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Defending Public Services

Volume 611: debated on Monday 23 May 2016

Today’s debate, chosen by the Opposition, is about defending public services, so I want to start by stating very simply that this Government do not believe in private wealth and public squalor; quite the opposite—we believe in prosperity with a purpose, and building high quality public services is perhaps the most important purpose of all. But there is a difference between the two sides of the House. Indeed, there is more than one difference. One is that we on this side are prepared to take the difficult decisions necessary to build the strong economy that will, in the end, fund those public services. A second difference is that we go further and say that securing funding from a strong economy is not enough, and that the battle for higher standards is as important as the battle for resources. Without high standards, we let down not just the taxpayers who fund our public services but the vulnerable citizens who depend on them.

So yes, we are proud to have protected schools funding since 2010, but we are even prouder that 1.4 million more children are in good or outstanding schools. Yes, we are proud to meet our 2% of GDP defence spending pledge, but we are even prouder of the professionalism of our armed forces operating in the Mediterranean today to help to find the wreckage of the tragically lost Egyptian airliner. Yes, we are proud to have protected science and research funding, but we are even prouder that this country continues to win more Nobel prizes than any other, apart from the United States. Yes, we are proud that, since 2010 and despite the deficit, we increased NHS funding by more than was promised by the Opposition at both elections. We are even prouder that failing hospitals are being turned around, that MRSA rates have halved and that cancer survival rates have never been higher.

With that, let me turn to the NHS and say up front that nowhere is the importance of the two challenges of proper funding and high standards more stark. I pay tribute to the 1.3 million staff who work in the NHS. Whatever they have thought over the years about the politicians running their service, their dedication to patients, their hard work, night and day, and their commitment to the values that the NHS stands for make up the invisible glue that has always held it together, whatever the challenge. I know that I speak for the whole House when I thank them for their service.

Let us look at what staff have achieved over the past six years. Compared with 2010, we treat 100 more people for cancer every single day. We treat 1,400 more mental health patients, 2,500 more people are seen within four hours in A&E departments, and we do 4,500 more operations. At the same time as all of that, hospital harm has fallen by a third and patients say that they have never been treated with more dignity and respect. In the wake of the tragedy of Mid Staffs, we should recognise the huge efforts of staff at the 27 trusts that have since been placed into special measures. Eleven have now come out, three of which are now officially rated as good. Neither Stafford nor Morecambe Bay nor Basildon—three of the hospitals of greatest concern—are now in special measures thanks to excellent local leadership and superb commitment from staff.

However, all NHS staff want to know about the funding of their service. The NHS’s own plan, published in October 2014, asked for a front-loaded £8 billion increase in funding not just to keep services running, but to transform them for the future. The then shadow Health Secretary, the right hon. Member for Leigh (Andy Burnham), said that the Conservative promise to deliver that funding was a cheque that would bounce, but we delivered that promise to the British people in last autumn’s spending review, and the increase was not £8 billion, but £10 billion. It was not back-loaded, as many had feared, but front-loaded with £6 billion of the £10 billion being delivered this year.

On the Secretary of State’s point about what the NHS asked for, is it not right that the forward view set out three different efficiency savings scenarios? It was not a case of the NHS asking for £8 billion. Does he really believe that the £8 billion— £10 billion including last year’s increase—will be sufficient to meet the NHS’s demands?

The right hon. Gentleman will have heard Simon Stevens being asked that question on “The Andrew Marr Show” yesterday. He was clear that £8 billion was the minimum of additional funding that he thought the NHS needed. In fact, we supplied £10 billion, which came with some important annual efficiency saving requirements. Indeed, for that £8 billion, the NHS recognises that £22 billion of annual efficiency savings are required by 2020, because even though funding is going up, demand for NHS services is increasing even faster. I will come on to talk about how we are going to make those efficiency savings. Some in this House have observed that without £70 billion of PFI debt, without £6 billion lost in an IT procurement fiasco, and without serious mistakes in the GP and consultant contracts a decade ago, the efficiency ask might have been smaller.

We all hear what the Secretary of State is saying: it is always somebody else’s fault. However, the fact of the matter is that I have been told by senior health professionals at the highest level—I do not watch “The Andrew Marr Show” often—that only two of this country’s health trusts are not in debt. Is that right?

That is not true, but we do all accept that there is financial pressure throughout the system. The question that is always ducked by Labour Members is how much greater that financial pressure would have been under Labour’s plans, which involved giving the NHS £5.5 billion less every year than was promised by the Government. I just point out that when Labour Members condemn the £22 billion of efficiency savings as “politically motivated”, as the shadow Health Secretary did in March, they cannot have it both ways. Her manifesto offered the NHS £5.5 billion less every year compared with what this Government put forward—

The hon. Lady shakes her head, but let us consider what the King’s Fund said in the run-up to the election:

“Labour’s funding commitment falls short of the £8 billion a year called for in the NHS five year forward view.”

It was there in black and white: Labour was committing to a £2.5 billion increase in the NHS budget, not the £8 billion that this Government committed to. The hon. Lady cannot have it both ways. If this figure was £5.5 billion, the efficiency savings needed would be not £22 billion, but £27.5 billion, which is a 25% increase. That would be the equivalent of laying off 56,000 doctors, losing 129,000 nurses or closing down about 15 entire hospitals.

I welcome the Secretary of State’s policy that foreign visitors should be asked to pay for non-urgent treatment that they get when they are here and that European visitors should have to recoup this through their national systems. Why do we need extra legislation, and how much money does he think we can get from that?

We need extra legislation to expedite the process. I point out to my right hon. Friend that that is another policy which has been opposed by the Labour party. All the time it says we should be doing more to get a grip on NHS finances and yet it opposes every policy we put forward in order to do precisely that. The answer to his question is that the issue with the NHS is primarily that we are not very good at collecting the money to which we are entitled from other European countries, because we are not very good at measuring when European citizens are using the NHS. This legislation will help us to put those measurement systems in place so that we can get back what we hope will be about half a billion pounds a year by the end of this Parliament.

We will no doubt hear later this afternoon the charge that the Government have lost control of NHS finances, but we strongly reject that charge. The House may want to ask about the credibility of that accusation from a party that is at the same time proposing a funding cut for the NHS and criticising the difficult decisions we need to take to sort out NHS finances.

Two months into this financial year, can the Secretary of State say whether or not the Department of Health broke its budget for last year?

We will find out those figures when the full audit is complete. I just say to the hon. Gentleman that efficiency savings are never easy, but a party with the true interests of NHS patients at heart should support those efficiency savings, because every pound saved by avoiding waste is one we can spend improving patient care.

Let me therefore outline to the House what we are doing to deliver those efficiencies, as well as to support NHS trusts to return to financial balance. First, we are taking tough measures to reduce the cost of agency staff, including putting caps on total agency spend and limits on the rates paid to those working for agencies. So far, that has saved £290 million, with the market rate for agency nurses down 10% since October and with two thirds of trusts saying that they have benefited. Our plan is to reduce agency spend by £1.2 billion during this financial year. Secondly, we are introducing centralised procurement under the Carter reforms. Already 92 trusts are sharing, for the first time, information on the top 100 products they purchase in real time, and we expect savings of more than £700 million a year during this Parliament as a result. Thirdly, given that the pay bill is about two thirds of a typical hospital’s costs base, we are supporting trusts to improve on the gross inefficiency of the largely paper-based rostering systems used at present. This should also significantly increase flexibility and the work-life balance for staff, as we announced last week. Finally, and perhaps most critically, we will reduce demand for hospital services by a dramatic transformation of out-of-hospital care, as outlined in the five-year forward view. If we meet our ambitions, we will reduce demand by more than £4 billion a year through prevention, improved GP provision, mental health access and integrated health and social care.

For as long as I can remember, unfortunately, discussions about the NHS have always been reduced to simplistic arguments about whether enough money is being spent on it, and whether efficiency is being improved enough. I think that the Government, in the present financial circumstances, have increased spending and pursued efficiency at least as effectively as any of their predecessors.

Does my right hon. Friend agree that the real issues that we ought to be considering are the rapid rise in, and the changing nature of, demand on this important service? Will he have time to consider things such as moving to a seven-day service; ending the curious divisions between the hospital service, GPs, community care and local council social services; providing for an ageing population with chronic conditions; and, at the same time, giving extra emphasis to mental health and all the things that have been neglected in the past? All these exchanges such as, “You should be spending more,” and “You are cutting, and we would spend more” are the sterile nonsense pursued by every Opposition that I can recall when they cannot think of anything positive to say.

My right hon. and learned Friend speaks with great wisdom, as he did during the junior doctors’ strike. Perhaps that is based on his experience of featuring in a BMA poster, which was put up across the country, as someone who ignored medical advice, because he smoked his cigar.

My right hon. and learned Friend is absolutely right. The crucial issue for the future of the NHS is the simple statistic that by the end of this Parliament we will have 1 million more over-70s to look after in England, and their needs are very different from those of the population whom we had to look after 20, 30 or 40 years ago. In particular, their need to be looked after well at home, before they need expensive hospital treatment, is a transformation. That is why a core part of what we are doing is to transform the services offered in mental health and in general practice, which I will come on to a bit later.

While the Secretary of State is talking about transformation, let me say that I agree with the right hon. and learned Member for Rushcliffe (Mr Clarke) that we have to start focusing on quality. In the east midlands, for example, the ambulance service has just been judged by the Care Quality Commission to be inadequate when it comes to patient safety. Things are in a real state of difficulty in our NHS. Ambulance services need improvement; what is he going to do about it?

I absolutely agree with the hon. Gentleman. In fact, I wanted to come on to talk about that perceived tension between money and the quality of care. Until three years ago, we did not have an independent inspection regime to go around ambulance services and tell the service, the public, constituents and Members of Parliament how good the quality of care is in each area. The first step is to have that inspection regime so that we know the truth, and then things start to happen, as is beginning to be the case in ambulance services across the country.

The big point—this is precisely what I wanted to move on to—is the worry, which is shared by many people, that an efficiency ask of this scale might impact on patient care. They should listen to the chief inspector of hospitals, Professor Sir Mike Richards, who points out that financial rigour is one of the routes to excellent quality, and that there is a positive correlation between hospitals offering the best care and those with the lowest deficits. In other words, it is not a choice between good care and good finances; we need both.

Before my right hon. Friend moves on, I want to draw him back to the question of charging international visitors for the use of the NHS. The Government now charges non-EU citizens £200 per person as part of their visa application. Will he tell the House why he has chosen the figure of £200, which seems extremely low? An equivalent private healthcare policy for a year would be £800, £900 or £1,000, and an equivalent level of travel insurance for the same period would be £400 or £500. Is there not an opportunity to tier this and perhaps charge people more as they get older and become more likely to rely on the NHS?

I recognise why my hon. Friend has asked that question. We do think very hard about the level at which we set that charge, which was introduced for the first time only a couple of years ago. The reason that it is set that low—I recognise that it is quite a low charge—is that a large number of people paying it are students who tend to have low health needs and be low users of the NHS. We want to ensure that we do not create an inadvertent disincentive for people coming to the UK when they can, at the same time, choose to do their studies in Australia and America. However, it is something that we keep constantly under review.

My right hon. Friend will of course be aware that there is a differential charge for students—some £150 a year rather than £200. Will he go away and consider whether there is a possibility of charging high earners who come to this country more than a couple of hundred pounds a year, because the charge does seem so low? Will he also specifically look at whether there is a possibility of charging people who are older more, as they are much more likely to rely on the NHS?

Let me repeat that we do keep this matter constantly under review. The important thing is that, for the first time, we are charging people who come to the UK on a long-term basis for their use of NHS resources. That is something that did not happen before.

Let me return to the crucial issue of this link between the quality of care and good finances. Why is it that it is so important not to see this as an artificial choice between good care and good finances? Very simply, it is because poor care is about the most expensive thing that a hospital can do. A fall in a hospital will cost the NHS about £1,200, as the patient typically stays for three days longer. A bed sore adds about £2,500 to NHS costs, with a patient staying, on average, 12 days longer. Avoidable mistakes and poor care cost the NHS more than £2 billion a year. We should listen to inspiring leaders such as Dr Gary Kaplan of Virginia Mason hospital in Seattle, which is one of the safest and most efficient hospitals in the world. He said:

“The path to safer care is the same one as the path to lower costs.”

That brings me on to the second way that this Government are fiercely defending our public services, which is our restless determination to raise standards so that people on lower incomes can be confident of the same high quality provision as the wealthiest. To their credit, the last Labour Government succeeded in bringing down NHS waiting times. I hope that that decade is remembered as one when access to NHS services improved. However, because of poor care identified in many hospitals post Mid Staffs, we should surely resolve that this decade must become the one in which we transform the safety and quality of care. Mid Staffs was the lowest point in the history of the NHS, so we must make it a turning point, or a moment that we resolve to offer not just good access to care, but care itself that is the safest and the highest quality available. The record of the past three years shows that we can do just that.

The King’s Fund has given credit to the Government for their focus on safety and quality of care. Patient campaigners have said that the NHS is getting safer and the main indicators of hospital mortality and harm are going in the right direction. However, there is much more to do, so what are our plans? First, we must deliver a seven-day NHS. It should never be the case that mortality rates are higher for people admitted at weekends than for people admitted in the week. Last week’s junior doctor contract agreement was a big step forward, but we also need to reform the consultants’ contracts, improve the availability of weekend diagnostic services and increase the number of weekend consultant-led procedures.

Secondly, a seven-day NHS also means a transformation of out-of-hospital services, especially access to an integrated health and social care system that needs to operate over busy weekends as well as during the week. It also means more GP appointments at convenient times, which is why we want everyone to be able to see a GP in the evening or at weekends. We are backing general practice with a £2.4 billion increase in its budget.

One group of people who particularly need integrated care are those who are addicted, as their life chances are most blighted. They need to be able to make a full recovery. Will the Secretary of State tell us what has been done to support that full recovery? Like me, is he looking forward to hearing the Minister for Culture and the Digital Economy, my hon. Friend the Member for Wantage (Mr Vaizey), conclude the debate, as we will perhaps hear how blighted communities are impacted by high-stakes fixed odds betting terminals? I would like to hear what is being done by the Government on that, as we need to act now to show that we have an all-round approach to improving life chances.

It is a pleasure to sit on the Treasury Bench with my hon. Friend the Minister for Culture and the Digital Economy for the first time in several years. I will leave him to respond to that point, but I will make a broader point in response to the question from my hon. Friend the Member for Enfield, Southgate (Mr Burrowes) which is that the change we need to make in the NHS is to prevention rather than cure. If we can stop people becoming addicted in the first place, whether to drugs, alcohol or gambling, we will reduce costs for the NHS in the long term. That is the purpose of many of our plans.

Thirdly, a seven-day NHS requires a big improvement in access to 24/7 mental health crisis care, so that whenever a problem arises we are there promptly for some of our most vulnerable people. We will deliver that alongside our broader plans to enable 1 million more people with mental health problems to access support each year by 2020.

May I commend the Government for accepting the majority of the recommendations from the independent mental health taskforce and allocating £1 billion to implement them? The Secretary of State has been talking about system change within the NHS. To deliver on the taskforce’s recommendations, we need system change to make sure that we have the sort of mental health services that the people of this country deserve.

My hon. Friend speaks with great knowledge and as chairman of the all-party group on mental health. He is absolutely right to say that we need system change. The system change we need is to stop putting mental health in a silo, but instead to understand that it needs to be part of the whole picture of treatment when a person is in hospital or with their GP; it needs to be integrated with people’s physical health needs. We need to look at the whole person. We will not get all the way there in this Parliament, but I think the taskforce gives us a good and healthy ambition for this Parliament and I am confident we will realise it.

I am pleased to hear the Secretary of State acknowledge the importance of quality of care in mental health as well, but of course there are also problems in areas such as learning disability, where there are some highly vulnerable individuals. After the shocking Southern Health exposé, does he really not think that the leadership of that organisation, which presided over some dreadful events and so many unexpected deaths not being investigated, need to be held accountable and to move on?

As the right hon. Gentleman knows, the chair of that organisation has stepped down, but he is absolutely right about accountability. Accountability needs to be about not just individual organisations within the NHS, but the people commissioning mental health care and care for people with learning disabilities. That is why, from July, we will for the first time be publishing Ofsted ratings on the quality of mental health provision and of provision for people with learning disabilities by clinical commissioning groups, so that we can see where the weak areas are and sort them out.

I conclude on quality by saying that important though a seven-day NHS is, we need to go further if we really are to make NHS care the safest and highest quality in the world. According to the respected Hogan and Black analysis, we have 150 avoidable deaths in our NHS every week. That is 3.6% of all hospital deaths with a 50% or more chance that that death could have been avoided. In the United States, Johns Hopkins University said earlier this month that medical error was the third biggest killer after cancer and heart disease, causing 250,000 deaths in the United States alone every year. That is why this year England will become the first country in the world to lead a transparency revolution in which every major hospital will publish its own estimate of its avoidable deaths and its own plans to reduce them. This year, we will focus particularly on reducing maternal deaths, stillbirths and neonatal death and harm, with plans I hope to outline soon to the House.

If we are to do that, perhaps most difficult of all will be transforming a blame culture found in too many parts of the NHS that still makes it far too hard for doctors and nurses to speak openly about medical error. Among other measures, we have set up a new healthcare safety investigation branch to conduct no-blame investigations when we have tragedies. It is modelled on the highly successful air accidents investigation branch. As in the airline industry, our model for reducing avoidable death must be transparency, openness and a learning culture that supports rather than blames front-line professionals, who in the vast majority of cases are only trying to do their best. Part of that new culture of responsibility and accountability must be a return to proper continuity of care, which is why this Government have brought back named GPs for every patient, which had been abolished in 2004, and are introducing lead consultants for people who go to hospital with complex conditions.

In conclusion, for this Government defending the NHS involves higher standards of care, wise use of resources and secure funding from a strong economy. Because the challenges we face in England are the same as in Wales, Scotland and Northern Ireland— indeed, the same as in developed countries all over the world—we should exercise caution in politicising those pressures, or we simply invite scrutiny of the relative performance of the NHS in different parts of the UK, which often shows that those who complain loudest about NHS performance in England are themselves responsible for even worse performance elsewhere.

What this Government want is simple: a safer seven-day service, backed by funding from a strong economy. Already we have delivered more doctors, more nurses, more operations and better care than ever before in NHS history.

I am about to conclude, so I shall finish, if I may.

But with that achievement comes a renewed ambition that our NHS should continue to blaze a trail across the world for the quality and safety of its care, and that is how this Government will continue to defend our biggest and most cherished public service.

I start by thanking the Health Secretary for joining us today. I know that he does not always choose to respond to me when I bring matters to this Chamber, so I am grateful to him for being here. I am conscious that, if the Cabinet deckchairs shift around after the referendum, this may be our last parliamentary exchange. If that turns out to be the case, let me put on record my best wishes for whatever he goes on to do, but may I gently suggest that a future career in resolving employment disputes may not be for him?

The topic of this debate is defending public services, and as the House would expect, I shall focus my remarks on what is happening to our health and care service. Listening to the Health Secretary today, one could be forgiven for thinking that all is well. One would have no idea that hospital finances are at breaking point, waiting lists are approaching a record high, and the NHS is facing a workforce crisis with endemic understaffing and broken morale. Put together, the triple whammy of challenges on the finances, quality of care and the workforce put the NHS in a very precarious position. Let me take each of those challenges in turn.

First, on the finances, the right hon. and learned Member for Rushcliffe (Mr Clarke) called it sterile nonsense, but it is fundamental to whether hospitals and GPs can continue to deliver the care needed for our ageing and growing population. One of the Health Secretary’s favourite soundbites recently has been to claim that the Government are giving the NHS the sixth biggest funding increase in its history. Indeed, he has made that claim six times in this Chamber over recent months, so I was surprised that it did not feature in his speech today. However, I think I may have an explanation for that omission. Last week the King’s Fund and the Health Foundation, two well-respected independent think-tanks, looked into his claim. I have a copy of their analysis, which states:

“We’re afraid to say, although perhaps not surprised . . . that we have a very different figure.”

They go on to say that, rather than being the sixth largest funding increase in NHS history,

“we find that . . . this year it is in fact the 28th largest funding increase since 1975”.

I completely defend the methodology that we used to come up with our figure, but does the hon. Lady not see the irony? She is criticising a £3.8 billion increase in NHS funding this year, when Labour’s own plans at the election last year were for a £2.5 billion increase—£1.3 billion less than this Government have delivered.

I am grateful to the Secretary of State for that intervention. He might want to rake over the last general election but he clearly does not want to talk about the crisis in NHS finances today, with a £2.45 billion deficit among hospitals at the end of this year, cuts to public health spending, and £4.5 billion coming out of the adult social care budget over the past five years. I am quite happy to debate NHS finances with him. The truth is that the NHS is getting a smaller increase this year than it got in every single year of the previous Labour Government.

The King’s Fund and the Health Foundation concluded:

“Getting public spending figures right is important, otherwise they can mislead and detract from the real issues. The fact is that the NHS is halfway through its most austere decade ever, with all NHS services facing huge pressures.”

May I recommend that the hon. Lady read a recently published book by Tom Bower which shows the utter failure of the Blair Government, who pumped billions of pounds into the NHS over a period of years but had no control over it and made no attempt to increase productivity, so that from 1998 performance flatlined for six years, and the then Health Secretary was forced to bring back health policies that they had abandoned in ’97?

I am grateful for the reading advice from the right hon. Gentleman, but I simply say this: I am very happy to defend the record of the previous Labour Government, who trebled the NHS budget and had the highest-ever public satisfaction ratings and the lowest-ever waiting lists.

We should be crystal clear about the crisis that we face today. The decade from 2010 to 2020 is set to be marked by the biggest sustained funding squeeze on the NHS ever. As a percentage of GDP, spending on health is set to fall from 6.3% in 2009-10 to just 5.4% by the end of the decade.

People who are listening to this debate will want some clarification. Is the hon. Lady denying the fact that if Labour were in government it would not have increased NHS spending in the way that this Government have done? I think she needs to be clear on that point.

We were very clear at the last election that we would have had an emergency Budget to put every penny that the NHS needs into its funding.

I was talking about the reduction of NHS spending as a proportion of GDP. In terms of real funding, the House of Commons Library has shown that, if spending as a percentage of GDP had been maintained at Labour levels, by 2020, £20 billion more would be being spent on the NHS each year. That demonstrates the scale of underfunding that we have already seen and just how tough the coming years are going to be. That is not to mention the deep cuts to adult social care, which have piled the pressure on to hospitals, and the £22 billion-worth of so-called efficiency savings that this Government have signed up to. I have yet to meet anyone who works in the NHS who thinks that efficiencies on this scale are possible without harming patient care.

I do not disagree with the hon. Lady that there are big pressures on the horizon, but can she say how much, beyond Simon Stevens’ predicted costs, her party is now pledged to spend on the national health service, because so far all we have heard is prevarication?

I am not going to be drawn into giving figures here at the Dispatch Box today. Yesterday the Life Sciences Minister was tweeting that we need a big public debate about funding of the NHS.

Three days ago, the scale of this crisis was laid bare. NHS Improvement, the body responsible for overseeing hospitals, published figures showing that NHS trusts ended 2015-16 with a record £2.45 billion deficit—I repeat, £2.45 billion. To give hon. Members some context, that is treble the deficit from last year. What is the key cause? It is the spiralling agency spend because of staff shortages. When this Government talk about more money going in, let us remember that, before that money gets to the frontline, the bulk of it will be spent on paying off the bills from last year.

Will the hon. Lady give us an idea of how much extra money and how many more personnel she thinks we need to deal with current levels of migration?

I am grateful to the right hon. Gentleman for that intervention. I actually think that the health service benefits more from migrants than the amount migrants cost it.

I want to tell all Conservative Members that Labour Members are not going to take any lessons about NHS spending from the party that has created the biggest black hole in NHS finances in history. It has got so bad that the Health Secretary cannot even guarantee his Department will not blow its budget. It is chaos: Ministers blame hospital bosses, hospital bosses blame Ministers and all the while patients are paying the price.

Faced with this crisis, we might have thought that the NHS would get more than a passing reference in the Queen’s Speech, but that was not the case. What is the Government’s answer when it comes to the NHS? Fear not: they will introduce a Bill to crack down on health tourism. With all the problems the NHS is facing, this Government want to focus Parliament’s time on debating a Bill that risks turning NHS staff into border guards.

Let me be clear: if such measures are about getting the taxpayer a better deal and ensuring fairness in the system, we will not oppose them. However, I must ask, given everything that is happening in the NHS right now, whether Ministers’ No. 1 priority is really to introduce legislation to charge migrants and their children for going to A&E. If so, my fear is that we will see the kind of dog-whistle politics that was so rejected by the people of London earlier this month, and which I hope will be rejected again on 23 June. The truth is that the cash crisis in the NHS is not the fault of migrants; it is the fault of Ministers.

I genuinely believe and have no doubt that the hon. Lady is committed to the NHS and I share her desire for a wider public debate, but does she agree that, to have a meaningful debate and to add value to her critique, she needs to set out what she sees as the financial requirements of the NHS, otherwise such a debate will not be very helpful?

I am grateful to the hon. Gentleman for his intervention, but he will just have to watch this space.

As I was saying, the truth is that the cash crisis in the NHS is the fault not of migrants, but of Ministers. Cuts to nurse training places during the last Parliament have created workforce shortages and led to a reliance on expensive agency staff. Cuts to social care have left older people without the help and support they need to remain independent at home, putting huge pressure on NHS services. The underfunding of GPs has left too many people unable to get timely appointments, which means they are often left with nowhere to turn but A&E. The financial crisis is a massive headache for NHS accountants, but we all know it can mean life or death for patients. Waiting time targets, which exist to ensure swift access to care, have been missed so often that failure has become the norm.

The hon. Lady is making a very political attack. In that context, would she care to explain why the performance for accident and emergency admission is far worse in Labour-run Wales than it is in England?

I would have thought better of the hon. Gentleman, but it is clear Conservative Members want to talk about anything other than their record in England. A&E performance is currently the worst since records began, taking us back to the bad old days of the 1980s, when patients were left waiting on trolleys in hospital corridors. The figures speak for themselves.

May I ask the hon. Lady to consider again what my hon. Friend the Member for Cheltenham (Alex Chalk) said? If A&E performance is the fault of Conservative politicians in England, is it not also the fault of Labour politicians in Wales, where it is 11% worse?

From memory, I seem to think the budget going to the NHS in Wales has been cut in Westminster.

Let us have a look at the figures. In March 2011—[Interruption.] The Health Secretary would do well to listen to these figures, because I am about to tell him the record of his term in office. In March 2011, 8,602 patients waited more than four hours on trolleys because no beds were available. Four years later, the figure was up sixfold, to 53,641. In March 2011, just one patient had to wait longer than 12 hours on a trolley. Four years later, 350 patients suffered that experience. The NHS waiting list now stands at almost 3.7 million people—the equivalent of one in every 15 people in England. Only 67% of ambulance call-outs to the most serious life-threatening cases are being responded to within eight minutes.

I could reel off more statistics, but I will instead read a letter that I received the other week:

“Dear Ms Alexander,

I recently had the misfortune of using the A&E at my local hospital in Margate. My wife feels that I was lucky to escape with my life.

My experience has convinced me that our health service has never been more under threat than since Mrs Thatcher.

The fact that I was sent home after 4 hours without seeing a doctor and returned by emergency ambulance with a now perforated appendix I blame mostly on the conflict between the Health Secretary and the Junior Doctors. Had this been resolved he would have been able to concentrate on the woeful lack of resources our NHS faces.”

Take the experience—[Interruption.] The Parliamentary Private Secretary to the Health Secretary says, “Show us the letter”. I have it here, and I got the permission of the individual who wrote to me before referring to it.

Let me refer to another example—the experience of Mr Steven Blanchard at the Swindon Great Western hospital last November. He said in an open letter to the Swindon Advertiser:

“We arrived at 6.40pm and were asked to sit with about 15 others in the unit. It became apparent this was a place of great suffering and misery…Firstly, there was a lady who was doubled up in pain who had been promised painkillers three hours before and I witnessed her mother go again and again to reception until she was begging for pain relief for her near hysterical daughter.”

Another old lady

“who had been left on her own by her son…was sat picking at a cannula in her arm trying to pull it out…A very frail and sick old man was sat in a wheelchair and he had been in the unit since 8am. He kept saying over and over ‘a cup of tea would be nice’…then I watched as urine trailed from him and fell on to the floor beneath the chair…At 10.30pm he was taken to a ward after 14 hours.”

Mr Blanchard said that he and his partner were finally seen at 1.20 am, and stated:

“Never before have I seen people crying out of desperation…I don’t know what is to blame or whether it’s lack of money or lack of staff but this place was what I can only describe as ‘hell on earth’.”

That is what is happening in our NHS in 2016, and such stories are becoming more common. Ministers may not like to hear it, but they need to start taking responsibility.

There are always pressures in the giant national health service as demand grows and expectations rise, and there always will be. The hon. Lady could have made this speech as an Opposition spokesman 10, 20, 30 or 40 years ago. After 20 minutes, she has not yet suggested a solitary policy proposal as an alternative to the Secretary of State’s, and she has not said whether she agrees with him about seven-day working and all the rest of it. She is describing sad incidents in which things have obviously not been ideal or as they should be, but does she have anything to suggest by way of policy that may contribute to helping the NHS in future?

Having had these exchanges over the Dispatch Box for the past nine months, it strikes me that the reality of what people are experiencing in hospitals is sometimes missing from these debates, and that is why I thought it important to quote from those letters.

On workforce challenges, nothing sums up this Government’s failure on the NHS more than the way that they have treated NHS staff. We have had pay freezes, cuts to training places, and the first all-out doctors strike in 40 years—a strike that the Health Secretary did not even try to prevent; in fact he provoked it. He has spoken about seven-day services, but he said little about how he proposes to improve weekend care without the extra resources and staff that the NHS will need. We can only assume that his plan is to spread existing resources more thinly, asking staff to do even more and putting patients at risk during the week.

The Health Secretary also failed to say what experts think about his approach. For example, Professor Sir Bruce Keogh said that the NHS was making good progress towards improving weekend care, but that that became “derailed” when the Health Secretary started linking seven-day services to junior doctors. Fiona Godlee, editor of The British Medical Journal, said that, by picking a fight with doctors, the Health Secretary has set back NHS England’s established programme of work on improving services at weekends. Not only does he have no plan to deliver a seven-day NHS, but he has ripped up the plan that was already in place to improve weekend care. You couldn’t make it up, Mr Speaker.

The Health Secretary often reads out his usual list of stats on staff numbers, but to know what is really happening we must look beyond the spin. A recent survey of nurses by Unison found that almost two-thirds believe that staffing levels have got worse in the past year, and 63% said that they felt there were inadequate numbers of staff on the wards to ensure safe and dignified care—that figure was up from 45% the year before. Whether GPs, nurses or midwives, numbers of staff have not kept pace with demand.

Analysis by the House of Commons Library shows that, in the Labour Government’s last year in office, there were 70 GPs per 100,000 of the population, but that figure has now fallen to just 66. In Labour’s last year, there were 679 nurses per 100,000 of the population, but there are now just 665. No wonder that doctors and nurses feel pushed to breaking point. If we do not look after the workforce, patients will suffer. There was nothing in the Queen’s Speech to help the workforce—no U-turn on scrapping NHS bursaries, no plan to train the staff the NHS so desperately needs, and no plan to improve working conditions.

My hon. Friend’s point about the workforce is important. Does she share my concern about those attacks on doctors and nurses, and the undermining of numbers? If we break the doctors we will in turn break the NHS, and it is a lot easier to get public support to privatise a broken NHS, than an NHS that is well, healthy and working as it should.

My hon. Friend makes a good point, and motivated staff are essential to providing high-quality care.

Under the last Labour Government, new medical schools were set up—including Hull York medical school—to train the additional doctors that we knew the NHS needed. The Queen’s Speech is a missed opportunity because there is no announcement about increasing capacity in those new medical schools that Labour brought in.

My hon. Friend is, as always, entirely right.

The Government have run out of answers and they have run out of people to blame. Whichever way we look at it—funding, quality of care or staffing—theirs is a record of failure. That will be the Health Secretary’s legacy. He rightly said “Never again” to Mid Staffs, but his time in office has been marked by tragedy and failure at Southern Health. He talks about patient safety, but his actions have made the NHS less safe.

The Government have failed patients and staff. They have proved the old saying true: we simply cannot trust the Tories with the NHS.

I welcome the legislative programme that the Government have set out in the Queen’s Speech, particularly on improving life chances for disadvantaged people, which is in the very best traditions of one nation Conservatives.

In opening the debate, my right hon. Friend the Secretary of State demonstrated his strategic vision and his clear personal commitment to improving life chances through the NHS. We owe him a debt of gratitude for the work he is doing in that respect, and for his work on ensuring that the NHS is fit for the future. There has been a great deal of discussion about NHS budgets—perhaps there was a lack of clarity from the Labour Front Benchers on their budgets—but, as my right hon. and learned Friend the Member for Rushcliffe (Mr Clarke) said, we need to talk not only about the budget, but how we use that money. That is the point I will focus on in my contribution.

In this Session, whether through legislation or other ministerial action, we need to ensure that we have a nimble, agile and responsive NHS for the future. We need public services that respond to people’s needs as they change. People’s lives are changing: we are living and working longer, and we have growing communities with more housing. The NHS, not simply Ministers, needs to respond to those changes to reflect our changing community needs.

The NHS cannot afford to lag behind its users—its patients—in its thinking. That is why I believe that, more than ever, the Government need in this Session to ensure that there is more devolution to local government to join together NHS spending and social care spending, which will help to make sure that our money goes further in future.

Sir Bruce Keogh, medical director of the NHS, has set out a compelling vision for the NHS in this changed world. People with non-life threatening needs should have access to care as close to home as possible, and people with life-threatening conditions should be treated in centres with the very best 24/7 consultant-led care. That is safer and better for patients.

Like many constituencies throughout the south-east, my community has grown not only in recent years, but throughout the recession. We need the Secretary of State to press for a nimble NHS that can respond to the changes in our community, and hopefully plan for the future. We need clinical commissioning groups to work to ensure that new doctors’ surgeries are delivered where there are new houses, and that hospitals deliver the very best every day of the week.

In my constituency, we are truly fortunate to have clinicians who are already ahead of that thinking. The Hampshire Hospitals NHS Foundation Trust already has fully funded plans, a site with planning permission and support across the community to establish a 24/7 critical treatment hospital, bringing together emergency care for the sickest patients in one site, leaving those requiring walk-in A&E, planned surgery and out-patient care to our local hospitals in Andover, Winchester and Basingstoke.

That approach has been developed by clinicians to keep services safe and sustainable, and I urge the Secretary of State to ensure that we listen to clinicians carefully. They often see the needs of the NHS changing before others do, and we need to ensure that those changes are put in place. The NHS investigation unit is looking at how we deal with delays at A&E, because the changes proposed by clinicians have not been brought forward in a timely manner. We are now awaiting a new models of care programme, and sustainability and transformation plan. In the meantime, my constituents regularly face more than four-hour waits in A&E, which I hope will come to an end when the long-awaited centralised critical treatment hospital is brought to fruition—after four years of planning and discussion.

Within the NHS programme for the future, we need to find ways to respond to the needs of other groups of people. The first Women and Equalities Committee report brought the needs of transgender people to the fore. It was clear from the evidence we received that access to primary and specialist care for this group of people was far from routine and, in some cases, quite shocking—another example of the need for the NHS to respond carefully to the needs of communities. I do not underestimate the challenges GPs face in our communities, but we need to ensure that they are tasked with, and deliver on, treatment and care plans for every group of people and do not leave minority groups out.

We live in a country with a proud tradition of fairness and some of the most comprehensive legislation in the world to protect disadvantaged people—the theme of the Queen’s Speech. Too often, however, legislation does not create the change in the delivery of public services that we in this House would perhaps like to see. I hope the Government will use every Bill in this parliamentary Session to challenge themselves on whether there is more that can be done to support disadvantaged people: whether, in the modern transport Bill, the Government could consider how disabled and older people can benefit from important developments in transportation; whether, in the local growth and jobs Bill, the Government could look more closely at the three quarters of pregnant women and new mums who suffer negative or discriminatory experiences at work, and bring forward measures to help to address this problem more speedily to unlock this important pool of labour for the future; and whether, in the education for all Bill, the Ministers responsible could look carefully at the House of Lords Select Committee paper on the achievements of disabled children in schools. Despite a great deal of work in recent years, we still need to be better at unlocking the educational achievement of disabled children. At the moment just 18% of children with special educational needs achieve good development, compared with 65% without.

The prison reform Bill will of course be pivotal in supporting disadvantaged people. I am sure there will be a great deal of debate on that today, but I would like very briefly to touch on the importance, in relation to the Bill of Rights, of the need to ensure that we really do tackle the disadvantage that people face. I refer again to the need to address the rights of transgender and non-gendered people. They suffer great disadvantage in our society. If we are to have a Bill of Rights, we need to tackle this issue head on.

Before I close, I want to touch on something very close to my heart from when I was a Minister: superfast broadband. I was delighted to see the Government propose a Bill to ensure that superfast broadband is seen as the essential utility that it is. I am sure the Health Secretary will have responded to this with great joy too, given his previous role as Culture Secretary.

The experience of my local authority means that I will be looking very carefully at the detail of the Bill. My local authority in Basingstoke has long seen superfast broadband as essential infrastructure, but when trying to make it happen, in terms of planning conditions for building, it has been blocked pretty firmly by the local planning inspector. Basingstoke and Deane Borough Council and Hampshire County Council have looked long and hard at how they might make progress on this. I am sure they will welcome, as I do, the measures in the Queen’s Speech. Indeed, they have asked the Government for superfast broadband to be a material planning consideration. I hope the Minister will clarify that superfast broadband will be a material planning consideration and indicate when that will come into force. My local community, like those of many other Members, has seen a rapid increase in the rate of house building, and we need to know when this might come into play.

Coventry has also experienced problems with BT’s delivery of broadband. That is one of the big problems. I know that Ministers have been looking at this, but we need urgent action. BT is a big problem in this regard.

The hon. Gentleman makes a point that many Members have made, but I am making a very different point—about ensuring that local authorities can make superfast broadband an essential prerequisite for new house building. No one can build a house in this country without water, electricity and the many other utilities we have come to rely on. Superfast broadband has fast become a basic utility of life, and that is how it needs to be viewed; I am sure that other Members will mention the performance of those who put the service into place.

The Government have a powerful opportunity to continue on their mission to improve life chances for disadvantaged people, not only in the obvious Bills, such as the one on prison reform, but in every single Bill on their agenda. I urge Ministers to consider carefully how they can bring that into play. While we might have some of the best equalities legislation in the world, when it comes to putting it into practice, we sometimes fall short. We need to admit that and up our game.

It is a pleasure to follow the right hon. Member for Basingstoke (Mrs Miller).

I hope the House will forgive me if I reflect on an historic event that took place in Scotland this weekend. For the first time in 114 years, the Scottish cup returned to Leith, in Edinburgh, when Hibernian won the cup final. For many years those of us who are fans of Hibernian have been used to taunts that the last time the cup came back to Easter Road, Buffalo Bill was in town and Queen Victoria was on the throne. At least those taunts are over. The hurt of losing 10 cup finals—of traipsing to Hampden to face defeat after defeat—is over. A fine game, between two teams entertaining the fans, took place in Scotland on Saturday, and I am delighted that the people of Edinburgh and Leith can celebrate a cup victory at long last.

There is little to be welcomed in the Queen’s Speech. It was a missed opportunity for progressive action on pensions, social security and the economy. The UK Government are caught in a civil war over Europe and have delivered a Queen’s Speech with a poverty of ambition. The Tory party is at war with itself and failing miserably in its war on poverty, which the Prime Minister talked about at the conference last year. We are seeing not a war on poverty but a war in the Conservative party.

One could perhaps compare the Conservative party’s disagreement over Europe to two men fighting over one woman. Is it possible that after such a catastrophe everyone can come back together as friends?

I am saddened at the depths to which the hon. Gentleman stoops. I am delighted to have friends and colleagues representing my party here and in government in Edinburgh, and they will continue to have our full support.

The Queen’s Speech demonstrates that the Tories are a threat to high-quality, well-funded public services. Having listened to the Leader of the Opposition last week on the Queen’s Speech, we are none the wiser as to what the Labour party is offering. We could have asked him, of course, had he been taking interventions, rather than forcing us to sit and listen to a monologue that lost the attention of his own party, never mind that of the House.

Some measures are to be welcomed, such as the likely delivery of the universal service obligation on broadband, as mentioned by the right hon. Member for Basingstoke, but the Queen’s Speech delivers nothing on pension reform for the WASPI women, on tax simplification or on social security, and no major action on the economy to boost exports and productivity.

The Conservatives have orchestrated some truly devastating cuts that have destroyed the safety net that social security should provide. We see through their rhetoric on life chances. The scrapping of legal commitments to tackle child poverty, the four-year freeze on working-age benefits, including child tax credit, working tax credit and jobseeker’s allowance, will see families losing up to 12% of the real value of their benefits and tax credits by 2020. We have seen the butchering of the very aspect of universal credit that might have created work incentives and the hammering of low-paid workers, to name just a few of the regressive cuts that will decrease the life chances of children across these islands.

Why do the SNP Government not put up taxes in Scotland if they feel that they need to spend more money?

One of the things we want to do in Scotland is to deliver economic prosperity and a fairer society. We want to invest in our economy in order to grow the economy. Let me remind the right hon. Gentleman that we fought the general election in Scotland on a progressive manifesto that would have seen us investing over the lifetime of this Parliament, throughout the UK, £140 billion by increasing Government spending by 0.5%—investing in innovation and in our productive potential with a view to delivering confidence and growth in the economy. This was a sensible programme that would still have seen both the debt and the deficit reduced. It was a sensible way of dealing with the problems we face both in Scotland and in the rest of the UK.

It does not matter how many times the Government use the soundbite of “life chances” because in reality the so-called assault on poverty is a crusade to refine what poverty is and a shift towards blaming individuals rather than the Government, so that their austerity agenda can continue to attack the most disadvantaged in our society.

Does my hon. Friend agree that all the rhetoric about the life chances strategy is incompatible with the austerity agenda that is all about balancing the books on the backs of the poor?

My hon. Friend is correct: we need to invest in our children and in our productive potential, giving life chances through opportunities, which are badly missing from this Government’s approach.

Imran Hussain, the director of policy for the Child Poverty Action Group, said:

“There is a disconnect between what the government is doing and saying. You can’t spread life chances when child poverty is expected to rise steeply.”

He said that there was

“very little evidence about poverty being caused by addictions or family breakdown”.

Recent Office for National Statistics figures show the true scale of poverty in the UK, with almost a third of the population experiencing poverty at least once between 2011 and 2014. The Institute for Fiscal Studies analysis of February 2016 found that absolute child poverty is expected to increase from 15.1% in 2015-16 to 18.3% in 2020-21. We do not want lectures from the Conservatives on improving life chances; all the evidence shows that exactly the opposite is happening.

What would it take for the Conservatives to wake up to the reality that increased child poverty is a direct consequence of their austerity agenda? Their attempt to disguise cuts with this life chances agenda is transparent. If the Government want to lift children out of poverty and give them an equal start in life, they must reverse their punitive cuts and be more ambitious about tackling in-work poverty.

The hon. Gentleman is making a powerful case against austerity, with which I agree, but the SNP Holyrood Administration in Edinburgh is forcing £130 million of cuts on Glasgow City Council, which covers one of the poorest areas in the country. How does that measure up with what he has been saying?

One of the things we have done since being in government in Edinburgh since 2007 is to protect local government. What we face is the consequence of the cuts that have come from Westminster. I am delighted that an SNP Government have, through the council tax freeze, saved individuals in a typical band D house £1,500—protecting the individuals, while at the same time protecting the budgets of councils. That is what the SNP Government have done in Edinburgh.

In Scotland, the SNP Government have protected public services, despite the cuts to the Scottish budget. With cuts to Scottish public services handed down from the Chancellor of the Exchequer, lacking in compassion and empathy, the poorest and the weakest in our society are paying the price for Tory austerity.

The SNP has put forward a credible, progressive alternative to the Queen’s Speech, proving once again that it is the only real opposition to the Government in the House of Commons. [Interruption.] In our dreams? Well, let us see what the Labour party is offering. We got nothing from the Leader of the Opposition last week, and we certainly got nothing from the Labour Front Bench. It is little wonder that Labour has fallen in the polls, and fallen to become the third party in Scotland. That is the reality: no hope, no vision, and no agenda from today’s Labour party.

Although the debate could be characterised as focusing specifically on defending public services, to my mind, and those of my colleagues, it should be seen in a much wider context. The SNP has published its own Queen’s Speech, which offers hope to the people of Scotland. It says that we should aspire to do better, and that we need to create the circumstances that will allow us to deliver sustainable economic growth, thus enhancing life chances for all, while at the same time recognising the necessity of investing in and enhancing our vital public services.

Our manifesto, like our Queen’s Speech, recognised the necessity of driving down debt and the deficit, but we would not do that on the backs of the poor and at the cost of our public services. We recognise not only that austerity is a political choice, but that its implementation is, in itself, holding back not just growth in the economy, but the potential of so many people throughout the United Kingdom. Cuts in public services withdraw spending from the economy, and that undermines our moral responsibility to deliver public services that support people and give them opportunities to return to work, as well as the vital support network that allows communities to function effectively.

The attacks on services for the disabled, women and young people are a result of the Government’s programme, which holds people back from making a full contribution to society. What we in the SNP have, by contrast, is a strategy that will enhance life chances for people in Scotland and throughout the United Kingdom. It is a progressive agenda, which recognises the responsibility of Governments to show leadership in creating the architecture that will deliver sustainable economic growth. That means investing for growth, delivering stronger public services, driving up tax receipts, and cutting the deficit. Our strategy is an appropriate response to the circumstances in which we find ourselves, but it also acknowledges the circumstances in which many Governments in the western world find themselves.

We in the SNP are ambitious for Scotland. That can, perhaps, best be evidenced by the programme of Nicola Sturgeon’s Government. That programme will tackle the attainment gap, while also focusing clearly on using what powers we have to influence innovation, recognising that there is a twin track: tackling attainment must go hand in hand with improving skills, enhancing capability, and creating competitive opportunities in the global marketplace.

We have focused specifically on export capabilities in key sectors. The manufacture of food and drink continues to be our top export sector, accounting for £4.8 billion in revenues. The value of our food and beverage exports, excluding whisky, rose from £755 million in 2013 to £815 million in 2014, an increase of 8%. In 2014, Scotch whisky exports reached £3.95 billion, accounting for 21% of the food and drink exports of the whole United Kingdom. Scotland has shown the way in increasing its export capability, and driving investment and jobs into our economy. That plays to our key strengths, and our reputation as a provider of high-quality food and drink. It is also based on segments of the market that offer long-term growth opportunities.

We need to tackle the relative decline of manufacturing in our overall economy that hampers our ability to meet the challenge of delivering prosperity. Growth sectors in the economy, such as biotechnology, can deliver opportunities for jobs and growth. We need a strategy which focuses on manufacturing growth that outstrips the service sector in terms of value added to our economy. That is not to downplay the desire to achieve growth in services, but to recognise that we have an imbalance in our economy that hampers our ability to maximise opportunities for all our people.

We cannot decouple a debate about defending public services from the wider economic agenda, because they are so completely intertwined. We need a well educated, healthy population who can rely not only on our education and health services but on our ability to deliver effective childcare, for example. When Conservative Members talk about small government, they reject the vital role of the state in providing much of the support that allows all of us to achieve our potential.

This Queen’s Speech is a missed opportunity to deliver a programme that could offer so much more to those who aspire to a healthier, wealthier and fairer society. We need to tackle inequality, to improve living standards for ordinary workers, to create a fairer society and to strike an effective balance between prosperity and investment in the public services that underpin a successful society. Today, we are moving away from that.

There is an increasing disparity between executive pay and rates of pay in the mainstream, leading to increased calls for action by shareholders and ultimately to stronger action if moderation cannot be achieved. With wage growth outpacing productivity growth, there are legitimate concerns about the sustainability of real wage growth and, as a consequence, taxation receipts and the ability of the Government to meet their targets, with all that that would entail for the public finances and, no doubt, for investment in our public services.

In short, to secure our public services, we need to tackle the shortcomings of the Government’s economic strategy. Of course we would invest for growth and create opportunities for investment by the private and public sectors, resulting in greater confidence and growth outcomes. Confidence and growth, on the back of modest investment in our public sector, would see the debt and deficit come down, by contrast with policies driven by this Government’s ideological desire to achieve a budget surplus at any cost. The logic behind that desire to achieve a budget surplus almost irrespective of economic circumstances beggars belief. If the Chancellor misses his growth forecasts, as has been the case on numerous occasions, his office can make the strategy work only through tax rises or, more predictably, cuts to public spending.

The trouble with this strategy is that we are now six years into it and it is not working. The squeeze on public spending is hurting and damaging services. Those of us who are old enough to remember the Thatcher Government elected in 1979 will recall the line from the Government that “if it’s not hurting, it’s not working”. Patently, it is hurting and it is not working—[Interruption.] It might have been John Major, but it is the same old Tories. The strategy is harming the life chances of people in Scotland and the rest of the UK.

Let me return to the Queen’s Speech and the future of the NHS. We strongly disagree with the UK Government’s moves to charge visitors to this country to use the NHS. NHS Scotland will not charge overseas visitors if they need to visit A&E or a casualty department if it involves a sexually transmitted disease or HIV or if they are sectioned under the Mental Health Act. That is the right thing for anyone to do in a civilised society.

Does the hon. Gentleman not understand that the Government are not proposing to charge for emergency treatment in A&E? Surely it is right, however, that if someone comes here and has elective surgery, they should pay the bill and get the money back from their own country.

In many cases, we are talking about the Government wanting to charge people who have come here to work and who are already paying their taxes. What a disgraceful way for any Government to behave! That measure is the latest indication that the Tories represent a real and present danger to the NHS.

The Conservatives have mismanaged the junior doctors’ contracts in England and shamefully filibustered the recent debate on a Bill introduced by the hon. Member for Brighton, Pavilion (Caroline Lucas) that would have restated the principle of the NHS being public and free. In the Scottish election, the Scottish Tory leader, Ruth Davidson, stood on a platform of reintroducing prescription charges. Such a measure would be a regressive tax on the ill. It is estimated that the SNP’s abolition of prescription charges has benefited around 600,000 adults living in families with an annual income of less than £16,000.

In England, the Health Secretary—who is no longer in his place—seems to favour confrontation with the health service, but we in Scotland favour a more consensual approach that delivers results. The SNP Scottish Government have delivered record funding for Scotland’s NHS despite Westminster cutting the Scottish budget. They will ensure that the NHS revenue budget rises by £500 million more than inflation by the end of this Parliament, meaning that it will have increased by some £2 billion in total. Health spending in Scotland is already at a record level of £12.4 billion. Under the SNP, the number of employees in the Scottish NHS is at a record high—up by nearly 9% since 2006.

Patient satisfaction with the NHS in Scotland is high, with 86% of people being fairly or very satisfied with local health services, which is up five percentage points under the SNP. That is the result of a popular SNP Government working together with our health professionals to deliver results. Unlike the UK Government, the SNP values and respects the work of all our medical professionals. Were we to move towards a new contract for junior doctors in Scotland, it would only ever be done on the basis of an agreed negotiated settlement. Thank goodness that we are still wedded to the principles of Beveridge in Scotland and will protect the ethos of the health service as a public asset for the common good.

Turning to further and higher education, one of our driving principles is that access should be based on ability, not ability to pay. Tuition fees of £9,000 and potentially more remain a heavy burden on the working families and students of England, and the UK Government must rule out the Higher Education and Research Bill raising the cap. The SNP has guaranteed free university education for all in Scotland, but Ruth Davidson and the Tories would have tuition fees north of the border if they ever got near Bute House.

Will the hon. Gentleman confirm that the SNP secured free higher education by butchering the further education budget, affecting some of the poorest in the community and those who need FE’s assistance most?

No, I will not, because that is not true. Full-time places at Scottish colleges have increased, and I will return to that point.

Ruth Davidson would want to introduce tuition fees in Scotland by the back door. Down here, the Tories are all for front-door fees. In Scotland, the Tories are all about back-door fees. The doors are locked to many who want to participate in education unless they can pay the price. Front door or back door, with the Tories there is always a price to pay. Young people from the most deprived areas in Scotland are now more likely to participate in higher education by the age of 30 since the SNP came to power—up from 35% of young people in 2007-08 to 41% in 2014-15—which is the result of the SNP’s successful education programme. The number of qualifiers from the most deprived areas increased by over 2,300 from 8,035 in 2007-08 to 10,395 in 2014-15.

Overall, since the SNP came to power in Scotland, the number of Scottish-domiciled, first-degree students going to university has risen by 11%. Last year saw a record number of Scots accepted to universities across the UK. That is a record to be proud of. Rather than carping from the sidelines, the Labour party should perhaps get behind what the SNP has delivered in Scotland for the people of our country.

The Scottish Funding Council has invested more than £76 million in additional widening access and articulation places over the past three years and continues to fund a wide range of other initiatives to support access. We will ensure that those who have a care experience and who meet minimum entry requirements will be guaranteed the offer of a university place and a non-repayable bursary of £7,625. In Scotland, we recognise that access based on ability, investing in our human capital, is the right thing to do. That is a non-negotiable principle. It is price worth paying for our children and our future. As my right hon. Friend the Member for Gordon (Alex Salmond) said some time ago:

“The rocks will melt with the sun before”

the SNP imposes tuition fees on Scotland’s students.

There is little good news for young people. Whether someone is young and looking to start a journey towards eventual retirement or is nearing retirement, there is much to fear from this Government. Given the injustices for many women, the UK residents living in many overseas countries suffering from frozen pensions, or the constant tinkering with pensions that undermines saving, there is little for which to commend this Government. The Government are playing a risky game on pensions; the new lifetime ISA muddies the waters in an already complex area. ISA savings from taxed income undercut the pension saving from pre-tax income—in other words, the Chancellor has found a convenient tool to increase tax receipts today, but that is not necessarily good news for individual savers. According to the Association of British Insurers, presented with a choice, no employee will be better off saving into a lifetime ISA than a workplace pension because of the loss of employer contributions. ABI calculations indicate that the long-term cost of forgoing employer contributions would be substantial—for a basic-rate taxpayer, the impact would be savings of roughly one third less by the age of 60.

The hon. Gentleman is making an important point, but does he not accept that one benefit of people saving for their retirement through an ISA is that it gives considerably more flexibility? As we go on our life journey, there are often times when we may want to draw down some of that money—for example, for a deposit to buy a house. Does he not see this as being about consumer choice? There is probably room for both of these things, although it is extremely important that we protect the existing pensions system as well.

This is a vastly important issue, and I genuinely want to work with the Government on it. All of us in this place have a collective responsibility to get pensions right. I will accept that there is a shared concern across the House, with a recognition that pension saving is not at a sustainable level in this country. My problem with the lifetime ISA proposal is that it undermines what should be the best route for all, which should be saving through the new auto-enrolment, with the incentives that are there. Of course, that will be discussed when the plans are presented to Parliament, but I say to the Government that they should be very careful with what they are doing, because we all share the ambition to get this right. I make the offer to the Government that we are prepared to work together to make sure that we get the best mechanisms to increase pension savings in this country.

Pension saving is at a crisis point, and no amount of regulation will right that problem—[Interruption.] I can hear some guffawing; I will try to wrap up my remarks, but I have been very generous in taking interventions from across the Floor. We need a fundamental overhaul of the pensions system. The Tories need to be more ambitious on pension reform and find real solutions that incentivise pension saving. The SNP has long called for the establishment of an independent pension commission to look holistically at pension reform, focusing on existing inequalities and paving the way forward for a fair, universal pensions system.

We must also prioritise fraud and scam prevention. Kate Smith, head of pensions at Aegon UK, commented that fraud and scams that pensioners are vulnerable to should really have been tackled in the pensions Bill. She said:

“I’m extremely disappointed that the government has failed to use the Queens Speech as an opportunity to tackle the ever-growing threat of pensions fraud via legalisation.

We still need to look at ways for the industry, regulators and pension industry to work together to raise the profile of pensions fraud to stamp it out and protect savers.”

I am going to wrap up my remarks, Madam Deputy Speaker, but let me just say that nearly 1 million people aged over 75 live in poverty and need more help from the Government, according to a report by City University London and Independent Age. It also suggests that the income of those aged over 75 is, on average, £3,000 a year less than that of younger pensioners. Those figures suggest the vital need for a sustainable income in retirement to be available for our older generation, and the Government must do more now to address that. There is so much that needs to be addressed to give confidence to savers and pensioners.

Our alternative Queen’s Speech proposed a universal pensions Bill to support a more progressive pensions system. Such a Bill would establish an independent pensions commission to investigate the inequalities in current and future proposed pension policies; fund transitional arrangements for WASPI women affected by the rapid pace of increases in the state pension age; and allow for further development of access to automatic enrolment and further options to incentivise pension saving. The complexity of the pension system is a real turn-off for savers, preventing them from shopping around or making sound savings choices. Just last week, the Bank of England’s chief economist, Andy Haldane, said that the British pension system was so complicated that even he failed to understand it, and he warned of the damaging consequences that that presents for consumers as they approach retirement. Conversations with countless experts and independent financial advisers have confirmed for me only one thing: they have no clue either.

That comment about having no clue could equally be made about the Government in the Queen’s Speech. We have outlined an SNP alternative, delivering a message of hope and vision for the people of Scotland. It is not too late for the Tories to open their ears and, indeed, their minds to a different direction. If the Government seriously want to increase the life chances of our children, they must return to the drawing board on social security cuts and admit that they have got it wrong, as they have done on the economy. Instead of the promised assault on poverty, we have been left with a Government plan that has a poverty of ambition. There is a different way, and I appeal to the Government to make the right political choice and abandon austerity.

The Queen’s Speech contains an important measure, the Bill of Rights, but we are told that we need to wait and get it correct. I have no problem with that. If there is to be a Bill of Rights, it needs to reflect the liberties and freedoms that have been hard won over many centuries by people and Parliaments in our country.

I welcome the principle behind the Bill of Rights—the simple principle that our ancient and modern liberties should rest on the decisions of this Parliament, to be upheld by MPs, as custodians of those liberties, or to be amended and improved as the British people see fit and as they express their will through general elections. It is extremely difficult to root our liberties and freedoms in inflexible international treaties, or to rely on the judgments of far-away foreign judges, who may not understand the mood, the temper, the history or the culture of our country, rooted in liberty and rooted in a titanic struggle to establish parliamentary control.

There is one obvious omission in the Queen’s Speech, for the reason that we do not yet know the will of the British people on the fundamental issue that overhangs the debates that we will have today and over the next few weeks. Do the British people wish to take back control? Do they wish this Parliament to find within itself the wit, the wisdom and the skill to wrestle back control of our laws, our taxes and our decision-making powers so that we can be freer, more prosperous, more independent and more democratic; or do they not wish us to do that? I earnestly hope that they will want to be on the side of freedom and liberty.

At the moment, we are but a puppet Parliament—a Parliament that struts upon the stage and pretends to be in charge and in control, but is not in charge or in control. Let us take the mighty issue of paying for our public services, which is at the heart of this debate. I am on the side of prosperity, not austerity. I think that we do need to spend more on health and education, and I welcome the extra money that the Government have managed to find. But how much easier it would be if the £7 billion of revenue that we collected from big businesses in the last Parliament but had to give back to those companies, because the European Court of Justice said that we were not allowed to raise it, were available for our public services. [Interruption.] How much easier and better it would be to banish austerity—and the chuntering of some Opposition Members, who rightly do not like austerity—if we had back the £10 billion of net contributions that we make to the EU every year, which we cannot spend on our own priorities because it is spent elsewhere.

I want us to take back control of our money so that we can banish austerity. I want us to take back control of that money so that we have it for our priorities of health and education. While we are taking back control, as a free people, we should empower people in an elected Assembly to decide how to raise revenue and which taxes to impose. I want us to restore that power on behalf of the British people. I would like us to abolish the tampon tax. I would like us to say to the European Court of Justice, “We do not accept your verdict that we have to put up taxes on green products to 20% from 5%.” However, that is its judgment, and that is what this Parliament will have to do after the referendum should we decide to stay in and not to leave.

The Government say that they have made progress in their renegotiation, that there will be some relaxation of the requirements, and that we will get a little bit more power back over the imposition of VAT. However, I have now read the document issued by the European Union after those negotiations and I am afraid to tell the House that that document makes absolutely no mention whatsoever of any deal or settlement between the United Kingdom Government and the European Union. It makes no mention of our need to abolish the tampon tax, and it makes no mention of our wish to keep our green taxes down at the 5% level because we want to encourage people to have more draught excluders and insulation so that they can keep warm in the winter at lower cost. It is not an unreasonable request, so why is there nothing in the European Union document on that reform that makes it clear that we could do that? There are only two things in that document: one is more centralisation of our future VAT system so that it can collect more and ensure that we are collecting all that it wishes; and the other is some general statement that perhaps at some point in the future, if the European Parliament and all the member states so agree, there could conceivably be some greater flexibility, but it is extremely unlikely.

The sadness of the document is that it shows that there is no political agreement whatsoever in the European Union to give back to us the right to impose the taxes that people should pay and that they might accept. There is absolutely no right for this Parliament to do what it clearly wishes to do by overwhelming majority on the issue of the tampon tax and the green tax.

We see before us the parting of the ways with those who believe that it is fine to belong to a subsidiary Parliament that pretends to be able to make choices on the part of the British people, but that has to give away a lot of its money to the European Union, has to accept a series of judgments on things such as trade union law, which it does not like, and has to accept that we are no longer free to make the laws that we need to make to reflect the will of the British people.

Is there nowhere in this Parliament on the Front Benches where we can find the Hampdens, the Miltons and the Cromwells not guilty of our country’s blood, who will rise up and say, “Surely now is the time to take back control, to make sure that we can choose our own laws, to make sure that we can impose our own taxes, to make sure that we can redress the wrongs before we ask people to pay those taxes, to go back to the fundamentals of United Kingdom democracy fought for over many centuries, and to go back to the foundations of democracy as so brilliantly chronicled in the founding documentation of the United States of America”? We can only say that we have a proper Parliament and not a puppet Parliament if we do those things. More Members need to urge their constituents that now is the time and now is the moment to seize control and to banish the puppet Parliament.

It is always a pleasure to follow the right hon. Member for Wokingham (John Redwood). He speaks with huge passion about these matters, and of course he has always been consistent in his opposition to being a member of the European Union. He also speaks eloquently about why he feels the way that he does.

The European debate—I say this as a former Minister for Europe—has dominated the Government’s agenda to such an extent that this Queen’s Speech is a shadow of what it should be. There is no great ideological commitment in it, so it is difficult to attack too much of it. It is important that, when we get past 23 June, we can then settle down to an intelligent legislative programme that is not dominated by people banging on about Europe —I include myself in that. Although crime has gone down in England and Wales, blue-on-blue crime has increased as far as the EU debate is concerned.

As I mentioned earlier, last Thursday the Minister for Employment was in my constituency with a very big red bus parked outside the biggest temple telling everyone that if we remained in the European Union, there would be a curry crisis and people would not be able to eat curry any more. It is important that we get the European debate into perspective.

As a fellow east midlands MP, you would expect me to say this, Madam Deputy Speaker, but I was surprised that there was no mention in the Gracious Speech of Leicester City winning the Premier league, but perhaps that will come next year.

I agree with the Government’s proposals regarding the revolution in the Ministry of Justice and our prisons. I and members of the Select Committee on Home Affairs have been very concerned about, for example, the number of people who go into prison with no interest in drugs and come out addicted to drugs. We are concerned that our prison system is not doing what it was intended to do: to punish, but also to rehabilitate. Although we expected the right hon. and learned Member for Rushcliffe (Mr Clarke), when he was Lord Chancellor, to talk about changing the way we look at prisons, we did not expect this from the current Lord Chancellor, and we are delighted that he has embraced the reform agenda. Ensuring that when people go to prison they are first punished, then rehabilitated and they do not pick up bad habits, so that when they come out of prison they do not reoffend and go back again, is one of the big issues that has confronted this Parliament for all the 29 years that I and the right hon. Member for Wokingham have been Members of it. How do we break the cycle?

I remember on a visit to a prison in the south of England speaking to a young man who was there because he had committed murder. He told me that his father had had a life sentence and he had a life sentence; he just hoped that his young son, who was then a year old, would not end up in prison. How do we break the cycle? I think we should work with the Government to make sure that our prison system does what it is intended to do.

The second issue I am interested in and concerned about is extremism. Although the Government are proposing legislation on extremism, I do not think they have gone far enough on the counter-narrative. The Select Committee is about to conclude its year-long inquiry into counter-terrorism. I am concerned, as is the rest of the House, about the number of young British citizens who decide to give up their life in this country and go and fight abroad. The current figure for those who have done so is 800, and 400 have returned so far. I cannot understand why we are not doing enough while they are still here to prevent them from going in the first place. Also, although there are programmes to detoxify those who return to this country, there is always the risk that having gone abroad to fight, whether in Syria or elsewhere, on their return they will retain the poison that was drilled into them abroad. It is important that we treat the counter-narrative seriously. We need to support our police and intelligence services in working out who is going, and work with families so that we can try to persuade people not to go.

Does the right hon. Gentleman agree that our prisons are a breeding ground for extremism and radicalisation, and that until we address that the flow of new extremists will continue?

The right hon. Gentleman is absolutely right. It is not just about preventing people without a drugs habit going to prison and coming out with one. We have been sending people to places like Belmarsh, which has been described as a place where jihadists seem to be able to influence young people. Knowing his great passion for mental health issues, the right hon. Gentleman reminds me that Simon Cole, the chief constable of Leicestershire, who is the lead on counter-terrorism in the Prevent programme, has talked about the number of jihadists who have mental health problems. These are all issues that we need to confront. We cannot necessarily do it by legislation, but we need to make sure that we have the framework in legislation to provide the resources, the time and the effort to work with people.

My final point concerns the sugar tax. I was delighted when the Chancellor of the Exchequer introduced it. We should acknowledge the fact that today is his 45th birthday. I hope he is having a sugarless cake because, as we know, a spoonful of sugar may help the medicine go down, but it is also one of the steps on the way to diabetes. As someone who suffers from type 2 diabetes and chairs the all-party parliamentary diabetes group, I believe the proposed sugar tax will send a clear message out to the retail companies. However, the manufacturers of drinks such as Coca Cola and Red Bull do not have to wait until the sugar tax comes into effect; they can start promoting sugarless drinks now.

I got into a lot of trouble because I did not want the Coca Cola van to come to Leicester at Christmas. I was accused by some people of robbing them of their Christmas. They had decided that the Coca Cola van was so strongly associated with the Christmas spirit—forget about Christianity, the birth of Christ and so on; it was the Coca Cola van that gave them Christmas—that I was severely criticised. I will make a deal with Coca Cola from the Floor of this House: if the company sends its van to promote non-sugar drinks, I will be happy to welcome it, but promoting a drink containing seven to 10 teaspoons of sugar, cannot be good for the health of our nation.

The right hon. Gentleman should recognise that since 2010 sales of diet drinks have increased by 33%, and in 2014 the crossover point was reached—more people purchased diet drinks than regular drinks.

That is a good statistic, for which I thank the hon. Gentleman. The change has come about only because of pressure from parliamentarians and from others outside Parliament, particularly clinicians, who have argued strongly that unless something is done, the health of the nation will be affected. That is why I tabled my urgent question on the obesity strategy. Unless we continue to put pressure on the manufacturers and the retailers, nothing will change.

Although we will have a sugar tax, it is still up to the supermarkets to ensure that they promote sugarless drinks. At Waitrose in Wolverhampton, which is not that far away from your constituency, Madam Deputy Speaker, there is a kiosk right in the middle of the store displaying only no-sugar products. The drinks with sugar content are put elsewhere. That is what the retailers have to do. The introduction of the sugar tax will encourage retailers and manufacturers to change their ways.

Finally, this is a hospitals and health debate—at least, it was opened by the Health Secretary. I shall not mention video games this time; I leave that to the Minister for Culture and the Digital Economy. I am very concerned about proposals from the local health authority to close the Leicester General Hospital. The possibility of reconfiguration is being considered. I have had had discussions with the chair and the chief executive of the hospital trust. I know that we have on the hospital site a world-class diabetes centre run by Professor Melanie Davies as well as Professor Kamlesh Khunti. We need to look very carefully at any plans that will diminish the services available to local people.

The general hospital site has been used by local people for years and years as a hospital site. We were promised a new hospital, accommodation for nurses and all kinds of things in the 29 years that I have represented that city. None of those promises have been realised. Although we in the community and I as the local Member of Parliament are prepared to enter into dialogue with the local health authority over its proposals, if the authority thinks it can close the hospital and give us nothing in return, there will be a bare-knuckle fight to try to preserve those services. I am not attached to the buildings—buildings are just a means of delivering services—but I am attached to the services. It is really important that we ensure that our health services remain the best in the world. I take the Secretary of State at face value: he wants our NHS to be the best in the world, and so do we. In order to achieve that, we need to make sure that it is properly resourced, keeps up with the developments in our population, and provides the expertise that is necessary for the NHS staff, to whom we pay tribute, to do their work so that it retains the best the world has to offer.

It is a great pleasure to follow the right hon. Member for Leicester East (Keith Vaz), who, as always, spoke very thoughtfully on a range of subjects, and with great passion in favour of curry and against sugar. However, I was rather surprised that he implicitly endorsed the fundamentally racist immigration policy we currently have in this country whereby any number of white Europeans can come and settle here, with or without jobs, whereas a curry chef from Bangladesh related to people in this country, with an offer of a job, cannot. That is implicit, inevitable and unavoidable for as long as we remain members of the European Union, and that is why so many members of the ethnic minority community in my seat and elsewhere will be voting to leave on 23 June.

I hope, Madam Deputy Speaker, that it is in order for me to speak to the amendment in the names of 54 right hon. and hon. Members, including me, which says that we

“respectfully regret that a Bill to protect the National Health Service from the Transatlantic Trade and Investment Partnership was not included in the Gracious Speech.”

I believe in free trade—I always have and always will. I think I am the only surviving Member of this House who has negotiated a trade treaty—the Uruguay round in the 1990s when I was Secretary of State for Trade and Industry. Therefore, when the Transatlantic Trade and Investment Partnership treaty was presented, my instinct was to support it, but the more closely I looked at it, the more parts of it came to worry me. TTIP is not primarily about free trade. The average tariff imposed by the United States of America on goods from the European Union is 2.5%, and that of the European Union on goods from America somewhat higher. Getting rid of them would be worth while, but it is not a big deal.

However, other aspects of the treaty are worrying. My main concerns relate to the investor-state dispute settlement system. That creates a system of tribunals—special courts—in which foreign multinationals can sue Governments, including the British Government, but the British Government cannot sue them, nor can British companies use those courts should they wish to.

These companies can sue the British Government if they feel that Government policies are harming their investments. For example, US companies could sue a British Government who wanted to take back into the public sector privately provided services in the NHS or education, or to open fewer such services to private provision. The British and EU Governments have denied that such suing is possible, but a cogent counsel’s opinion argues that, because these tribunals can award unlimited fines, and have different evidence criteria from British courts, they could, at the very least, exert “a chilling effect” on Government decision making.

Up until now, most of the concern about this has been expressed by people who have opposition in principle to any private provision in the health service. I do not have opposition in principle, although I have always believed that the scope for it is limited in practice.

I found an example in my own constituency that illustrates the problem that could arise if TTIP were in force. A surgicentre, privately owned, set up by Tony Blair and working alongside the NHS Lister hospital in Stevenage, which serves my constituents, ran into terrible problems. The whole system under which surgicentres were set up was daft; it did not work. So I lobbied against it, as did my right hon. and hon. Friends from Stevenage and north Herts—all of us Conservatives. We lobbied that it should be brought back into the NHS, and we were successful.

However, had TTIP been in force and the company fallen into the hands of an American health company—most private hospitals in this country are now American-owned—the company could have sued the local NHS for taking back that service. At the very least, it might have won massive damages. It might even have been able to prevent that from happening entirely. Even if it had lost, the case would have cost the local health service a massive sum, because the average cost of these cases is $8 million. It seems to me that Members should be very cautious about signing up to a treaty that might have such a consequence.

These tribunals were originally invented to encourage investment by American and other companies in developing countries that had poor systems of government. Their courts were, frankly, unreliable and sometimes corrupt, so a parallel system of courts was set up with the agreement of the local Government. Such Governments were prepared to suffer the indignity of having courts that could overrule their own judiciary and laws in return for encouraging investors to invest in their country, in the knowledge that, should those investors be expropriated, either directly or as the result of Government policies, they could get fair compensation. That was fine, but such courts are not necessary to encourage investment in the UK. America invests more in the UK than in any other country in the world. American companies, like those of many other countries, choose to have cases heard in British courts because they trust our courts system. We do not need a parallel system of courts to encourage and promote investment in this country.

The Government say, “This is impossible. It won’t happen.” If it is impossible, does it really matter if they make such an assurance doubly sure by exempting the NHS from TITP, as amendment (c) suggests, just as the French have exempted their motion picture industry and artistic endeavours from the scope of the treaty? The very fact that the Government are not willing to do so, or have not been so up till now, raises some doubts, at least in my mind, about how secure we will be.

However, the Government have now accepted the amendment, although it is true that they did not have much choice, given the wide support for it in the House. That means the Government are now committed to bringing forward a Bill, and it is very important that they do so speedily, so that we can see whether it will achieve what we want to achieve and so that Members with wider concerns than mine—indeed, I have some further concerns about whether environment or health standards should be taken entirely out of the purview of Parliaments in the ways envisaged—can amend and adapt the Bill accordingly. If the Government do not bring in such a Bill or delay it until after the referendum, we will realise that something fishy is afoot.

Is the TTIP draft treaty not just another example of what I was trying to say, which is that more and more things are no longer under the control of British law makers and electors, but under the control of unelected people in Brussels, and that such things are not amendable once they have been agreed?

My right hon. Friend is absolutely right. If we let TTIP through, it will be a further transfer of law-making power away from this country to international bureaucrats and multinational companies.

There is a referendum dimension to the TTIP treaty issue. First, the only absolutely certain way of preventing it is of course not to be part of it—by leaving the EU on 23 June. We might be able to exempt ourselves or to prevent the treaty from going ahead if we remain in, but that is far from certain. Secondly, as my right hon. Friend has said, there is a certain similarity between such courts of a supranational nature—run by bureaucrats to enforce laws negotiated by bureaucrats, which have never been endorsed by this House and are not open to rejection by it—and it is natural that those courts should sympathise with each other and carry the treaty forward. If we were outside, we could negotiate our own deal with the United States, which I hope would not need any such system of courts. Why should America need such courts to invest in this country or for us to invest in the United States? That deal would require a stripped-down and far simpler Bill, and it would be far quicker and easier to negotiate.

Some people have said, “But President Obama has said we won’t be allowed to negotiate a deal and we’ll have to go to the back of the queue”, but the House of Commons Library has revealed that there is no queue. After the negotiation of TTIP, there are no countries with outstanding negotiations with the US. Not only was President Obama trying to bully us, but he was doing it on the basis of a bluff. We will be not at the end of the queue but at the front of it, and we will no doubt be able to negotiate with his successor.

I hope that hon. Members will consider the EU dimensions of TTIP seriously. I accept that people who are very optimistic about what we can achieve within the EU, and about what the EU might be able to achieve in negotiating TTIP with the Americans, might want to take the risk. It is not a risk that I want to take. It is not a risk that those who give high priority to the NHS, or those who are worried about environmental standards, health protection standards and potential threats to our education and other public services, will want to take. In the light of the topic of today’s debate, I hope that we will give priority to protecting public services rather than going along with something that none of us has ever seen—we are not allowed to see it, and it is being negotiated in secret—and that has aspects that most of us ought to find offensive to the House and dangerous to the people of this country.

Thank you, Madam Deputy Speaker, for allowing me to deliver my maiden speech today.

In keeping with the tradition of the House, I would like to take a few moments to pay tribute to my predecessor as Member of Parliament for Sheffield, Brightside and Hillsborough, Harry Harpham. I am doubly proud to say that not only was he a dedicated and conscientious Labour MP, but, as many colleagues will know, he was also my husband. He served in this House for less than a year before his death, but in that time he made his mark. He spoke powerfully against the Chancellor’s cuts to tax credits, knowing the suffering they would cause the people he represented, and, as a lifelong trade unionist, he made an eloquent speech in defence of workplace rights when they were threatened by the Trade Union Bill.

I would also like to pay tribute to Lord Blunkett, who, as colleagues will know, stood down as the MP for Sheffield, Brightside and Hillsborough at the general election last year. David has been a tireless champion of Sheffield since he was elected to the council at the age of 22. He led the city through the turbulent years of the 1980s before becoming an MP in 1987, and his drive and tenacity soon propelled him to the Front Bench. There simply is not time for me to list all his successes as Education Secretary and later Home Secretary, but fortunately anyone who is familiar with the last 25 years of British politics will know that his achievements speak for themselves.

My constituency sits in the north-east of Sheffield, perched above the city centre on one side and the Don valley on the other, where once upon a time we could find the steelworks that were the foundation of our economy. It was my constituents and their forebears, including my father, who worked in them, forging not just steel but their own fame and reputation and that of the city along the way.

But times have changed, and after the pain and upheavals of the 1980s, we find that these days working lives are not dominated by a single industry. Having said that, nearly 20% of my constituents work in health and social services, so it is with good reason that I say we are a community that cares for one another. We are a diverse constituency, with people and communities from across Europe and beyond, both recently arrived and long-standing. Sheffield has sometimes been called the biggest village in Britain thanks to the friendly, open nature of its people. We were the first city to join the gateway protection programme back in 2004, through which we have provided a place of safety for 1,000 refugees. Plans are well under way to welcome a further 225 fleeing the conflict in Syria over the next three years.

Sheffield became a city of sanctuary in 2007, with more than 70 local organisations working to bring asylum seekers and refugees together with local people to celebrate the strength that we all gain through our diversity. I am proud to represent a constituency and city that are so welcoming and tolerant.

What maiden speech would be complete without singing the praises of the local football team? This Saturday, Sheffield Wednesday will be battling Hull City at Wembley for a place in the premiership. If—or should I say when?—Wednesday win, they will be back in the top flight of English football for the first time in 16 years, which is exactly where they belong. I am a proud Wednesdayite, and while I may not have much in common with the players, I like to think that we are all coming down to London to put Sheffield firmly on the map, and I wish them all the best for the weekend.

Like anywhere, we face our fair share of challenges. The rate of unemployment in Brightside and Hillsborough is more than double the national average, and we are ranked 9th in the country for the number of households with dependent children where no adult is in employment. More than a third of children in my constituency are classed as living in poverty. Seven food banks now serve my constituency, and it goes without saying that I have nothing but praise for those who give up their time to collect, sort and distribute the donations that people in the area willingly give to help those who find themselves backed into a corner. The fact that people have to rely on food parcels at all in 2016 speaks volumes about the Government’s determination to tackle inequality, particularly when a third of those who rely on them are children.

Perhaps the most troubling aspect of the growth in food-bank use is the way that it is now taken as read that people will have to rely on them. They have become accepted as part of the landscape, and arouse little comment. It is frankly disgraceful that we have reached the point where those in most need can no longer rely on the state to help them through hard times, and that is a damning stain on the Government’s record.

Ironically, Harry chose to make his maiden speech during a debate on productivity and the Government’s skills agenda. He said that the jobs being created in Sheffield were often low-skilled, low-paid, zero-hours contract work. He was right, and I find it sad that a year on, the Government have still not grasped the need to provide proper skills training, so that my constituents can find worthwhile, meaningful work.

One of the most pressing concerns for my constituents is the availability of housing, and I was deeply disappointed by the Housing and Planning Act 2016, which will do nothing to help people in Sheffield to keep a roof over their heads. Nearly 40% of my constituents live in council or housing association homes, and the introduction of fixed-term tenancies, alongside the hated bedroom tax, will cause them more needless worry and upheaval. For the Government, it seems that social housing is now a temporary benefit that people are to be chivvied out of, rather than a home to settle down in and to build a life.

I am glad to make my maiden speech during today’s debate on public services, because after a lifetime of working in them I feel somewhat qualified to speak up in their defence. I started my first job as an assistant at Firth Park library aged 16, and since then I have worked across library services, further education, and the NHS. I know from long personal experience how important each and every one of our public services are, and that they are often a lifeline for ordinary working people. They protect and empower those who would otherwise be unable to fend for themselves, and they are the living expression of the belief that everyone, whatever the circumstances of their wealth or health, should be able to live dignified, fulfilling lives.

Over the last six years, those services have borne the brunt of an ideologically imposed austerity that has left them withering on the vine. Men and women working across the public sector are being asked to do more with less and less. Morale is at rock bottom across the board: teachers, doctors, police officers, nurses, firefighters, social workers, prison and probation officers—the list goes on. They have all dedicated their working lives to public service, and all see on a daily basis their ability to serve being undermined by this Government.

I make no apology for saying that I am Sheffield born and bred. I grew up there, have spent my whole life working there, and raised a family there. We may sometimes be blunt, but it always comes from the heart, and it is in that spirit that I intend to work for the people of Sheffield, Brightside and Hillsborough. No one would have chosen the circumstances that led me to this Chamber, but nevertheless here I am. I am deeply humbled by the trust that my constituents have placed in me, and I pledge to repay that trust by fighting for their interests and making sure that their voices are heard loud and clear here in Parliament.

I congratulate the hon. Member for Sheffield, Brightside and Hillsborough (Gill Furniss) on her maiden speech. It always takes courage for an hon. Member to make a maiden speech in this daunting Chamber, but it must especially have been so when she paid tribute to her predecessor—her late husband—whose untimely death robbed this Chamber of a promising new Member who spoke with equal passion for his constituents in her city of birth, Sheffield. She will clearly be a great champion for her constituents, and will speak with the bluntness that she declared. I am sure she will be a much respected Member.

I did not intend to address the issue of the European Union, but will respond to the points made by my right hon. Friends the Members for Hitchin and Harpenden (Mr Lilley) and for Wokingham (John Redwood), to whom I listened with great interest. I listened with care to the concerns of my right hon. Friend the Member for Hitchin and Harpenden about the Transatlantic Trade and Investment Partnership. It is surprising that those who have been campaigning to leave the EU, and who for so long have criticised the EU for not completing enough trade deals despite the fact that the EU has more trade deals than any other country—it has far more than the United States—find themselves in the position of criticising trade deals. In my judgment, the benefits of TTIP include a £10 billion a year trade boost to our economy, which would enable us to invest more in public services.

First, may I clarify to my right hon. Friend that I have long campaigned against TTIP? Secondly, Switzerland has more deals than the EU, including deals with China, Australia and India. The only countries with which the EU has deals that China does not are very minor states.

My point is that the EU has trade deals with more than 50 other countries, whereas the US has only 14. I thought the narrative was that we want the EU to have more trade deals.

The issue is this: any modern international trade deal will involve some kind of binding arbitration mechanism. My right hon. Friend is clear that he opposes the Canadian free trade deal, but that has been championed by my hon. Friend the Member for Uxbridge and South Ruislip (Boris Johnson), who leads the leave campaign, as a model that our country should adopt if we leave the EU. It is also true that the Trans-Pacific Partnership, the North American Free Trade Agreement and even the World Trade Organisation all involve some kind of arbitration panel that takes decisions out of the hands of elected Chambers. If we are to take the position that any trade deal of that kind should be resisted if decisions can no longer be taken by elected Members, none will be acceptable. We would then be in the position of trading without any such arrangements, at potentially enormous cost to our country.

My right hon. Friend the Member for Wokingham spoke with characteristic passion about parliamentary democracy and described this place as a puppet Parliament. I note that none of the Bills in the Gracious Speech that are of interest to me and my constituents are restricted or affected by our membership of the EU. That goes to a central point: we can vote on and discuss much of our legislation and domestic affairs without the encumbrance of the EU. I therefore find it difficult to accept that the 650 Members of the House of Commons are puppets, and that our views and votes on those matters are entirely irrelevant simply because of our membership of the EU. That strikes me as an exaggeration, legitimate though the concern about parliamentary sovereignty might be.

I welcome the proposed prisons and courts reform Bill, having been the author of “Prisons with a Purpose” before the 2010 general election. The document urged the rehabilitation revolution and a transformation of the way in which we run our prisons. The radical reforms proposed by the Government are welcome in respect of reducing reoffending.

A number of measures are of special interest to my constituency of Arundel and South Downs in West Sussex. The neighbourhood planning and infrastructure Bill will address a problem that I spoke about in the House recently. The welcome reform of neighbourhood planning introduced under the Localism Act 2011 empowers local communities to make plans that benefit their local area, but they must not be undermined by speculative developments that call into question the legitimacy of plans that have been voted on democratically in referendums. It would be very welcome if the neighbourhood planning and infrastructure Bill addressed those problems and prevented those speculative development applications. We should remind ourselves that neighbourhood plans have had the effect of producing more and not less housing than was originally intended. Therefore, the proposal will not reduce house building, but will properly empower local communities.

The digital economy Bill is welcome—I am delighted to see my hon. Friend the Minister for Culture and the Digital Economy on the Front Bench. He will know of the concern that many in rural areas have to close the emerging digital divide. We want to ensure that the Government’s welcome proposal to extend superfast broadband throughout the country reaches those in hard-to-find rural areas—they, too, are entitled to fast broadband speeds. That is important for rural employment, but it is also important on the ground of fairness. It will take new means, and I hope the Bill sets out measures that will future-proof broadband provision to ensure that the speeds obtained in those areas meet tomorrow’s as well as today’s needs. Many areas in my constituency currently cannot get broadband at all.

I welcome the education for all Bill and its promise to meet the Conservative party manifesto commitment to a fair funding formula for our schools. West Sussex schools are unfairly disadvantaged in that respect.

I also welcome the modern transport Bill. I should like to refer to two crucial infrastructure issues that affect my constituency. First, on the A27 upgrade, I am delighted that the Government have announced that that major route will be upgraded to include the Arundel bypass and that funding has been provided. I hope the plans continue to timetable, so that work on the bypass begins by the end of the Parliament, as has been set out.

Secondly, the rail service to my constituency is a concern to a large number of hon. Members on both sides of the House. The performance of the Govia Thameslink Railway franchise has simply been unacceptable over the past year, hugely inconveniencing passengers. It must be said that 60% of the delays are the responsibility of Network Rail and result from infrastructure failure. It should also be acknowledged that the Government are embarking on major infrastructure investment, including the £6 billion London Bridge upgrade, which will improve services. Nevertheless, GTR is not meeting the self-set targets in its performance improvement plan. Those targets were low in ambition, but the company is falling below its original performance thresholds set one year ago to improve performance for customers. That failure is exacerbated by the entirely misconceived industrial action of the RMT on driver control of doors. It cannot be a safety issue when drivers rather than guards already control the doors on 40% of Southern services. Industrial action has exacerbated existing problems with the service, meaning a very serious level of disruption for passengers over the past few weeks. This is now causing real anger among my commuting constituents and many others in the area covered by the franchise.

First, there is no justification for the industrial action and it should not continue, and nor should the unofficial industrial action caused by drivers and guards who seem to be suffering from an unusual level of sickness. Secondly, the management of the GTR franchise must recognise that, while the proposed measures to reform how it runs the trains may be justified, its management of the franchise as a whole has been absolutely lamentable. It has brought the Government’s rail policy into disrepute. It is essential that the company and Network Rail are held to account for their poor performance and that they meet their own self-set performance improvement standards.

Does my right hon. Friend think that the licence to operate this service should be taken away and a new supplier found to ensure it is delivered properly and in line with what he would expect?

My hon. Friend raises a fair point. The ultimate sanction available to the Government for the failure of a franchise to perform effectively is to withdraw it. Indeed, that has been suggested by the Prime Minister. The franchise has only just been awarded. One problem is that the company failed to plan for enough drivers, so for the past year there has been a driver shortage. There has literally been an inadequate number of drivers available for the trains and there is a very long training period. The company assures the Government that it can improve its performance. The Government are reluctant to withdraw the franchise and find themselves in the position of running the railway, but unless the position improves more radical measures will have to be taken to deal with the underperformance of this service. Frankly, it has been simply appalling. It is unacceptable for the rail-travelling public in this area. It is time that both Network Rail and Southern recognise that it is no longer acceptable to deliver a low-standard performance of this kind.

It is a great privilege to be called to speak in this debate at this particular juncture. You will know, Mr Deputy Speaker, that sometimes Mr Speaker teases me a little about my long service in the House. I, in turn, accuse him of being slightly ageist. Well, I have to say that of all the maiden speeches I have heard, the speech delivered to the House by my hon. Friend the Member for Sheffield, Brightside and Hillsborough (Gill Furniss) was one of the best. It was delivered with passion, knowledge, experience and wisdom. She will be a first-class Member of Parliament representing her constituents, because she knows her community. She has lived and worked in her community. We are all proud of her, and Harry would be proud of her, too. I look forward to her brilliant career. [Hon. Members: “Hear, hear.”]

Some of us will have been a little hurt by the remarks of the right hon. Member for Wokingham (John Redwood), who was very keen to tell us that he is passionate about freedom and liberty. I do not mind him using his speech to say how passionately he is against the European Union, but to seem to suggest that we who oppose that view and who believe our liberties work better as members of the EU do not care about freedom and liberty is a little hurtful. As I said to the Prime Minister on an earlier occasion, I was born the day before the worst day of the blitz. German bombers bombed the street in which I was born. Seventy years of peace and prosperity can be too easily taken for granted.

When looking at a Queen’s Speech, it is important to track what has been left out or forgotten. There are some high-flown ideas at the beginning of the speech:

“My Government will use the opportunity of a strengthening economy to deliver security for working people, to increase life chances for the most disadvantaged and to strengthen national defences.

My Ministers will continue to bring the public finances under control so that Britain lives within its means, and to move to a higher wage and lower welfare economy where work is rewarded.”

The Secretary of State for Health, at the beginning of his speech, said that he did not believe in private wealth and public squalor. I do not believe that he believes that and I do not believe that the Government believe that. What they do believe is in some ways more insidious: private sector good, public sector bad. That is the message I get all the time from Government Members. Those of us who have worked in education, health, welfare, transport or housing know that lurching towards the private sector for an answer is not always the right or most efficient way. I feel embarrassed to hurt the feelings of those sitting on the Government Front Bench, but I mention in passing the botched rail privatisation that nobody wanted and which was executed badly. We now spend more money on trains, which are normally run by foreign-owned companies, than any other country in Europe—and to provide what? A very poor service.

We have heard a very large number of long speeches about health. I represent the constituency of Huddersfield. It looks as though we are going to lose our hospital and A&E not because anything is wrong with it—it used to be very high performing and financially sound—but because it has to absorb a weaker health trust next door, the Calderdale and Huddersfield NHS Foundation Trust, and because we are imprisoned by a PFI contract that we cannot deny or modify. That is a real threat.

The elephant in the room is that the health service is struggling to make ends meet. It is underperforming not because we do not have amazing and dedicated staff, but because we do not have enough of them. We do not have enough doctors, nurses, A&E specialists or people supporting doctors. The fact is that the NHS needs more resources and investment. I will say this a number of times in my speech: it also needs more imagination to deal with new demands. Yes we have an ageing population and need to deliver healthcare in a different way, but that needs leadership and imagination that does not exist at the current time.

Members on all sides complain about the health service lacking resources, but they go through the Lobby to vote for High Speed 2. On the latest figures, HS2 will be three times more expensive than it was predicted to be: £138 billion and rising. The Cabinet Secretary has now been drafted in to look at this, because even the revised costs are out of control. It seems strange to be ploughing money into HS2 when, according to the Queen’s Speech, we will very soon end up with driverless cars. We will have the ability to dial a number and have a pod arrive outside our house and take us anywhere in the country. I predict that by the time we have completed HS2, in 2033, it will be redundant, because driverless cars and the new generation of transport will have wiped out the need, just as the invention of the railways did away with the effectiveness of, and the investment in, canals.

As you would expect, Mr Deputy Speaker, I want to home in on education and skills, on which subject the Queen’s Speech gives me great cause for concern. First, enforced academisation will diminish local education authorities’ role in education and so take away a great deal of wisdom and resource that we have relied on for many years. I can see academisation being a very disabling influence on the whole of our education system. In one small paragraph, the Queen’s Speech also makes reference to new private universities. The Government are persistent in their ideology—ideology with a little i not a big I. In almost everything they touch, we see not big, bold privatisation but back-door privatisation. Academisation will lead to a greater role for the private sector. The changes to the BBC, under the new BBC charter, will mean much more privatisation by the back door. The same will happen with private universities. Will they train doctors, engineers and those in the high sciences? No, they will go for the low-hanging fruit—for legal degrees and accountancy—that cross-subsidises the difficult stuff in our universities.

I want to end on two little things. The Queen’s Speech referred to the northern powerhouse, but we see no resources or the knowledge to take us forward on that course. Lastly, I want to say something about defence—something the House would not expect from me. Today, we could get the whole of our defence forces—100,000 men and women—into Wembley stadium. If anybody wants to read the truth about our lack of preparation for defending this country, they should read Max Hastings in The Sunday Times this Sunday. We are struggling to maintain a credible force for the defence of our country and the maintenance of our liberties. At this time, the EU is a bedrock of our freedoms.

It is a pleasure to follow the hon. Member for Huddersfield (Mr Sheerman). Having listened carefully to his remarks, I would take issue with his assertion that many on the Government Benches are fully committed to the notion that private sector is always good and public sector is always bad. That is not my approach. I wanted to speak in this the third day of the debate on the Queen’s Speech because I think that the delivery of quality public services is critical to what we deliver to our constituents, and it is really important that we have an open mind about how we deliver those services effectively. The biggest employer in my constituency, Salisbury hospital, is from the public sector. It has just gone through the rigours of a Care Quality Commission inspection, and I am grateful to Professor Sir Michael Richards for his constructive observations around that and the way to move forward.

I welcome the many Bills in the Queen’s Speech that seek to address the biggest issues facing our nation, both now and under all Governments: how we create the conditions where the most vulnerable can be helped on to a better pathway. I was genuinely shocked and saddened when listening to the response from the Leader of the Opposition last week, when he said:

“Apparently, it is all about instability, addiction and debt—all things that can be blamed on individuals about whom Governments like to moralise… Poverty and inequality are collective failures of our society as a whole, not individual failures.”—[Official Report, 18 May 2016; Vol. 611, c. 16.]

I agree that it is a failure of society as a whole that people in our communities must endure complex, ongoing problems, but it is not about labelling society collectively or people individually as failures, and it certainly is not about moralising; it is about a credible analysis of the diversity of individuals’ problems, recognising that it is incumbent on Government to deliver a customisation, adaptation and reformulation of public service delivery if they are sustainably to meet the needs of our communities. It is naive to say that a financial measure of poverty, by itself, is likely to provoke a meaningful recognition of the complexity of poverty.

I want to make some observations about several of the proposed Bills, but three themes will emerge as I contemplate them. The first is about the need to innovate in public service delivery and the second is about the need to integrate. Going back to my opening remark, it is not about public versus private; it is about recognising that sometimes we need to innovate and integrate good public services, bringing in new ideas and providers able to improve how we have done things to date. The third important element is about timeframes. I vividly remember, in my six years’ service as a magistrate, seeing individuals come back again and again before the court for crimes related to the same underlying problems—typically addictions—in their lives. On average, it takes people seven attempts at rehabilitation to overcome some of those addictions. There is no one template for delivering those sorts of services. That is why we need to be careful, when we frame the legislation, to put in place reasonable measures of what success looks like and to show an understanding of the complexity of the lives of the people we are trying to help.

My enthusiasm for the children and social work Bill is infused with a strong conviction that the Government are absolutely right to look at looked-after children and care leavers, who experience some of the worst outcomes, in terms of life trajectory, of any in our society. It is important, however, that innovation is examined. In local authorities near me and across the country, we are beginning to look at schemes, such as those run by Safe Families for Children, where trustworthy families are engaged to look after children when underlying issues need to be dealt with in families. I recognise that the pathway to securing the engagement of safe families for children obviously necessitates more work in order to complete the process of safeguarding, but this is an example of where innovation and integration with existing public sector provision—in this case, within local authorities —can deliver enhanced outcomes.

On all the Bills, we need to look at how health, education and social services can work better together, so that the payback is significant. I remember, three or four years ago, being asked to visit a residential centre in Devon, with the Amber Foundation, which was working with young adults leaving the criminal justice system and in grave danger of not finding their way—often they were without family support and, being low-skilled, finding it difficult to get into employment, and typically they had been engaged in the criminal justice system previously. I hope that when we come to consider the proposed legislation, we will find room to enfranchise groups such as the Amber Foundation into the delivery of services. It is through commitment over time that those individuals are able to find a sustainable trajectory into independent living. We need to be honest and real about the challenges that those individuals face. I welcome the overdue reform of adoption. I have seen too many cases in which the evaluation stresses reasons why not, while in the meantime too much time passes and the individuals are left behind.

I welcome the education for all Bill, and there is particular enthusiasm in my constituency for the fair funding formula. Wiltshire is the third worst funded local authority, and that has a significant impact on the ability of schools to plan their budgets going forward. It is critical at the moment in the formation of a multi-academy trust, because trying to anticipate what the uplift will be is significant in giving assurance to governors as they come together.

When we look at options facing young people at 18-plus, it is important to be clear about the integration of the great macro-policy goal of having 3 million new apprenticeships with enabling children from difficult backgrounds to get on to a pathway that will deliver the skills and employment opportunities that they crave.

The prisons and courts reform Bill is also very welcome. The emphasis on rehabilitation to reduce reoffending is wholly necessary. Importantly, it will introduce new boards with external experts and emphasise prisoner education and the necessity to have a pathway to employment.

Finally, there is the digital economy Bill, and this is a massive issue for rural Wiltshire. I have campaigned on it for many years. We must have a reliable plan for the last 5% in particular. The universal service obligation must have meaning and teeth in ways that my constituents and those across rural England can fully understand.

I finish where I started. I have no ideological objection to the integration of innovative ways of delivering public services. I hope that this Government will continue to have ambition and will measure their success in a way that allows further developments to take place so that we can meaningfully address the conditions of the poorest in our society with solutions that give them dignity and the justice that they deserve.

We can all recognise that this Queen’s Speech contains a thin raft of legislation and that it is perhaps a Queen’s Speech in hiding for obvious reasons. It is certainly one that misses out many things that people might have thought would be included. It may not contain some terribly bad things, but we can ask a central question about it, following on from the thoughtful contribution by the hon. Member for Salisbury (John Glen). It is not just a question of changing services and ensuring we get the best out of them, because we need to think about who actually achieves the things set out in the Bills.

We should ask ourselves whether it is good enough to pass legislation and then say, “Get on with it; it is down to you. We have done our bit on the legislation, and it is your job now.” Here lies an increasingly central flaw in the roster of Bills presented for our inspection. They certainly do not come with any “how to do it” impact assessment. It is important to recognise that we can have good public services only if we have good public servants carrying them out. When it comes to many of the measures in the Queen’s Speech, one cannot say, “That is a good thing.” One should increasingly say exactly how to make it more than just a good thing, so that it actually becomes a good thing achieved.

The title of today’s debate is “Defending Public Services”, but there seems to be a disjunction between what a service can do and what is coming its way as a result of this and other recent Queen’s Speeches. We discuss this one against a background of a crisis in funding for the NHS. We know that the NHS simply cannot do what is required of it as a public service with its existing funding. Deficits are rising for hospital trusts, and it is not sufficient to answer, as the Prime Minister did in his opening speech, that it is necessary to do “more with less”. The people who are doing more with less are the public servants who have to carry out the services.

Statistics show the number of doctors per 100,000 head of the population between 2009 and 2015. There were 70 per 100,000 in 2009 and 65.5 in 2015. The same figures for nurses are 680 in 2009 and 664 today. That shows exactly what is happening. Public servants are doing more with less and continuing to have more and more piled on them with less and less resource—until, I suspect, the service starts to break down.

Social care is the other part of the health service revolution that we have debated today, but £1 billion has been taken out of social care budgets in the past year alone, with £4.5 billion taken out over the last five years. Local government is generally responsible for social care and social services, but councils have lost something like 79% of their direct funding between 2010 and 2020, with a further £3 billion of cuts announced in last year’s autumn statement.

The most deprived areas of the country, those with the most pressing concerns on social care and the most disadvantaged seem to suffer the worst cuts. How can it be that nine out of 10 of the most deprived areas are seeing cuts above the national average? We face a Queen’s Speech, on the other hand, that places substantial new requirements on those desperately stretched services in the areas of the country that need them the most. In my authority, by no means one of the most deprived parts of the country, £72 million has been cut from the budget since 2010, and there is expected to be a further £90 million a year by 2020.

The services that we seek to defend are, frankly, in a position of near starvation as they seek to provide us with the cover and the response to statutory responsibilities that we require. For example, the Queen’s Speech contains a requirement for further responsibilities to be put on local government and social care departments under the Children and Social Work Bill. This is what the Prime Minister said:

“So, in this Queen’s Speech we are saying to care leavers: you will get guaranteed entitlements to local services, funding for apprenticeships and a personal mentor up to the age of 25. All this will be included in our care leavers covenant, so that our most disadvantaged young people get the opportunities they deserve.”—[Official Report, 18 May 2016; Vol. 611, c. 26.]

Who could disagree with that? On the other hand, who could disagree with the people who are going to do those things?

I declare an interest in that my daughter is a social worker. I am very proud of her hard work in becoming a social worker in the first place and her dedication in carrying out her duties and responsibilities. I see her on a daily basis, so I can see the effect as her case load gets stretched and the authority has to cut corners increasingly just to keep the service going. These new requirements are going to be a huge strain on her; she will be one of the many people who will have to carry out this new piece of legislation as part of her local authority responsibilities. I know, by the way, who will get the blame if services fail because departments cannot stretch themselves far enough to take on those new responsibilities. It will not be the Government who presided over that near-starvation, but the poor social services departments that were worked into the ground while they were just trying to cope.

The Prime Minister spoke of the services that local authorities would provide, but they are decreasingly in a position to do so. New responsibilities are coming their way, not just for social care but for planning, as a result of the neighbourhood planning and infrastructure Bill, and for buses, as a result of the bus services Bill. Moreover, authorities apparently have an interesting future in connection with the devolution of business rates. It is being suggested that the local growth and jobs Bill will enable them to retain 100% of business rates, and who would disagree with that? I have championed the idea for many years. However, when it comes to who will implement the retention, there is as yet no indication of how business rate devolution will be married up with local equity. It appears that the authorities with the highest business rate bases will do much better than those in the most deprived areas which have much lower bases, and whose public servants will suffer as a result.

It has been announced that combined authorities will be handed powers from above, but they will be left with the same responsibilities and the same costs. How will they be funded? An authority that takes on devolved powers in south Hampshire, for example, will do so through a levy from a pooled business rate, which means that other authorities will have less money with which to support their already stretched services. I suspect that “more out of less” will not redound to the benefit of the public servants who are working in those authorities.

This is the central problem for our services. We can talk all we like about the sunny uplands, and about what shiny new words in shiny new pieces of legislation mean for people, but if those words are not followed by a commitment to make the services that will deliver on the promises work, they are hollow promises, and that, I think, is what this Queen’s Speech suffers from.

Like me, Mr Deputy Speaker, you will know that Lancashire has some of the finest public services in our country. I represent the police force and the health service in my constituency with the greatest pride here in Parliament, and rely on them when I am at home in Lancashire.

However, proud as I am of our public services in the north-west and Lancashire in particular, we need to show that our businesses and our economy will improve in order to support them. This Queen’s Speech—a one nation speech—did not give preference to the private sector over the public sector, but set out a programme in which both could succeed, and in which, specifically, the northern powerhouse, which was mentioned by the hon. Member for Huddersfield (Mr Sheerman), could play a central role.

Many years ago, my home city of Liverpool contributed more to the Exchequer than the City of London. In 1889, when our great county council—Lancashire county council—was formed, our first civic leaders, some of whom had been Cabinet Ministers, resigned as Members of Parliament to lead it. Was that because, at the time, it was said that the empire’s bread hung by Lancashire’s thread? Well, it may have been, but I believe that the real reason was that those MPs—including former Cabinet Ministers—knew that more power resided in our great northern cities, and in our town halls, than at Westminster and in Whitehall.

Of course, all that changed during the first and second world wars. As we waged total war in this country, it became necessary to concentrate power in London. We saw the nationalisation of our industries, and we saw many decisions taken away from our great regional local authorities. Just as the power came to London, wealth and skills moved away from the north of England to the south. The Queen’s Speech, and its commitment to the northern powerhouse, means that some of that money and power will be removed from London and returned to the north. London has had it for far too long, and we want it back.

This scheme did not drop out of thin air. My right hon. Friend the Chancellor of the Exchequer first advocated the idea of a northern powerhouse in June 2014, at the Museum of Science and Industry. It could not have happened in a better place than Manchester, close to our Free Trade Hall. With your indulgence, Mr Deputy Speaker, I want to reflect a little on the progress that we have made in the last 23 months.

During debates in the House, Members often ask why so much money is spent on London’s infrastructure. Why has London been given Crossrail 1, and why is it to be given Crossrail 2? Well, one reason is that Transport for London unifies all the London boroughs so that they can work on infrastructure projects throughout this great capital. For far too long, our local authorities in the north of England have been in competition with each other when it comes to rail and road infrastructure projects, rather than working together to ensure that we have a plan in the north to enable our cities to grow. That is why I am so pleased that we now have Transport for the North fighting for our cities and towns throughout the region.

It is so important for the north of England to become super-connected. What do I mean by “the north of England”? Well, within 40 miles of Manchester we have Leeds, Liverpool, Lancashire, Cheshire, Yorkshire, and the city of Sheffield. That belt of counties, towns and cities encompasses 10 million people. One powerful urban conglomeration could become one powerful, super-connected economic unit, which would not compete with London, and would certainly not pull London down, but would create growth and wealth throughout the north of England so that we could compete not just with the south, but with other cities across the globe. If the north were an independent economy, it would be the ninth largest economy in the European Union, and—much as it pains me, as a Lancastrian, to say this—if Yorkshire were its own country, it would have created more jobs in the last five years than the whole of France.

Of course the northern powerhouse is hugely important, but we are also very excited about the digital economy Bill. The commitment to super-connect every house with a universal broadband connection is important to our rural communities throughout the north-west of England. It is a glue that can bind towns and villages into the northern powerhouse project, and Lancashire can play its part.

We have three world-class universities; Uclan—the University of Central Lancashire—Lancaster, and, of course, Edge Hill. However, I must make an appeal to Lancashire county council. If we are to have a powerful, knowledge-based economy in which we all become wealthier and more successful, the council must not cut our library services. If we want young people throughout Lancashire to be able to study in peace, and to look things up on the internet in, for instance, Bacup, Whitworth and Crawshawbooth libraries, we must be far-sighted. We cannot focus on short-term cost savings. I accept that budgets are under great pressure, but we must have a long-term plan, and that will not be served by robbing our young people of their libraries.

In the last 23 months, we have also seen development to help the northern powerhouse to grow throughout Lancashire. The Heysham link road is nearing completion, and a close partnership with Peel Ports in both Liverpool and Heysham is enabling us to create a global gateway through the sea for the north-west’s industry. That, of course, includes the aerospace industry. We are very lucky in Lancashire—our aerospace industry is globally pre-eminent—but we must ensure that, through the northern powerhouse project, we can build on the success of that existing industry. In my own constituency, companies such as J. and J. Ormerod plc, Linemark, WEC Engineering and of course the world-famous Crown Paints are already making the northern powerhouse a reality.

I have a simple ambition, and I hope that it will be reflected in the Queen’s Speech. It is to drive the northern economy ahead and to narrow the north-south divide. In a one nation speech, we in the north of England must show that we do not want to drag down London or the south; rather, we want to create a more prosperous north of England to rival and succeed the south as we build our economy. Those who talk the northern powerhouse down—as the Leader of the Opposition did in his response to the Queen’s Speech—are making a mistake. Perhaps the ambition of Members from across the House who represent the north of England is not understood in Islington or other parts of London. People who say that the northern powerhouse is dead just because one infrastructure project has been delayed or because one business has closed do not understand the scale of our ambition. I caution those Labour Members who are hanging on in the south of England— one of whom we have just heard from—against talking down the north, because to do so would be a terrible mistake. I know that the hon. Member for Southampton, Test (Dr Whitehead) did not do that; it was the Leader of the Opposition who talked it down in his response to the Queen’s Speech.

I have some small suggestions for the Government. First, we have handed over an unprecedented amount of power to our cities through city deals in Preston, Leeds, Liverpool and Manchester. There was some criticism when civil servants from the northern powerhouse were brought to London. Let us reverse that by creating a northern powerhouse board made up of civic leaders based in the north of England. Secondly, people in the business world want clear guidance about how they can be involved in this project. It excites businesses across the north of England like no other Government initiative, and we have to get the information out there. Finally, I hope that the Government will keep in mind our creative industries in the north-west. Those industries are supremely successful at competing on a global scale, and the northern powerhouse must drive that forward and celebrate those industries.

I was hoping for a lot more from this Queen’s Speech. I hoped that there would be something to address the ever-growing housing crisis in this country. I also hoped that there would be something on the environment or on the long-awaited and much promised Bill on wild animals in circuses. But mainly, I hoped that there would be some hope for my region and my constituency. Yet again, however, we heard only scant warm words with the brief mention of the northern powerhouse—the Chancellor’s pet project—which does not even seem to reach the north-east.

I do not think the Chancellor heeded my words on the lack of measures for the north-east in his ultra-shambolic Budget back in April, when I warned him that, despite his ambition to be king of the north, he needed to recognise that there was a lot more of the north beyond Manchester before he got to the wall. Mercifully, his time as Chancellor is almost up. Who knows where he will be when winter comes, post-referendum: in No. 10 or in the wilderness on the Back Benches? His legacy for the north-east is, sadly, only more pain and hurt.

Today’s debate is all about our public services, and I want to highlight the damage that is being inflicted on them by this Conservative Government, who are continuing to starve them of proper investment while forcing through damaging and unnecessary legislation. The Tories are now trying to dismantle and ruin two of our country’s greatest and most precious institutions: the NHS and the BBC. These are two public services that we probably all use almost every day and both are central to our national way of life. This Government are hellbent on completely changing the culture and ethos of the two institutions. They have already started the process, but we must not let them complete it.

Since the Conservatives came into office in 2010, the NHS has faced crisis after crisis, all of which could have been avoided if it had been given proper investment and support. Instead, we saw an unnecessary top-down reorganisation of the NHS that disjointed funding streams and placed unnecessary burdens on services through cuts that have been detrimental to our constituents’ experiences of using the NHS. This abysmal mismanagement of the NHS by the Health Secretary and his equally appalling predecessor is compounded by the fact that 3.7 million people are currently on waiting lists, by the understaffing of our hospitals and by patients’ struggles to see their GP. The mismanagement has been acutely felt in the north-east, with the prime example being the underperformance of the North East Ambulance Service NHS Trust. That was the subject of a Westminster Hall debate about two weeks ago in which I and a dozen other north-east colleagues raised our numerous concerns. I hope that the Government have listened to those concerns and will act as soon as possible.

Instead of addressing the issues that the NHS is facing on a day-to-day basis, the Health Secretary took it upon himself to enter into a protracted fight with our junior doctors. They do an amazing job of treating patients in difficult circumstances, yet he has battled with them remorselessly over their pay and conditions. It is welcome that a deal has now been struck between the Department of Health and the junior doctors after everyone was at last brought back around the negotiating table. However, this all could have been avoided, including the recent strike action, if only the Health Secretary had meaningfully listened to the junior doctors’ concerns about the impact the proposed changes to their contracts would have on the NHS.

The Health Secretary must rethink his entire strategy for the national health service and ensure that it does what it was created to do. I want to quote from the leaflet that every home received when the NHS was launched in 1948:

“It will provide you with all medical, dental and nursing care. Everyone—rich or poor, man, woman or child—can use it or any part of it.”

It was Nye Bevan who said:

“Illness is neither an indulgence for which people have to pay, nor an offence for which they should be penalised, but a misfortune, the cost of which should be shared by the community”.

We should have seen something like that in this Queen’s Speech. But wait—no, that only happens in a Labour Queen’s Speech. That is how we got our NHS in the first place.

The BBC is another of our treasured public services that the Government are trying to undermine. The Culture Secretary is using tactics that can only be described as bullying and intimidation to make the BBC accept a new charter—which is in no one’s interests other than those of commercial media moguls—and he has shown his true colours by going on record as saying that the disappearance of the BBC is a “tempting prospect”. Those are the words of the man who is supposed to be in charge of nurturing and championing British culture and talent.

The Government’s proposals aim to hobble the BBC, and they will put its position as an independent public broadcaster in jeopardy by introducing Government appointees to oversee the organisation. That is a clear attack on the BBC’s independence and its ability to hold the Government to account. Putting Government-approved people on the board would threaten the very existence of the BBC as we know it. Peter Kosminsky, the director of “Wolf Hall” and winner of the BAFTA Best Drama award, has said that

“the BBC’s main job is to speak truth to power—to report to the British public without fear or favour, no matter how unpalatable that might be to those in government.”

Those words remind us of exactly why the Government must maintain the integrity that the BBC has come to be respected for, not just in the UK but right across the world.

The BBC is not only one of our main sources of news and information; it also acts as a beacon for British culture and talent and is a true cornerstone of UK plc. From giving that much needed break to up-and-coming artists on BBC radio stations to the many TV programmes that showcase the greatest aspects of British life—commercially successful shows such as “Strictly Come Dancing” and “The Great British Bake-Off”, informative and incredible documentaries such as “South Pacific”, “Frozen Planet” and the many other David Attenborough documentaries that have taken us into some of the most remote and exotic places in the world—the BBC is the very best of British in everything it does, and we get to enjoy all that for the remarkably good-value price of just 40p a day while sitting in the comfort of our own home. However, the Culture Secretary has persistently put the future of commercial BBC programming in jeopardy by saying that the BBC should focus on broadcasting for the public good. He clearly forgets that all shows broadcast by the BBC, whether commercial or informative, are for the public good. The two cannot be separated because commercially successful programmes help to fund world-class documentaries that are viewed across the globe. My Opposition colleagues and I will do everything in our power to ensure that one of our most treasured institutions is protected, continues to drive creativity in the 21st century, and is accessible to all.

Going back to Peter Kosminsky, he also said in his acceptance speech at the BAFTAs:

“It’s not their BBC, it’s your BBC.”

Never have truer words been said about our BBC. We need to defend it at all costs from the damage that this Government wish to inflict upon it. Our NHS and BBC make us proud to be British. When it comes to damaging those two precious public services, the Government will not get an easy ride either from Opposition Members or from the wider public watching today.

Does the hon. Lady agree that the BBC is uniquely able to tackle difficult issues such as controlling abuse? She may have been following the recent story in “The Archers” relating to Helen Titchener, which showcases the BBC at its best. If the hon. Lady goes on to the “Free Helen Titchener” JustGiving page, she will see that the BBC has been involved in helping to raise £130,000 to support women’s refuges across the country.

I am so pleased that I allowed that intervention, because it was excellent. I thank the hon. Gentleman for that, and I do agree with him.

The NHS and the BBC are cherished institutions, providing an essential public good. They are the very best of British. The proposals are a damning indictment of this Government’s attitude towards our country and those two great institutions, of which I believe the whole country is immensely proud. That is why we cannot allow them to be dismantled or diminished in stature or performance. On the day that the NHS was founded, Nye Bevan said:

“The NHS will last as long as there are folk left with the faith to fight for it.”

His words apply equally to the BBC in this context, as much as he intended them for the NHS. We need to have faith now, and we need to fight for both of them before it is too late. Otherwise, the NHS and the BBC, which our grandparents’ generation so proudly created, will no longer be there for our grandchildren, who will never forgive us.

It is a pleasure to follow the hon. Member for Washington and Sunderland West (Mrs Hodgson). I also place on the record my appreciation of the memorable maiden speech of the hon. Member for Sheffield, Brightside and Hillsborough (Gill Furniss). The connection between those two hon. Members is that I look forward to visiting their football teams next season and not having to suffer attending St James’ Park.

The Queen’s Speech contained some 21 Bills. I do not intend to refer to all of them in the time available to me, but I want to mention some and to express my views about some that appear to be missing. It is almost de rigueur to discuss the EU referendum in our speeches, and I look forward to the Government needing to bring forward legislation to disentangle us from the European Union once we, the British people, have set ourselves on to the path of freedom and democracy.

As for today’s debate, I particularly want to talk about the national health service and not only some of the key issues contained in the Queen’s Speech, but some things that do not require legislation. The Bill to ensure that people who do not pay taxes in this country have to pay their way when using the NHS should be welcomed across the House. We all recognise that the NHS requires additional funding and needs resources, but it is a national health service that the people who live, work and play in this country rely on for their health; it is not an international health service to treat the rest of the world. I hope that that Bill will receive support right across the House, including from the Opposition.

I congratulate the Health Secretary on achieving an end to the negotiations with junior doctors that paves the way for a proper seven-day NHS. I went looking around my constituency at the weekend on behalf of constituents who want a weekend GP service, but no GP surgeries were open at all. That is the reality. GPs widely advertise as being open Monday to Friday, but no GP service is available in my constituency on a Saturday or a Sunday. If someone is ill or needs medical treatment, there is no choice but to attend A&E, leading to increased pressure on the emergency services. Equally, it is important that the Health Secretary negotiates terms with GPs that ensure that a service is available for people needing routine medical procedures at the times of day and on the days of the week when people want the service to be provided and not just when it is convenient for GPs.

The NHS’s cumbersome investment decision-making process must also be disentangled. The Royal National Orthopaedic hospital, which I am proud to champion, has been making a case for its rebuilding for some 30 years. Six years ago, we received confirmation from the coalition Government that money was available to do exactly that. However, despite draft outline business case after draft outline business case and so on, we are still waiting, six years on, for the business case to be signed off. It is ridiculous in this day and age that our NHS is spending more money on management consultants to make decisions than on consultants to deliver medical treatment. I hope that our health team can resolve the problem without the need for legislation by ensuring that we cut through red tape and enable decisions to be made—a business-like approach to running the NHS without introducing any form of privatisation whatsoever.

I warmly welcome the proposed sugar tax, because it is a great means of driving behaviour. For most people, the sugar content of many drinks is masked, which is clearly unhealthy for people of all ages, young people in particular. The change is a sign of the way things are going. Something that seemed to pass without too much celebration last week was that we finally got clearance to introduce standardised packaging of tobacco products when the court case brought by the tobacco companies collapsed in the High Court. That is good news. I was also pleased by Axa’s decision to remove the £1.7 billion of its policyholders’ money that was invested in the tobacco industry. It quite rightly said that investing in tobacco products was destroying its customers’ health and it then had to pay out on insurance claims to support those customers. That shows the way things are going. I hope that the Chancellor will consider not only the sugar tax, but a levy on tobacco companies through increasing the cost of a packet of 20 and then ensuring that all the money raised goes directly to funding local health initiatives to stop people smoking and to prevent them from starting.

I also welcome the digital economy Bill. For the unaware, I had the honour of working for BT for 19 years before being elected to this House. Back then, I promoted the idea of BT having a universal service obligation to provide superfast broadband. In fact, broadband full stop would be a start, and speed could be increased thereafter. My constituency is on the edge of London, yet it has a series of housing estates, built more than 20 years ago, in which it is impossible to get broadband—that is outrageous. We have people who work in the City of London, in very responsible jobs, who would like to work from home but are unable to do so because BT fails to provide broadband of a reasonable speed. In this day and age, it is outrageous that they should be deprived of that fundamental service, on which we all rely. As we ask more and more people to work from home, so that they do not congest the roads and do not have to travel to an office to do their work, they should have the facilities to be able to work from home, if they so wish. I look forward to that becoming more and more a focus of attention for the Government.

I also welcome the neighbourhood planning Bill. As hon. Members on both sides of the House have said, we need to build more houses in this country for people to live in. I strongly supported the Bill that became the Housing and Planning Act 2016, which creates the environment in which houses can be built. The neighbourhood planning Bill clears up the issue and prevents the process whereby plans are clogged up and development is prevented from taking place. We should set out our plan, and I support the Government’s plan to generate more and more housing for younger people to be able to purchase and so get their foot on the ladder of property ownership.

One of the most fundamental local services is refuse collection. Although localism is welcome, it cannot be appropriate that, right across London, and probably across the country, people who move, probably every six months, because of private rental arrangements suddenly find that the refuse collection systems and the colours of the bins are totally different depending on the borough. They are therefore totally confused as to what should happen. As a fundamental service to people, we should seek to ensure that we have a sensible waste-collection service in this country; we should sort out who pays for it and how it is collected. At the moment, it is one area where local decisions can be made but clearly there are vast differences in the quality of services being provided.

I am also pleased that the education Bill will be coming forward, and I am glad that the Government have wisely dropped their decision to force schools to become academies. I welcome academies being created, but forcing schools to do that would be the wrong thing to do. Finally, I will just mention the counter-extremism and safeguarding Bill, in the short time I have left. I have—

A theme has been emerging during the debate; it is the apparent “lack” or “poverty” of ambition in Her Majesty’s Gracious Speech. That theme has come from speakers on both sides of the House. When the hon. Member for Harrow East (Bob Blackman) was talking rubbish—or was it refuse collection? [Interruption.] I knew he would not mind that. However, there was still the criticism, “Here’s all the things I would have liked to have seen in the Gracious Speech.” We have heard very little about what is actually in it. If this Queen’s Speech and agenda are regarded as largely harmless or tame, it still is not the job of the Opposition to roll over in the face of that. I encourage them robustly to test each of the measures thoroughly, no matter how harmless they may appear, and to improve upon them, if that is possible.

With that in mind, I wish to focus my comments on the following promise:

“Legislation will be introduced to establish a soft drinks industry levy to help tackle childhood obesity.”

The Minister for Community and Social Care, who was before the House earlier today, promised that there would be a full package of measures to address childhood obesity, but we have seen that that package is in fact a single action: putting in place a new tax. I commend the Government for wishing to tackle childhood obesity, but I have yet to be convinced that a tax or levy on soft drinks will achieve that. If taxation was indeed the way to tackle bulging waistlines, Her Majesty’s Government would have found the holy grail, but it is important that the Opposition test this measure before blindly following it, saying, “It sounds good. It looks good. It seems to be a positive measure. Let’s support them in it.”

The over-taxation of products does not lead to reduced consumption, as we have seen with cigarettes and alcohol; consumption does not drop dramatically, although it might be controlled, and the root cause is not addressed. When taxation has been introduced at the highest levels possible, we have seen crime associated with those products increase. Let us just say that I am sceptical about a levy on sugar. It is one of those policies that sounds good and catches the headline, but it has no sound evidential base. Public Health England and the McKinsey Global Institute, in 2014 reports and studies, state that portion size, the reformulation of products, exercise, education on nutritional values and parental control have a greater impact on obesity than any taxation policy. The one country where this policy has been introduced is Mexico, where it has not worked at all. For children, the actions of their parents probably do more to improve their lifestyle than a tax on their parents’ weekly shopping cart. This sugar tax is a stealth tax dressed up as a health measure, and the Government should not be pursuing it.

The target of the tax is the soft drinks companies, but they are already taking steps to follow the evidence, through the reformulation of some of their drinks. In fact, soft drinks are the only food and drink category where sugar intake is falling year on year, and that has been the case since 2012. I therefore have a number of questions and I hope the Government will attempt to address them, either this evening or when they try to introduce this measure later in the year. Did they formulate their tax plan on 2012 evidence or on evidence since then? Do they intend to direct this tax at other higher sugar content products, in order for us to see what the Minister said earlier about the full package of measures? Where, therefore, is the real ambition of this policy?

Why have the soft drinks companies been singled out, when the evidence shows that they are already reducing sugar content in their drinks? Soft drinks are not even in the top 10 for calories contributing to the UK diet. Other products—for example, confectionary—are far higher up that list in terms of sugar content. Soft drinks form the only category of food and drink where the amount of sugar in take-home products is being reduced, and that has been the case since 2012. That fact is backed up by the 2014 Department for Environment, Food and Rural Affairs food survey—a Government survey—which showed that the switch to a diet drink from a regular sugar content drink has now taken place and that more of those drinks are now being drunk. If the Government intend to tax something, why put a levy on something that is already reducing the sugar content? They make all these promises about how they are going to spend the money, but that money is going to run out. They may promise that the money they raise will go on schools, but the figures that I have before me show that the commitment of £285 million to fund extended school days will cover only 25% of our secondary schools. If the Government pursue this tax, in five, 10 or 15 years from now, they will cover even fewer schools, so why pursue the tax at that level? The Office for Budget Responsibility predicts that the levy will raise less money year on year, but the Government have yet to set out how they will meet their commitment if that prediction is borne out.

I have tabled a number of written questions on this matter, and I have had some answers back from the Chancellor. Some of my questions were also to the Department of Health. No cost has been given for the policing or implementation of the levy. We have been promised a wide consultation, but we have had little apart from a sugary and sweet soundbite. The Opposition should challenge this a lot harder, because there is not the evidence to put it in place.

There are 21 Bills in the Queen’s Speech, and I could talk quite a lot about most of them, but I want to focus predominantly on the digital economy Bill. The announcement of that Bill will resonate in my constituency, because it creates the right for every household to have access to a high-speed broadband facility. I represent a very rural area, where people will be watching this with interest.

We use the phrase “a digital economy”. It is a nice slogan and a nice catchphrase, but in a world that is more reliant on the internet and mobile communication—as I look around the Chamber, I see that many colleagues have their iPads and their mobiles with them, and we are all using the internet—I argue that there is no other form of economy. Without the internet, we will struggle, and it is the rural economy in the High Peak that I am concerned about.

When we came into office six years ago, only 45% of the country had access to superfast broadband. To date, we have provided superfast broadband to 90% of the UK—an extra 4 million homes and businesses. By the end of next year, we will have reached 95%. That is the result of a huge investment by the Government, local councils, devolved Administrations and BT, which totals some £1.7 billion. That is no mean achievement. However, we cannot stop there; we need to continue working to connect significantly rural areas such as the High Peak. The progress made since 2010 is welcome, but the rurality of the High Peak makes it crucial that we continue to drive this forward. We cannot rest on our laurels thinking, “Aren’t we clever?” and congratulating ourselves on a job well done.

There are many advantages to living and working in the countryside, and particularly in the High Peak. We have fabulous countryside, outdoor pursuits, clear air and breathtaking scenery. The area could be called the playground of England. However, there are challenges, and some might say that there is a price to pay for all those benefits. Things that many urban areas take for granted are not as readily available in rural areas. When I was elected to this place six years ago, I was struck by the fact that when I leave the flat to come to work, there is a bus every five or six minutes. In rural areas, we get one every half hour or every hour.

Some things are very different in rural areas, and fast, efficient broadband is one of those things. It is crucial to a successful business. No matter how beautiful the surroundings, how breathtaking the scenery or how clear the air, if a business cannot operate profitably and successfully, all those wonderful things pale into insignificance. Rural areas such as mine need businesses. We need them to be successful, so that they can create jobs and support the local economy. We have a fantastic tourism industry, but in the winter we need other businesses to support our local economy.

Although we have made great strides in rolling out faster, better broadband, the last 5% that we talk about is just as important as the first. A new broadband universal service obligation that gives all citizens and businesses the legal right to a fast broadband connection is something that I would welcome with open arms. My hon. Friend the Member for Harrow East (Bob Blackman) mentioned it. He used to work for BT, so he will have greater knowledge of this than I do, but I agree with everything he said.

I have said in this Chamber and elsewhere on many occasions that, in my view, broadband is now the fourth utility. Many years ago, we had a small business based in my home village of Chapel-en-le-Frith. In those days, we used to advertise in the Manchester Evening News and the Exchange and Mart, and the phone number was the main thing that people looked for. The phone number at the time started with 0298—it was before the 1 was put in—and we moved the business to Greater Manchester, which was only a few miles down the road, to get the 061 area code so that people would see the phone number and think, “Ah, that’s Manchester.” Somebody in, say, Bolton would look at it and think, “They are just down the road,” although actually we were not that close. Those were the sorts of decisions that people made then; that was in 1982.

Things have changed hugely since then—as, I suspect, have most of us. Businesses that want to start up or relocate look for different things, but one of the first things that they consider nowadays is the availability and speed of internet access. Existing businesses have also contacted me to express their concerns about broadband provision. This is about not just attracting new investment and new businesses to rural areas, but retaining the businesses that we already have.

There is an industrial estate in Buxton, in my constituency, called Tongue Lane. Several companies trade on the estate, employing many local people between them. I want to touch on two briefly. Bells Shoes exports hundreds of pairs of shoes around the world. Over the years, it has grown from a high street retailer—it is well known on the high street in Buxton, in Spring Gardens—to a significant exporter of shoes across the world. It is a testament to its commitment to the area that it has remained in Buxton.

Otter Controls—everybody in this room probably uses one of its products—makes thermostats. It was started after the second world war, when the founder of the company devised the bimetal strip to enable the temperature to be controlled in electrically heated flying suits for the Royal Air Force. That, in itself, is a fantastic story, but we are time-limited today, so I cannot go into it. The company operates on Tongue Lane industrial estate and employs many local people.

Both companies, and others on the estate, have contacted me recently about the inadequate broadband provision. The estate was not originally included in the Digital Derbyshire scheme, but because of savings and advances in technology, it now will be. That is good news, not only for the companies but for the many local people that they employ. As both companies are significant exporters, it is also good news for UK plc.

There will be a discussion about what is termed “fast”: how fast will it be, will it be fast enough and can it be made faster? The initial commitment, as part of the universal service obligation, is 10 megabits per second, but we need to be sure that that is future-proofed. As more and more services are provided online as time progresses, it must be possible to speed it up. I am sure that those finer details will be explored during proceedings on the Bill. I welcome the fact that Ofcom will be given the power to review the speed to ensure that it remains sufficient for the needs of the day.

We need to ensure that that commitment is matched by delivery. The last 5% will be, by its nature, the most difficult. It will be a challenge, and it will not be easy, but if we give people the legal right to such broadband, we have to be able to deliver it. What is more, it must be available at an affordable and competitive rate. I recently met BT and Digital Derbyshire in the village of Chinley, where a new fibre-enabled cabinet has been fitted. That is a welcome move, but there are still areas of the village of Chinley that will not be served by the cabinet. In other areas of the High Peak, Councillor Sarah Helliwell, who was newly elected last year, is already dealing with requests from her residents in the Hope valley who are desperate for faster broadband. Other constituents of mine, such as Andy Byford and Steve Otty, who has corresponded directly with the Minister, are eager for a faster, better and more viable internet connection. Although we are getting better and faster connections in the High Peak, they are by no means universal. The coverage is still varied and patchy. The word that has been used is “universal”, and the coverage must be just that. As I have said, to achieve that will be difficult, challenging and, in places, expensive. I stress again that as well as being universal, it must be affordable.

I have great confidence in the ability of the Minister and the Government to deliver this huge commitment. I look forward to the day when I can tell prospective businesses that I am trying to attract to the High Peak that we can offer them fast, effective broadband that is suitable for their needs. I look forward to being able to say to High Peak residents who tell me that they want faster broadband that they, too, can receive a broadband service that lives up to their expectations and requirements, no matter where they are.

There is much else to talk about in the Queen’s Speech, but I will leave it there on the digital economy Bill, because other colleagues want to speak and I am conscious of the time. I congratulate the Government on the measure and I look forward to its being delivered as quickly and efficiently as possible.

Each year, the Government put before Parliament their expenditure programme, the Budget, and their legislative programme, the Queen’s Speech. These two moments in the parliamentary calendar are meant to encapsulate what the Government are all about, what they will do and how the country will change. Ministers like to make grand claims on the merits of their programmes, and it is our duty to detach the cheerleading and scrutinise the reality of what is being said.

The scrutiny of the March Budget saw the Government’s triumphalist claims fall apart under the weight of reality. Debt forecasts are up, growth is down, and public services are continuing to be chipped away, with inner-city constituencies such as mine hit the hardest. We saw little ambition to enable the fifth largest economy in the world to work for ordinary people, or any ambition truly to invest in our futures.

Two months on from the Budget, the new legislative programme is now before us. It comes with more triumphalist claims about life chances, but in reality those claims mask a Government coming apart at the seams. We know the Prime Minister’s eye is on Europe, and his potential successors are sizing up his job. It is a Tory Game of Thrones. The White Walkers are out to get him, but before we feel sorry for this beleaguered Prime Minister struggling to keep Britain in the EU, let us remember that it is his weakness before his party and his MPs that has brought us to the brink of an exit from Europe—an exit that would be disastrous for our country.

Let us look at the Queen’s Speech. It is possible that not everything in it will be bad. It is possible that the lifetime savings Bill is a positive development, but we cannot be sure without seeing the detail. There is a lot more that is not good for Britain and will exacerbate the public service crisis. Above all, there is a glaring gap, which is a lack of purpose and a lack of direction. The programme does not even attempt to tackle the country’s many challenges, which include: a growing housing crisis with a need for many more social, intermediate and affordable homes; an ageing population and health inequalities; a skills deficit and productivity gap that contribute to chronic low growth; and an air pollution crisis in our capital and, as I understand it, elsewhere.

Ministers claim that the programme is about life chances and a one nation approach, but let us look at what is happening. There is a growing gap in life chances across the country. The Government’s own Social Mobility and Child Poverty Commission says:

“There is a gulf between today’s divided Britain and the ‘one nation’ the Prime Minister desires to lead.”

The commission says there is

“a growing social divide by income and by class.”

Wealth inequality has risen for the first time in almost a decade, says that deeply socialist paper, the Financial Times. The Institute for Fiscal Studies says two thirds of children in poverty live in working households, up from just over half in five years. The number of children living in absolute poverty, after housing costs, has risen by 500,000. Public services are under ever more pressure, and things are getting markedly worse than they were in 2010.

NHS waiting times in England are longer, with more than 3.5 million people on waiting lists. A&E has seen the worst performance figures on record, with patients waiting longer to be seen. There are also longer waiting times to see a GP. Cuts to older people’s care have seen delayed discharges from hospitals reaching a record high. Cuts to nurse training places have led to staff shortages, and also created a massive financial hole as agency staff have had to be hired to cover the vacancies.

There are fewer police and fewer firefighters. Social services are under strain, and social worker vacancies are on the rise. Sure Start centres have closed. Teachers and doctors are leaving the professions. Museums and libraries have been decimated, leaving children and families without basic educational resources to supplement their schooling. House building is at its lowest since the 1920s, and homelessness in London has leapt 80% since 2010. These are not just figures, but personal stories of anguish. We are seeing a real impact on lives, on jobs, and, ultimately, on life chances. That is the real story of Britain under Conservative rule.

I must praise the valiant efforts of councils, especially Labour councils, to try to keep things running. They are innovating, but with the financial squeeze—a 25% cut in budget during the last Parliament and an 8% cut set for this one—and the policies of this Government, it is becoming ever more difficult to do so. That is the rub: the Government have the wrong priorities. Who supports what is happening in the NHS—the unnecessary reorganisation and the attack on junior doctors? It is certainly not the patients or NHS staff. The NHS is a prized national asset and provider of collective health security. The Government’s approach is more about the prejudices of the former Health Secretary and the bunker mentality of his successor. I am glad that there has been some backing down, but it is simply not enough.

Who supports the Government’s plans for the BBC? Looking at my postbag, it does not seem to be the licence fee payers, the actors or the programme makers. What benefit is it to Britain to run down the BBC, a prized national asset with a global reputation? The action seems to be more about the prejudices of the Secretary of State for Culture, Media and Sport. There has been a backing down, but it is not enough.

Who supports the forced academisation of all schools? It is not the teachers, the parents, the pupils, or even the Tory councils. What does it solve to force good schools to concentrate on unnecessary reorganisation? It is more about prejudices relating to state schools. There is little consideration of the real issues of falling school budgets, chronic teacher shortages, not enough good school places and children being left to fall behind. There has been another backing down on academisation, but why the need for so many U-turns, and why is the Bill even in the Queen’s speech? Those are just some examples of the wrong priorities; there are many more.

A long time ago, the Prime Minister said:

“We will trust the professionals.”

How little we hear of that now. The Government’s approach is riven with contradictions. The devolution agenda offers a real opportunity for improved services. I am talking about the opportunity to bring services together in localities and to use new technologies and ways of delivery. We also have new leadership. I am delighted that Sadiq Khan was elected Mayor in London and Marvin Rees in Bristol. There is a real opportunity there, but devolution is going hand in hand with a raft of Government cuts. It is the political interference that is having a lasting effect. The Government are driving the destruction of the sense of public value, public service, and public assets and the principles of collaboration and excellence. I plead with Ministers and Government Members to be a little more honest. The right hon. Member for Chingford and Woodford Green (Mr Duncan Smith), freed from the shackles of Cabinet responsibility, admitted when he resigned that there is a lack of fairness and compassion. He said that the disabled will be impacted by the Government’s policies, which have been

“enacted in order to meet the fiscal self-imposed restraints that I believe are more and more perceived as distinctly political rather than in the national economic interest.”

This Queen’s Speech is not about the challenges that are facing Britain. It is not an honest conversation about how public services can be improved and reshaped to meet the needs of all of us in the 21st century. Sadly, it is a missed opportunity from a Prime Minister who is running out of time to prove that he can leave a positive legacy for our public services and indeed for our country.

It is a pleasure to be called to speak in this debate on the Gracious Speech. There is always a theme in these debates on the Queen’s Speech—a list of goals that are not present, a list of what should have been in there that was not, and what people do not like about it and what they do like about it. What has saddened me is that the common theme from the Opposition is that they do not think that there is much in the Queen’s Speech, and yet, as we have just heard, there are 21 separate Bills. There is quite a lot in there.

It takes me back to 2010, when I first became an MP, because this Queen’s Speech is all about why I wanted to come into politics in the first place. Looking back to 2010, I see that on my website I described myself as the fresh-faced MP for Blackpool North and Cleveleys. That is no longer true—I look in the mirror now and see that the lines are slightly deeper, the eyes slightly more sunken; I am on the wrong side of 40—but one thing has not changed: my belief that I got into politics to stand up for the people who are directly under the state’s care who have no one to stand up for them. They include the patients in hospital, whom we discussed in opening today’s debate; the young people in care waiting to be fostered or adopted, who the Prison Reform Trust told us today are over-represented in the youth justice system, not just by a small amount but by an absolutely massive amount; and the prisoners in our prisons who are not being educated properly or rehabilitated, which has a direct impact on the number of victims there will be if we do not reduce reoffending. Getting that right has to be the right thing to do.

Does the hon. Gentleman share my concern about the radicalisation, both Islamist and neo-Nazi, that takes place in prisons? Is there not a need for the Government to tackle that? People are going into prison with some sort of innocence in terms of religious belief and coming out with a radical opinion. There has to be something done.

I thank the hon. Gentleman for making that point. He tempts me to indulge in a nine-minute disquisition on how we balance the presence of faith in our prison system with the need to safeguard against radicalisation. I agree with him broadly, but I do not want to go down that path, tempting though it may be. I would much rather focus on the fact that what brings all this together—standing up for those who have no one else to stand up for them—is this idea of life chances, which is the theme behind the Queen’s Speech.

The Whip should listen carefully now: although I hate the phrase “life chances”, he should not write that down in his little black book, because to my mind what we are really talking about is social justice. Like Ruth Davidson, I am proud to say I am a John Major Conservative. I believe in equality of opportunity. I do not believe in equality of outcome because it cannot be guaranteed, but I do believe that part of achieving social justice is taking ownership of the consequences of our policies. We have to have some regard for the outcomes.

That can be hard to justify when we look only at globalised national statistics. They do not give us the granular narrative detail of individual lives. Many times in this Chamber we have debated how we measure child poverty, what the best indicators are, what they mean, and how we tackle child poverty. We can disagree constructively on what those indicators are and how we utilise them, but I believe we need to go down another level. A good example is an article I urge everyone to read that appeared in The Atlantic magazine last month about the proportion of Americans who, if landed with an unexpected bill for $400, would not be able to meet it out of their earnings. Shockingly, some 47% of Americans would not be able to pay that bill for $400 without recourse to either borrowing from others or payday lending. I shudder to think what the figure is in this country. No doubt a sociology department somewhere is preparing a research funding request as we speak to find out that information. We need to burrow down so much more into the detail to get a true understanding of how to improve life chances.

Think about the connection between social isolation and ill health—the number of lonely elderly people in my constituency who probably do not speak to anyone day in, day out, and the younger people with serious health conditions who may feel socially isolated. Social isolation is the key predictor of future ill health and therefore future demand on the health service. That has to be taken into account. Think also of children. I visit many primary schools and I know that in the more deprived parts of my constituency there is a major problem with the number of children arriving at school aged four who are untoileted. Think of the burden that places on the staff in toilet training them, taking them away from the educational aspects of their job.

Another wider issue for older children perhaps, those who are eligible for free school meals, is how many of them are not fed properly during the school holidays. I know the hon. Member for Washington and Sunderland West (Mrs Hodgson) is deeply concerned about that. Although all that is difficult to measure, it gives a different dimension to the story of life chances from the national global figures for whether child poverty is going up or down in any particular set of years we all focus on. We need to be much more creative in our approach.

I had hoped that by talking for an extra five minutes, my hon. Friend the Minister for Culture and the Digital Economy would have returned to his seat to hear what I am about to say about Department for Culture, Media and Sport issues. I know he has to wind up the debate and I was hoping to help him. He published an excellent culture White Paper just before the Queen’s Speech—the first since Jenny Lee’s ground-breaking document in the 1960s. The key element of the latest White Paper is about broadening participation. I had not really thought about it in those terms, but I was invited by a constituent, James Nash, to a concert by the National Youth Orchestra at the Liverpool Philharmonic hall a few weeks ago. James plays trumpet at grade 8 —grade 8 is a requirement to play in the National Youth Orchestra. He is very proud of his participation and thoroughly enjoying the experience. He went to a local comprehensive and is very musically talented so this is a fantastic opportunity for him, yet that orchestra is a charity, supported by the Arts Council.

I had the pleasure of hearing Thornton Cleveleys Brass Band the Sunday before last. For the first time ever, it has won a regional division of its national brass band competition at the fourth tier, I gather, of brass bands. It will soon compete in Cheltenham in the national competition. That band is looking for funds and it will be going to the Arts Council, which now supports brass bands thanks, I believe, to the Minister’s intervention. That broadens participation by so many young people who enter music through the local brass band.

There are many ways in which culture is broadening horizons, but unfortunately in Lancashire there is one way in which those horizons are narrowing rapidly—through the very sad decision by Lancashire County Council to close so many of our local libraries. Almost half of Lancashire’s libraries are being shut. I am losing Cleveleys library, which has a children’s centre attached, and Thornton library, which is just over the constituency boundary but I feel I have a share in it with my hon. Friend the Member for Wyre and Preston North (Mr Wallace). We all recognise that councils have to make savings. What I find so frustrating is that when others have come up with solutions to help to keep libraries open and make the savings, Lancashire County Council will not sit down and listen.

Wyre Borough Council wants to convert all Wyre’s libraries into a community interest company, thereby forgoing many of the business rates and other associated costs that make them so expensive to run for the county council. By doing that, it can save the money the county council wants to save and keep every single library open, but shockingly the county council will not even sit down and talk about it. The hon. Member for West Ham (Lyn Brown) rightly praised councils that innovate. Please could she have a word with Lancashire to persuade the council to innovate? Many other councils of all stripes have rethought how they do library provision. Why can Lancashire not do the same? Does it want to make a cheap political point? I desperately hope not, because that would be a tragedy.

I remember back in 2008 the right hon. Member for Leigh (Andy Burnham) taking the visionary step of calling a public inquiry because Wirral Metropolitan Borough Council had chosen to close so many of its libraries. I attended that public inquiry. I know he is not here, but I very much hope that my hon. Friend the Minister for Culture and the Digital Economy will agree to meet me to discuss whether Lancashire’s plans are enough to justify another public inquiry under the terms of the Public Libraries and Museums Act 1964. The council has an obligation to provide a “comprehensive and fair” service. My concern is that what Lancashire is planning is not fair—I know that is a subjective term—and it is certainly not comprehensive.

My constituents, who have been accustomed to going to Thornton and Cleveleys libraries will now have to go further afield, to Fleetwood and Poulton, shortly after seeing all their bus connections to such areas slashed by the county council. That is doubly frustrating. I urge Ministers at least to arrange for me to have a conversation with my hon. Friend the Minister for Culture and the Digital Economy to discuss those issues.

On a wider point, whenever I come here, I desperately try to believe that all of us are here for the right reasons—we all want to make things better for the people we represent in our constituencies. Some of us hide it better than others, perhaps, by our conduct in this place. Some are more bolshie, some are ruder, some cat-call me from a sedentary position and some chunter away, but I always try to find something positive in what the other person is saying, and I urge all Members to try to do that.

Whatever we think of the phrase “life chances”, the issues that it covers are surely the reason why we came here today. I urge all Members to look for the positives in what this Government are trying to do. I know that the Opposition have to scrutinise us, but I hope they will open their hearts occasionally to find the good stuff that we are doing and help us to do it better still, rather than just criticising us for being anti-public sector, anti-everyone and anti-everything.

In that vein, I will try to be constructive, but I need to point out the current situation. I want to challenge the Government on their assertion that they will “deliver opportunity for all”, as the Prime Minister put it last Wednesday, or extend life chances for all. All the evidence indicates the contrary.

We are one of the most unequal countries in the world and under this Government that is set to get worse. In the UK 40 years ago, 5% of income went to the highest 1% of earners. Today that income figure is 15%. The Institute for Fiscal Studies forecasts indicate that between 2015 and 2020 the 90:10 ratio—that is, the ratio of income at the 90th percentile of the household income distribution to income at the 10th percentile—will increase from 3.8 to 4.2, largely as a result of tax and social security changes. In other words, the richer people are, the more quickly they will accumulate even more income, and the poorer they are, the less income they will accumulate.

We know that that is bad for society. If we are looking for constructive criticism, there is so much evidence to show that as the gap between rich and poor widens, everybody suffers in terms of social mobility, life expectancy, mental health and crime. Everything gets worse when we become more unequal, and that is what is happening. It is not just a matter of income; it is also about wealth, as we know from the Panama papers, which revealed that the richest are keeping their assets in offshore tax havens where tax is avoided and evaded.

According to the Equality Trust, in the past year alone the wealth of the richest 1,000 households in the UK increased by more than £28.5 billion. Their combined wealth is now more than that of 40% of the population—that is 10.3 million families. While the wealth of the richest 1% has increased by 21%, the poorest half of households saw their wealth increase by less than a third of that figure. I could go on. This is constructive criticism. This is the effect of the Government’s policies.

The Government, like the coalition, have a regressive approach to their budgets, and it looks as though this will continue. Regressive economic policies where the total tax burden falls predominantly on the poorest, combined with lower levels of public spending, are key to establishing and perpetuating inequalities, with all the damage that I have just described. As has been pointed out, when Labour was in government NHS spending increased by 3.2% in real terms, whereas between 2010 and the present, we have seen a decrease from 6.2% to 5.9%. That has caused a financial crisis for many trusts. In my own area in Greater Manchester, where we have had the opportunity of devo Manc, we are expecting a deficit of £2.2 billion by 2020. That is the projected outcome of the unfavourable devolution of that budget.

The same is happening in education and, in my area, in social security and support for disabled people. We have seen a general decline in support for disabled people since the 1960s. I am looking critically at Labour’s record too. In 2012 1.3% of GDP was spent on support for disabled people. Now that figure is 1.1% and it will decline to 1% by 2020. It is particularly the people on low income, including the working poor, and the sick and the disabled who have been hammered and continue to be hammered by this Government. As a result of the Welfare Reform Act 2012, 3.7 million people will have had £28 billion of cuts in support.

We have just passed the Welfare Reform and Work Act 2016, which will compound the cuts. We are all aware of one of those—the cut of £1,500 a year to approximately 500,000 people who have been found not fit for work in the employment and support allowance work-related activity group. That is anathema, particularly as the evidence shows that on average disabled people have extra costs of £500 a month.

That and further cuts will plunge disabled people into poverty and affect their condition. Ultimately it will affect the demand on the NHS and social care. The Government’s own data released last August show that people on ESA and incapacity benefit in 2013 were 4.3 times more likely to die, compared to the general population, which shows just how vulnerable they are. These figures were released during the August bank holiday after the Government were compelled by the Information Commissioner to release them.

Research published last November in a peer review journal estimated that the work capability assessment alone was associated with 590 additional suicides, 280,000 additional cases of self-reported mental ill health and 725,000 additional anti-depressant prescriptions. Just a week ago, when Parliament was not sitting, the Government published the peer review reports on 49 social security claimants who had died between 2012 and 2014. At the time the former Secretary of State denied that the Government held any records on people whose deaths may have been linked to the social security system. We now know from those reports that 10 of the 49 claimants had died following a sanction, and 40 of the 49 deaths were the result of a suicide or suspected suicide. That has occurred throughout the country. The heavily redacted reports highlight widespread flaws in the handling by Department for Work and Pensions officials of claims by vulnerable claimants.

Last week I called for a statement to be made on those reports, but the Leader of the House refused, so I am putting on record the questions to which I want answers. What action has been taken to address the recommendations from those reports? Will the Government review the recommendation from the Select Committee’s sanctions report last year to establish an independent body to review the deaths of social security claimants? Will they agree to an independent review of sanctions and stop the rollout of the current pilot on in-work sanctions? Finally, given the links of those deaths to the work capability assessment, will the Minister recognise that that process has lost credibility, and will he make the fresh start that we want to see?

In 2009 we became signatories to the UN convention on the rights of persons with disabilities. The Government promised a White Paper on employment to set out how they intend to halve the disability employment gap by 2020. Where is that dealt with in this Queen’s Speech? The Prime Minister said last week that the Government were reducing the disability employment gap. No, they are not. The evidence shows the contrary—that it is up from the previous year to 33%. Only 124 employers have signed up to the Disability Confident campaign. Last year 37,000 disabled people benefited from Access to Work, out of 1.3 million. That clearly will not cut it.

On education and training, why is there is such a delay in children being assessed for education, health and care plans? Why are we not increasing the number of apprenticeships available to disabled people? What will the shifting of the disabled students allowance on to higher education mean for disabled people? What about the 42% reduction in access to transport funding, which is making disabled people prisoners in their own home, and the cuts in home adaptations for disabled people? I have not even mentioned the £4.6 billion of cuts to social care, also impacting on disabled people. The cuts to local government funding will also have a direct impact on them.

This Government must look at the cumulative effect of all these cuts on disabled people, and they must value claimants in our social security system. Like our NHS, it is based on principles of inclusion, support and security for all, and it is there for any one of us, should we become sick or disabled.

It is always a pleasure to follow the hon. Member for Oldham East and Saddleworth (Debbie Abrahams). It is a privilege to be able to speak in today’s debate.

I start by echoing the comments by my hon. Friends the Members for Harrow East (Bob Blackman) and for High Peak (Andrew Bingham), in particular, and other hon. Members, about the digital economy Bill. I am delighted that the Minister for that business area, my hon. Friend the Minister for Culture and the Digital Economy, has just walked into the Chamber. This Government have done a splendid job in trying to roll out broadband. It is very difficult to make inroads into the last 5%, but the universal service obligation and the commitment to 10 megabits is absolutely right. I look forward, in particular, to my rural constituents and their small businesses being able to access 21st-century technology in the very near future. On behalf of those constituents, I thank the Minister for all his hard work.

I am a doctor, as you know, Mr Deputy Speaker, and I have to declare that interest since most of my contribution will be about healthcare. The Gracious Speech rightly began with the economy, however, and we found out why that might be over the weekend when Simon Stevens, the head of the NHS in England, made it very clear that without a sound economy one cannot have an effective healthcare system. That is absolutely fundamental to the delivery of public services in general, and particularly to the national health service. It is perhaps ironic that Simon Stevens was once a Labour councillor. I wonder what he would make of the financial illiteracy displayed this afternoon by Labour Front Benchers, who must answer the fundamental question about what they would want to spend on our national health service beyond Simon Stevens’ five year forward view. On a number of occasions they have been pressed on this matter and failed to come up with an adequate answer. I say ever so gently that Labour Front Benchers must answer the point being made by me and other hon. Members about precisely what figure they would be prepared to commit to our health service, since at the last general election they opposed the Government’s spending plans, and had they been in government now, enacting their proposals made only a few months ago, our national health service would have little chance of seeing the £30 billion overall extra spend to the end of this decade that it so desperately requires.

I very much welcome the commitment to the so-called seven-day NHS. As it happens, I was visiting a constituent in a busy hospital ward this weekend, and from the activity that I saw, it seemed that the NHS was working at full tilt. However, in some important respects, our health service is different at the weekends from how it is midweek. It is absolutely right that the Government should be attempting to roll out Sir Bruce Keogh’s 10 clinical standards, particularly the four he has identified as most important in this matter. The seven-day working week is essential to being able to do that in a comprehensive fashion. I commend the Government for the efforts that they have put into this for the past several months.

I also welcome the commitment to dealing with sugar. We heard earlier about the perils of obesity and the time bomb, as it were, that this presents to the younger generation. If we are going to be true to our mission on public health and preventive health, it is absolutely right that we should send out the right message to those who sell fizzy drinks—sugary drinks—and ensure that we try to reduce consumption of those things.

The Secretary of State has a very tough job, in my opinion. He has to improve outcomes—which are not good in this country compared with countries with which we can reasonably be compared—and deal with increased public expectations, demographic change, and economic stringency. I am very pleased that I do not have his job. If I may say so, the strain is showing—on the national health service, I hasten to add, not on the Secretary of State—since we know from last week’s data that there is a £2.5 billion deficit that involves two thirds of trusts being in the red. That is set to endure, since we have a real issue in reconciling the money going into the national health service, welcome though it is, with the extra demands being put on the health service all the time through the demographic changes that I mentioned.

We are now 18 months into the five year forward view, and the £22 billion in savings looks challenging, to put it mildly. Those savings are predicated on a number of assumptions—in particular, a continuing input into public health—and yet, necessarily, the local government grant has been squeezed this year. According to the Health Foundation, we also have a £6 billion social care cost funding gap. All this impacts on health generically. Simon Stevens made his prognostications based on continuing spend on public health and on social services, both of which have been squeezed. I make no criticism of the Government on that, since it is absolutely necessary to deal with the economy, as I said in my opening remarks. It has happened, nevertheless, and therefore, I am afraid, undermines much of what Simon Stevens had to say. We need to bear that in mind when we assess how realistic is the £22 billion figure, which, by his own admission at the time, required what he described as a “strong performance” by the national health service.

“Five Year Forward View” talked of a “radical upgrade” of public health and prevention, stating that public health was its first priority. Many of us can remember the Wanless report by the late Derek Wanless, which said that improvements in public health and prevention were absolutely essential if his “fully engaged” scenario was to be enacted. The recent Carter review showed a considerable unwanted variation across our national health service. In this, there is some hope for squaring the budget, since if there is such a wide variation across the national health service, there must surely be capacity to improve practice across the service and thus generate efficiencies. However, it appears that Carter has stalled, and we need to have a proper plan for the future on how the differences may be dealt with and, we hope, erased. Beyond some useful sharing data, it is not clear that Carter has been progressed in the way that we might want. I fear that if we do not give it a bit of oomph, there is a risk that it will go the same way as Wanless, which would be a great pity.

I very much support the seven-day-a-week national health service. As I have said in the past, I am not terribly convinced by the mortality data that underpin it. I am much more persuaded that we need to look at items of clinical service to underpin the argument for a seven-day NHS. I am thinking particularly of things like palliative care services. I am thinking about the fact that there are no routine endoscopy lists on a Saturday and a Sunday. That has huge implications for people who have had an upper gastro-intestinal bleed on a Friday, for example. The upper gastro-intestinal endoscopy example is a good one, since it touches on Bruce Keogh’s standards 5 and 6, which recommended endoscopy within 24 hours of a bleed. That is not happening in many of our acute hospitals. A lot of the remedy has to do with considering how to network hospitals, and perhaps reconfigure our national health service estate, in order to ensure that when people are acutely unwell they go to a unit that is capable of managing their healthcare needs in the most efficient and effective manner and ensuring that they have the very best chances of leaving hospital in good order.

We are faced with the reality of a healthcare system that is working at full tilt, and of which we are enormously proud, but delivers healthcare outcomes that could be better by international standards. Part of the reason is that we do not spend enough on healthcare. The reason I do not envy the Secretary of State for Health is that he is going to have to grip the reality that in this country we spend very much less than countries with which we can reasonably be compared—8.5% of our GDP compared with 11% in the Netherlands, Germany and France. I have no easy solution for that, but I do suggest, ever so gently, that we need to look a little more broadly at potential solutions. We could think, perhaps, of having a non-partisan commission that may grapple with this extraordinarily difficult and complex matter, because one thing is for sure—the institution that is held most closely in the public affection is our national health service, and we must fund it properly.

Order. Before I call the next speaker, I am afraid that I will have to lower the speech limit to eight minutes to ensure that everybody can get in. I call Paul Blomfield.

I will endeavour to meet that demand, Madam Deputy Speaker. It is a pleasure to follow the hon. Member for South West Wiltshire (Dr Murrison), who made a very measured speech. I came close to agreeing with his last point, if not his earlier criticism of our Front Benchers, because this Queen’s Speech provided an opportunity to tackle the funding crisis in the NHS. Sadly, however, it did not take that opportunity; nor did it tackle the crises in social care and, indeed, the impact of the disproportionate cuts on local government. Instead, the Government are turning their ideological fire on two areas of hugely successful public provision—the BBC and higher education. The hon. Member for Salisbury (John Glen) made the point that we should not be ideological in the public versus private debate. He is right: what matters is what works.

In that context, what is the BBC White Paper all about? If the BBC were some colossal failure, plumbing new depths in unpopularity, there might be cause for reform, but we all know it is not such a failure. The BBC is the envy of the world. It is hugely popular in the UK, as we know from the overwhelming support it received in the Government’s own consultation. It is fair to say that the Government’s plans are not as bad as some of the leaks made out. I hope that that is an indication that the Government are listening. It is probably the tried and tested strategy of leaking something really bad so that, when they publish something that is simply bad, everybody breathes a sigh of relief and thinks it is okay.

Although the plans are not as terrible as was feared, there are still serious concerns. Underlying the proposals appears to be the idea that the BBC is bad for the market and therefore has to be reshaped in line with the views of the Murdochs because it is too popular, too successful and too good at what it does. The Government want to add new distinctiveness criteria to the BBC’s mission statement, which they say should be

“discernibly different in approach, quality and content to commercial providers”.

In so much of what it does, the BBC is already different, so what is this about?

The proposals could stop the BBC competing on a level playing field with commercial providers in producing popular and successful programmes. This Government believe in markets to drive up quality, so why are they interfering in this market to handicap the most successful player? They want the charter to make it clear that the licence fee is not solely for the use of the BBC, and they want to establish a contestable fund for which commercial rivals can bid. What is that about?

Why is there a requirement for the BBC to recruit 150 local reporters to feed news content to local newspapers? We all support local newspapers, and we should debate their future, but quietly top-slicing a block of public funds for that purpose without a full debate sets a dangerous precedent. The proposal for Ofcom not just to become the BBC regulator, but to have a brief to assess the market impact of

“any aspect of BBC services”

sends a worrying signal, as does the plan to undermine the BBC’s independence by allowing the Government to appoint as many as half of the non-executive directors to its new all-powerful board, which will have responsibilities for editorial direction and programming.

What is it all about? Is it that successful public services challenge the Government’s world view that only the private sector can deliver quality, or is it just that the Government do not like the BBC? In 2008, the Prime Minister wrote that the BBC has a “left-wing bias”, is “instinctively pro-Big State” and has become “oversized and over-reached itself”. His one-time hon. Friend the Member for Uxbridge and South Ruislip (Boris Johnson) has called the BBC

“statist, corporatist, defeatist, anti-business and”—

of course—


Perhaps most revealing is the Culture Secretary’s comments that the BBC’s approach to impartiality drives him “insane” and that its ceasing to exist is a “tempting prospect”. I must say that those comments actually make him unfit for the post he holds. Prejudice is no basis for good policy, and I hope that the Government will think again.

I hope the Government will also think again about the higher education White Paper. We have one of the best university systems in the world. It is good for UK students, and, despite the best efforts of the Home Office, it is good at attracting students from all over the world, bringing in over £10 billion of export earnings, so we should take care about meddling in it.

The higher education White Paper proposes a teaching excellence framework. I agree that a focus on teaching excellence is a good thing, but if we get the measurement of teaching quality wrong, we will create perverse and unintended consequences. That concern was expressed by the Business, Innovation and Skills Committee, when we looked at the proposed metrics, which also risk damaging our reputation internationally. Our universities are known around the world for the excellence of our independent quality assurance. If we move from the current system of quality assessment to the proposed three tier ratings, we will immediately send out a message internationally that not all our universities are outstanding. A system of ranking might be okay if it were part of an internationally agreed approach, but if we take a unilateral stand on dealing with quality assurance within our university system, we will be sending out the message that our system is not quite good enough, which will damage our brand and deliver students into the hands of our competitors. As I have said, the Home Office is already spectacularly effective at doing that.

There is also a risk in opening up the sector to new providers. We do not need to look very far to see that risk in practice. We simply need to look at the United States, on which the model is based. Universities operate there on a business model in which unscrupulous providers milk the publicly funded loans system and recruit students to substandard courses: the public lose, the public purse loses, students lose, and the companies pick up the profits. In recent years, more than two dozen companies running for-profit colleges in the United States have been investigated or sued by state prosecutors. Together, the 152 schools under investigation received about $8.1 billion in federal student loan and grant payments in the last fiscal year, according to an analysis in The New York Times. Some of those companies are already operating in the UK and are looking for the opportunity, which this higher education White Paper provides, to extend their operations. As with the BBC, it seems that the Government are not making decisions on the basis of what works and are putting ideology before the evidence. On both these matters, I urge them to think again.

It is a pleasure to follow the hon. Member for Sheffield Central (Paul Blomfield) in this debate on the Queen’s Speech. In the time afforded to me, I want to focus on the defence of three key public services—the NHS, schools and the BBC.

On the first, 28% of my constituents in Bexhill and Battle are over the age of 65, versus a national average of 17%. There are forecasts that the national average will reach 25% by 2050, which is a cause for great celebration. However, as a result of an ageing population, my constituency has the highest rate of dementia in mainland Britain. East Sussex has the highest percentage of over-90s in the UK, and is predicted to be able to make the same claim for the over-75s and the over-85s in the years to come. Accordingly, the state of the NHS is of particular importance to my constituents—not just those who rely on it in their older age, but those who need to access it across the age spectrum.

I have ruptured, and this week re-ruptured, my Achilles tendon, so I have been something of a drain on NHS resources. It has, however, given me the opportunity to witness, at first hand, the NHS and the first-class people who work in it. I want to say a huge thank you to every clinician and employee for what they do for my constituents. Their clinical expertise, dedication and care make me incredibly proud to be British and equally determined that we should listen to their ideas for and concerns about the NHS.

The decision by our junior doctors to call the first ever all-out strike was a deeply depressing outcome of the breakdown of the contract negotiation. On the day of the strike, I went to the picket line to meet the junior doctors who had looked after me following my first Achilles tendon rupture. I spent an hour listening to the concerns of those junior doctors. Some concerns were linked to their personal circumstances and their feeling that it was unfair, in their position, to have only the same rights as a fixed-term employee when it came to the unilateral imposition of contract terms. Other concerns were about their workplace and their ability to do their best in the face of increased demand from patients.

On that day, I was asked whether I would write to the leader of the BMA and the Secretary of State for Health and pass on those junior doctors’ desire for talks to resume and a negotiated settlement to be reached. I duly did so and was delighted when talks were subsequently held and a resolution was reached. I hope that the junior doctors will consider the settlement negotiated by the BMA a fair compromise that is worthy of acceptance, and I thank the Secretary of State for going the extra mile.

It is clear to me that, once the contract is finally negotiated, we should have a grown-up debate about the future of the NHS. Can we expect it to meet the needs of an ageing population, carry on purchasing ever more expensive drugs, deliver innovative treatment and cope with an increasingly obese population when we as a nation only put 8% of GDP towards health? In the French and German model, it is 11% of GDP. Inflationary patient demands on the NHS equate to a 4% increase per annum, yet the increase in spending, welcome as it is, is running at 2%. This Conservative Government have spent record amounts on the NHS, but does the current situation make it reasonable that those who fail to take individual responsibility, or who waste the time of our doctors or nurses or disrespect them, should pay towards their care or be denied it? I welcome the Government’s decisions to introduce a new Bill to tax sugar content and to strengthen existing rules to ensure that all health tourists from abroad pay for their treatment. However, we could also look closer to home in expecting patient responsibility in return for treatment.

I am intrigued by the requirement for the NHS to deliver £22 billion of savings at the same time as introducing a seven-day NHS. If we are to have a fully functioning NHS on a Sunday, it means absorbing all the costs of running and supporting such a service. I ask myself whether I want to have my physiotherapy on a Sunday, and the answer is that I do not.

I share my hon. Friend’s confusion, but in fairness, it is only right to point out that weekend working means meeting the four key clinical standards that Sir Bruce Keogh outlined. I fear that my hon. Friend will probably not be getting his physiotherapy at the weekend.

I thank my hon. Friend for that clarification—it turns out that I will be satisfied, then. However, the point is that when we talk about a truly seven-day NHS, we need to be absolutely clear what services there will be on a Sunday. Those who work in the profession want the flexibility and freedom to work hours that allow them to experience an enriched life and to raise a family. They want to succeed in the workplace and to make a contribution in their field. If they cannot, they will decide to work in another profession. I hope that that will be taken into account when changes are made to Sunday operating practices.

From discussing the pressures on the modern-day NHS with Government, clinicians and managers, it appears to me that there are many shared views on patient safety and individual patient responsibility. Like most of my constituents, I yearn for the day when politicians and clinicians join together and recommend the difficult decisions that both parties know are required. Our NHS would be stronger for it, and our patients would be better served.

I turn to our schools. I was particularly pleased by the introduction of the new White Paper on education. The day after it was announced that schools would be forced to become academies, I spoke in this place about the need to allow good and outstanding schools to make their own choice. I am delighted that the Government have made that alteration, although rightly not for schools for which local education authorities are not fit for purpose or those that are no longer of a viable size.

That is not to say that becoming an academy is not a good idea for a school that wants to. I have just spoken of junior doctors’ desire to take control of their career and their destiny, and it strikes me that we now have a generation of headteachers who are no longer willing to be told what to do by their LEA but want to make their own decisions about how to run their school and whether to expand. It comes down to choice, which drives up standards. I hope that my local schools will consider making their own determination on expansion.

The “Educational Excellence Everywhere” White Paper, published in March, states that every school will become an academy. Is that choice?

The choice to become an academy will be there for every school that wants to take it. As has been made clear, if the LEA is no longer fit to deliver and is not functioning properly, a school will be required to do so. [Interruption.] I see that the hon. Gentleman is now having a separate conversation having asked me that question, but I have done my best.

Somewhat unusually, I have a high proportion of Church of England and Roman Catholic schools in my constituency. For academisation to work in my community, a local cluster of schools forming a multi-academy trust looks the most feasible idea. I welcome the Department for Education’s guidance to help the Church to become a part of that, and I look forward to working with my diocese to ensure that it is able and willing to do so. Without it, the advantages of academisation will be hard to deliver.

Overall, I am incredibly excited by the proposals contained in the White Paper, which will deliver fairer funding to a rural constituency such as mine, where our spend per pupil is almost half of that in parts of London. They will also give headteachers more freedom to train and recruit, which is a particular challenge in a rural constituency such as Bexhill and Battle.

In the past 12 months I have visited a school a week in my constituency and have been fortunate enough to spend time with my brilliant local heads and teachers. I welcome the Government’s ring-fencing of schools spending, but I am conscious that schools are addressing a funding gap following increased national insurance and pension contributions and the advent of the national living wage. The more power my local schools are granted to determine how to spend their budget, the better they will deliver education. I look forward to playing my part in helping the education Bill become law.

I confess that I am a happy and enormous supporter of the BBC. The programme for its future that the Government are seeking to deliver is intended to promote social mobility and empower people from all backgrounds to succeed to their true potential. Having failed my 12-plus exam and attended a secondary modern school, I found that much had passed me by in the years between 12 and 16. It was only when I went to a further education college for my A-levels and experienced independent thought and working that I discovered a love of learning. Having the BBC as an additional source of learning and inspiration was essential in getting me to university. This rarely comes up in debate, perhaps because many in positions of influence had the benefit of a more rounded education, but for those of us who have had to grab every opportunity to better ourselves, the BBC has been an essential rung on the ladder in the advancement of social mobility. Having got involved in discussions on the details, I am delighted that the Government’s charter renewal will preserve and improve the BBC, and I thank them for that.

The programme that the Government outlined in the Queen’s Speech is evidence that they will fight to defend public services, not just by preserving all that they do well, for instance through the BBC’s charter renewal, but by introducing reforms that enable more innovation and provide more power for decisions to be taken locally, such as through the education White Paper. I look forward to supporting the Government when difficult decisions on reform have to be made for the benefit of my constituents in Bexhill and Battle.

It is a real pleasure to follow the hon. Member for Bexhill and Battle (Huw Merriman), who came to the debate from the viewpoint of people on the frontline. That is to be commended, because what they do on behalf of us and our constituents is most important. We should never move far away from focusing on that.

I want to speak about what the Queen’s Speech offered my constituents on the two biggest issues of concern to them: local health services and the future of our steel industry. Local health services are severely challenged. We were told last week that NHS trusts nationally had reported a deficit of £2.5 billion in 2015-16. When I asked the Secretary of State earlier whether he could rule out the books not being balanced at the end of the year, he was unable to do so. Some 121 of 138 acute trusts ended 2015-16 in deficit, so there is a real problem with the finances. Members on both sides of the House have echoed that today.

In the Scunthorpe area, our whole health economy is severely challenged financially. Balancing the books is a long-running problem for the clinical commissioning group and the local hospital. That raises the question, which hon. Members have asked today, of whether there is enough cash in the system to allow local health services to do the job we expect. There are wonderful people working in the system in the Scunthorpe area and elsewhere in the country—nurses, care workers, porters, doctors, paramedics, administrators and many others. They go to work every day determined to do a good job, but as my hon. Friend the Member for Southampton, Test (Dr Whitehead) said, they are being asked to do more for less, day in, day out, which produces a strain. As the hon. Member for South West Wiltshire (Dr Murrison) said, the system is at full tilt —or we might say at full stretch.

There have been challenging evaluations of our local health services during the past six months, and we have received poor Care Quality Commission reports for mental health, hospital and some care services, and most recently for ambulance services. People are not going to work to do a bad job, but there is strain in the system and that is reflected in issues of quality and delivery. Disproportionate cuts to social care are adding to the strain on the system.

Locally, there has been an ongoing review of health provision, “Healthy Lives, Healthy Futures”, and there is a general recognition that the way forward is to move resources into the community and closer to patients. That is the theory, but managing to deliver it is challenging because the acute demand at the secondary care end of hospitals, and people turning up at accident and emergency, does not get any less. How do we turn off the tap at that end so as to invest where we know it is needed?

As many Members have said, the real challenge is the ageing population. The Secretary of State said that there will be 1 million more people over the age of 70 by the end of this Parliament, which illustrates the challenge to the system. My hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams), many other Members and I are wearing badges from Dementia Friends, which is a reminder of the growth in demands on mental health services, particularly with an ageing population. Despite the excellent work done by the Alzheimer’s Society and others, much more is needed to deliver what needs to be done.

There are massive challenges, and it would be good if it were easier for local services to develop their local workforce, so that healthcare assistants can be translated into nurses, and other innovative things can be done to meet local needs. Given the importance of community services, pharmacies are being challenged by the Government’s desire to take away £170 million of pharmacy funding. That is not a huge figure, but it seems to run counter to the desire to recognise pharmacies as deliverers of community services, particularly for older people who are close to the community, or those who suffer from mental health problems. Why challenge pharmacies in that way? The other week I was proud to present in this Chamber a petition signed by more than 800 local people that said, “Look after our local pharmacies.” As we consider the challenges to health services, we will see that much can be done intelligently to work with the situation and make it better.

I was disappointed that there was nothing in the Queen’s Speech—just as there was nothing in the Budget—to support the steel industry at its time of great challenge. A real industrial policy would make a difference to setting a strategic path, and give confidence to all players, be they employers, trade unions or other stakeholders in our manufacturing industry, especially our steel industry. The Government have been slow to respond to the challenges facing our steel industry, and I hope that in a week Tata long products will move into new ownership, and there will be a new and positive chapter for the future. Today is the closing date for expressions of interest in the ownership of the other part of the Tata empire from across the steel industry in the UK.

The fact that such things are happening does not mean that the Government can go to sleep. They must wake up and do more, including on business rates. When Tata invests in a new blast furnace at Port Talbot, or a reconditioned blast furnace at Scunthorpe, it is ridiculous that that capital investment should mean an increase in its business rates. That is the economics of madness. We should have a system to encourage investment in further production, not penalise it.

We must do more on procurement. The Government’s procurement policy has positive aspects, but when businesses such as DONG Energy develop the North sea wind farm, the test is whether they use UK steel or not. We need action against Chinese dumping, to address the lesser duty rule, and we must stop dragging our feet and stopping the European Union carrying out measures that would support our steel industry.

In those two big challenging areas—the local health economy and the steel industry—the Queen’s Speech does not offer a great deal at the moment. However, this debate, and contributions from across the House, can allow it to be developed into something much better.

It is a pleasure to follow the hon. Member for Scunthorpe (Nic Dakin), who as always represents his constituents with great passion.

I intend to focus on matters in the Queen’s Speech that relate to communications and the digital economy. In her Gracious Speech, Her Majesty spoke of legislation to be introduced to

“improve Britain’s competitiveness and make the United Kingdom a world leader in the digital economy”.

I wholeheartedly support that aim, and a great deal has already been achieved. Britain must be a nation where technology continuously transforms the economy, society and government. The UK has embraced digital transformation, and it is one of the most advanced digital economies on the planet. The internet as a UK industry sector has surpassed manufacturing and retail, and represents the second-biggest economic sector. That has come about as a result not just of the Government’s policies, but from the entrepreneurial efforts and passion of British businesspeople.

According to the Centre for Retail Research, UK consumers will spend an average of £1,372 per person online this year. Online retail as a percentage of total retail is 23% in the UK, which is more than double that of Germany and three times that of the US. A key driver of that is the underlying strength and sophistication of the UK’s financial services industry, and consumer confidence in the security of credit card and financial information online. That is not the case in many other countries, and lack of confidence in the security of online financial data has inhibited the development of the digital economy not only in the developing world, but across many countries in Europe. UK consumers’ online habits are so strong that, when asked what other lifestyle habit they would give up for a year instead of giving up the internet, 78% said they would rather give up chocolate; 21% said they would give up their car; alarmingly, 17% said they would give up showering; and most alarmingly of all, 25% said they would give up—I am not sure how to phrase this, Madam Deputy Speaker—intimate relations.

Later on, perhaps, but I will spare my blushes now.

Digital is a UK success story. At 12.4% of GDP, the UK internet economy is the largest of the G20 countries—it is double the size of the US internet economy, three times that of Germany and nearly four times that of France. I have said this many times in the Chamber but it is often overlooked: the G20 average is 3.5% of GDP.

The digital economy employs more than 1.5 million people and is growing at more than double the rate of GDP growth. Clearly, we are already in a leading position in the world. The issue is not so much about becoming a world leader in the digital economy, but retaining and further strengthening our leadership position. Broadband plays a key role in that. We have made huge progress—superfast broadband of at least 24 megabits per second is available in 90% of homes and businesses in the UK, up from a mere 45% in 2010. Ofcom statistics show that business connections sometimes lag behind domestic connections, and companies such as BT Openreach need to do much more to get businesses connected and to improve customer service overall, particularly in remote and rural areas.

The broadband market remains confusing to many consumers and businesses. Research commissioned by Ofcom found that around half of small and medium-sized enterprises found that information about suppliers and tariffs was difficult to compare. I am therefore pleased that the Government are making progress to improve competition, particularly by making the switching process clearer and easier in both the broadband and mobile markets.

On the specific digital measures announced in the Queen’s Speech, I very much welcome the digital economy Bill, which will deliver on the manifesto commitment to roll out universal broadband and increase competition. The new electronic communication code will make it easier and cheaper to build mobile and superfast broadband infrastructure. We must protect and support our digital industries, which is why the introduction of equal penalties for infringements of online and physical copyright is so important. I warmly welcome the proposals to protect children with age verification for accessing online pornography.

The BBC has played a key role in shaping how we are educated, entertained and informed in the UK, via radio, TV, print and online. The BBC iPlayer is one of the most-used digital content sites in the UK. According to last year’s annual report, in January 2015 alone, 264 million iPlayer requests were made. Similarly, more than 27 million unique users in the UK went to BBC News online each week in the first three months of 2015. Those numbers will be higher now.

The BBC has clearly played and will continue to play a key role in the future of the UK digital economy. I therefore welcome the proposals in the recent White Paper to secure the BBC’s future. Many people have been in contact with me about the future of the BBC, expressing suggestions and concerns. I am glad that many of those fears were allayed in the White Paper. Contrary to the predictions of some, there was no wholesale destruction of the BBC, no abolition of the licence fee, no meddling with TV schedules and no instruction not to make popular programmes. Instead, there will be a longer charter, clarity on funding, improved governance, and opportunities for more commercial exploitation of the BBC’s hugely valuable content library. The simple fact of the matter is that the BBC will be in a stronger not weaker position as a result of the recommendations in the White Paper.

There is much to be praised in the Queen’s speech, and I am confident that the focus on the digital economy and technology will have long-lasting consequences that will benefit the UK economy for decades to come.

The title of the debate before the House is “Defending Public Services”. Last week, I listened carefully to the Prime Minister’s speech following the Queen’s Speech and heard the phrase “life chances” repeatedly used in such a way as to suggest that meaningful and fundamental measures to militate against inequality were announced in the address. Indeed, a life chances strategy was set out.

The Government cannot have it both ways. On the one hand, we hear the incessant banging of the drum for austerity, and on the other we have rhetoric that is supposed to convince us that the appalling life chances of too many of our citizens and our children are being addressed. The Government seem content to see children living in poverty with all that that means. That is not consistent with a life chances strategy, or with a social justice agenda.

I have spoken before in the Chamber, as have so many others before me, about what poverty really costs. It costs families their hope and their motivation. It robs children of the confidence and the self-esteem that would enable them to reach their true potential. Poverty robs those subject to its vagaries of their physical and too often their mental health. Quite simply, it puts people into an early grave after a lifetime of suffering. Children in poverty are more likely to self-harm, and young men in poverty are twice as likely to commit suicide.

What is the response of the Government, who say they are committed to a life chances strategy? They slash support for disabled people and cut support for the working poor. What is required is a credible plan to look at the rising costs facing low-income families. It would be laughable if it were not so ridiculous and painful that we have a Government who seek to send parents to parenting classes but fail fundamentally to address the fact that far too many parents are finding it extremely difficult to put food on the table.

What this programme for government cannot hide, despite the strategies and platitudes set out last week, is that the watchword for this Government has been and continues to be austerity. This austerity is defined by cuts to the public sector across the board, hitting, as it always will, the most disadvantaged, stripping workers of their rights and reducing the working poor to using food banks.

Our Prime Minister has told us:

“you can’t have true opportunity without true equality…I want us to end discrimination and finish the fight for real equality in our country today.”

If he is really serious about helping working families who are struggling hard, he must look again urgently at the impact of the austerity agenda on working and low-income families. We are heading for an even more confirmed position, where generations are glued to the bottom rung of the ladder of opportunity. This, of course, will be blamed on a lack of moral fibre or even poor parenting, but the real cause is a lack of opportunity to access employment, a decent income, proper childcare and suitable housing. We are all aware of the Government’s scrapping of legal commitments to tackle child poverty in the Welfare Reform and Work Act 2016, a revision of legislation that introduced new measures of poverty that, bizarrely, did not include income. Measuring poverty is not enough—we know it exists. The cruel changes in support for families will put too many families under intolerable pressure. If the Government are serious about ending poverty and increasing the life chances of all children, the narrative that suggests a person will be living in poverty as a result of decisions made by that individual needs to change. Low income is not merely a symptom of poverty, but a direct cause of reduced life chances. Any life chances strategy has to recognise which factors militate against people’s life chances. If it does not do that, it is doomed to fail.

The four-year freeze on working-age benefits, including child tax credits, working tax credits and jobseeker’s allowance, will see families lose up to 12% from the real value of their benefits and tax credits by 2020. How does that improve the life chances of those living in poverty? How does that help the nearly 4 million people who experienced persistent poverty for two out of the past four years? It is a shocking state of affairs when most children living in poverty today in the UK have at least one parent in work. There needs to be some creative thinking about how to tackle the lack of reliable work that pays enough for families to make ends meet. Any new approach must complement, not replace, current efforts to measure and tackle child poverty. Measuring incomes and providing safety nets for the vulnerable and those in need should be our priority.

Absolute child poverty is projected to increase from 15.1% to 18.3% by 2021 as a result of planned tax and benefit reforms. Disabled lone parents with young carers are set to lose £58 a week as a result of the loss of the disability premium under universal credit, placing additional care burdens on young carers. If the much heralded life chances strategy is to mean anything, it would benefit from being guided by the Scottish National party’s proposed social equality Bill, which would strengthen social security entitlements by restoring work allowances for low-income workers and single parents. It would actively pursue ways to break down barriers to employment for disabled people and address the gaps in support that have been created by slashing support for disabled people.

None of this is rocket science. All it needs is a recognition that poverty is a scourge we must eradicate and that all that is required is political will—political choice. Warm words and talk of strategies will not lift families out of poverty and neither will empty rhetoric. Universal credit has failed: it has not incentivised work; it has punished those on low pay. Any system of welfare must be based on need, compassion and respect. Those principles should also guide any strategy that seeks to improve life chances for all. The Government should reflect on that today, if they are serious about tackling the corrosive and life-limiting effects of poverty.

It is a great pleasure to follow the hon. Member for North Ayrshire and Arran (Patricia Gibson).

I want to talk about protecting and supporting vulnerable people, particularly children and young adults, which is a theme that emerges strongly from the Government’s legislative programme, and focus on life chances. On 31 March 2015, there were 69,540 looked-after children, and according to Adoption UK, as many as 61% of them were looked after by the state because of abuse or neglect. Only 5,330 looked-after children were adopted during the year ending last March, which was a welcome improvement, proportionately, on previous years but still far too few.

I therefore welcome the ambition in the Children and Social Work Bill to provide more children with stable and loving homes through long-term adoption. Stability, security and permanent affection are central to enhancing life chances, and the new commitment to extend the right of care leavers to a personal adviser up to the age of 25 is central to that mission, and I warmly welcome it. The assumption that a young person will be ready to face the world at the age of 18 became old fashioned long ago and was never really the case for people in the care system.

When it comes to looking after the nation’s young people, an increasingly important issue is harmful sexual behaviour. Child abuse gets a lot of coverage but harmful behaviour between children does not. I am currently chairing an inquiry with Barnardo’s into support and sanctions for children who display and are victims of harmful sexual behaviour. We have heard harrowing testimonies from young people with experiences ranging from the use of sexual language inappropriate for a particular age to the sharing of explicit images, online grooming and sexual acts themselves. The risk is increased for children in care.

This issue is rarely tackled because it is tough and uncomfortable to do so, but it is important that both perpetrators and victims have the chance for their experiences to be heard and that we in Parliament act. One young person was looked after from the age of 12. She had an abusive family background and parents with mental health difficulties and was a victim of child sexual exploitation while being looked after in a local children’s unit. She was described as naive, keen for affection and vulnerable to coercion and was exploited by men whom she believed to be her boyfriends.

In such circumstances, we must make sure that the duty of care, which should be shared by everyone—parents, foster parents, carers, teachers, social workers, medical practitioners and police forces—is indeed shared and that there are no gaps or loopholes. I hope that Ministers will take issues such as harmful sexual behaviour into account when considering the precise measures in the Bill, particularly around foster care, the role of schools, police training and standards for social work. I will be highlighting our inquiry’s recommendations to the Government when they are announced within the next few months.

I turn now to the counter-extremism and safeguarding Bill. As a member of the Home Affairs Committee, I take a particular interest in this area, but I am sure that Ministers recognise that tackling extremism is not just a home affairs issue. It is a challenge for our justice system; within education, it is a duty-of-care issue; it is a foreign policy and defence concern; it is an equalities matter; it involves social media; and, above all, it is a life chances issue. It cannot be tackled in isolation as just a home affairs issue, because the causes, the consequences and the challenges are global and multi-dimensional. I know that Ministers will closely consider how Departments across Government can be brought together to make the Bill as effective as possible.

Members of the Muslim community are fighting for the survival of their families and communities, seeking to challenge divisive and hateful views, and deserve our support and encouragement as they challenge those ideologies on their own doorsteps. These ideologies and this extremism, increasingly rife, are like an invasive species. The Islam that came to this country with the communities that have settled here since the second world war is not the Islam now taught in some Muslim schools or practised in certain mosques. Wahhabi Islam is not the faith of my parents and does not reflect the cultural richness of the Muslim communities of the subcontinent, from which most of our diaspora come. Rather like an invasive species, Wahhabism has driven out many of the traditions that make my faith a spiritual rather than a political journey. It represents teachings that interpret Islam as a narrow stone age rulebook intolerant of modern society’s norms or indeed much of the basic human decency that we take for granted.

The fight against extremism is not one that should be fought just from Westminster using Westminster’s tools. As the Prime Minister noted in a reply to me last Wednesday, we must empower Muslims to challenge intolerant and hateful ideologies. It takes a huge amount of courage to speak out against organisations when there are self-appointed leaders who groom the young and impressionable. To tackle extremism and to protect vulnerable young people from being attracted to it, we have to challenge it both at source and later on in its journey. We need to think about the establishments, groups and forums where some of these divisive ideas are coming from. I hope the Bill will look at how we can prevent religious or educational establishments from receiving overseas funding if they are unwilling to sign up to an agreed set of tolerant principles that their own society considers acceptable. We already have rules that funders of political parties and unions must adhere to, so why not have them for these other institutions, too?

Safeguarding children from extremism requires powers to take action in any education setting where vulnerable children may be at risk of grooming and indoctrination. Grooming a child for sexual exploitation was once misunderstood; now it is rightly a cause for extreme action and punishment. The same should be the case for educators and youth leaders who teach hate, including those at the centre of events in Birmingham’s “Trojan horse” schools. We should never allow those individuals back into the classroom or to have any leadership role with children.

On integration and life chances, I have been very encouraged by my conversations with Louise Casey about her review of relations within and between communities, and I am sure that the Government will look to incorporate some of her central recommendations into this and other legislation.

Modern challenges in modern times need modern and bold legislation. Being cautious is not the job of a responsible Government who are effective at taking on those challenges. So I warmly welcome the proposals set out in this Queen’s Speech, and the values and aims that thread through them. When each of these proposals is taken forward, I urge the Government to stay the course and to continue to be ambitious in tackling the challenges they have rightly prioritised as needing our attention and focus.

It is a great pleasure to follow the hon. Member for Wealden (Nusrat Ghani), who gave a powerful speech about child sexual exploitation, extremism and Wahhabi ideology. I am glad that she sits on the Home Affairs Select Committee. She also mentioned the Trojan horse affair; if she looked into it in detail, she would realise that the speed and nature of the Government’s academisation programme increased the risk to children, as Peter Clarke laid out in his report to the Government. I urge the hon. Lady to read it if she has not already done so.

To deliver the Gracious Speech, we were told that Her Majesty Queen Elizabeth II required a lift to get up to the relevant Floor in the House of Lords. That strikes me as a rather suitable metaphor for the Queen’s Speech, which needs a fork-lift truck to make it relevant, effective and indeed challenging for the modern era. This is, contrary to what the previous speaker said, a rather tinkering set of measures, setting out the narrowness of the current Tory vision, especially on public services.

Today’s debate is about “Defending Public Services”, but I am more interested in the reform of them. What was missing from this Queen’s Speech was what we were told was the guiding principle of this Parliament—productivity. Absolutely no mention was made of the kind of wealth creation and productivity we need to pay for the public services that we all rely on. Productivity has already gone from this Government’s agenda. If we want to move away from the low-wage, low-skill economy, which my new hon. Friend the Member for Sheffield, Brightside and Hillsborough (Gill Furniss) highlighted in her wonderful maiden speech, and find a way through secular stagnation, we need a focus on productivity. There was nothing in this Queen’s Speech about it.

Let me turn first to education and schools policy. In March, the Government White Paper on schools policy came out. It said that “every school” would become “an academy”—and I thought the Conservatives believed in choice. It said that

“by the end of 2020, all…schools will be academies”.

We now know that this policy has been junked in a series of U-turns on education policy. What was once one of the intellectual strengths of the Conservative party—education policy—has now collapsed. We have had the stats fiasco and the free school fiasco, where even Toby Young has revealed that the policy he sought to pioneer was doomed from the beginning. We have had the term-time holiday fiasco. We have had a Conservative Government trying to ban parent governors from schools. What could be more un-Conservative? [Interruption.] I am sorry if I am wrong about that; the policy may have already changed during my speech.

We have also had a U-turn on mass academisation. The Government have devalued the policy on academies: what was a pioneering Labour programme to help the most disadvantaged schools—those suffering the most difficulties—has become a “one size fits all” policy, which is not working. My local secondary schools in Stoke-on-Trent are academies, and their conversion from local authority status has not altered the challenges.

I must put on record my horror at the sponsorship of St Peter’s School in Stoke-on-Trent by the Woodard Corporation. It has betrayed the prospects of those children. We have seen a regional schools commissioner fail to step up to deliver change, and we have seen Ministers let five years of education collapse under the Woodard Corporation. The fact that the corporation runs any schools in England is, to my mind, totally shocking.

When it comes to schools policy, we know what matters: strong leadership, well-motivated, well-qualified teachers, and a faculty that is committed to change. It does not matter whether we are talking about a local authority school, a free school, a university technical college or an academy. However, the Government’s “every single school an academy” policy—maybe it comes, maybe it goes—is not the right approach.

I support the policy on national citizenship service, and I think that the Government should make it a vehicle for more effective teaching of citizenship. I look forward to the proposals on the national funding formula. As for reform of the university sector, I think that the Minister has listened to some of the concerns that have been expressed, but I oppose the fee hike. British students—English students—are among the most indebted, if not the most indebted, in the world, and now we want them to pay even more. If we want more money to go to our universities, it should come from general taxation rather than the pockets of students.

The liberalisation of entry to the university market is another issue. Universities can play an important regeneration role, and I respect that, but we must also protect the brand of Universities UK and its success around the world, which can be lost quite quickly. I think we need some reassurances about that.

At this point I should declare an interest, as a university lecturer. I am in favour of rigour in teaching and the teaching excellence framework, but I must urge Ministers to beware of the bureaucracy that surrounds that. University teaching is currently subject to a great deal of quality control. We certainly need more transparency and quality, but the creation of ever more regulations, and perhaps a new Ofsted, requires careful judgment.

One continuing theme is planning for the northern powerhouse. I am a supporter of combined authorities and of metro mayors, and I hope that our Front Bench will be more supportive of those policies, because I think that they demonstrate the capacity of the Labour party and what it can do in office. However, I should like them to go further. I think that, in creating combined authorities, we have missed an opportunity to reform public services. I should like to see more decentralisation of finance, and more liberalism allowing combined authorities to raise and spend taxes locally. I should like to see the commissioning of schools taken away from Whitehall and given to combined authorities, so that we can have real local control over schools policy. I should like to see a much more innovative programme for local utilities and the provision of local power in combined authorities.

One of our greatest public services is the BBC. It is bizarre that—just as with universities—a great global force for Britain should spend half its time trying to prevent Her Majesty’s Government from undermining it. In most other countries in the world, the Government would be supporting an institution like the BBC. We need reassurances from the Minister, who I know takes these issues very seriously, about appointments to the new unitary board: will that mean more jobs for the Conservative boys and girls? We need reassurances about the five-year review: will that mean an ability to restrain influence? We also need reassurances about the ratchet of distinctiveness.

I do not know the lift in which Her Majesty rose to give her gracious address, but something tells me that, rather like Her Majesty herself, it might contain German elements. That is a symbol of the great debt that we in this nation owe to Europe. If we vote to leave Europe, everything in the gracious address that the Government want to do will be lost.

On the Monday of last year’s Queen’s Speech debates, at almost exactly this time, I made my maiden speech. Twelve months on, I am delighted to see legislation being brought forward to implement so many parts of the manifesto on which my colleagues and I were elected. This Queen’s Speech is about improving life chances for all. It is about securing our economy so that we can provide the excellent public services on which our constituents, and we ourselves, depend. It is about delivering a truly seven-day NHS and about making our promise on parity of esteem for mental and physical health into a reality.

I depend on the national health service, as do my family. When we needed it most—when my children were born and when my wife was taken ill—the NHS was there for us. I am proud of, and will always be grateful for, the fantastic care provided in our health service, but I have also seen how the level of healthcare available varies depending on when you have to go into hospital. My daughter turned eight a few weeks ago. When she was born, there were complications during labour but, as this was in the early hours of the morning, consultants and some specialist staff who would normally have responded were not available. Fortunately, with the support of the excellent midwives on duty, everything turned out okay. Surely we have a responsibility, however, to do everything we can to reduce those risks, regardless of what time it is or which day of the week you go into hospital.

The Conservative manifesto promised to ensure that people could access good quality healthcare seven days a week in our NHS. This was a key commitment and I am pleased that legislation is being brought forward to allow for it to be delivered. People will be able to see a GP in the evenings and at weekends to suit modern life. Making it easier to see a GP should relieve pressures on other parts of our national health service, while those patients who need urgent or emergency hospital care should have access to a similar level of consultant-led assessment, diagnostic tests and treatment seven days a week. Under the new proposals, they will be seen by a consultant and have diagnostic tests available, and the most critically ill patients will be seen within the hour.

This can be done only because of the extra money that is being invested in the NHS, and that is achievable only because of our strong economy. The chief executive of NHS England said on “The Andrew Marr Show” yesterday that when the economy suffers, the NHS suffers. However, this Government have put rebuilding the economy and protecting our NHS first. In Dudley, my local hospital trust’s income last year was £64 million higher than it had been five years previously. That has allowed us to have 60 more doctors and 192 more nurses, midwives and health visitors in Dudley than there were in 2010. That is an example of a stronger economy leading to a better-resourced national health service.

That includes mental health care—a part of the NHS that has too often been viewed as the Cinderella service. The Health and Social Care Act 2012 introduced a commitment to parity of esteem between mental and physical health, and I am delighted to see the right hon. Member for North Norfolk (Norman Lamb), who did so much to bring about that legislation, in his place tonight. This Queen’s Speech includes further measures to turn that commitment into a reality for everyone in the country who needs mental health care.

In response to the mental health taskforce, the Government announced an additional £1 billion. This will fund all the taskforce’s priority recommendations. With the increased funding going into mental health services, the focus now rightly shifted from treatment to prevention. Members might not be aware that one in 10 children between the ages of five and 16 have a mental health problem. We need to intervene early, instead of simply throwing money at prescription drugs or treating the symptoms at a later stage. It is a false economy if we do not tackle problems early, before they end up becoming much more expensive and, more importantly, before they cause even more distress and human cost to the individual and their family.

While we are increasing NHS funding, we have a responsibility to ensure that the available resources are focused on services for all our citizens who depend on the NHS. It is right that people who come to Britain for elective healthcare should cover the costs of their treatment rather than expect British taxpayers to pick up the bill. This Government were the first to act to tackle health tourism and the abuse of our NHS, and I am pleased that the Government are to go further with the Bill announced last week, extending the rules on charging people who come here for non-emergency treatment.

I am proud of our NHS. Of course, it is not perfect, but the NHS provides a generally excellent service, free at the point of use. Our NHS has remained so great because of its ability to change and adapt. It has not attempted to preserve whatever was right for 1947 in aspic. Instead, it has responded to changing needs and demands. The measures in the Queen’s Speech will allow our national health service to continue to respond to the challenges of today and of tomorrow, offering the best chances for everybody at every stage of their life.

It is a pleasure to follow the hon. Member for Dudley South (Mike Wood), who spoke with passion about the NHS, a theme to which I will return. There can be no denying that the legislative programme outlined in the Gracious Speech is thin and aimed at preserving Tory party unity in the run-up to the EU referendum rather than at tackling head on the issues that the country faces, which is a great pity. This evening, I will concentrate on an issue affecting many of my constituents that was almost entirely absent from the Gracious Speech: the appalling state of mental health provision, and emergency provision in particular, across the country.

Our NHS currently faces an unprecedented financial crisis. Under Labour in 2009-10, the NHS reported a surplus of £2 billion. In the last financial year, the NHS in England reported a record deficit of £2.45 billion. It was the worst ever performance in the history of the NHS and worse than that predicted by NHS England. The deficit is kept from being significantly higher only by a series of creative accounting steps taken in a vain attempt to reduce the number of negative press reports about such disastrous performance.

This week, my family has again been profoundly grateful for the NHS. My mother, who spent many years working in the NHS, was admitted a week last Sunday after attending A&E. She was admitted at the weekend, but there was no absence of either diagnostic tests or expert healthcare at any level of the NHS. I am grateful to the dedicated staff who cared for her, and I am glad to say that she was discharged today. Over the past week, my family have seen NHS staff stretched to the limit, including nurses working 12-hour shifts without time for a break. My mother was not in the correct ward for the condition from which she was suffering, but an overspill patient on another ward, because no beds were available. She was admitted with a physical illness, but of all the pressures caused by the financial crisis facing our NHS it is mental health provision that is one of the biggest casualties.

Since May 2010, clinical commissioning groups across the country have reduced the amount spent on mental health, and we are seeing the consequences. In my constituency, for example, funding for first episode psychosis treatment has seen huge cuts and the number of mental health in-patient beds has been reduced, meaning that people in need of mental health care are in many cases left waiting for extended periods, either at home unable to cope or all too often in A&E. My constituency is served by King’s College hospital, a leading teaching hospital, and the Maudsley, a world-leading psychiatric hospital. Yet despite that combination of exceptional skills, expertise and facilities, the provision for mental health patients in A&E is simply not good enough. Despite the previous Labour Government setting aside funds for a dedicated waiting and assessment area for patients with mental health needs in A&E, it is yet to be delivered. On far too many occasions, patients attending A&E and requiring admission are unable to access a bed, because patients on the wards have yet to be discharged due to a lack of social care provision when they leave hospital.

I welcome the additional spending, although it is limited, on mental health that was announced in the Budget for tackling eating disorders, improving perinatal mental health services and providing mental health liaison services in every A&E, and the Government’s stated ambition of parity of esteem for mental and physical health. But much of the funding has previously been announced, and the overall budget assumes, incorrectly, that NHS trusts, including mental health trusts, will be able to attain unachievable levels of efficiency savings—the failure to do so being one of the main causes of the £2.45 billion deficit the NHS in England currently faces.

The commissioning of in-patient beds for child and adolescent mental health services within England is a national disgrace. Young people in urgent need are shuttled from one end of the country to another as a matter of routine. On the same day as a young person from Liverpool was placed on a ward in London, a young person from my constituency in London was admitted to a ward in Liverpool. No one would think it acceptable for a patient in cardiac arrest to be sent from London to Liverpool, and we should not accept a young person in mental health crisis being moved around the country in this way. Too many young people find themselves in hospitals dozens of miles from home, thus increasing their vulnerability, inhibiting the support that family and friends are able to provide to aid their recovery, and complicating their discharge planning.

The shortage of tier 4 CAMHS beds also means that young people frequently find themselves waiting in A&E for unacceptably long periods—often days at a time. We must see this for the scandal it is; we would not regard it as acceptable for a young person with a broken leg to spend days in A&E with only the most basic triage care, and it is just as unacceptable for someone with a mental health crisis to have to do that. The first step in achieving parity of esteem for mental health is to acknowledge these failures for the scandal that they are.

In my constituency, as across too many parts of the country, there is also an unacceptable shortage of places of safety for people who are detained under section 136 of the Mental Health Act 1983. That shortage delays the help that people who are desperately unwell urgently need. It is clear that there is too little co-ordination of the planning of the provision of places of safety, with police services, A&E departments and mental health services failing to work together to address the need. In London, the Metropolitan police have taken welcome steps to work towards eliminating the use of police cells as a place of safety for people in a mental health crisis who have committed no crime, but, without adequate multi-agency planning, this unilateral decision has exacerbated the pressure on A&E, resulting in situations where NHS staff are responsible for detaining patients and keeping them safe without having the required resources or an appropriate environment in which to do so.

One of the most shocking illustrations of the lack of parity of esteem between mental health and physical health is life expectancy: people suffering from serious mental illnesses such as schizophrenia or bipolar disorder can have a life expectancy 10 to 15 years lower than the UK average. Many mental health patients are dying early from heart attack, stroke and cancer rather than any cause linked directly to their mental health. Suicide is now the leading cause of death for men aged 18 to 49, with close to 5,000 people tragically taking their own lives in 2014. The recent Mental Health Taskforce report recommended the creation of local, area-based, multi-agency prevention plans, with a particular focus on high-risk locations and supporting high-risk groups. I urge the Government to implement the recommendations in full.

Our mental health services are failing too many people. One in four of us will suffer from mental ill health at some time each year, and all of us will know someone close to us who suffers from mental ill health. We are falling very far short of achieving parity of esteem for mental health. I find it astonishing that the Government do not seem to recognise this for the urgent priority that it is, and have failed to include any measures to address it in the Gracious Speech. The absence of significant measures in the Queen’s Speech to tackle these important issues speaks volumes about the priorities of this Government and how out of touch they are with the day-to-day needs and concerns of so many of the people I represent.

It is a great pleasure to follow my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes). Coincidentally, my mother, like hers, has been taken into hospital over the last week, and I can only echo her praise for the dedication of the NHS staff who have been providing the treatment. My hon. Friend made a number of powerful points about mental health services, which is a cause close to my heart, and I entirely agree with what she said in her very good speech.

I am pleased to speak in today’s debate on public services, at a time when hospitals, schools and other public services are facing cuts, unnecessary change and uncertain futures. My constituents in south Manchester will be surprised to hear the Prime Minister label this Queen’s Speech a continuation of his Government’s life chances strategy. Manchester City Council has seen more than £350 million-worth of cuts over the past six years, resulting in cuts to leisure centres, libraries, road repairs, community mental health support and social workers. This is a statistic I have used in this place before, but if Manchester had our fair share of cuts—I am talking not about being protected from cuts, but about having our fair share—we would be £1.5 million a week better off, which would pay for a lot of public services. We have not had our fair share. We have been hit, as have so many deprived northern boroughs, very unfairly.

Not only that, but my constituents have suffered from the bedroom tax, from unfair sanctions and from cuts to the benefits that help them to get by in life. For many people in south Manchester, it will be hard to accept the contention that the Queen’s Speech has quality-of-life concerns at its core when so many of the local services that make up the fabric of our communities are being stripped away. That is the context in which we discuss the Queen’s Speech today, sitting as we do in an institution that is at the heart of British culture and tradition.

There are two other great British institutions that, more even than anything in this place, make me feel proud to be British, and they both face big challenges. Our NHS, still reeling from the unwanted top-down reorganisation, is in a crisis of rising demand for services paired with massive financial deficits in NHS trusts. For patients, the latest statistics confirm a worrying trend. The proportion of patients being dealt with in A&E within four hours of arrival decreased to 87%, against a 95% target. In March, performance against the key target of patients starting treatment within 18 weeks of a GP referral reached its worst level since the target was introduced.

My constituency is home to many of the 5,000-plus medical and healthcare students in Manchester universities. With the attack on student nurse bursaries, the Government are asking them to do more with less and to work long hours with no help. That, at the same time as the junior doctors’ dispute, has hit the morale of the staff who form the backbone of our NHS. A survey by the healthcare professionals network showed that four out of five healthcare workers had considered leaving the NHS in the last year, and that stress has become the single greatest cause of sick leave for doctors. That is the legacy of a Tory Government for the NHS.

Similarly, the BBC faces an uncertain time, overseen by a Secretary of State whose commitment to it is questionable. The Government’s concessions on scheduling and finance were welcome, but in the Labour party we believe that any final proposals must protect the BBC as a financially and editorially independent public service broadcaster.

I do not want to be entirely negative. There are some measures in the Queen’s Speech that I agree with, if they are done properly. I certainly support reforms to adoption processes, and reforms to support for young people in care and care leavers. If they go alongside properly funded social workers and adoption staff, they could help to tackle what I think is one of the biggest problems in society, namely, that we fail too many of our people in care and we fail them when they leave care, with devastating consequences for their future and for our society.

I also welcome the potential of the local growth and jobs Bill to make a difference. I have always argued for local authorities to retain business rates growth, so I am interested to see the detail of the plan for councils to keep 100% of business rate revenue. The devil will be in the detail, however, and there will have to be some kind of floor-and-ceiling redistribution mechanism to ensure that the poorest areas, such as Manchester, are not hit hardest. Similarly with the new school funding formula, it is vital that the areas that need additional funding most are not hit.

Perhaps of most immediate interest for the people of Manchester is the prospect of a buses Bill in this Parliament. Finally, there is the prospect of Manchester being given the powers that London has had for so long—powers to franchise a bus system that better serves the people of Greater Manchester. We have been calling for that for years, and it is time the Government acted. A deregulated bus service has failed Greater Manchester, and if the Chancellor is to revive the northern powerhouse initiative, this is a good place to start.

Too often, an inefficient marketplace produces unbalanced bus networks. I see that 100 yards from my house on the bus route through Wilmslow Road in Withington. Popular routes are being flooded with different providers, and other routes in my constituency have to go without services because the profits of companies come before a good service to the public. The public purse still provides 40% of the revenue that goes into bus services in Greater Manchester. We need to be able to make that money work more effectively. The buses Bill is a vital first step towards the flexible and inter- connected transport system that Greater Manchester so desperately needs, but it must be implemented properly. I look forward to working with the Government on this where possible and to the Bill moving forward.

Although there are some good proposals in the speech, there are plenty of underwhelming measures, and some bad and dangerous proposals, too. The proposed British Bill of Rights is, as a policy, as confused as it is unnecessary. The Human Rights Act 1998 that we have today is a modern-day Bill of Rights that has repeatedly protected the vulnerable. Let me quote Liberty:

“Day in, day out, the Human Rights Act is used by ordinary people—including victims of crime, those with physical disabilities or mental health problems, and children—to achieve protection, truth and justice. It is one of the cornerstones of our modern and diverse democracy.”

If the Government really are going to listen to consultation, they should listen to the many voices across the country who say that they should think again, recognise the indispensable protections that the Human Rights Act offers and drop these proposals.

Ultimately, there is a lack of vision and ambition in this Queen’s Speech. It is a missed opportunity to tackle the inequality and insecurity in our country. There is the failure to address homelessness, the lack of an industrial policy, the misplaced focus on ensuring that good and outstanding schools have to become academies, instead of on producing the high-quality teachers of the future, and the lack of measures to link up health and social care. This Government are not addressing the most pressing issues in our public services.

This Queen’s Speech will give little hope to my constituents, who are hoping to see an ambitious Government aware of the struggles that they face. Although I welcome some of the Bills planned, the Government have shown that they are not prepared to fund public services properly. This Queen’s Speech will be forgotten quickly. However, the painful legacy of this Government on public services will not be.

It is a pleasure to be called to contribute to this debate on the Gracious Speech. It is also a pleasure to follow my hon. Friend the Member for Manchester, Withington (Jeff Smith), who talked about how our public services are under pressure, and that is a subject to which I should like to return in my contribution.

This Government’s record on protecting public services is woefully inadequate. Unfortunately, I have read little in the Queen’s Speech to suggest that their performance will improve any time soon. Whether we are talking about policing, the NHS, fire services or local government, the story is the same—cuts and more cuts. As my hon. Friend the Member for Huddersfield (Mr Sheerman) stated earlier, the Government seem to suggest that the public sector is bad, and indeed there does appear to be a constant push to privatise public services. We have yet another example of that with the desire to privatise the Land Registry.

We know that the Government have used the global financial downturn as a reason for implementing the most severe financial austerity that our country has ever seen. On the one hand, they have found the money to reduce inheritance tax, capital gains tax and the rate of tax for the highest earners from 50p to 45p, and on the other, they have made huge cuts to the income of working families and to welfare for disabled people, and created significant hardship across the public sector.

I have spoken on a number of occasions in this Chamber about the cuts to policing and the impact that those cuts have had on police services, most notably on neighbourhood police services. Today, I wish to concentrate on council services. As someone who spent 20 years as a county councillor before coming to this place, I have seen at first hand the many excellent examples of locally delivered, democratically accountable public services. I have also seen first-class examples of collaboration between local authorities and other public sector agencies, and in some cases with the third sector and the business sector, too. All too often in these examples, the lead is taken by local authorities because of the strategic responsibilities and overview that they have. In my view, that role is unique and should be protected.

Unfortunately, in my last few years as a councillor, I witnessed the consequences of Tory cuts. It reminded me of when I was first elected as a councillor in 1995 when, for the first two years under the last days of the Major Government, times were tough. I remember millions of pounds being cut from council budgets. Following the election of a Labour Government in 1997, a commitment to local public services was restored and funded properly. Unfortunately, that funding reverted to form in 2010. Since then, the budget for the Welsh Government has been cut by around 10%, and that has impacted hugely on local public services in Wales. I pay tribute to all local authority staff across the sector who, despite the odds and having to do much more for less, still try to deliver key public services as best they can.

Despite a significantly reduced budget, the Labour Welsh Government have led the way in tackling poverty and deprivation. The Jobs Growth Wales programme has been hugely successful, supporting 15,000 young people with job opportunities. That scheme is continuing with £25 million of European funding and will support the creation of 8,955 new job opportunities for 16 to 24-year-olds. The success of Jobs Growth Wales is yet another example of why the UK needs to remain in the EU.

As right hon. and hon. Members will know, local government in Wales is devolved to the Welsh Government. That was hugely beneficial to Welsh councils because in the first years of Tory austerity the Welsh Government under Carwyn Jones protected councils from the severity of the cuts for as long as they could. I remember talking at the time to local government colleagues in England, who were hit hard by austerity, and comparing our situation with the huge difficulties that they were having in delivering services.

Many people in the communities I represent rely heavily on the services provided by Merthyr Tydfil County Borough Council and, on the Rhymney valley side, by Caerphilly County Borough Council. Both authorities have worked hard in recent years to protect front-line services as best they could in the face of unprecedented financial cuts. Both councils pay the living wage to their employees—and I mean the proper living wage as suggested by the Living Wage Foundation, which specifies an hourly rate of £8.25, to take people above the poverty line. It is not the pretend national living wage that this Government introduced, which is clearly not a living wage.

Two key services delivered by local authorities that are also statutory services are education and social services, and they utilise the lion’s share of the budget, despite significant pressures. Many of the other services provided by councils are discretionary services, but are hugely valued by the public none the less. They include highways, leisure and community centres, youth services, libraries, arts and tourism, to name but a few.

I think that councillors across our country have done an excellent job in a very difficult situation. This Government are making significant cuts to public services, and that is placing local councillors in an impossible situation. We know that large organisations such as councils should always look for ways to be as efficient as they can be, and efficiency savings are a good way of reinvesting in front-line services, but what this Government have done is more to do with an ideological dislike of public services than with encouragement and support for vital local services.

To balance their reduced budgets, councillors are having to cut services to local communities. When we see our libraries having to cut their hours, our youth clubs being reduced and our potholes taking longer to repair, we must recognise that that is a direct result of this Government’s actions and their complete disregard for local public services. Cuts have consequences, and this Government must recognise that.

Another example of the Government’s attitude to public services is their treatment of the BBC. The BBC is respected around the world for its high-quality programmes and is one of the UK’s greatest cultural organisations. It is an excellent example of a great British public service. Any attempt to scale back the BBC would have a devastating impact on the UK’s creative industries—the fastest growing sector of the UK economy. I have received many emails from constituents across Merthyr Tydfil and Rhymney expressing their support for the BBC. We know that the Government have been forced to backtrack on many of their more extreme proposals, but as my right hon. Friend the shadow Secretary for Culture, Media and Sport said recently:

“There are still real concerns that the Government will seek to influence the BBC’s editorial decision making”.

That must be avoided. The independence of the BBC remains of paramount importance. We must continue to celebrate the BBC as one of the UK’s great economic success stories.

Finally, while we are discussing defending public services, I would like to mention the Transatlantic Trade and Investment Partnership. There is widespread concern that this trade agreement, currently under discussion between the EU and the US, would be detrimental to the NHS. Reassurances have been given, notably by EU Trade Commissioner Cecilia Malmström last year when she said:

“Member states do not have to open public health services to competition from private providers, nor do they have to outsource services to private providers. Member states are free to change their policies and bring back outsourced services back into the public sector whenever they choose to do so”.

Labour’s 2015 manifesto stated that we would ensure that the NHS is protected from the TTIP treaty and I am pleased to support any amendment that reinforces this.

I am one of many speakers in this debate who feel that in significant ways this Queen’s Speech falls short of addressing some of the big challenges of our time in this country. I want to address two of those.

The NHS and the social care system face an existential challenge. I agree with the right hon. and learned Member for Rushcliffe (Mr Clarke), who says that it is not just about money. The system often seems to be completely dysfunctional as a result of the inappropriate divide between health and social care, between physical health and mental health, and between primary care and secondary care. This must be addressed so that we can shape care around the needs of patients.

There is no escaping the fact that there is a financial issue. It makes no sense that between now and 2020 we are projected to spend a decreasing percentage of our national income on the health and care system, at a time when demand is rising rapidly. There are consequences from that trend. I believe the Secretary of State for Health when he says that he cares passionately about patient safety, but as the hon. Member for Dulwich and West Norwood (Helen Hayes) pointed out so effectively, the underfunding of mental health services in our country has massive consequences. As we heard last week, there has been an increase in the past year in the number of people who are shunted around the country in search of a bed. That is a scandalous practice. We know that it is associated with an increased risk of suicide, yet it continues to happen in increasing numbers.

When the pressure increases, crisis management takes over. We cut preventive services in order to prop up acute hospitals, and the services that we cut are the very services that prevent people from going into hospital in the first place. It makes no sense and it needs to change. I have two proposals which the Government need to consider.

I repeat again that I think this is the time for a 21st-century Beveridge report, bringing the parties together to come up with a new long-term settlement for the NHS and, critically, for the social care system. Also, we should consider the case for a dedicated health and social care tax. That has been proposed by people from across the political spectrum. It is the only area of public policy where there is an inexorable rise in demand, yet by protecting the NHS we disproportionately cut other areas of public service. It therefore seems to me that there is a very strong case for carving health and social care out and introducing a dedicated tax. Lord Patten on “Any Questions?” last week made the case for it. Lord Finkelstein for the Conservative side has also argued for it, as has the right hon. Member for Birkenhead (Frank Field).

We are losing pace with other European countries in our spend on health and social care, and there are consequences from that. I know, as I have said, that the Secretary of State cares about patient safety, but the safety of patients is being put at risk by the financial pressure that the NHS faces.

Finally, I want to address the prison reform Bill. I welcome the reforms in it, but something much more fundamental is needed. I encourage the Secretary of State for Justice, with his reforming instincts, to go further. A fundamental failure of public policy is reflected in the number of people in our prisons with mental ill health, learning disability and autism, and the number of people in prison in connection with drug addiction or offences relating to the criminal market in drugs. We are seeing a spike in the number of suicides in our prisons, which should horrify all of us. We need to do something about that.

The Secretary of State needs to go beyond the civilising proposals that he has for our prisons and look at radically reducing the number of people who end up inappropriately in our prisons. Germany and Finland imprison about half the number of people that we do. Those are not lawless countries, yet they manage to adopt a much more civilised approach. There should be a presumption against short sentences. We know that people leave prison and reoffend in vast numbers. That does not protect the public. There should be a much greater use of mental health treatment orders as an alternative to putting people in prison, and a renewed focus on restorative justice to address the causes of crime.

There needs to be the long overdue declaration of an end to the war on drugs, which has failed so fundamentally internationally. It criminalises vast numbers of our fellow citizens. Every year in our country, it puts billions of pounds—about £7 billion—into the hands of organised crime. It is associated with extreme violence in our communities. This makes no sense, and too many people end up in our prisons as a result of this misplaced policy. Just as many states in the United States are now moving towards a much more rational policy, and just as Canada has now committed to legislating to regulate the market for cannabis rather than leaving it in the hands of organised crime, I believe that in this country we should follow the same route, with a rational, evidence-based policy that does not criminalise people inappropriately for doing exactly the same as many members of this Government will have done in their youth. Instead, we need to take money away from criminals and collect tax revenue to spend on our essential and vital public services. It is time for a more rational approach. I hope that at some point this Government recognise that if they are to address the problems of crime in our society, ending this futile war on drugs is one of the steps that they must take.

It is a pleasure to follow the right hon. Member for North Norfolk (Norman Lamb). I refer to my entry in the Register of Members’ Financial Interests and my position as chair of the Public and Commercial Services union parliamentary group.

There is a slight disagreement between me and two Labour Members as to the best “Game of Thrones” characters to compare with the Government. Let me offer the Lannister family as perhaps the most accurate description of the current predicament in the Conservative party. The Government are the Lannisters and the Conservative party is the rest of King’s Landing. Like the Lannisters, the Government are being overrun by zealots and fanatics who are ensuring that they cannot get things done because they are more interested in purity. I will leave it to others to identify the High Sparrow, although it would be fair to say that today there has appeared to be more than one candidate for that post. In the circumstances of the current season of “Game of Thrones”, the comparison with the Government is uncanny.

This programme for government fails to address the many problems and major issues that society is facing. There is nothing for those who regularly require the services of a food bank, which represent the largest growth industry in the United Kingdom. Who would have thought that we would be in an era where that was the case?

Where is the legislation to crack down on the abuse of companies not complying with paying the national minimum wage? How does that square with the madness of closing 90% of HMRC offices and making HMRC staff redundant? We now know, through the National Audit Office, that some 209,000 people in the past year have not been paid the national minimum wage—a doubling of those who are not being paid proper wages. Those who are owed arrears in payment of the national minimum wage now number 58,000, compared with 26,000 in the previous year.

Where is the legislation to abolish employment tribunal fees, which are blocking access to justice for many workers and are so expensive that people will not pursue their claims because the fee is larger than the wages they are owed? Where is the legislation to aggressively go for tax avoidance? We now know, through written answers to questions, that some 3,765 workers in the Department for Work and Pensions are chasing alleged benefit fraud of £1.2 billion, and at HMRC 320 employees are chasing tax avoidance of £70 billion. If there was more investment in HMRC to tackle tax avoidance, just imagine how much money that could bring in.

I want to raise the issue of public sector workers who have had what is in effect a pay cut. In the past year, many have been paid a 1% increase in wages, but have seen that go in the 1.4% increase in national insurance contributions. That is in effect a cut for many public sector workers, and the Government have not suggested anything to deal with that problem, or indeed to help the real genuine wealth creators—the low-paid who work for long hours to keep the economic wheels turning.

It continues to be an unacceptable part of the Government’s programme to take the “Devil take the hindmost” approach to social security and to pursue sanctions in a sanctions regime. That goes even further, because I now know from my constituents that they have to pay for expensive telephone calls to the Department for Work and Pensions to pursue their claims. There is a free helpline for making a claim, but if there is a mistake—for example, if someone has not have received their money—they have to pay for the call. That recently happened to a constituent of mine, and the phone call to pursue their claim cost £9. For someone who has not been paid any money and is waiting for money to go into their bank account, that is completely unacceptable. I am asking the Government to do something about that during the coming year.

I want to raise the very important issue of industrial relations in the public services, particularly the attitude of the UK Government. They keep viewing the trade union movement as the enemy. The trade unions are being ignored when they should be listened to. They are ignored when Departments make announcements, as was the case when the Department for Business, Innovation and Skills decided to close its Sheffield office. Trade unions have been locked out of employee-management one-to-one meetings to discuss an employee’s future, as is the case in Her Majesty’s Revenue and Customs. Such actions will only stir up resentment towards the Government from trade unions and public sector workers, who often go way beyond their job descriptions to ensure the delivery of public services.

The programme for government does not address the major challenges affecting our society. I hope that the Government will take cognizance of early-day motion 47 in my name, which calls for a full public inquiry into the scandal of blacklisting in the construction industry. I want to praise the trade unions and the Blacklist Support Group for pursuing employers in court recently on that very issue.

If there is not a change in attitude by the Government—if they do not invest in public services, if they decide against delivering what I believe should be world-class public services, with motivated staff—it will only cost more in the long run. The biggest casualty of cuts will be the public services themselves, and further strain will be put on them. It will then be passed to another generation to build an equal society without poverty.

In the coming year, I pledge to my constituents to pursue the major issues and problems we need to face as a society. I fear that the Government are not up to such a task while they are pursuing economic illiteracy.

I welcome the Minister for Culture and the Digital Economy to his place and look forward to hearing what he has to say, but it is extraordinary that the Secretary of State for Culture, Media and Sport could not be bothered to turn up to wind up his part of the debate on the Gracious Speech at the very beginning of this new parliamentary Session. What a dereliction of duty. Who knows whether he is otherwise engaged—no doubt on the vote leave battle bus—or whether the Prime Minister simply does not trust him enough to let him out of the Cabinet dog house to which he has no doubt been confined on the shortest of leashes because of his support for the leave campaign.

We have had a broad-ranging and excellent debate. We have heard from 31 Back-Bench colleagues, one of whom, my hon. Friend the Member for Sheffield, Brightside and Hillsborough (Gill Furniss), made an excellent and well received maiden speech. It showed quite clearly what a great MP she is going to be, rooted as she is in the community that she now represents. Sad though the circumstances are that have brought her to this place, it is quite clear from her remarks that she will do an excellent job.

This was the Queen’s Speech that was not supposed to happen ahead of the EU referendum, and it showed. As my right hon. Friend the Member for Leicester East (Keith Vaz) and my hon. Friend the Member for Stoke-on-Trent Central (Tristram Hunt) said, we were told in Government briefings in March that the Queen’s Speech was to be postponed until after the EU referendum, but the Prime Minister then changed his mind. Perhaps that explains the ill thought out programme, with a small number of Bills, many of which seek to do things that everyone agrees with, being cobbled together to give an impression that all is well with this relatively newly elected Government—except that it is not.

We can see clearly that the Prime Minister is not focused on this legislative programme because he is otherwise engaged. It is no wonder, given that his fractious, warring Cabinet members seem to have lost all mutual respect, denouncing each other in language more suited to bitter political enemies. I will give two examples. The erstwhile Welfare Secretary thinks that the Chancellor tells fibs—he has said today that Pinocchio,

“with his nose just getting longer and longer and longer”,


“very similar to the Chancellor. With every fib you tell, it gets longer. Who am I to judge how many there have been?”

Meanwhile, the Employment Minister has accused the Prime Minister of “concocting Armageddon scenarios”, calling some of his claims about what will happen if we leave the EU “fantastical”, “hysterical” and “incredible”. It was clear from the context that she did not mean it in a positive sense.

We have heard an echo of those debates on the Government Back Benches today, with the right hon. Members for Hitchin and Harpenden (Mr Lilley) and for Wokingham (John Redwood) being opposed by the right hon. Member for Arundel and South Downs (Nick Herbert) on EU issues. My hon. Friend the Member for West Ham (Lyn Brown) called it a Tory “Game of Thrones”, and the hon. Member for Glasgow South West (Chris Stephens) even went so far as to offer parallels with individual characters from that drama. It makes for an interesting spectacle, but not for good governance or an ambitious legislative programme.

Could the hon. Lady give us an up-to-date view on how the Labour party is getting on with the arguments on unilateralism and the nuclear deterrent?

Certainly not in 10 minutes.

The Government’s extraordinary decision to announce that they will accept an amendment to the Humble Address if necessary, clarifying that the NHS will be exempt from arrangements in the Transatlantic Trade and Investment Partnership, is highly unusual, not to say humiliating for them. That major concession before we have even got to the end of the debate on the Gracious Speech shows how desperate the Prime Minister is to avoid being defeated on the Floor of the House by his own Brexit-driven rebel Back Benchers, at least 25 of whom have signed the amendment—enough, along with all the rest of us, to defeat the Government. Without that retreat, this would have been the first vote on a Gracious Speech lost by a Government since 1924.

That also shows how willing Tory Brexit rebels are to inflict such a defeat on their own Prime Minister. Indeed, some reports over the weekend suggested that it would be followed by the rebels going on strike to block Government legislation after the referendum unless some of their number were promoted—an extraordinary state of affairs. Meanwhile, one pro-remain Minister is reported to be demanding that the rebels should all be kicked out of the Tory party; a Tory “Game of Thrones” indeed. No wonder this legislative programme is so slim. The Prime Minister will be spending all his time after 23 June on party management. I can only congratulate the right hon. Member for Hitchin and Harpenden, who spoke to his amendment with great cogency, and my hon. Friend the Member for Dewsbury (Paula Sherriff) on causing such Government turmoil. My hon. Friend has now secured Government concessions on both the Budget and the Queen’s Speech—she is really getting the hang of how this place operates.

I am sure the hon. Member for Blackpool North and Cleveleys (Paul Maynard) will be glad to hear that the Opposition agree with the aims behind some of the legislation that has been announced. In the case of the Department for Culture, Media and Sport, how could one object to the Cultural Property (Armed Conflicts) Bill, which will implement The Hague convention to which the UK has been a signatory for many years? We support it wholeheartedly. We also welcome the aims behind the digital economy Bill, as did the right hon. Member for Arundel and South Downs, the right hon. Member for Basingstoke (Mrs Miller) and the hon. Members for Harrow East (Bob Blackman), for High Peak (Andrew Bingham), for Mid Worcestershire (Nigel Huddleston) and for Rossendale and Darwen (Jake Berry).

We particularly welcome the proposed introduction of the universal service obligation for broadband, automatic compensation for customers deprived of good service, and enhanced transparency for consumers to make an informed choice. We will look carefully at proposals to introduce a new electronic communications code, protect intellectual property rights online, and introduce age verification for pornographic websites. It is extremely disappointing that the Government will break their promise to automatically roll-out broadband to all households, so perhaps the Minister will spell out the additional costs that many households and businesses will need to bear to get connected, and give us the total number that he expects will be adversely affected.

Despite their desperate efforts to appear uncontroversial in this legislative programme, the Government pose an underlying threat to all our public services—many of my hon. Friends referred to that during the debate. The Government seem to know the price of everything and the value of nothing, and their obsession with marketisation as a prelude to privatisation leaves them with a tin ear to the value of the public service ethos. As my hon. Friend the Member for Huddersfield (Mr Sheerman) said, they seem to believe that the public sector is automatically bad, and the private sector automatically good.

Unfortunately, the Government are developing that theme across Departments. As my hon. Friends the Members for Washington and Sunderland West (Mrs Hodgson), for Manchester, Withington (Jeff Smith), for Sheffield Central (Paul Blomfield), for West Ham (Lyn Brown), and for Merthyr Tydfil and Rhymney (Gerald Jones) said, the Government seem unable to accept the fact that public service broadcasting and the public service ethos—as exemplified by the BBC—makes a hugely positive contribution to our society, boosts the UK creative industries and creative economy, and is successful and massively popular, providing great value for money for licence fee payers and high-quality broadcasting for us all. Channel 4 fulfils its remit without any input from the taxpayer or licence fee payer.

However, the Secretary of State for Culture, Media and Sport has shown himself to be utterly committed to denigrating and diminishing the BBC, which he recently described as no more than

“a market intervention of around £4 billion by Government”.

He wants to privatise Channel 4—he said so just last month, although I notice that there is no Bill for that in this legislative programme.

The constant assumption that the private sector is better, and that the public sector should be diminished or sold off, is based on ideology, not evidence, and is out of step with public opinion. Just last week the BBC announced that it would start to do what the Secretary of State said he wants, which is to cease activity that duplicates what can be done in the private sector—something he calls “distinctiveness”. The BBC announced that it would remove its online recipes. The huge public outcry was instructive, and the Government should take note. So far 195,000 people have signed the petition asking the BBC to keep that trusted resource. The Secretary of State immediately said that the plan was nothing to do with him, but we all know that it was.

Some of our debate has been about the national health service—our most loved public service—and I tell this House and the Government that the Labour party will not stand by and watch the health service be denigrated, reduced or cut. This legislative programme will do nothing to deal with the real challenges facing our public services, whether our NHS or the BBC. We know the value of our public services, and we will make it our business to speak up for and defend them.

I am pleased to respond to this debate, and I apologise that I slipped out for a while to attend the Oscars—I refer, of course, to the fantastic Oscar’s book prize, which was started by the journalist James Ashton and his wife, Viveka, in honour of their son, who sadly died at a young age. It is a prize for children’s literature and picture books, and I am pleased that the award went to the fantastic Spanish author, Gemma Merino—are we not pleased that in this country we are able to award a prize to a Spanish author, one of our European brethren?

The winning book was called “The Cow Who Climbed a Tree”. I have not read the book, but I do know that it features a cow that does something unusual—it climbs a tree. That reminded me of this debate, which has been a bit topsy-turvy. A former Trade and Industry Secretary condemned a trade treaty with the United States, my right hon. Friend the Member for Wokingham (John Redwood) called for more investment in public services and not for tax cuts, and the hon. Member for Huddersfield (Mr Sheerman), who is not in the Chamber, recommended that hon. Members read The Sunday Times, a Rupert Murdoch paper, and in particular columns by Max Hastings, to get a real taste for the truth in public policy.

This is a special day, and I want to mark two important occasions. First, it is the Chancellor’s 45th birthday, which was mentioned in the debate. Secondly, I may be the first to congratulate the leader of the Scottish Conservatives, Ruth Davidson, on her engagement. Many others have congratulated her on eclipsing the Scottish Labour party and on the fact that she is breathing down the neck of the Scottish Nationalist party.

The debate has very much been about football. The right hon. Member for Leicester East (Keith Vaz) was not wearing his scarf but still managed to mention his championship-winning team—a team that wins rather than a party that loses, such as the SNP.

The SNP won the election and increased its share of the vote—it got nigh on 47% of the vote. The Tories got 22% of the vote, which is less than they got when Thatcher was in power. If the Minister calls that breathing down the neck, I do not know what he would think about a real challenge.

The hon. Gentleman doth protest too much, and he certainly spoke extensively. As well as Leicester, we heard mention of Sheffield Wednesday, and I wish them the best of luck in the premier league play-off. The hon. Gentleman is a fan of Hibernian, so he obviously had a good weekend. We also had a brief mention of West Ham, who are ably led by the Conservative peer Karren Brady.

Before I mention individual speeches, may I reject the persistent criticism from the Opposition about this being a thin Queen’s Speech? We focus on sugar-free drinks and the sugar tax, but the Queen’s Speech is packed with fantastic nuggets. My Bill will push forward the digital economy. The Department for Transport will focus on autonomous vehicles and on spaceports. We have a commitment to 1 million more homes; the devolution of business rates to give more powers to local councils; rigour for our universities; much needed changes to adoption rules; greater freedom for headteachers and teachers; prison reforms; and a focus on skills and apprenticeships.

We have heard formidable speeches, but I hope hon. Members forgive me if I single out the maiden speech of the hon. Member for Sheffield, Brightside and Hillsborough (Gill Furniss). It was a fantastic speech, and particularly poignant for the fact that it came within a year of the maiden speech of her late husband Harry Harpham, who is sadly missed from the House. She talked about skills, housing and libraries. I may not agree with the hon. Member for Huddersfield that we should always read Max Hastings, but I agreed with him when he followed her speech by saying that she will be a formidable Member of the House and a fantastic spokeswoman for her constituents.

Much of the debate focused on the national health service, and my right hon. Friend the Secretary of State gave a robust exposition of his important reforms. He has worked incredibly hard over the past four years to put patients first. The key point is to put patient safety and patient outcomes first.

Many Members spoke in the debate, including my right hon. Friend the Member for Basingstoke (Mrs Miller), my hon. Friends the Members for Harrow East (Bob Blackman), for South West Wiltshire (Dr Murrison) and for Dudley South (Mike Wood), the right hon. Member for Leicester East, and the hon. Members for Ross, Skye and Lochaber (Ian Blackford), for Huddersfield, for North Antrim (Ian Paisley), and for Scunthorpe (Nic Dakin), but I should like to mention the hon. Member for Dulwich and West Norwood (Helen Hayes) and the right hon. Member for North Norfolk (Norman Lamb), who focused on mental health. For a long time, mental health has been the Cinderella, but my right hon. Friend the Secretary of State deserves a great deal of credit for raising its profile and importance, and for investing in it. We need to focus on that incredibly important service as much as possible.

We had mentions of education. The right hon. Member for Leicester East talked about prison reform, which is an extraordinarily important issue, and with my cultural hat on may I say how important culture could be in giving prisoners life chances and aiding their rehabilitation?

I notice from your glance in that direction, Mr Speaker, that I was warned by several of my colleagues not to mention them in my peroration, such is the terror with which you are held, in case they were not in the Chamber to hear their names mentioned, so I had better stop mentioning hon. Members and hon. Friends. I will, however, turn briefly to the BBC, which has been much maligned by those on the Opposition Benches.

The hon. Members for Washington and Sunderland West (Mrs Hodgson), for Manchester, Withington (Jeff Smith), for Sheffield Central (Paul Blomfield) and for Merthyr Tydfil and Rhymney (Gerald Jones) all spent their time talking down the BBC. I found it particularly surprising that the hon. Member for Sheffield Central—he obviously had not heard the hon. Member for Huddersfield extolling the virtues of the Murdoch press—dared to suggest that we were somehow shaping our approach to the BBC at the behest of Rupert Murdoch. I tell you this, Mr Speaker, with utter sincerity and truthfulness that the only organisation that has ever lobbied me to clip the wings of the BBC is The Guardian.

Mr Speaker, I know you well enough to know that you may not know what The Guardian is. It is a left-wing newspaper and website that has been going through some interesting changes recently in terms of its chief executive and the chairman of its trust. It comes to me regularly—quite legitimately, I have to say—to say that it is trying to make a living, as it were, digitally in the digital world. It has been opening websites. It opened an office in Australia and came to complain about the presence of the BBC in Australia taking talent from The Guardian in Australia and paying too much. It also lobbied me about the presence of the BBC in the US, where The Guardian also wants to have a presence.

The serious point is that we have to be aware not just of the fantastic virtues of the BBC, but that it is seen by other media groups, such as The Guardian, as a competitor. We have carried out much needed reform of the BBC. We have put its regulation on a proper footing—it will be regulated by Ofcom, with a unitary board. We have emphasised, in deference to The Guardian, the importance of the BBC being distinctive. We have strengthened its independence by ensuring that it can appoint half the members of the unitary board, and we have put in place a mid-term review so that the BBC can keep pace with technological change. That is only right and proper.

The other important aspect of the Queen’s Speech is the digital economy Bill, which was mentioned by my hon. Friends the Members for Mid Worcestershire (Nigel Huddleston) and for Salisbury (John Glen), my right hon. Friend the Member for Basingstoke, my hon. Friend the Members for Rossendale and Darwen (Jake Berry), my right hon. Friend the Member for for Arundel and South Downs (Nick Herbert), and my hon. Friends the Members for High Peak (Andrew Bingham) and for Harrow East. This is an important point. The hon. Member for Garston and Halewood (Maria Eagle) asked me to talk about the universal service obligation we are bringing in to make it a right to get superfast broadband, and what the extra costs might be for people applying for it. She well knows that if one applies now for a telephone landline under the universal service obligation, one has to make a contribution if the costs exceed a certain level. Of course, that level is many, many thousands of pounds, so it is not as if we will be asking many people, if any, to make a contribution. We will consult after we have legislated for this important right. I hope the hon. Lady will make a contribution to that consultation and perhaps advise us on what level she thinks any threshold should be set at.

I welcome the hon. Lady’s welcome for the cultural protection Bill in relation to The Hague convention. The Bill should have been passed by the previous Labour Government. In fact, I was the Opposition spokesman at that time—as you know, Mr Speaker, I was made Opposition spokesman in about 1874. I was ready and willing to take it on as my first Bill as an Opposition spokesman, but have had to wait eight long years to take it through as a Minister.

This is a Queen’s Speech packed with passion, packed with aspiration and packed with ambition. It is a one nation Queen’s Speech that focuses on the life chances of those who are hardest to reach. This has been a vigorous and important debate. I have to say with utter sincerity that it has been an absolute pleasure to listen to hon. Members on both sides of the House and to hear the passion and the principles that they bring to these issues. Their knowledge, expertise and independence of mind are everything that makes this House of Commons great and everything that makes this country great; a great country and a great member of the European Union. [Interruption.] I am just trying to match the rhetoric.

The debate stood adjourned (Standing Order No. 9(3)).

Ordered, That the debate be resumed tomorrow.