“Bairns come first” is the title of a report recently produced by a number of organisations, including Fife Gingerbread and Citizens Advice and Rights Fife. It found that a third of families who should have been claiming child maintenance support did not apply, that a major barrier to applying was the £20 application fee, and that the 4% collection fee had a serious impact on family budgets. Will the Prime Minister undertake to review those unfair charges?
Trying to ensure that those responsible for children actually pay for their children when a family has broken up has been a long-standing question which this House has addressed. There have been various ways of dealing with it through the agency that has been responsible. It is right that the changes that have been introduced are on a more level basis and more people are able to access the support they need as a result.
I thank my hon. Friend for raising that. I know that the issue of the north-west relief road in Shrewsbury has been of particular concern to him; it is a priority for him and it has received considerable local backing. I understand that the local Marches LEP has put in a bid for feasibility funding so that it can prepare a business case for the scheme. What I can say at the moment is that the announcement of the successful bids for feasibility funding is expected very shortly indeed.
The Government’s sustainability and transformation plans for the national health service hide £22 billion of cuts to our service, according to research by the British Medical Association. That risks
“starving services of resources and patients of vital care.”
That quote comes from Dr Mark Porter of the BMA. When he calls this process “a mess”, where is he wrong?
The national health service is indeed looking for savings within the NHS which will be reinvested in the NHS, and I remind the right hon. Gentleman that it is this Government who are providing not just the £8 billion of extra funding that the NHS requested, but £10 billion of extra funding. Sustainability and transformation plans are being developed at local level in the interests of local people by local clinicians.
It is very strange that the Prime Minister should say that, because the Select Committee on Health, chaired by her hon. Friend the Member for Totnes (Dr Wollaston), says that the figure is actually £4.5 billion, not £10 billion; there is quite a big difference there.
Part of the reason for the strain on our national health service is that more than 1 million people are not receiving the social care they need. As a result of that, there has been an increase in emergency admissions for older patients. Margaret wrote to me this week—[Interruption.] It is not funny. She described how her 89-year-old mother suffered two falls leading to hospital admissions due to the lack of nursing care, and went on to say,
“My mother is worth more than this.”
What action will the Prime Minister take to stop the neglect of older people, which ends up forcing them into A&E admissions when they should be cared for at home or in a care home?
Of course social care is an area of concern, and it is a key issue for many people. That is why the Government have introduced the better care fund and the social care precept for local authorities, and why we are encouraging the health service and local authorities to work together to deal with precisely the social care and bed blocking issues that the right hon. Gentleman has raised.
We have introduced the better care fund and the social care precept, but let us just look at what the Labour Government did in their 13 years. They said that they would deal with social care in their 1997 manifesto. They introduced a royal commission in 1999, a Green Paper in 2005 and the Wanless review in 2006. They said they would sort it in the comprehensive spending review of 2007, and produced another Green Paper in 2009: 13 years, and they did nothing.
As the Prime Minister well knows, health spending trebled under the last Labour Government and the levels of satisfaction with the health service were at their highest ever in 2010. This Government’s choice was to cut social care by £4.6 billion in the last Parliament, at the same time as they found the space, shall we say, to cut billions from corporate taxation bills. This is affecting patients leaving hospital as well. In the last four years, the number of patients unable to be transferred from hospital due to the lack of adequate social care has increased by one third. Will the Prime Minister ensure that her Government will guarantee all our elderly people the dignity they deserve?
I recognise the importance of caring for elderly people and providing them with the dignity they deserve. The right hon. Gentleman says that this Government have done nothing on social care, but I repeat that we have introduced the social care precept, which is being made use of by my local authorities and by his local authority. We have also introduced the better care fund. He talks about support for elderly people, but let me remind him which Government it was who put in place the triple lock for pensioners. That has ensured the largest increase in pensions for elderly people.
The precept is a drop in the ocean compared with what is necessary for social care. I shall give Members an example. I am sure the whole House will have been appalled by the revelations in the BBC’s “Panorama” programme this week. They showed older people being systematically mistreated. The Care Quality Commission’s assessment is that the care homes run by the Morleigh Group “require improvement”, and it has issued warning notices. The commission goes on to say that the owner
“has allowed the services to deteriorate even further. She has utterly neglected her duty of care to the residents of these homes.”
What action are the Government going to take to protect the residents of those homes?
The right hon. Gentleman raises the issue of the quality of care that is provided in homes and the way in which elderly people are treated. I am sure everybody is appalled when we see examples of poor and terrible treatment being given to elderly and vulnerable people in care homes. What we do about it is ensure that the Care Quality Commission is able to step in and take action and that it has powers to ensure that nobody in the chain of responsibility is immune from legal accountability. We know that there is more that can be done, and that is why the CQC is looking into ways of improving its processes and increasing its efficiency. The Minister for community health and care, will be writing to the CQC shortly to see how we can improve what it does. It is the CQC that deals with these issues, and we have that in place. Is there more we can do? Yes, and we are doing it.
The problem seems to be that that home was understaffed. We should not blame often underpaid and hard-pressed care workers; we should be ensuring that there are enough of them—properly paid— in all such homes. There was a serious problem of understaffing, and it was the last Labour Government who established the CQC. A warning notice is insufficient —we need stronger action than that.
Yesterday, the Government proposed that patients may have to show passports or other ID to access non-emergency healthcare. Have the Government considered the impact on elderly people? The last census showed us that 9.5 million people in this country do not have passports. Instead of distracting people with divisive, impractical policies, could the Prime Minister provide the NHS and social care with the money that it needs to care for the people who need the support?
Over this Parliament, the Government will be spending half a trillion pounds on the national health service. The right hon. Gentleman asks about a process to ensure that people who are receiving NHS treatment are entitled to receive that NHS treatment. For many years, there has been concern about health tourism and about people turning up in the UK and accessing health services but not paying for them. We want to ensure not only that those who are entitled to use the services are indeed able to see them free at the point of delivery, but that we deal with health tourism and those who should be paying for the use of our health service.
Simon Stevens told us two weeks ago that the next three years will be the toughest ever for NHS funding and that 2018 would see health spending per person cut for the first time ever in this country. The National Audit Office has reported that the cost of health tourism is over a hundred times less than the £22 billion of cuts that the NHS faces from this Government. The reality is that under this Government there are 6,000 fewer mental health nurses and a record 3.9 million people on NHS waiting lists. All of us who visit A&E departments know the stress that staff are under and that waiting times are getting longer and longer. One million people in this country are not receiving the social care that they need. Instead of looking for excuses and scapegoats, should not the Prime Minister be ensuring that health and social care is properly resourced and properly funded, to take away the stress and fear that people face in old age and the stress that is placed on our very hard-working NHS and social care staff?
Billions of pounds extra into social care through the social care precept and the better care fund; half a trillion pounds being spent on the national health service; a record level of investment in mental health in the national health service—[Interruption.]
There is a fundamental point that the right hon. Gentleman refrains from mentioning: we can afford to pay for the national health service and for social care only if we have a strong economy creating wealth, and that is precisely what he is going to hear from the Chancellor of the Exchequer in a few minutes’ time.
Thank you, Mr Speaker—and I will repeat it. Some remainers do not seem to understand the meaning of the word “democracy”, which I would remind them is government by the people, especially the rule of the majority. With that in mind, what reassurance can my right hon. Friend give my constituents and me that article 50 will be triggered by March next year?
I am clear that we will trigger article 50 by the end of March next year. My hon. Friend is absolutely right to make the key point: it was decided by this Parliament, six to one, that the people should have the opportunity to vote on membership of the European Union. The vote was held, the turnout was high and the public gave their verdict. There must be no second referendum and no attempt to weasel out of this, and this is the Government who will deliver on the vote of the British people.
We on the Scottish National party Benches have repeatedly brought up the issue of the devastating impact on disabled people of the UK benefits system. The Government plan to cut support for people with long-term health difficulties by £30 a week. Last week, my hon. Friend the Member for Airdrie and Shotts (Neil Gray) proposed a motion, which was passed by this House with support from both Labour and Conservative Members, for these cuts to be postponed. Will the Prime Minister act on the vote of this House?
Let me tell the right hon. Gentleman what we have been doing in relation to benefits for disabled people: the overall funding for disability benefits will be higher in every year up to 2020 than it was in 2010; we have been focusing support on those who most need it—those who are not able to get into the workplace; and for those who are able, at some stage, to get into the workplace, we have been providing a wider package of support. I am pleased to say that over the last three years nearly 600,000 more disabled people are now in the workplace, with the dignity of having a job, which is what many people with disabilities want to have. So we are focusing help on those who most need it and helping those with disabilities who want to get into the workplace to do just that.
But it is widely trailed that the Prime Minister will make changes that will impact on benefit recipients in work. Will she confirm that she has no intention of helping people with disabilities and medical conditions? Why should people who are unable to earn a living be punished for their disability or illness by losing £30 a week? Does she have any intention of changing that?
I have just set out for the right hon. Gentleman the ways in which we are providing support and help for those people who have disabilities. As I said, the overall spending on disability benefits will be higher in every year to 2020 than it was in 2010. But it is also important to recognise that when we give support for people with disabilities, it is not simply about the benefits system and how much money they are given; for those who are able to get into work and are on that part of the employment and support allowance, we provide packages that are outside the benefits as well, because we recognise that people want the dignity of getting into the workplace. That is what we are helping people with disabilities who can work to do.
My right hon. Friend is absolutely right about the importance of infrastructure expenditure in helping to deal with productivity in our economy, and I am pleased that that £1.3 billion for new roads does show us investing in the long-term future for Britain. It is about delivering jobs and economic growth, and about making sure that this economy works for everyone. It is just one part of the package that we are proposing, but of course my right hon. Friend the Chancellor will be setting our proposals out more clearly in a few minutes’ time.
Obviously, this is a very difficult time for the whole family. I am sure that we are all concerned about the reports of the impact that detention in Iran is having on Nazanin Ratcliffe’s health. This is an issue that has repeatedly been raised with the Iranian Government by the UK Government—by both the previous Foreign Secretary and the current Foreign Secretary. I personally raised it with President Rouhani on 20 September in New York, and I stressed the importance of finding a resolution as soon as possible. I have since written to President Rouhani requesting confirmation of the charges, the sentence and the appeals process, and I have asked for assurances that Mrs Zaghari-Ratcliffe will be allowed full legal representation and regular contact with her family. We will continue to do everything that we can for the family, and that includes the British Government remaining ready to help to bring back Mrs Zaghari-Ratcliffe’s daughter to Britain if that is the request.
I am sure my right hon. Friend will recognise that we are subject to our own Prudential Regulation Authority, but the overall point that he makes about the importance of house building is absolutely correct. We do need to build more homes. That is something that the Government have been doing. We have seen about 900,000 new homes being built since 2010, but there is more for us to do, and that is what this Government are working on.
I have been very clear in this House on many occasions about the plan that we have for Brexit. Crucially, we will be leaving the European Union and we will be triggering article 50 by the end of March next year, and that is when the formal negotiations will start. It is absolutely right that we do not set out at this stage every single detail of our proposed negotiating strategy, because that would be the best way to get the worst possible deal for Britain.
My right hon. Friend is absolutely right. The extra investment that we will be putting into research and development is a crucial part of our long-term task of ensuring that we have the economy and the growth and prosperity that we need in this country. The new funds will help to put us at the cutting edge of scientific discovery. That is already happening. I visited the Wellcome Genome Campus in Cambridge on Monday and saw for myself the really exciting and transformational work that is being done, and it is coming out of the knowledge base and the scientific research of the United Kingdom. We want to see more of that, which is why we will be investing in it.
The hon. Gentleman is right to raise the issue of the appalling atrocities that are taking place in Aleppo, and it is right that we, along with our international allies, should be doing all that we can to try to bring this to a stop. He will recognise that the issue of who hosts sporting events is not in the Government’s remit. What is in the Government’s remit and what we are doing, as I say, is working with our international allies to put more pressure on Russia to stop the appalling atrocities—the appalling attacks—that are taking place in Aleppo. What we want to see is an agreement for a political transition to a Syria without President Assad.
My right hon. Friend will, of course, be waiting in anticipation for my right hon. Friend the Chancellor’s autumn statement, but he is absolutely right that, as we look at improving productivity in this country and as we look to the economy of the future, the provision of superfast broadband and those new technological opportunities for people is absolutely a crucial part of that, and that is something that this Government recognise and will act on.
May I send our best wishes to those police officers who were assaulted in the hon. Lady’s constituency last week? It is important that we recognise that when police officers go out on duty—and, indeed, for many off duty—they sometimes find themselves intervening in situations where they are on the receiving end of assaults and violence against them. They are willing to go forward in the line of duty, where others are not, and we recognise that. One of the things we want to do in relation to this is to identify rather better the number of assaults that are taking place. That is why last year we issued some provisional figures. We are improving those figures now this year. Sentencing guidelines already allow for an assault on a police officer to be taken as an aggravating factor into account, but also new developments, like the body-worn videos, actually help to provide the evidence that ensures that people can be brought to justice and that actually deter assaults in the first place.
I know that the Prime Minister shares my concern at the level of acute hospital bed blocking. Does she agree that part of the solution is to promote community hospital beds, where they still exist in places such as Warminster and Shaftesbury, as part of the sustainability and transformation planning process?
As regards the STP process, of course, that will take place at local level—it will be at the local level that these proposals will be considered and put forward by local clinicians—but the concept of being able to deal with bed blocking in a variety of ways is absolutely right. There are good examples around the country of where having those step-down beds available is actually resolving the problem of bed blocking. There are other ways in which that is being done—in those parts of the country where social workers are being employed by hospital trusts, for example. But is it very good to recognise the good practice when it is being done, and we shall see more of that across the country.
The question of whether or not an individual would be extradited or a request would be made for extradition is for the appropriate investigation and prosecution authorities to decide. We do, of course, recognise the concerns about those cases where it is still possible to bring people to justice, and obviously we want to see that being done.
During the past six years we have had three major referendums, all eliciting varying degrees of excitement. Does the Prime Minister agree that one can have too much excitement, and will she therefore rule out any further referendums in this Parliament?
The Government are taking action in a variety of ways to address homelessness. One of the key things we need to do is ensure that we see more homes being built in this country. The hon. Lady talks about austerity in the tone that she uses, but austerity is about us living within our means. When we talk about the Government providing support for individuals, we should always remember that taxpayers have to pay for that support, and many taxpayers are themselves struggling to get by.
The Prime Minister will be aware that yesterday the Peninsula Rail Task Force launched its report, which was commissioned following the storms that severed Devon and Cornwall’s vital rail link, just as our vital rail link was severed again, this time by flooding. Does she welcome the report and will she commit the Government to ensuring that the vision it outlines is delivered?
I do not recognise the picture that the hon. Gentleman presents of what the Government are doing in relation to the armed forces. We are investing billions of pounds in ensuring that our armed forces do have the missiles, the ships for the Royal Navy and the other pieces of equipment for the other armed forces. The picture that he presents is not the picture I recognise.
In this country we value the independence of our judiciary—that is, the independence of members of the judiciary when they come to make their judgments in court. Also, they are independent and it is for them to determine what they choose to put in their speeches. It is not for the Government to tell them what to do.
As millions of public sector workers face another year of suppressed pay, after another week of shambolic Brexit negotiations, and with the national health service facing a winter crisis and crying out for cash, does the Prime Minister worry that her Government are only just about managing?
We are very clear about the amounts of money that we are putting into the national health service. The hon. Gentleman talks about the negotiations. Actually, the negotiations for us leaving the European Union do not formally start until we trigger article 50. We will trigger article 50 by the end of March next year. The hon. Gentleman wants to stop us leaving the European Union by denying the people the decision and the deliverability of the vote that they took, rightly, on 23 June. He wants to deny people what they want; we are going to give it to them.
May I raise with the Prime Minister the concerns of millions of drivers and hauliers across the United Kingdom who worry about the cost of driving and fuel duty? Will the Government look at keeping that down? Will they also look at how forecourt pricing has worked as the oil price changes? The prices jump like a rocket and fall like a feather.
I recognise that, as my hon. Friend says, many people look with very great concern at the cost of motoring in this country. I suggest, as I have to some of my other hon. Friends, that he be a little more patient and wait for the Chancellor’s autumn statement.
The Prime Minister has talked about her worries about social care, but surely we have to judge her by her actions. In the last six years there has been an average 37% cut in local authority funding—57% in my area—and nearly a quarter of all those older people in need of social care have been denied any help at all. What is she going to do about it?
The hon. Lady might have noticed that I have been asked several questions about social care—[Interruption]—and I will give the answer that I have given previously. What the Government are doing about social care is to put more money in through the better care fund, to give local authorities the opportunity that is in the social care precept and to make sure that health and social care come together to ensure that we deal with the issue of bed blocking.
How many of us would charge into a darkened store at night knowing that inside were three mask-wearing, crowbar-wielding thugs trying to rob it? My two constituents, Nigel Dunmore and Grant McGarry, did just that; as a result of their intervention, the thugs fled, leaving the money, and the staff were hurt less, although one of the gentlemen was himself hurt. Will my right hon. Friend join me in praising their courage and selflessness in carrying out this extraordinary act of bravado?
I absolutely agree with my hon. Friend and I commend the bravery and courage shown by those two individuals—Nigel and Grant, I think he said—who stepped into that situation to ensure that it was not as bad as it might have been. That is incredible bravery; many members of the public would not have been willing to step forward in that way. Will he pass my best wishes—and the best wishes of the whole House, I am sure—on to those individuals?