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Dr. Peter Brand (Isle of Wight): I am grateful to the hon. Member for East Worthing and Shoreham (Mr. Loughton) for leaving me a few minutes. I noted his contribution, but I did not agree with a great deal of it.
The debate has been wide ranging. I shall not speak about the NHS part of the Queen's Speech. My concern is the missed opportunity to examine what all the Government Departments are doing in relation to health--the broader aspects of health.
Health is not the business only of the Department of Health. It is the business of the Home Office to make sure that people feel secure, that the streets are safe and that people feel connected with their community. A curfew will not help with that.
Health is very much the business of the Department for Education and Employment. I look forward to seeing the details of the legislation dealing with disabled children in schools. At present, there is not a good link between the two Departments, and with social services, to establish what constitutes proper care, for example, of people with autism. Such guidelines require education, health and social services input.
I am pleased that we are linking health and social security. People should feel secure socially, but I am sorry to say that the way in which social security is accessed often creates ill health, rather than overcoming it. The mechanisms for getting support are complicated. If people are prepared to abase themselves, they do well, but if they are confused, upset, mentally ill or stroppy, it is extremely difficult for them to get access to some of the services that they need.
People with a mental illness cannot get their housing benefit verified until they have been seen by a verifying officer. The word of their community psychiatric nurse, whom they may know, or a psychiatric social worker is insufficient.
Even within the limited scope of the legislation that will come before us in the next year, there are opportunities to address some of these issues, so that the legislation will reflect some joint thinking at the top, at Government level, so that the people who deliver at client, patient or citizen level are helped, rather than obstructed, by Government initiatives.
Mr. David Willetts (Havant): We have had a wide-ranging debate this afternoon, with some fascinating contributions. I learned a lot about complementary medicine from my hon. Friend the Member for Bosworth (Mr. Tredinnick), who is no longer here. We also heard from my hon. Friends the Members for East Worthing and Shoreham (Mr. Loughton) and for West Chelmsford (Mr. Burns).
My hon. Friend the Member for East Hampshire (Mr. Mates) spoke powerfully about a constituency matter that affects the people in Havant whom I represent, and who have suffered grievously as a result of the crisis at the Queen Alexandra hospital. It is the main hospital serving my constituency, and I was there last Friday for an up-to-date briefing on the problem.
The Secretary of State for Social Security sometimes disappoints me with his failure to answer my questions on social security, but I wish to make it clear that I do not expect him to display any familiarity with the crisis at the QA hospital. However, given the disappointing absence of Health Ministers from the Front Bench, to which my hon. Friend the Member for East Hampshire drew attention, I hope that he will draw to his colleagues attention the seriousness of the situation in south-east Hampshire. I see that a Health Minister is here now--the hon. Member for Barrow and Furness (Mr. Hutton) has finally arrived.
There is a serious problem in health care in south-east Hampshire as a result of the problems at the QA hospital that my hon. Friend the Member for East Hampshire described. I endorse everything that he said, but I should like to add a further point now that a Health Minister is on the Front Bench. I asked the acting chief executive about the reasons for the collapse of the sterilisation service which led to the almost complete abandonment of orthopaedic and eye surgery. As a layman, I asked why the hospital had all its eggs in one basket and why it was trying to operate with only one central sterilisation unit, especially when the services required for sterilisation of large instruments for orthopaedic surgery are so different from those for instruments for delicate eye surgery.
I asked why the problem could not be solved bit by bit. Some eye surgeons would like to have a dedicated small-scale sterilisation unit for their delicate instruments. I was told that safety regulations and specifications from the Department and the health service were pushing the hospital in the direction of a large-scale sterilisation unit that is supposed to treat everything from the largest instruments used by orthopaedic surgeons to the delicate ones used for eye surgery. Any sensible assessment of risk would suggest that it is dangerous to go that way because any problem would bring the entire hospital to a halt. It also puts greater strain on the staff, who must be trained to have sufficient skill to handle both the instruments for eye surgery and the very different ones for other surgery. If we break down the problem and separate out the sterilisation activities, we might find that it is easier to train the staff to do the work well. As both Ministers of State, Department of Health are now here, I should like to endorse what my hon. Friend the Member for East Hampshire said and stress the seriousness of the crisis that we face in south-east Hampshire.
The Queen's Speech as a whole reveals what historians will say as they get to grips with the Government. As my hon. Friend the Member for Sevenoaks (Mr. Fallon) said, the Government began with an extremely favourable economic inheritance and a massive parliamentary
That is why the most extraordinary aspect of the Queen's Speech is its omissions. It has already been pointed out, for example, that it omits any mention of legislation on adoption. However, will the Secretary of State for Social Security clarify the strangest omission of all, about which there has been confusion for the past 24 hours? What will happen to the improvements that he has offered to the vaccine damage payment scheme? He will recall that on 27 June, in his statement to the House on the matter, he said:
We were surprised and disappointed, therefore, that that uncontroversial and simple measure was not contained in the Queen's Speech, as my right hon. Friend the Member for Richmond, Yorks (Mr. Hague) pointed out in his powerful speech yesterday. When I explained what had happened, an enterprising journalist from the Daily Express telephoned the No. 10 press office. He was told first that there would be no legislation on the vaccine damage payment scheme, but later the press office changed its line and said that there would be legislation on the scheme and that, amazingly, it was somehow to be squeezed into the regulatory reform Bill, even though the background notes on that Bill contain no reference to it.
Will the Secretary of State clarify that muddle? I would be happy to give way to him if he wants to make it clear. The lady who chairs the vaccine victims support group has made clear her disappointment. She thought that legislation would be introduced, as we did. The Secretary of State said that the Government would legislate as soon as possible, but now we simply do not know whether there will be legislation. I hope that the Daily Express and my right hon. Friend the Member for Richmond, Yorks have led the Government to make one of their faster U-turns on the Queen's Speech and that we will now be told that that legislation will be introduced. That would be good news and would confirm what we always suspected: No. 10 listens to the Daily Express rather than the Secretary of State. If vaccine legislation is to be introduced, we will welcome and support it, but we need to know.
The debate has also touched on long-term care and care in nursing homes for our frail and elderly people. The shadow Secretary of State for Health, my hon. Friend the Member for Woodspring (Dr. Fox), spoke powerfully about that earlier. There is nothing short of a crisis in the care homes sector. Many homes are closing as a result of the interaction of uncertainty and onerous regulation on the one hand, and inadequate funding on the other. The Government cannot both impose extra regulatory burdens, with their attendant uncertainties, and then fail to
We understand that ending the preserved rights regime could be a feature of the legislation. If that change is happen, will the Secretary of State guarantee that no residents who are currently in care homes will have to move as a result of ending the preserved rights regime? That is the subject of widespread anxiety, so I hope that he will make the position clear.
If the right hon. Gentleman touches on that subject, will he also explain exactly what the Government have against pensioners living in residential accommodation or nursing homes? His social security policies seem deliberately designed to make the lives of such pensioners as wretched as possible--although the Government claim differently. A Department of Social Security press release published on 16 December 1999 referred to the following statement by the Secretary of State:
The rules are even more absurd than that, in that pensioners who pay their own bills are entitled to the winter fuel payment, but those who receive financial assistance from social services are not. The latter group would gain from receiving money directly through a guaranteed increase in their basic state pension rather than through a special scheme that does not reach them. Many of those people already get their television licence at the reduced rate of £5. Almost nothing that the Government have announced over the past year, supposedly to help pensioners, has helped the hundreds of thousands of pensioners in residential care and nursing homes. We will emphasise that point in the months ahead, because those pensioners would be major beneficiaries of our proposals to simplify the pension regime.
We shall scrutinise carefully the proposed Bill on fraud, because we are used to the Government's claims to be tackling that problem. At the last count, they had issued 42 press releases about their crackdown on fraud, averaging about one a month. There has, however, been no reduction in fraud and error in the social security system. The Government mass produce press releases, but they produce no action. We hope that, at last, there will be some action on fraud, but the auguries are not encouraging.
The Secretary of State commissioned a report by John Scampion, the social fund commissioner, on organised benefit fraud. The report contained telling criticisms and uncomfortable truths about the way in which the Department of Social Security was failing to tackle welfare fraud. The report was smuggled out on a Friday night in a shabby, cyclostyled edition with none of the gloss that we associate with Government press releases.
The Secretary of State claimed last week that there had been a significant reduction in fraud and customer error in income support and jobseeker's allowance. He said that, between October 1998 and September 1999, fraud was running at £1.02 billion. What, then, did the Government achieve as a result of all the initiatives outlined in their 42 press releases? Between April 1999 and March 2000, the figure had fallen to £1.01 billion. Although his press release stated that that was a great achievement, a warning from the statisticians, buried in the statistical notes, said that the figures were full of uncertainties. The difference between £1.02 billion and £1.01 billion is so narrow as to be statistically insignificant.
The Government are not making progress. There is a massive volume of fraud out there--a figure of £7 billion has been mentioned by Ministers--and they are not tackling it. The £7 billion figure breaks down, according to Ministers, into £3 billion of definite fraud, £2 billion of probable fraud, and a further £2 billion of possible fraud.
Perhaps the Secretary of State's biggest failure in his Department is the same as that of the Government as a whole, as revealed in the Queen's Speech. It is the complete absence of any sense of strategic direction, or of any coherent vision in the legislative programme before the House, with regard to the reform of social security and welfare.
Insofar as I can understand the Secretary of State's strategy for social security, it appears to consist of taking lone parents off means-tested benefits, and of putting pensioners on means-tested benefits instead. That is what it seems to boil down to, and the tragedy is that the right hon. Gentleman is failing to deliver either policy.
In May 2000, there were 910,000 lone parents on income support: by August, after the heroic efforts of Ministers and their programmes, that number had fallen--amazingly--to 909,000. At that rate of progress, it will take quite a long time to achieve the Government's objectives for getting lone parents off income support.
Meanwhile, the Secretary of State is financing an expensive advertising programme aimed at trying to get pensioners on to means-tested benefits. He is also failing in that: he is getting pensioners on to means-tested benefits no more quickly than he is getting lone parents off them.
In its document entitled "Income-Related Benefits Estimate of Take-up 1999"--which I am sure is the Secretary of State's bedtime reading--the Department estimates that the number of pensioners entitled to the minimum income guarantee but not claiming it at between 530,000 and 870,000. The mid-estimate is therefore 700,000.
What has the Secretary of State achieved with his £15 million take-up campaign? We know that the Department has written to 2.5 million pensioners, and that about 500,000 or more have torn off slips or telephoned the helpline for further information. At that point, however, the Government's problems begin. Of the 500,000 people who have applied for the minimum income guarantee, only about 60,000 have returned completed forms to the Department. If the Secretary of State wishes to give the House an update on that when he responds to the debate, I should be very grateful.
Although Ministers would not answer Opposition Members' questions on the matter, they inadvertently provided answers to one of their Back-Bench colleagues and miraculously released information to him that was not available to us. That information made it clear that, of the 60,000 returned forms, fewer than half were leading to successful benefit claims. The latest information is that 24,746 responses have resulted in successful claims--again, I should be grateful if the Secretary of State were to provide the House with an update.
Thora Hird has appeared on our television sets morning, noon and night, £15 million has been spent on an advertising campaign, income support has been renamed after a Soviet fighter aircraft--and, despite all their best efforts, the Government have managed to get 24,746 pensioners on to the minimum income guarantee, and 1,000 lone parents off income support. It is not a very good strategy, is it?