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1.53 pm
Mr. Mike Gapes (Ilford, South): In the time available, I cannot cover all the points I had hoped to cover, but I wish to start with an extremely important one--it is a disgrace that the adoption Bill is not being brought forward at this time. Such a Bill would have been passed easily by the House and would have commanded widespread support, especially among the millions of people who are step-parents, who have step-parents or who are the siblings of stepchildren.
There was a real possibility of important action being taken to which the previous Secretary of State for Health was very committed, as was the hon. Member for Battersea (Mr. Bowis), formerly a junior Minister at the Department of Health but now the Under-Secretary of State for Transport. Apparently, the Government have again given way to the reactionary views held by some of their Back Benchers and have decided not to bring forward the proposals.
I shall concentrate on the problems suffered by Redbridge and Waltham Forest health authority and north-east London generally. The Under-Secretary of State for Health, who has just resumed his seat, will recall that, a few months ago, in an exchange with me, he at least admitted that my constituents were experiencing special problems. Those problems are getting worse.
The bogus league tables produced by the Government show that seven of the 20 worst performing trusts in the country are in the North Thames health authority area and in Essex. In my health authority are Forest Healthcare NHS trust, the second worst performer in the country, and Redbridge Healthcare NHS trust, the sixth worst performer. Havering Hospitals NHS trust and others nearby are also in the bottom 20.
For many years, there has been a serious loss of hospital beds in central London, which has had knock-on consequences out into north-east London and Essex. My health authority is discussing with five local trusts a scheme to manage the crisis in accident and emergency care expected this winter.
We have a health authority with a £2.9 million deficit. We have Redbridge Healthcare NHS trust, with a predicted deficit of between £500,000 and £1 million. We
have Forest Healthcare NHS trust, with an on-going £8 million deficit and a programme of change to try to manage that. The deficit is partly due to the double running costs of the large Claybury mental hospital, whose recent closure had been planned for 20 years.
In the same health authority we have the large Goodmayes mental hospital, which is due to close by 1999. We are told that it will be reprovisioned by the private finance initiative. Do not hold your breath. We expect that to have serious costs. I do not know what their impact will be, but I guess that they will place an already stressed budget in extreme difficulty.
Local newspapers regularly report problems in accident and emergency departments. We read that the need to provide beds for A and E causes elective operations to be cancelled. In August--a relatively light time--at the Redbridge Healthcare NHS trust, King George hospital cancelled 25 elective operations a week.
The position is very bad, but the adjoining Barking and Havering health authority is to close the A and E department at Oldchurch hospital and concentrate all services at Harold Wood. The nearest hospital for people who live in Barking and Dagenham is not Harold Wood but King George in Redbridge, on the A12. It is estimated that, every year, another 20,000 people will attend the A and E at Redbridge--a hospital built for 50,000, which is already coping with 70,000. My constituents' operations for elective work will be cancelled to make space to allow for the additional pressure on that hospital from the accident and emergency department.
We are in crisis already, and the Government are not providing the necessary resources. I have a message for this Government and the next Government. The problems in the North Thames regional health authority area and in north-east London are acute, and my constituents already cannot cope. We have hard-working, dedicated nurses and midwives in our hospitals. It is reported that 12 nurses--disastrously, a third of the nurses in the department--left the A and E department in King George hospital in the past few weeks because they felt that management was not preparing adequately to meet the expected problems. The Government should be prepared to admit that there are special problems. North Thames health authority and Redbridge and Waltham Forest health authority need resources to solve the imminent crisis in accident and emergency services and to prevent the cancellation of operations that will otherwise be necessary well into next year.
Ms Harriet Harman (Peckham):
It is difficult to do justice to the extremely thoughtful contributions of hon. Members on both sides of the House to this wide-ranging debate. We have talked about the state of society, guns, drugs, adoption, child abuse, general practitioners and hospitals.
Mr. Burden:
Does my hon. Friend agree that the debate should perhaps have covered accountability of hospital boards? Is she aware of the apology recently
Ms Harman:
I totally agree with my hon. Friend.
In his response to the Queen's Speech on Wednesday, my right hon. Friend the Leader of the Opposition said that the Government must be judged on their record. It has clearly emerged from today's debate that the Government's record on social security is a record of failure. The best welfare is work, and the Government have failed on welfare because they have failed on work. None of the Bills proposed in the Queen's Speech will set that right.
The Government have failed to achieve even the social security objectives that they set themselves. They said that they would reduce dependence on benefit, but the number of people on means-tested benefit has doubled. They said that they would cut social security spending, but the social security budget has risen. They have failed people who are without work, their families and their communities and they have failed the taxpayer, who must pick up the bill.
The Government have failed because they refuse to tackle the causes of the problem. They blame the rising social security bill on the people who claim benefits. Their approach is founded on the view that the unemployed will work only if their benefits are cut enough. The result is a social security system that becomes more and more expensive, and more and more brutal and degrading for those who depend on it.
The poverty that drives up the social security bill is a direct consequence of the Government's policy of high unemployment and low wages. They ignore the plight of the people at the bottom: the marginalised and excluded in a divided Britain and a fractured society.
Ms Harman:
I shall give way to the right hon. Gentleman, although it is hard to understand how he can disagree with the notion that we have a divided Britain and a fractured society.
Mr. Lilley:
The hon. Lady is wrong to say that the current rise in the social security budget is due to rising unemployment. We, almost alone in Europe, have falling unemployment. The biggest and most rapid rise in the social security budget relates to the state earnings-related pension scheme. The hon. Lady opposes our measures to cap the growth of SERPS. The biggest unexpected growth in the budget comes from the increasing numbers of elderly people who are living longer. That is not the price of failure; it is the price of success. The next biggest source of growth comes from the increasing availability and generosity of benefits to disabled people. Does the hon. Lady count that as a failure or as a success?
Ms Harman:
I shall deal with the points made by the Secretary of State in an intervention only one and a half minutes into my speech.
It is no good the Secretary of State quoting unemployment figures. His budget and his benefit bill cover many people who are of working age but who are not working. They, too, must be taken into account. I shall deal with that matter later.
The Government said that unemployment was a price worth paying, but look at who is paying the price. The young man who has left college; despite his hard work at school and college, cannot find a job and feels that he has been thrown on the scrapheap before he has even begun. Look at who is paying the price--the man who lost his job two years ago and still cannot find another, despite his skills, because no one wants those skills, and the woman bringing up her children on her own, who wants to work but cannot. The price is being paid by their communities, which are shattered by poverty and unemployment.
Labour believes that work is the best form of welfare for people of working age. Work restores dignity to individuals and helps to rebuild communities. But when unemployed people get work, too often it is low-paid work which must be topped up by benefits, or it is insecure. People get a job one day and lose it the next. High unemployment, a low-wage economy, an insecure labour market--that is the Tories' record and there is nothing in the Queen's Speech to deal with those problems.
Matters do not have to be like that. We will tackle the problems to get people off benefit and into work because that is the only way fairly and justly to reduce the social security bill. Our priorities are clear. On unemployment among young people, for example, we will end the situation where young people see their father and mother out of work and are themselves consigned to a life on benefit, the second generation unemployed--not wealth cascading down the generations, as the Government promised, but despair and poverty.
We will impose a windfall levy on the unfair and excessive profits of the privatised utilities to pay for a new deal for those under-25s who are excluded and left out. We will help the long-term unemployed back into work with a tax break for employers who take on those who have been unemployed for more than two years.
We will do more. There are 1.5 million women bringing up children on their own. Under the Conservatives, lone mothers have the lowest employment rate and highest benefit dependency rate in Europe. British single mothers are less likely to be working to support themselves and their children and are more likely to be dependent on benefit than single mothers in any other country in Europe. The position is getting worse. More women who are married or cohabiting and who have children are going out to work, but the number of lone mothers at work has fallen. Lone mothers are the ones who most want and most need work. Surveys show that 90 per cent. would work if they could. They do not want to depend on benefit, but they are trapped.
I recently spoke to a woman called Beth who lives in Manchester. She is bringing up three children on her own. She had a job, but had to give it up. With the cost of her child minder and the loss of her benefit, she was worse off in work and now she is back on benefit. She and her kids are living--existing--on £120 a week. She does not want a hand-out; she wants a hand up. She wants to work, but she cannot do it on her own. She needs Government support to overcome the barriers that are shutting single
mothers out of the world of work and trapping them on benefits: the problems of matching work with school hours and making work pay.
The Government's failure to act hits everyone. Mothers who cannot work are stuck on dependency and the taxpayer picks up the bill, to the tune of £10 billion a year. Most important, perhaps, is the fact that those women are bringing up children who see nothing of the world of work and expect that their fate will be the same as their mother's--to depend on benefit. I see that clearly among my constituents in Peckham. They want to work not just for themselves, but because they do not want to bring up their children to expect benefit.
Mothers need basic advice and information, the chance to train and gain new skills, and child care. That is the purpose of our programme for single mothers. We will give advice and information. We will make sure that single mothers have their own adviser who will look at the difficulties of their circumstances and will help them to find the jobs, training and after-school care that they need.
We will create more nursery places by scrapping the costly and bureaucratic nursery voucher scheme and we are examining how to use some of the deadweight of the £10 billion spent on income support and other benefits for lone mothers, by transferring some of that money to support a network of after-school clubs. Such clubs would be good for mothers, good for communities and good for children. It is good for children to be involved in what the hon. Member for Eltham (Mr. Bottomley) referred to in his thoughtful speech as worthwhile activities. In after-school clubs, children can enjoy art, sport, homework, chess and many other activities. The Tories just say to lone parents, "Here's your weekly giro. Come back when your youngest child is 16." That is not good enough.
After four years of denigrating and sneering at lone mothers--remember the Secretary of State's little list not so long ago of women who get pregnant to jump the housing queue--I suppose that we should be grateful that at least he has come up with a pilot project, "Parent Plus". We welcome the U-turn in his language, but his policy is still to attack single mothers. We fully expect that he will cut or freeze the value of benefits for lone mothers in the social security uprating, without giving any help to get them into work. It is not so much a carrot and stick approach as a fig leaf and stick. Some 1.5 million single mothers will have their benefit cut, with possibly--only possibly--10,000 receiving advice.
Government failure has meant that dependency has stretched from the cradle to the grave. The Secretary of State mentioned people in retirement who were dependent on benefit. That is due in large part to the Government's failure to ensure a safe and secure second-tier pension in which people can invest during their working life to ensure that they do not retire on to means-tested benefit. They have cut the value of the basic state pension, they have cut the state earnings-related pension scheme twice, they have put VAT on gas and electricity and people have had to sell their houses to pay for long-term care. The Government have betrayed pensioners.
We have plans for action to support people moving from benefit to work and to ensure that they can save for their retirement so that they do not retire on to
means-tested benefit. We are proposing action that people want, which will also reduce the social security budget and its burden on taxpayers.
The Secretary of State is nothing if not brazen. First, the Government create the conditions for housing benefit fraud on an unprecedented scale, then the Secretary of State blames local authorities for causing that benefit fraud, even though 90 per cent. of them have exceeded the targets on fraud that he set them. Having caused the problem and blamed someone else, he expects credit from the House for his actions to bring a partial halt to the fraud that he has created. I very much fear that, were it not for my hon. Friend the Member for Birkenhead (Mr. Field) and the work of his Social Security Select Committee, we would not have even that partial measure. I hope that the Secretary of State will take up my hon. Friend's sensible and practical proposals, but the Government's proposals, as they appear at the moment through briefings in the papers, appear not to tackle the heart of the problem that they have created. We have yet to see the Bill, but I fear that it will need to be strengthened massively.
The Government have borne down on claimant fraud, but they have ignored landlord fraud and have failed to tackle the major problem of organised fraud. We propose that the Government should give local authorities greater powers to fight organised landlord fraud. The Social Security Select Committee found evidence of widespread abuse of the housing benefit system, amounting to one fifth of all direct payments of housing benefit to private landlords.
Local authorities should have the power to refuse direct payments to private landlords in all but the most exceptional circumstances to stop phantom tenancies. Councils should be required to provide details of payments to landlords direct to the Inland Revenue to make sure that they pay their income tax.
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