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Members on both sides of the House have said that these are difficult times for the global economy, but my right hon. Friend was able to report that the economy is stable and resilient and continues to grow. Importantly, he reported that the Government are meeting their strict fiscal rules for public finances. I appreciate that one of my colleagues from Scotland, my right hon. Friend the Member for West Dunbartonshire (John McFall), spoke earlier, but I shall give a quick flavour of the impact that todays Budget will have there.
More than 750,000 pensioner households will benefit from the additional one-off payment of £100 to households including someone aged over 80 or from the additional payment of £50 to households including someone over the age of 60.
Bob Spink: I am grateful to the hon. Gentlemanperhaps I can call him my hon. Friend, given that all Members of this House are now my hon. Friend. Given that women pensioners are more likely to suffer poverty, and accepting what he said about how welcome the extra payments are, does he regret the fact that the Chancellor has not used the opportunity of this Budget to drive towards greater equality between women and men pensioners?
Mr. Brown: The hon. Gentleman makes an interesting point. This Government have done much for women pensioners, but we recognise that there is still much more to do. Later in my speech I shall discuss one aspect of that subject which has disturbed me somewhat.
More than 300,000 families will benefit from the increase in the child element of child tax credit by some £50 a year from April next year. I shall focus on one or two highlights of todays Budget statement that are important to a significant number of people in my local area, but first I come back to the point raised by the hon. Member for Castle Point (Bob Spink). If what I say is negative, it is something that I need to get out of my system. It arises not from something that was said today, but from what I see as a missed opportunity following last years Budget statement.
In that statement, the reduction in the basic rate of income tax from 22p to 20p and the abolition of the 10p rate, which come into effect next month, were announced. The news caused deep anxiety, and within days I and several colleagues met my right hon. Friend the then Chancellor, now the Prime Minister, to make him aware of our concerns. I have also discussed the matter with the present Chancellor a couple of times. Although 700,000 pensioners will be removed from the tax bracket next month, many people in areas such as the one that I represent, which regrettably has a low-wage economy, will not see a positive impact. In areas with a low-wage economy, we find households that struggle to get by. It is those low-income households, women pensioners under 65 and people who may have retired because of ill health who, unfortunately, will be paying extra tax after 1 April. The only reassurance I have is that any extra tax that we generate will go into public services, which, I believe, need continuing investment.
I am delighted that the Chancellor chose to defer the introduction of a 2p increase in road fuel duty, especially with crude oil prices so volatile. I wrote to my right hon. Friend and discussed the matter with him, and I would like to think that he listened to me, but I suspect that he was listening to other representations as well. The decision will come as a great relief to households in my constituency, but we face a real challenge. Some people, we hear, are talking about the price of a barrel of oil reaching $200 in coming years. It has taken a long and painful time to reach $100 a barrel, but the fact that some people have in recent weeks been speaking freely of $200 a barrel is extremely difficult to swallow. As a nation, and perhaps globally, we have to think about how to face that challenge. Can we get people out of their cars?
When crude oil prices are so volatile, the price differentials that have been mentioned in the Chamber this afternoon and on previous occasions are exploited. We see wide-ranging price differentials. The hon. Member for Caithness, Sutherland and Easter Ross (John Thurso) mentioned the figure of £1.26 a litre. Parts of Scotland have extremes, but differentials have crept in even in areas where there are not extremes, and we desperately need to look into that.
I fully support the green agenda, but individuals can be moved out of the comfort zone that the private car provides only if suitable public transport is available and affordable. In my area, the local bus network is nowhere near adequate, and it is more expensive than it should be. I wrote to Stagecoach, which is the main
provider of public transport in my area, complaining about the increase in bus fares. I am disappointed that no Scottish National party Members are here, but I want to read to the House what was said to me. The letter says:
I feel that it is important to highlight the fact that this year in particular bus operators in Scotland are subject to higher operating costs than our counterparts in England. This is a direct result of the current Scottish Governments decision not to award the increased level of Bus Service Operators Grant...we may find ourselves in the position that we may have to increase fares by a further amount later in the year.
That is only one of a number of issues that have arisen of late. I know that colleagues paint the rosy picture that Scotland is a land flowing with milk and honey. It is an admirable country to live in, but there are some underhand practices taking place in Scotland under the current Administration in Holyrood.
It has been raised, both on the Floor of the House and in Westminster Hall debates, that £34 million was allocated, as a direct result of the Barnett formula, to supporting disabled children and their families. That was a direct result of the pre-Budget statement made towards the end of last year. We cannot account for that money, and it is my belief and the belief of many of my colleagues that the money has gone towards filling a major black hole in the SNP Scottish Executive budget, which has led to the freezing of council tax. It is an admirable concept to freeze council tax, but should it be done at the expense of disabled children? Should it be done, potentially, at the expense of those in rural areas who desperately need public transport?
The increase in alcohol duty has been mentioned. I intervened on the hon. Member for Dundee, East (Stewart Hosie) to make the point that his party was in a dilemma, as the SNP Cabinet Secretary for Finance and Sustainable Growth had pleaded with the Chancellor not to increase duty on whisky, whereas the Cabinet Secretary for Justice in Scotland had said that there should be significant increases in the price of alcohol to combat antisocial behaviour and binge drinking.
The hon. Member for Ribble Valley (Mr. Evans) has left the Chamber, but I have heard it said more than once in the Chamber this afternoon that by increasing duty the Chancellor was tackling the issue of binge drinking and heavy drinking. The Chancellors comments on the increase in duty came to some 135 words, but not once was binge drinking or heavy drinking mentioned. In fact, he summed up by saying: It is only because I have taken these decisions on alcohol and on closing tax loopholes that I am able to provide additional support for families and lift more children out of poverty. That, and no other reason, is why there is an increase in the duty on alcohol.
As I suggested earlier, my view is that alcohol and its price is only one aspect of what we as a nation need to do to tackle the unsavoury behaviour that we see on many of our streets, in towns, cities and even villages, and on some housing estates. Let us be perfectly
honest: if there is an increase in the price of alcohol, young people will manage to get their hands on additional money to buy it. We should never forget that sometimes they are not going out to buy it or getting others to buy it; they are taking it from home.
There was a wry smile on the faces of some of my hon. Friends when the hon. Member for Caithness, Sutherland and Easter Ross declared that he would at some stage become the grand master of the Keepers of the Quaich. Let me assure the House that that is not some kind of secret organisation, as the title may suggest.
All in all, it has been a good Budget under difficult circumstances. My hon. Friend the Member for Stafford (Mr. Kidney) made the point that the Chancellor passed his test today. I hope that this is the first of many Budgets that we will hear from him.
Anne Snelgrove (South Swindon) (Lab): I present two petitions on behalf of my constituents, protesting against the closure of Westcott Place post office and Guildford Avenue post office. Both post offices are extremely well used. Westcott Place serves the central area of my constituency, which is a very poor area, and Guildford Avenue serves a mainly elderly population.
Dr. Richard Taylor (Wyre Forest) (Ind): I am grateful for the opportunity to initiate the debate, and I am revelling in the fact that I have three minutes extra, so I do not have to watch the clock. The Minister, whom I am pleased to see in his place, knows that on occasions, even though I sit on the Opposition Benches, I am trying to be helpful to the Government. This is one of those occasions.
Everybody admits that some accident and emergency departments are struggling under enormous loads. Ambulances stacking outside have been drawn to our attention in several press reports, national and local, in the past few weeks. I want to try to find out why too many people are coming. Then we can tackle the issue and think of possible cures, as I believe that the problem is not intractable.
I start with one example of completely inappropriate use of an accident and emergency department. I know of a lady over the age of 90, living alone, with end stage cancer. She could not cope, so she called her general practitioner. To his credit, he came. Some people have trouble getting their general practitioners to come out. However, he took the easy way out and did not solve the problem. Because she was going to see her specialist the next day, he took no decision and told her to see the specialist.
The lady saw her oncologist, and to her great sadness and disappointment, he said, Im very sorry. It is impossible to admit you, so she went home. She was desperate. The only thing she could do was call 999. She was taken to another hospital. She was not well enough to give a full history or details. As well as blocking up the accident and emergency department, she had further investigations and a scan, which she had already had. Sadly and inevitably, she died a few days later. Such situations are absolutely unacceptable, and there areor should beways of avoiding them. The name that I am using may be slightly out of date, but there are multi-agency response, or MARS, teams, which include nurses, therapists and social workers. They are specially designed to be called by a general practitioner or anybody concerned about elderly patients or patients with long-term illnesses in particular.
Dr. Taylor: MARS teams can be called out to solve the problems of the elderly and those with long-term illnesses, including cancer, so that they can avoid going to A and E departments and being admitted unnecessarily to hospital. Has the Minister any idea of the distribution of such teams and the publicity? The case that I mentioned did not happen in my area, but that GP obviously either had no access to such a team or did not know of its existence.
I am making a call for the unification of the health service and closer co-operation between primary and secondary care. Such co-operation was made much
more difficult by the purchaser-provider split, which drove a wedge between GPs and their hospital colleagues. Last night, I was at a meeting of the Royal College of Physicians with several MPs; it has just started a new initiative for the future of care closer to home which it calls Teams without Walls. I shall quote one or two extracts from the colleges paper:
General practitioners and consultants have traditionally worked together for the benefit of their patients. However in recent years this relationship has been more difficult with an organisational split between primary and secondary care. Now things are changing; new life is being given to the notion that they should work closely together once more.
We coined the phrase Teams without Walls. New teams not bounded by institutions to provide high quality sensitive and accessible care across the primary secondary interface.
There is good evidence to support this approach for long term conditions and the elderly in particular...This is not just about consultants providing sessions in the community, it is about new teams, with specialist nurses, therapists and pharmacists.
A second way to reduce the load on A and E departments is through the effective use of emergency care networks. The network between the really major trauma centre and the ordinary district general hospital A and E department is well worked out. Ambulance workers, doctors and hospitals know that if someone has major burns, head injuries or chest injuries, they do not go to any run-of-the-mill A and E department, but to the local major trauma centre.
However, not so well worked out and understood are the much more local networkson a county-wide basis, for example. A county may have one or two routine and ordinary accident and emergency departments and a number of minor injuries units or urgent care centres. The networks have to work effectively in those centres so that people know that for certain conditions they can go to a minor injury unit and for others they can go to an urgent care centre. Knowing that will keep them out of and away from A and E departments.
The Minister knows that after a great struggle, there is in my patch a pilot trial involving having a doctor in our minor injuries unit. There is some good news from my constituency. A report to the acute trust board on 28 February said:
The pilot has demonstrated that there is a modest but important clinical demand for a doctor-led
at Kidderminster Hospital...The pilot has demonstrated that such a service can be provided safely...The Trust should consult on establishing the UCS on a permanent basis.
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