dementia. Will the Minister consider writing to clinical commissioning groups to remind them of their obligations and patient entitlements?
I thank the hon. Gentleman for his question. There has been no national removal of ear wax services, which can still be commissioned locally. NICE guidance is clear on the types of services that should be commissioned. Traditional methods of manual ear syringing are no longer offered for safety reasons, but electronic irrigation and microsuction should be being offered. If his local CCG is not commissioning such services, I am happy to meet him and them to discuss why not.
GPs provided the service for decades. We all understand why the NICE guidance means that they no longer offer syringing, but there is a gap in that many clinical commissioning groups are not offering alternative services. We are talking about people with dementia or receiving end-of-life care who literally cannot hear and are going deaf. The Minister must be direct with CCGs on this issue.
Regional Health Inequalities
I am determined to tackle unfair disparities in health outcomes. That is why I launched the Office for Health Improvement and Disparities. OHID’s regional directors of public health will work with local government and the wider health system to empower local partners with the tools they need to respond to disparities in their regional and local areas. We will also publish a health disparities White Paper later this year, with a strong focus on prevention, to improve health for the whole population.
I thank the Secretary of State for his answer, but a decade of under-investment and mismanagement have left 4.5 million people on waiting lists and staff shortages of more than 100,000 people even before we entered the pandemic, which exacerbated health inequalities. I welcome the work his Department is doing, but the reality is that people who live in a constituency such as mine are twice as likely to end up on a waiting list for treatment for more than a year as those in better-off areas. While I welcome what he has announced today, may I ask that he puts in appropriate investment to go along with tackling those appalling health inequalities?
The hon. Lady is right to talk about the importance of tackling health inequalities; on that we absolutely agree, and I hope she will contribute to the health disparities White Paper that I mentioned a moment ago. However, it is wrong of her to suggest that some of the current challenges we face are because of under-investment or because of a smaller workforce than otherwise. We have the largest investment ever going into the NHS. Its budget this year is bigger than the GDP of Greece. It is the highest amount ever, rising by billions each year. We also have more going to social care than ever before, and the highest level of workforce that the NHS has ever seen in its history.
Surely one of the cruellest health inequalities is in fertility treatment. Of the 106 CCGs in the country, only six limit the age at which women can have in vitro fertilisation treatment to 35, and two of those are in Hampshire. Will the Secretary of State meet me to discuss how we can end that most devastating of postcode lotteries?
Warm words from the Secretary of State, but people in the most deprived parts of England are almost three times as likely to lose their lives from an avoidable cause as those in the least deprived areas. With the cost of living soaring and the Resolution Foundation estimating that 1.3 million people will be pushed into poverty as a result of the Chancellor’s spring statement, those inequalities will worsen. Why will the Secretary of State not just admit that his Government have failed the poorest communities, and start doing something about it?
The hon. Gentleman acts as though health inequalities are something that has just emerged under this Government. There have been long-running health inequalities in this country over decades under successive Governments, and this Government are putting in record investment and coming up with the ideas to deal with them. As ever, the Labour party has no idea how to deal with the challenges this country faces.
Mental health is a serious challenge of our time. It is totally unacceptable that waiting times, average number of sessions and minimum number of sessions differ according to which part of the country someone lives in. Sadly, recent statistics show that in Stoke-on-Trent people are taking their own lives at double the national average. That is why I am proud to support the cross-party “No Time to Wait” campaign, led by James Starkie with the backing of The Daily Telegraph and the Royal College of Nursing, for the provision of mental health nurses in GP surgeries, which could make a real difference to those who bravely come forward asking for help. Will my right hon. Friend meet me, hon. Members of this House who are supportive, and James to discuss how we can make that possible?
Yes, of course; I would be delighted to meet my hon. Friend and others to discuss the campaign. He speaks with passion and I know this is something he has long campaigned on. I have had time to look at some of the content of the campaign, but I would certainly be happy to discuss it further.
NHS Waiting Lists: Southampton
Reducing waiting lists and waiting times, exacerbated of course by the impact of the pandemic, is a key priority for this Government. Southampton, like the rest of the country, will benefit from the detailed actions set out in the elective recovery plan published by my right hon. Friend the Secretary of State a few months ago. In addition, as part of Solent Acute Alliance hospital upgrade programme, University Hospital Southampton NHS Foundation Trust has received £12.1 million to increase capacity at Southampton General Hospital.
The hospital trust in Southampton, which is an excellent provider, is desperate to get back to elective surgery and non-life-threatening procedures, but finds that it cannot because it cannot integrate covid treatment into general ward activities, and has a continuing high level of staff sickness, which means that procedures are often undertaken very inefficiently in terms of resources. What assistance can the Minister provide for the trust to enable it to get on the front foot as regards elective procedures and non-life-threatening treatments in the near future?
The hon. Gentleman rightly pays tribute to the staff at his hospital trust, and I join him in doing so. The number of those in his area waiting for an elective procedure or routine operation has reduced slightly. There is more to do, but the trust is making inroads, as he says, and I know that it wants to do more. As we set out in the elective recovery plan, some innovations, such as surgical hubs, allow a greater separation between covid areas, or areas where covid may be present, and elective activity is a key part of that. If it is helpful, I am always happy to meet him to discuss the specifics of his local hospital.
Poor Housing Conditions: Health Outcomes
The Government are committed to tackling poor-quality housing. In the social housing White Paper, we committed to a review of the decent homes standard to test whether it is up to date and reflects current needs and expectations. The levelling-up White Paper sets out a commitment to halve levels of non-decency in all rented homes by 2030, with the biggest improvements in the poorest-performing areas. These reforms will have a positive impact on health, and we will work closely with the Department for Levelling Up, Housing and Communities to support their implementation.
The NHS spends a staggering £2.5 billion-plus annually on treating people with illnesses directly linked to living in cold, damp and dangerous conditions. As a consequence, severe respiratory diseases such as asthma, mesothelioma and other asbestos-related diseases are on the increase, mainly in the most deprived areas. Sadly, more and more people are dying. How does the Government’s levelling-up policy plan to tackle this increasingly urgent health issue?
The hon. Gentleman raises a really important issue that we are determined to tackle. Housing is one of the key determinants of health. A decent home can promote good health and protect from illness and harm. As he said, poor housing conditions have severe consequences for mental and physical health. That is why we are determined, not just through the levelling-up White Paper but through the health disparities White Paper that will be published later this year, to set out a bold ambition to reduce the gap in health outcomes and the actions that the Government will be taking to address the wider determinants of health, including the impact of poor housing on health.
In North Devon it is not just the quality of housing that is causing health issues but the lack of availability of affordable housing and a complete collapse of the private rental sector, which is creating mental health issues among my constituents and also means that my much-loved North Devon District Hospital is struggling to recruit adequate local medical services. What steps is the Department taking to try to address these concerns?
My hon. Friend raises an important issue specific to her area, and other areas that attract people who go there for their holidays and are perhaps not there on a permanent basis. We are determined through our White Papers to address every health inequality, whether caused by a moving population or a static population, in the sorts of areas that the hon. Member for Wansbeck (Ian Lavery) talked about.
Cancer Treatment Backlogs: Derbyshire and England
Cancer treatment and diagnosis remained a top priority throughout the pandemic, with 4.4 million urgent referrals during the period and over 1 million people receiving cancer treatment. Thanks to the brilliant work of our NHS staff, first treatments for cancer have been maintained at above 94% of usual levels over the course of the pandemic. However, we know that fewer people came forward, so we are now seeing record numbers of people coming through the system, with November last year having the highest number of 11,000 cancer referrals per working day.
I asked specifically about Derbyshire, but I did not get an answer. Derbyshire clinical commissioning group has failed to reach any of the cancer referral targets for the most recent 12 months. Although this is a national failure, the shortages are particularly acute in Derbyshire. These failures have tragic consequences. My constituent Paul Bryan is just 58. He has been attending his surgery for two years; he kept getting dismissed and was not tested, and now the prostate cancer that was undiagnosed for all that time has spread to his ribs, spine and bones, and his diagnosis is terminal. His family are urging the Government to show more urgency to improve outcomes, so that other families do not have to experience such needless heartbreak. Will the Minister explain to the Bryans why the Government rejected the workforce planning amendment to the Health and Care Bill that could have helped our NHS get the cancer specialists it needs and prevented heartbreak like the Bryans in other families?
I am sorry to hear about the case of the Bryan family, but I reassure the hon. Gentleman that, in Derby and Derbyshire, 92% of treatments start within 30 days, despite record numbers of patients coming forward. To tackle the issue of getting people diagnosed earlier, which is key to getting more successful treatment, we are rolling out rapid diagnostic centres across the country so that people can access screening and testing much more quickly and easily. We have 159 of those live right now, with more to follow.
Personalised healthcare is a key priority in my reform agenda. I recently set out a new ambition: that as many as 4 million people benefit from personalised care by 2024, covering everything from social prescribing to personalised support plans. We are also on track to deliver 200,000 personal health budgets and integrated personal budgets by 2023-24.
I welcome the Secretary of State’s answer. My constituents are still telling me that they are experiencing some delays beyond the NHS guidelines on diagnosis for special treatment. What plans does my right hon. Friend have to address the lack of capacity and need for capacity in specialty-trained doctors and specialist diagnostic equipment, to make personalised care a reality?
My hon. Friend is absolutely right to mention the importance of the workforce and medical equipment. He will be reassured to know that the NHS has more doctors and nurses working for it than ever before, with more in training than ever before. We are investing record amounts of capital for new medical equipment, including investment in some 160 new community diagnostic centres, which will all include the latest, state- of-the-art diagnostic equipment.
Mental Health Support for Veterans and Military Charities
NHS England has several bespoke services for veterans, including Op Courage, the veterans’ mental health and wellbeing service, which provides a complete mental health care pathway for veterans. Veterans can benefit from personalised care plans, ensuring that they can access support and treatment both in and out of hours. As part of the care and support available to veterans, Op Courage works with military charities and local organisations to provide healthcare and address wider health and wellbeing needs, including for drug and alcohol addiction.
My constituency of Airdrie and Shotts has a long military history, with many people having previously served in the armed forces. When I meet veterans from my constituency, we often discuss the mental health of veterans. The war in Ukraine will undoubtedly have an immediate and lasting impact on the mental health of veterans, as they may be reminded of their experiences of war. To help support our veterans, will the Department come forward with a package of emergency funding for armed forces mental health charities?
The hon. Lady raises a very good question. Last year, we committed an additional £2.7 million to further expand Op Courage following the recent events in Afghanistan, and NHS England has put in place several bespoke services and initiatives to meet the needs of our armed forces community. In addition to Op Courage, there is the veterans trauma network, the veterans prosthetic panel and the veteran-friendly GP accreditation scheme, but given ongoing events in Ukraine, we will of course keep everything under review. I am very happy to meet the hon. Lady to discuss further what may be required.
Our veterans have risked their lives for our country and deserve excellent mental health support. We must go even further: from the military frontline to frontline workers who have kept us safe, everyone deserves proper mental health provision. People have stepped up to protect our country and save lives during the pandemic, so is it any wonder that teachers and NHS staff are so furious with the comments made by the hon. Member for Lichfield (Michael Fabricant), about how they would go back to the staffroom and have a “quiet drink”, in an attempt to justify the indefensible actions of the Prime Minister? What does this say about the effect of mental health on our frontline staff? Will the Minister please condemn those comments and apologise for the hurt caused by those remarks?
I am very happy to say that we of course thank very much all the staff who have been on the frontline, whether veterans or teachers, and involved in everything that kept us going throughout the pandemic. We are of course very much aware of the impact of those stresses and strains on mental health. There is additional support for mental health, and there will continue to be additional support for young people’s mental health and for adult mental health. That is one reason why I launched a call for evidence last week to inform a new 10-year cross-departmental mental health vision, and I urge everybody to input into that process before it closes on 5 July.
NHS Workforce Planning
The workforce are the heart of our NHS, and I join the Minister for Care and Mental Health, my hon. Friend the Member for Chichester (Gillian Keegan), and Opposition Members in paying tribute and putting on record our thanks to those who work in the NHS. In the short term, the NHS has well-established processes to ensure that the health service has the right number of staff with the right skills, and that is alongside our investment in workforce expansion, including delivering 50,000 more nurses over the course of this Parliament. For the longer term, we have commissioned Health Education England to set out the key drivers of workforce supply and demand. It is due to report this spring. Building on that, my right hon. Friend the Secretary of State has commissioned NHS England to develop a long-term workforce framework. We will share the conclusions in due course.
The anti-immigration, “hostile environment” rhetoric and actions of this Government are having a significant impact on our NHS workforce, both by not encouraging people to come here to work in our NHS and by discouraging current staff from staying here. The Health and Social Care Committee recommended the introduction of a national policy framework on migration to support national and local workforce planning. When will the Government implement that recommendation?
I am very grateful to the hon. Lady for her question. We are clear, and always have been clear, about how much we value the huge contribution that overseas workers in our NHS make towards keeping our health service up and running, and delivering first-class care every day. There are three strands to our approach to building and increasing our workforce. The first is increasing the numbers of people training in this country and the second is increasing retention. The third focuses on the workforce who come from overseas and who are incredibly welcome here. Indeed, the number of people coming from countries outside the EU into our NHS workforce has increased.
The Minister will be aware that I have highlighted the challenge for rural areas in developing a workforce plan on a number of occasions. Indeed, the last report from the all-party parliamentary group on rural health and social care made 10 recommendations, including for how we might address workforce planning in rural areas. Will the Minister advise me of what steps he has taken to put in place any of those recommendations to improve the plight of those living in rural areas?
I am grateful to my hon. Friend, who takes a close interest in this issue, which she and I have discussed on a number of occasions. She is right to highlight the challenges that some more remote or rural communities can face in securing the workforce they need to meet their communities’ needs. The HEE work and the subsequent workforce framework will be looking at that across the whole range of different geographies and the challenges they face.
The Scottish Government have recently bought Carrick Glen, a private healthcare hospital, in order for it to become part of the national network of treatment centres, which once fully operational will have capacity for over 40,000 additional surgeries and procedures each year. In contrast, the UK Government have taken the path of further privatisation of the NHS, so what recent assessment has the Minister made of the impact on the workforce of further privatisation of NHS England?
I am grateful to the hon. Gentleman, and had we been going further down the route of privatisation, his question might have had a little more resonance. What we are doing in the NHS in England is investing in our workforce and investing in our national health service, while of course working closely with the independent sector to maximise the use of its capacity in parallel to make sure we bring down waiting lists and waiting times.
Our healthcare system is standing at a crossroads, and sooner or later we will have to make a choice between endlessly going back to the taxpayer to ask for more money and reforming the way in which we do healthcare in our country. Last month, I unveiled an ambitious new programme of reform, setting out how we are going to prioritise prevention, offer more personalised care, deliver improvements in performance and back the people making the difference in the NHS. The objective of this agenda is simple: to bring about the biggest transfer of power and funding in decades from our ever-expanding state to individuals, their families and their communities.
In Gloucestershire Hospitals NHS Foundation Trust, 30% of patients do not medically need to be in hospital; they are waiting for discharge. That figure is twice the national average. Will one of the Ministers contact the relevant people in the health service in Gloucestershire to ask them for ways in which the Government could help them to reduce that figure, because as it stands lives are being put at risk?
My hon. Friend is right to raise this. We are already in contact with the acute trust in Gloucestershire and some of the other trusts that are finding delayed discharge a particular challenge. My hon. Friend will know that, because of the pandemic, what has been a long-term challenge has become much more acute, not least because of the lost beds due to infection protection control and staff absences both in healthcare and in social care. Our delayed discharge taskforce is making a difference—the numbers are coming down overall—but we will be working with Gloucestershire.
I am very happy to answer if you will allow me, Mr Speaker. The hon. Gentleman could have asked me a question on anything to do with health and care—anything he wanted—but instead he chooses to talk about my personal affairs before public life. That was his choice. He could have asked me about the covid backlogs that he pretends he cares so much about. He could perhaps have given me suggestions—
Thank you, Mr Speaker. I would just say to the Secretary of State that he should be careful what he wishes for. I hope he will at least reply to the letter I sent him last Thursday—I will place a copy in the Library of the House. He has been stonewalling journalists’ questions, but since he says he wants to talk about the Government’s record, let me ask him about that instead. We went into the pandemic with NHS waiting lists already at 4.5 million. We went into the pandemic with NHS staff shortages of 100,000. We went into the pandemic with social care staffing vacancies of 112,000. So it is not just the case that the Tories did not fix the roof while the sun was shining; they dismantled the roof, removed the floorboards and now they have no plan to fix it. Where is the Secretary of State’s plan to fix the NHS crisis?
Order. Once again, I remind Members that topicals are short and punchy questions, not lengthy statements. A lot of Back Benchers on both sides deserve to get in to raise constituency matters, so please let us give them time. I do not want a lengthy fall-out, and these are Health questions.
Mr Speaker, you have been very generous to the hon. Gentleman: you gave him another try, but that was another failure to ask a question. Again, the hon. Gentleman is not asking about the serious issues, which again shows that he will play petty party politics and that Labour has no plan for the challenges this country faces.
Like many across the House I have been deeply disturbed by the reports we have all seen from Shanghai and my thoughts are with the people affected. It shows what a dangerous fallacy this whole idea of zero covid was, and it also shows that we are the most open country in Europe and that we have got the big decisions right. We did not listen to the Opposition when they said we should not open up in the summer, and we did not listen to them when they again called for restrictions in the winter. We are showing the world how to live with covid.
I thank the hon. Lady for her question, and we have met to discuss this previously. I am happy to discuss with Health Education England whether one of its centres for dentist development could be suitable for her constituency.
No one, with the possible exception of my hon. Friend the Member for Kettering (Mr Hollobone), is more passionate than my hon. Friend the Member for Wellingborough (Mr Bone) about seeing improvements delivered in their local hospital, and I had the pleasure of visiting. As my hon. Friend will know, the £46 million was allocated originally for an urgent treatment centre; the hospital asked that that be changed and it folded in with the overall programme. It has yet to submit a business case for the enabling works; when it does, I will make sure that it is expedited.
As the hon. Gentleman is aware, I know his constituency well; it is my birthplace. He might also know that just a couple of months ago I visited his constituency and met members of the local community at the Deeplish community centre to talk about exactly what he has rightly raised today: the importance of tackling inequalities in Rochdale and beyond. We will set out our plans in our upcoming health disparities White Paper.
I share my hon. Friend’s concerns, which is why the NHS commissioned this review from one of our top paediatricians. It is already clear to me from her interim findings and the other evidence I have seen that NHS services in this area are too narrow; they are overly affirmative and in fact are bordering on ideological. That is why in this emerging area, of course we need to be absolutely sensitive, but we also need to make sure that holistic care is provided, that there is not a one-way street and that all medical interventions are based on the best clinical evidence.
The hon. Lady raises a very important question. We want a society in which every person with dementia and their families and carers receive high-quality, compassionate care from diagnosis through to end of life. We have provided £17 million this financial year to NHS England and NHS Improvement to increase the number of diagnoses. That funding was spent in a range of ways, including investing in the workforce to increase capacity in memory assessment services.
The Secretary of State will have read the scandal exposed in The Sunday Times this weekend that six babies are born every month after being exposed to sodium valproate, which has been known for many years to cause disabilities. Last year the Government consulted on putting warning labels on valproate. Is it not time to go much further and ban the prescription of sodium valproate to epileptic pregnant mothers?
My right hon. Friend is right to raise this, and many of us will have seen the recent reports, especially from the families affected. It is right that we reconsider this and make sure that sodium valproate, and any other medicine, is given only in the clinically appropriate setting.
Thank you, Mr Speaker. I will try not to make this one a waste. I was grateful to the Minister for meeting me to discuss my ongoing campaign to restore the A&E to Bishop Auckland Hospital. Many of my constituents face a long drive to get to Darlington or Durham, and given that swift treatment can be a significant factor in outcomes for conditions such as strokes and heart attacks, does he agree that having A&E services spread geographically rather than just in strong population centres is an essential part of keeping our community safe?
I did indeed have a positive and constructive meeting with my hon. Friend. It is right that we have access geographically spread to A&E services, but the decisions are rightly taken by clinical commissioners on the basis of clinical evidence. I know that she will continue fighting the corner for the reopening of her local A&E with tenacity and passion.
I would be pleased to have the meeting that the hon. Lady has suggested. She should know that we just closed the consultation on the 10-year cancer plan. There has been a fantastic response. She may also have seen the announcement that we made today about lung cancer health checks. With improvements like that, we intend to do a lot more.
One of the best ways to maximise NHS capacity is to increase people’s access to GP appointments and treatments such as mental health services and physiotherapy in their own communities. Will the Minister join me in backing our bid for a new health centre in East Leake and in calling on Nottinghamshire’s clinical commissioning group to prioritise funds for this vital service?
I thank my hon. Friend for her question. I had an excellent visit to the surgery in East Leake, and I look forward to the submission of the business case so that we can look at it further. She is right that investing in primary care does a huge amount to support the health of the local community.
The hon. Lady raises a very important point. I know that children’s mental health services are treating more young people than ever. However, the demand has quadrupled since the pandemic and that is why we have invested £79 million in these services. By 2023-24, an extra 345,000 more young people will be accessing support. I mentioned the call for evidence. It is important that we work through our vision for our 10-year plan. We are also introducing mental health support teams in schools, which will help, plus access to community and mental health hubs, and more young people will have access to eating disorder services, but there is a lot of work ongoing.
I know from discussions with constituents that needle phobias are a real thing. Will my right hon. Friend therefore tell the House what support the Government are giving to intranasal vaccine delivery systems to ensure that the maximum number of people take up the vaccine?
The Department of Health and Social Care commissioned research through the National Institute for Health and Care Research, co-funded with UK Research and Innovation, for an Imperial College London study, worth £580,000, looking specifically at the safety and effectiveness of two covid-19 vaccines administered by respiratory tract. The study is ongoing, but it is in the later stages of the phase one clinical trial, and the results will be made public in due course, following peer review.
Those providing social care often work long hours and are a real lifeline for the most vulnerable. Will the Minister act to ensure that those in social care are paid properly with a real living wage, as Citizens UK is campaigning for?
Actually, according to Skills for Care data from 2020-21, the majority of care workers were paid above the national living wage in that year. Most care workers are employed by private sector providers who set their terms and conditions. However, we have committed £1.36 billion to the market sustainability and fair cost fund, which will support local authorities to move towards paying providers a fair cost of care. We hope that will lead to better sustainability and better staff.
The Government recognise that menopause services need to improve, which is why menopause is a priority area in our women’s health strategy. We recognise such services are often best provided in primary care, but that some women need specialist services. We are looking at that in our women’s health strategy and the menopause taskforce.
In December last year, the Department of Health and Social Care promised three urgent actions to tackle the gender health gap: the appointment of a women’s health ambassador; legislation to ban hymenoplasty; and the publication of the women’s health strategy for England in spring 2022. Can I ask the Minister when those vital actions are actually going to happen?
I welcome all that my right hon. Friend is doing to address health inequalities. However, could I ask him to look carefully at public health funding for my borough of Bexley, as we are seriously underfunded compared with similar boroughs in London?
In a recent survey by Carers UK, almost half of unpaid carers said that they are currently unable to manage their monthly energy bills and expenses, and that any further increases would negatively affect their own physical and mental health, or that of the person they care for. What steps are being taken, along with the Secretary of State for Work and Pensions, to support those hard-working exhausted unpaid carers with the cost of living?
I thank the hon. Lady for her question and of course we have a great deal of gratitude for every unpaid carer. Around 360,000 carer households on universal credit can receive an additional £2,000 a year through the carer element. The weekly rate of carer’s allowance increased to £69.70 in April 2022. Also, real-terms expenditure on carer’s allowance is forecast to increase by around £1.3 billion. In addition, there is a big focus, in our reforms and in the White Paper, on what more we need to do to support unpaid carers.
Global Migration Challenge
With permission, Mr Speaker, I will make a statement on the United Kingdom’s approach to the global migration challenge.
The United Kingdom has a long and proud history of offering sanctuary to refugees. In recent years alone, we have welcomed more than 185,000 people through safe and legal routes, including from Syria, Hong Kong, Afghanistan and, more recently, Ukraine. In addition, we have welcomed more than 40,000 people in recent years through our refugee family reunion routes. This Government have done more than any other in recent history to support those fleeing persecution, conflict or instability.
But we cannot focus our support on those who need it most or effectively control our borders without tackling illegal migration, which is facilitated by people smugglers—serious organised criminals who profit from human misery, who do not care about people drowning in the channel or suffocating in the back of containers. We must break their lethal and evil business model by removing the demand for their repugnant activities. This type of illegal migration puts unsustainable pressures on our public services and local communities. Every day, the broken asylum system costs the taxpayer almost £5 million in hotel accommodation alone. The cost of the asylum system is the highest in over two decades at over £1.5 billion.
As the Prime Minister said last week:
“We cannot sustain a parallel illegal system. Our compassion may be infinite, but our capacity to help people is not.”
That is why the new plan for immigration and its legislative vehicle—the Nationality and Borders Bill—are so vital. Once again, I urge hon. Members and Members in the other place to follow this elected House in backing the Bill.
At the heart of this Government’s approach is a simple principle: fairness. Access to the UK’s asylum system should be based on need, not on the ability to pay people smugglers. More than 80 million people around the world are displaced. Others are on the move because they want a better life. There is a global migration crisis that demands innovative and international solutions, and this Government are taking firm action.
When we published the new plan for immigration back in March last year, we set out three very clear objectives: to increase the fairness and efficacy of our system so that we can better protect and support those in genuine need of asylum; to deter illegal and dangerous routes of entry to the UK, thereby breaking the business model of criminal smuggling networks and protecting the lives of those they endanger; and to remove more easily from the UK those with no right to be here.
The Ministry of Defence has taken command of small boat operations in the channel. Every small boat incident will be investigated to determine who piloted the boat and could therefore be liable for prosecution. These reforms are a truly cross-government effort, including the Home Office, the Ministry of Defence, the Crown Prosecution Service, Border Force and the Ministry of Justice.
A nationwide dispersal system will be introduced so that asylum pressures are more equally spread across local authorities. Currently, 53% of local authorities in England, Scotland and Wales do not accommodate asylum seekers under the dispersal system. It is simply unfair that a national burden should be felt disproportionately by certain areas of the country.
For the first time, the Government are building asylum reception centres to end the practice of housing asylum seekers in expensive hotels. A new reception centre in Linton-on-Ouse in North Yorkshire will open shortly. Far from being outlandish, as some in the Opposition have commented, asylum reception centres are already operational in safe EU countries such as Greece and they are funded by the EU.
Just last week, I signed a new world-leading migration and economic development partnership with Rwanda. Under this partnership, those who travel to the UK by illegal and dangerous routes, including by small boats across the channel, may be relocated to Rwanda, where they will have their asylum claims considered. Those in need of protection will be given up to five years of support, including education and employment training and help with integration, accommodation and healthcare, so that they can thrive there. The UK is supporting this investment in Rwanda over five years, boosting the Rwandan economy and increasing opportunities for people living there, further cementing the trading and diplomatic relationship between our countries.
This is a bespoke international agreement reached last week with Rwanda; I came to Parliament as soon as was reasonably practicable following the conclusion of that agreement. The agreement is compatible with all our domestic and international legal obligations. Rwanda is a state party to the 1951 United Nations refugee convention and the seven core United Nations human rights conventions, and has a strong system for refugee resettlement. The United Nations has used Rwanda for several years to relocate refugees, and of course it was the European Union that first funded that.
This agreement deals a major blow to the people smugglers and their evil trade in human cargo. Everyone who is considered for relocation will be screened and interviewed—that will include an age assessment—and will have access to legal services. In relation to accounting officer advice, contrary to reports in the newspapers, the permanent secretary did not oppose this agreement; nor did he assert that it is poor value for money. Rather, he stated in his role as accounting officer that the policy is regular, proper and feasible, but that there is not currently sufficient evidence to demonstrate value for money.
It is the job of Ministers to take decisions—more often than not, tough decisions—in the interests of our country. Existing approaches have failed, and there is no single solution to these problems—something that I think Opposition Members may have encountered in the past as well. Change is needed, because people are dying attempting to come to the UK by illegal and dangerous routes. This partnership is the type of international co-operation needed to make the global immigration system fairer, keep people safe and give them opportunities to flourish. This will help to break the people smugglers’ business model and prevent loss of life, while ensuring protection for those who are genuinely vulnerable.
This Government are delivering the first comprehensive overhaul of the asylum system and of this type of illegal migration in decades. At the heart of this approach is fairness. Access to the UK’s asylum system must be based on need, not on the ability to pay people smugglers. The demands on the current system, the cost to British taxpayers and the scandalous abuses are increasing. The British public have rightly had enough. Our new plan for immigration will improve support for those directly fleeing oppression, persecution and tyranny through safe and legal routes. It will deter illegal and dangerous routes of entry to the UK, make it easier to remove those with no right to be in the UK and provide a common-sense approach to controlling immigration, both legal and illegal. I commend this statement to the House.
We have seen, over the past week, this unworkable, shameful and desperate attempt to distract from the Prime Minister’s lawbreaking. The Home Secretary should not go along with it, because she is undermining not just respect for the rule of law, but her office, by providing cover for him. The policies that she has announced today are unworkable, unethical and extortionate in their cost to the British taxpayer.
There was no information from the Home Secretary about the costs today. Will she admit that the £120 million that she has announced does not pay for a single person to be transferred? She has not actually got an agreement on the price for each person; in fact, £120 million is the eye-watering price that the Home Office is paying just for a press release. What is the rest of the cost? What is this year’s budget? How many people will it cover? The Home Office has briefed that it might be £30,000 per person to cover up to three months’ accommodation, but that is already three times more than the ordinary cost of dealing with an asylum case in the UK.
The Home Secretary said in her statement that she would provide five years of costs. In Australia, offshoring costs £1.7 million per person, which is over 100 times more than the ordinary asylum cost here. Where will all the money come from to fund the plan? She says that she will save money on hotels, but the only reason why we are paying a fortune in hotel costs is that Home Office decision making has totally collapsed. On the Home Secretary’s watch, the Home Office is taking only 14,000 initial asylum decisions a year, half as many as it was taking five years ago. It is taking fewer decisions than Belgium, the Netherlands and Austria, never mind France and Germany. The costs to the UK taxpayer have soared by hundreds of millions of pounds because the Home Secretary is not capable of taking basic asylum decisions—and because she is not capable of taking those decisions, she is trying to pay Rwanda to take them instead. Whether or not people are refugees, whether or not they are victims of modern slavery, whether or not they have family members in the UK and whether or not they have come from Afghanistan, Syria or even Ukraine, the Home Secretary is asking Rwanda to do the job that she is not capable of doing.
The Home Secretary says that this policy will deter boats and traffickers, but the permanent secretary says otherwise: he says that there is no evidence of a deterrent effect, and that there has been a total failure to crack down on the criminal gangs that are at the heart of this problem. The number of prosecutions for human trafficking and non-sexual exploitation has fallen from 59 in 2015 to just two in 2020. The criminals will not be deterred because someone whom they exploited was sent to Rwanda. They do not give money-back guarantees under which they lose money if their victims end up somewhere else instead. They will just spin more lies. The Home Secretary is totally failing to crack down on criminal gangs. Why does she not get on with her basic job, crack down on human traffickers, do the serious work with France and Belgium to prevent the boats from setting out in the first place—which she did not even mention in her statement—and make decisions fast?
The Home Secretary is using this policy to distract people from years of failure. She promised three years ago to halve the number of crossings, but it has increased tenfold, and this will make trafficking worse. The top police chief and anti-slavery commissioner has said that the Home Secretary’s legislation will make it harder to prosecute traffickers. When Israel tried paying Rwanda to take refugees and asylum seekers a few years ago, independent reports showed that that increased people-smuggling and increased the action of the criminal gangs. This is the damage that the Home Secretary is doing. She is making things easier for the criminal gangs and harder for those who need support, at a time when people across our country have come forward to help those who are fleeing Ukraine—to help desperate refugees. Instead of working properly with other countries, the Home Secretary is doing the opposite. All she is doing is making things easier for the criminal gangs.
Will the Home Secretary tell us the facts? Will she tell us about the real costs of this policy, and the real damage that it will do in respect of human trafficking and people- smuggling? Will she come clean to the public, and come clean to the House?
That response to my statement was, if I may say so, wholly predictable. It is important to say to everyone in the House that we cannot put a price on saving human lives, and I think everyone will respect that completely.
The right hon. Member for Normanton, Pontefract and Castleford (Yvette Cooper) was a Minister in the Blair Government when the powers that give this Government the legal basis for this policy were introduced. When she occupied a seat in the Blair Government, I do not remember her exploding in synthetic rage when all those policies were implemented, after Acts were passed in 1999, 2002 and 2004 to bring about similar partnerships —the same partnerships, by the way, that were used to establish the Dublin regulations to return inadmissible asylum seekers to EU member states. The right hon. Lady has gone on record multiple times attacking the Government for abandoning those regulations, and at the same time calling for a replacement. Now she is attacking the Government for using the very powers that only a few weeks ago she said we could still be using if we had not left the EU.
What we have heard today from the right hon. Lady and the Opposition demonstrates their absolute inability to understand this issue—the differentiation between legal and illegal migration. They should be honest about their policies. They stand for open borders and uncontrolled immigration. I will, if I may, go even further: the right hon. Lady described the policy as unworkable and extortionate. If it is unworkable, it cannot be extortionate. We will make payments based on delivery. That is the point of our scheme. Nowhere in her response to the statement did the right hon. Lady put forward an alternative that would actually seek to deal with people-trafficking and deaths in the channel. Importantly, the Labour party is being exposed today as having no policy, and no idea how to stop people-smuggling.
With respect to my right hon. Friend, from what I have heard and seen so far of the removal to Rwanda policy, I do not support it on the grounds of legality, practicality or efficacy. I want to ask her about one specific issue. I understand that only young men, and not families, will be removed. The Home Secretary is shaking her head, so I have obviously misunderstood the policy in that sense. If it is the case that families will not be broken up—the Home Secretary is nodding—where is her evidence that this will not simply lead to an increase in the trafficking of women and children?
I am happy to meet my right hon. Friend to discuss this further, and to give her further information —[Interruption.] Calm down and listen. First and foremost, the policy is legal and a memorandum of understanding has been published that states very clearly—[Interruption.] Members are not even listening, so there is no point. The MOU states clearly in terms of the legal—[Interruption.] If Members are interested in listening to the responses, please do. The MOU that has been published spells out in full detail the legalities and the nature of the agreement. I think my right hon. Friend the Member for Maidenhead (Mrs May) would respect the fact that I am not going to speak about the eligibility criteria on the Floor of the House. [Hon. Members: “Why not?”] Because, as my right hon. Friend will know very well, those types of criteria are used by the smuggling gangs to exploit various loopholes in our laws to do with, for example, legal action to prevent removals. Opposition Members write to me frequently asking me not to remove some of the failed asylum seekers and foreign national offenders who have no legal basis for remaining in our country. I will be happy to meet my right hon. Friend to discuss this further.
This is a cruel and catastrophic policy. It will not hurt smugglers, but it will further seriously harm people who have fled persecution. It will do untold damage to the international system of refugee protection, and to what little remains of the UK’s reputation for upholding international law. This is worse than temporary offshoring; it is offloading responsibility altogether. As the United Nations High Commissioner for Refugees has said, people fleeing persecution should not be “traded like commodities”, and in words of the Refugee Council, this is nothing short of cash for deportations. We know that 85% of refugees are in the developing or least developed countries, yet here is the wealthy UK offering them cash to take some more. So much for global Britain.
The only thing that is transparent about this policy is its dodgy timing and grubby political motivation. In the interests of proper transparency, will the Home Secretary finally publish a detailed estimate of how many billions this policy will cost? She was chuntering that she had the deal sorted out, so she should now announce it to Members of the House. And for what are we paying this money? Can she say what percentage of asylum seekers coming to the UK will be subjected to this abysmal treatment? Reports from Rwanda suggest capacity for probably around1%, but certainly less than 5%. Is that correct? We are told people will be screened before transfer, but how can a pathetic screening interview possibly pick out trafficking survivors, torture victims or LGBT people? Quite simply, it cannot, so is she happy to see those people subjected to this treatment?
Why are women and children within the scope of this policy? Will people going through the screening process be able to access legal advice? Why are we not allowed to see the criteria for deciding who will be sent? Where is the transparency in that? How will she monitor their treatment? Her Government have completely failed to stop abuses in UK detention centres, never mind in centres that are 5,000 miles away. In short, this disastrous policy has nothing to do with the global migration crisis and everything to do with distracting from the Prime Minister’s political crises. It is absolutely sickening, for all that.
Just for the record, I think the hon. Gentleman’s latter comment was absolutely unacceptable. It does a great disservice not just to this Government and the officials who have worked for over nine months on this partnership, but also to our counterparts in Rwanda who have been working with us, to my international counterparts who are working collectively to tackle the issues of illegal migration, and to some counterparts in the EU as well.
To answer some specific points, I think it is shameful that the hon. Member for Cumbernauld, Kilsyth and Kirkintilloch East (Stuart C. McDonald) is playing party political games on that point, just like the Labour party. [Interruption.] If the hon. Gentleman lets me answer the question, I will.
The other point is that Rwanda has successfully resettled more than 130,000 refugees. I think the hon. Gentleman’s comments are a slur on the successful efforts of our partners in Rwanda. Rwanda is a safe and secure country with respect for the rule of law. I think hon. Members should listen to the undercurrent of their tone towards Rwanda, which has done a great deal to provide safety, refuge, security and a new life to many refugees from around the world.
The hon. Gentleman asked about the approach we will take. Everyone considered for relocation will be screened and interviewed, they will have access to legal advice, and decisions will be made on a case-by-case basis. Nobody will be removed if it would be unsafe or inappropriate for them.
The hon. Gentleman is not the first hon. Member to mention legal obligations and the legalities. Rwanda is beholden to the same legal obligations on human rights as the United Kingdom and I make the point again that I think there is something really quite unpleasant about the undercurrent of the tone towards Rwanda.
The latest figures suggest that, in December, more than 7,000 people in Birmingham were claiming asylum support amounting to tens of millions of pounds. Does my right hon. Friend agree that this partnership with Rwanda will reduce the reliance on hotels and reduce the number of small boat crossings?
There are a number of things—[Interruption.] If the right hon. Member for Islington South and Finsbury (Emily Thornberry) were less hysterical and actually listened, she might learn something about the new plan for immigration.
It is important to reflect on a number of points. The answer to my hon. Friend’s question is yes, because we do not want people to be in hotel accommodation. It is a cheap point for Opposition Members to make, but we had to use hotel accommodation to protect people during the pandemic, and Public Health England guidance spoke to that.
On decision making—[Interruption.] If the right hon. Member for Islington South and Finsbury chooses to listen, the new plan for immigration is about speeding up asylum decisions and processing through legislation and the digitalisation of the system. I have to add that, because every single Opposition Member voted against this policy, they clearly want open borders. They just want to have uncontrolled migration, and they have done nothing to come up with an alternative plan on this issue.
The announcement made last week, when Parliament was not sitting, has caused a great deal of confusion about what this policy actually entails. Unfortunately, the Home Secretary turned her head away from the microphone when she responded to the right hon. Member for Maidenhead (Mrs May), so I wonder whether she will answer the question of who will actually be eligible to be sent to Rwanda. Will it be single young men, or will it be women and children? What percentage of asylum seekers does she think will be sent to Rwanda?
On eligibility, as I have already said, everyone considered for relocation will be screened and interviewed and have the right access to legal advice and services, and decisions will be made on a case-by-case basis. That is absolutely right and proper, but the fundamental principle in relation to this policy and the new plan for immigration, in which I am sure the right hon. Lady is well versed, is that it will apply to people who are inadmissible to our asylum system and to people who have come to our country illegally: through illegal and dangerous routes.
The asylum reception centre to which my right hon. Friend referred will be at Linton-on-Ouse in my constituency. I am not a nimby in any shape or form but, nevertheless, the RAF base on which it will be situated is at the centre of that small rural village. Local people are understandably concerned that this is not an appropriate place to put such a reception centre. Will she meet me to discuss that decision and to see what can be done?
The Home Secretary asserts that Labour Members do not understand the issue, but she will be aware that a former permanent secretary at the Home Office, Sir David Normington, said last week about her Rwanda policy:
“It’s inhumane, it’s morally reprehensible, it’s probably unlawful and it may well be unworkable”.
How does she come to know better than a former Home Office permanent secretary?
First, I am surprised that the right hon. Lady is using Sir David’s name in vain, given that a former Labour Home Secretary infamously and discourteously described the Home Office leadership and management as “not fit for purpose” during Sir David’s tenure. Things have moved on in terms of the asylum system. Her party and other Opposition Members continuously vote against the new plan for immigration, but they have no plan to deal with these important and difficult issues. It will bring in the reform that our country needs, while making sure that we preserve the efficacy of safe and legal routes for people fleeing persecution to come to our country and get the support they need.
My right hon. Friend deserves great personal credit for seeking to tackle the dreadful crisis that exists in the channel, but does she accept that many of us have grave concerns that the policy she has announced simply will not work? On the cost, can she confirm that she will not be using expensive military aircraft to make the 9,000-mile round trip? Also on cost, will she ensure that before the House of Commons votes on this matter tomorrow we know the cost per asylum seeker of those she is sending to Rwanda?
My right hon. Friend knows Rwanda incredibly well. We have had many discussions about it and I am very happy to meet him to have further discussions. We will not be using military planes for any removals. He will, like many Members of this House, be pretty familiar with the approach we take to removing failed asylum seekers and foreign national offenders to return them to their country of origin or to third countries. There is a whole process around this, which involves a lot of operational work and detail. I am happy to talk to him privately about that because the ways in which we can do this are complicated. He makes further points that I am happy to discuss with him as well.
I am incredibly proud of this country and this Government’s track record in providing a safe welcome to more than 185,000 asylum seekers and refugees since 2015, but I hope that my right hon. Friend will be ramping up the welcome for Ukrainian refugees—I know she will be working flat out at it. What I find abhorrent and inexplicable is the way in which many Opposition Members, and even those in the top echelons in the Church of England and in other faiths, seem to have completely forgotten the images of children lying drowned on our beaches. How can they not seek to try to remedy that appalling situation? These people are not refugees and asylum seekers—they are coming from France.
I thank my right hon. Friend for her comments and observations. She will be well aware of the work that our noble Friend Lord Harrington is currently doing in the other place on the Ukrainian scheme in terms of resettling people and bringing people over for the Homes for Ukraine scheme.
The left in particular like to preach compassion, but there is little compassion when they do not have the backbone to make difficult decisions when it comes to the protection of human life. For months and months, they have talked about saving lives and lost lives, and now that there is the prospect of action to save lives and to go after the evil people smugglers, they wring their hands and choose to play party political games.
Members throughout this House are desperately concerned about the children who are often on these boats, so can we have a straight answer from the Home Secretary? Does she intend one of the criteria that prevents somebody from being sent to Rwanda to be their being under 18? Crucially, where will the processing and the decision making as to whether or not somebody is under 18 take place? Please, Home Secretary, be straight and honest with us about what you intend to do with these children. We all deserve better.
I have already spoken about the processing and the eligibility—[Interruption.] Yes, I have. I absolutely have. Operational decisions are for the officials and practitioners on the ground who undertake them. That is part of our process that the hon. Lady should respect.
The shadow Home Secretary, the right hon. Member for Normanton, Pontefract and Castleford (Yvette Cooper), was slightly wrong when she talked about human trafficking. This is not human trafficking; this is people smuggling. This is about evil gangs being paid money to take people across the channel. They do not care about the lives of these individuals. The only way we are going to stop the people smuggling is if we reduce the demand for it, and the Home Secretary’s Rwanda policy is absolutely right. Does she agree that her policy is morally the right thing to do?
My hon. Friend is absolutely right that there is a distinction and a significant difference between people trafficking and smuggling. It is the people-smuggling gangs that we are trying to stop. We are trying to break up their business model and end their evil trade, and it is absolutely right that we do so. When it comes to cases of human trafficking, it is a well-known fact that it is down to the work of my right hon. Friend the Member for Maidenhead (Mrs May) with the Modern Slavery Act 2015, and the work of this Government, that we have stood up the legalities and the proper processes to give those people who have been trafficked the legal protection and the safety and security that they need in our country.
Will the Home Secretary tell the House how many people she expects to send to Rwanda in the first 12 months of the scheme? She will be aware that Rwandan Government Ministers are on the record as saying that they expect their capacity to be in the hundreds, with a few thousand over the five-year period. Given that 28,000 people crossed the channel last year, does the Home Secretary really think the scheme is going to have the deterrent effect that she claims for it?
The Home Secretary is quite properly focused on saving lives, so may I ask her a practical question? The World Bank has said that Rwanda has one of the highest incidences of malaria in the world. Our own Government website warns travellers about hepatitis A and B, tetanus, typhoid, cholera and tuberculosis, not to mention rabies and dengue fever, which cannot be vaccinated against. What are the Government going to do, both from an ethical and moral point of view and to protect the British taxpayer against compensation claims, to protect the asylum seekers who go to Rwanda?
My right hon. Friend makes some important points. The partnership we have undertaken with the Rwandan Government is based not only on direct support, technical expertise, education and training but, as I said in my statement, on providing care in terms of individuals’ health and resettlement needs.
The proposal to treat refugees differently based on how they arrived in the UK undermines a key principle of refugee protection. Such an approach weakens the very foundation of the 1951 refugee convention and contradicts the steps agreed to by the UK upon signing up to the global compact on refugees. What legal assurances did the Government seek about the protection of people in Rwanda, which has an authoritarian regime with one person in power for 30 years?
I have already been very clear that Rwanda is a safe country. People arriving in the United Kingdom are coming here illegally from safe countries, which is where they should claim asylum in the first place. Rwanda is not just a safe country, as I have said, but one that has resettled over 100,000 refugees. I appreciate that the hon. Lady just mentioned countries in both the EU and UN, both of which have deemed it safe to send asylum seekers to Rwanda, and Rwanda is beholden to the same legal obligations on human rights as the United Kingdom. The hon. Lady’s tone towards Rwanda is deeply offensive in the light of our partnership relationship.
My hon. Friend is absolutely right. I pay tribute to her work with the Home Office as the Member of Parliament for Dover, which has been at the forefront of receiving people coming to the UK, and to her county council, which has been under significant pressure for many years. The dispersal policy, which was first proposed by the leader of Kent County Council, has taken time to be pushed forward, but it will not only have a significant impact on the people and taxpayers of Kent, but see the principle of fairness applied to people who rightly come to our country through legal routes as opposed to those with no legal basis to be in the UK.
This afternoon the Home Secretary has described Rwanda as a safe and secure country, saying that to suggest otherwise is a slur. However, on at least two occasions only last year, the United Kingdom called for an investigation at the United Nations into torture, deaths in custody, extrajudicial killings and forced disappearances in Rwanda. Was that a slur by the UK, or was it a well-founded request? What was the outcome of the request? What legal assurances has she obtained from Rwanda regarding the treatment of any asylum seekers sent there?
Under this agreement, as I have said, Rwanda will process claims in accordance with the UN refugee convention and national and international human rights laws. Importantly, it will ensure that individuals are resettled in the right way. Over 130,000 refugees have been resettled in Rwanda, and it is not just a safe country, but one where both the UNHCR and the EU have resettled individuals. Finally, with all partnerships—[Interruption.] If hon. Members would like to listen, I will answer the question. We have thorough discussions in all partnerships, and in these negotiations, including those on human rights, we have worked closely with the Rwandan Government on the need to protect vulnerable people seeking safety and a new life.
The Home Secretary is right to deal with the issue of criminal people trafficking and to recognise the frustration of many at the length of time it takes to remove people who are here unlawfully from this country. The caveat many of us would enter, however, is whether this scheme will achieve either of those objectives. Can she tell me how she can assume that a set of criteria to determine claims, as clearly must be drawn up, is likely to be free from legal challenge, if the criteria are not published and transparently available? Would it not be much better to invest the significant amounts of money we are talking about in speeding up the work of our current immigration system, in recruiting more immigration tribunal judges and in more investigative resource for the Home Office, so that we can achieve the objectives without the financial and potential legal risks that the current scheme involves?
We are doing both. My hon. Friend will know that the legislation for the new plan for immigration does exactly that by introducing the one-stop shop for immigration courts and tribunals, stopping the merry-go-round of various legal practices being used to prevent the removal of individuals with no legal right to be in the United Kingdom and the constant right of appeal in the immigration courts, which slows down the processing of cases. That is the purpose of the new plan for immigration. There are clauses in the Nationality and Borders Bill that, I repeat for the benefit of the House, the entire Opposition voted against, because they do not want to see the issue of illegal migration and reform of the asylum system addressed at all. Those are many of the challenges we are confronted with every single day.
I alluded to that in my statement earlier. This is exactly what is required to break up the evil people-smuggling gangs. We are bringing in that deterrent effect, but I have been clear that there is no single solution. Frankly, those on the Opposition Benches can scream hysterically as much as they want, but they do not have a plan. They have supported for decades uncontrolled migration through whatever route. There is a degree of dishonesty now with the British public, at a time when we could come together to support the proposals, now that we have proposals in the Nationality and Borders Bill and a safe third country, which many called for in debates as the Bill went through this House and the other place. Now they just wring their hands and, typically, just oppose any option or solution that could make a difference.
We can see from the level of questions coming from the Opposition, especially the Labour party, that they are completely out of touch with the British public. In the interests of safety, can the Home Secretary please confirm that if anybody does not want to go to Rwanda, they can claim asylum in France?
The Home Secretary has been pressed several times on the question of who will and who will not be liable to be included in this scheme, and specifically whether it will include women and children. She has refused to say, despite having been asked by the Chair of the Home Affairs Committee and the former Prime Minister, the right hon. Member for Maidenhead (Mrs May). If the Home Secretary knows how many people she believes will be included in the scheme over the coming months, surely she knows what the criteria will be. If so, is it not her duty to inform this House of them?
I have made the point several times about those who are inadmissible to the asylum system, which is those who come to our country through illegal routes. We have made abundantly clear time and again that we are bringing in these reforms to stop that illegal trade in people smuggling, by creating safe and legal routes for women, children and families so that they do not have to be put in the hands of the evil people smugglers. As I have said, we will consider everyone for relocation through the process I have outlined on a case-by-case basis, and no one will be sent to the third country if it is unsafe or inappropriate for them.
Asylum is sought by some of the world’s most desperate people fleeing some of the most horrendous sorts of crimes, but sadly this process is abused by so many people traffickers exploiting the vulnerability of those people. What reassurance can my right hon. Friend give that she will continue to develop safe and legal routes for some of those people who have been left in refugee camps around the world for so many years?
My right hon. Friend makes the most important point about safe and legal routes. As I announced in my statement, we have resettled over 180,000 people through safe and legal routes—more than any Government in recent years. Those routes include Syria, Afghanistan, Hong Kong and now Ukraine. We will continue to do exactly that. I have said in the House on a number of occasions that safe and legal routes should be bespoke because every single crisis is unique. It is right that we work with the right international partners to make sure that we provide safety and security for those fleeing persecution and oppression.
I cannot comment on the schemes of other countries when they are not comparable to what the British Government are doing. This is a different scheme. It is a migration and economic development partnership. It is not comparable to those of other countries that the hon. Gentleman refers to.
I know the Home Secretary has worked tirelessly with our European partners to try to stop vile people smugglers, but it is evident that more measures are urgently needed. Does she agree that a fair and just immigration and asylum policy should not rely on someone’s ability to pay, nor on whether they are young enough or fit enough to attempt to jump the queue by making the journey, and that to oppose any measure to stop these people smugglers is immoral?
My hon. Friend is absolutely right. We see the scale of not just the global migration challenge but the level of criminality that has been associated with migration and illegal migration for decades. This is not a new phenomenon, as I have repeatedly said in the House many, many times. It is right that we absolutely go after the individuals who are responsible for this trade in people smuggling and stop these routes being viable. We cannot do this on our own. We have to work internationally with our partners in the EU, but other international partners as well, who want to step up and be part of the solution, and also to demonstrate to other countries around the world how we can resettle refugees in a good, proper way.
The permanent secretary at the Home Office concluded that he could not tell whether this was value for money, but on every number and every question of cost, the Home Secretary has failed to answer. Can she answer the point made by the right hon. Member for Maidenhead (Mrs May)? If this deters certain people from crossing, surely the people traffickers and smugglers will just load the dinghies up with women and children and make sure that they get their money somehow; it does not break the business model.
I am sorry, but I want to dispute that point. It is our moral responsibility and duty not to just wring our hands and let the people-smugglers carry on trading in human misery. We have a responsibility to find solutions. It is disappointing, as I have repeatedly said, that the Opposition just sit on the sidelines carping and playing political games. The message to the British people is obviously that they just want uncontrolled immigration, they do not have a solution to this problem, and they are not prepared to work with the Government to stop this awful and evil trade of people smuggling.
It is an important point. Of course, there is a lot of work that takes place with immigration enforcement and our operational teams. I should just add that for those who go through the asylum process, as claims are processed in the United Kingdom, issues such as absconding will have an impact on how their asylum claim is viewed and treated.
I suspect that there are more asylum seekers housed in my constituency than in those of many who have been hectoring the Secretary of State this afternoon. I have heard their stories, and I know of the misery caused by people trafficking and of the desperation of those who hand over huge amounts of money and risk their lives to get into the United Kingdom. I therefore support the Secretary of State’s aim to wreck this evil trade. However, if after a lengthy procedure only a very small percentage of those processed will have left the country, will not the people smugglers still be able to argue, “It’s worth your while handing money over to us and risking your lives”?
The right hon. Gentleman has made a number of points, and made them incredibly well, about the human misery. The way in which people’s lives are put at risk is absolutely shocking and tragic. We want to stop that and break it, and we have to do so upstream. It is not good enough to wait for it to come to the shores of the United Kingdom or the coastline of France, because that is simply too late. That is why a whole array of work has been redoubled, working with intelligence and security partners upstream, and with different Governments, so that we can target, intercept and prosecute the gangs—not just in our country, but in other countries further upstream.
I welcome the Home Secretary’s statement and the new plan for immigration. Does she agree that there is nothing moral at all about a system that perpetuates evil people-smuggling and puts a disproportionate burden on constituencies such as mine with regards to temporarily housing migrants?
My hon. Friend is absolutely right. I come back to two points about the issue of criminal gangs and people smuggling. This is not a new phenomenon; it is well established. We have to work not only with our international partners to break the model and have the right level of prosecutions domestically, but with our counterparts on intelligence, intelligence sharing and prosecutions outside the United Kingdom. Much of that is in the new plan for immigration and the Nationality and Borders Bill, which Members on the Government side of the House support but Opposition Members do not. My hon. Friend is also absolutely right to say that it is unfair that a handful of local authorities across the United Kingdom—in England and Wales—have stood up to provide housing accommodation and meet the needs of asylum seekers. That is a shameful reflection on many other local authorities, but that will now be remedied through the dispersal policy.
I cannot accept that the Secretary of State believes that this policy is about protecting people, when we all know that it is utterly harmful. The Archbishops of Canterbury and York were right to speak out against the Government’s unworkable plan to send asylum seekers and refugees to Rwanda. The Government’s language criminalises vulnerable and traumatised people. The Archbishop of York was right to say that
“there is, in law, no such thing as an illegal asylum seeker. It is the people who exploit them that we need to crack down on”.
This policy will also cost the UK taxpayer billions of pounds, as has happened in Australia—is that not correct?