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Mr. David Drew, supported by Julia Goldsworthy and Mr. Nick Hurd, presented a Bill to amend the Sustainable Communities Act 2007 to make further provision regarding the consideration of proposals and the representation of parish councils; and for connected purposes.
That leave be given to bring in a Bill to prescribe the maximum wage that can be paid; and for connected purposes.
In effect, the Bill puts a cap on the maximum wage that can be paid to any person in any one year. Mr. Speaker, you will remember that it is 10 years since the minimum wage was introduced. In April 1999, 2 million people benefited from a minimum wage of £3.60 per hour. Since then, the minimum wage has been increased by 60 per cent. to £5.80 this October. Millions more hard-working families have benefited from that landmark legislation, of which the Labour Government should be really proud.
There was opposition, of course. You will remember, Mr. Speaker, that the CBI and others argued that there would be job losses. That has not been the case. There are still pockets of resistance to the minimum wage, however; I note that the hon. Member for Christchurch (Mr. Chope), supported by some of his colleagues, intends to bring forward the Employment Opportunities Bill on 12 June. Let us be in no doubt that that would axe the minimum wage. Instead of going backwards, we now need to go forwards. We need to complete the policy circle and seriously consider the introduction of a maximum wage. In an unprecedented time of economic difficulty, hard-working families and pensioners are facing real problems.
There are genuine concerns about executive pay packages. It simply cannot be right that some chief executives are receiving more than £6 million a year. It cannot be right that Terry Leahy, the chief executive of Tesco, has a salary package of £4.3 million, which is equivalent to the average earnings of 335 of his employees working in Tesco. It is completely wrong that there are directors at Tesco, BP and Vodafone who are each individually receiving a salary of more than £1 million a year, and it cannot be right that some of these people are being paid bonuses for performance targets that they cannot meet. Bonuses should be for success, not for failure. People abhor the golden pension package. What really disturbed people was the £730,000 payment to Sir Fred Goodwin, who should have been sacked rather than rewarded.
Against that background, people want change. When they are asked about wage policy, they say that the gap between the highest paid and the lowest paid is too high. Eighty per cent. of people think that those who are paid the lowest should get more and that those who are paid the highest should get less. They want change; they want to see the introduction of a maximum wage. Outside the Westminster village, away from the political classes, there is a growing demand for openness, fairness and justice, and we should listen and respond to it.
There has been a lot of academic work on the maximum wage, but not much of a political policy focus. However, things are changing. It is significant that in February this year President Obama talked about a maximum wage of $500,000 for executives of companies that have received a state bail-out. It is interesting that UEFA and football clubs across Europe are now talking about maximum wages and transfer fees capped at 51 per cent.
of a clubs income for their players. Maybe in the not-too-distant future the telephone number figures that professional footballers have been receiving will disappear.
So how would we set a maximum wage? There is a simple solution. We could say to everybody that no one should receive more than the Prime Minister£194,000 a year. That is not far-fetched. Just look at what is happening in, dare I say, Kazakhstan, where its Prime Minister, Karim Massimov, made such a proclamation earlier this year. The New Economics Foundation, in its paper, The Alternative Mansion House Speech, advocated a minimum wage capped at £1 million.
However, there are fairer and better ways to do it. If we are sensible, we need to link the minimum wage to the maximum wage. For example, there is a strong case for arguing that the maximum wage should be 10 times the minimum wage. Based on £5.60 an hour, that would give a maximum wage of £120,000. A rule of 100 would provide a maximum of £1.2 million. Another approach would be to link the maximum wage to the average weekly wage, which was £479 last year. Some, such as my right hon. Friend the Member for Rotherham (Mr. MacShane), have argued that the multiple on the average wage should be 20 times, which would produce a maximum wage of £115,000 per year. It is clear that one of the consequences of a maximum wage policy would be that if the top bosses and chief executives wanted to increase their pay, they would have to increase the pay of everyone who worked in the company. That really is progressive politics.
At the end of the day, it does not matter what process is used to calculate the maximum wage. The issue is not one of practice but one of principle. It is right and
popular that we should move to a fairer society. If events over the past month have taught us anything, it is that we need to be clear that voters abhor greed and injustice. There is a crisis in the economic system, and a matching crisis in our political system, and reform is necessary and urgent. We need to set out a clear agenda and, what is more, an agenda for action. I am confident that the Bill that I wish to introduce provides a vehicle not just for debate and discussion but for progressive policy, change, justice and fairness.
We are an island, but we are not isolated. We are competing in an international field, and many of the people who would be severely damaged by such a Stalinist Government restriction would leave this country, and particularly the City of London and many of its businesses. The damage that that would do to this country would be immeasurable. Going back to a communist-type restriction whereby the Government decide wages and jobs is unthinkable. It would be uncompetitive, and it would destroy us.
That this House has considered the matter of stroke services.
When the House last debated stroke services in July 2007, we had not introduced the stroke strategy for England. However, it was clear from the content of that debate that Members on both sides of the House were united in their wish to see services across the stroke pathway improved for what is one of the major health conditions, and one that has historically been regarded as a poor relation.
The strategy was launched by my right hon. Friend the Secretary of State for Health at the stroke forum conference in Harrogate in December 2007. I know from what he has told me and many other Members that he found the occasion particularly moving, as the strategy was received with great pleasure. Indeed, it has been universally welcomed. The national stroke audit of 2008 by the Royal College of Physicians stated:
For the first time since we started conducting a national sentinel audit for stroke...ten years ago, there is reason for optimism...If implemented,
should result in services that are the envy of the world.
Strokes are devastating and the human cost is enormous. Every year, some 110,000 people in England have a strokeone every five minutes. Some 900,000 people in England live with the consequences of strokes, which are the largest single cause of severe disability in adults. More than 300,000 adults in England have lasting disabilities as a result of a stroke.
Having a stroke has been described as an earthquake in the brainit certainly is; it is a brain attack. Strokes can have shattering consequences for families and carers as well as the individuals who suffer them. There is also a major economic context to stroke, since the cost to the economy runs into billions of pounds every year.
John Bercow (Buckingham) (Con): The Under-Secretary has referred to the consequences of stroke, including disability. Will she confirm that something of the order of 100,000 stroke victims suffer the consequence of a communication disability? In that context, will she underline the critical role, which needs to be deployed early, of intervention by a speech and language therapist, not least to address eating, drinking and swallowing, and to attempt to ensure that permanent damage to the ability to communicate is not suffered? That is critical, and I welcome the fact that we are debating the subject today.
Ann Keen: The hon. Gentleman has done so much work on the subject, and I know that the House will want to congratulate him on that. He is absolutely correct. I know from my many years of experience as a nurse the consequences for the patient and the family if the assessment is not made correctly. Not having a proper examination of a swallow reflex can lead to very serious consequences for the patient, making recovery so much longer. The issue that the hon. Gentleman has raised is crucial.
Mr. David Drew (Stroud) (Lab/Co-op): Does my hon. Friend accept that, as well as early intervention, those who suffer aphasiaan extreme form of strokeneed a lot of help over much time? There is always a problem about when that help is cut away. Does she agree that we must be sympathetic and ensure that it is done at the last possible moment, and not too early?
Ann Keen: I certainly agree with my hon. Friend. The consequences after such a devastating attack on the brain for a persons ability to lead any sort of normal life are catastrophic. I hope that, as the debate progresses, such issues will be raised and that I can address them.
We are aiming for a revolution in our stroke services. The strategy is a 10-year plan, and we are in only the first yearwe have a long way to go. However, I want to outline some improvements that are already happening. My right hon. Friend the Secretary of State for Health said in the stroke debate in 2007 that he intended to make stroke a top priority for the NHS. We have done that, and that has been recognised in the NHS operating framework for 2009-10, in which stroke services are covered by a tier 1 vital signa must do for the NHS. Each strategic health authoritys vision for the next stage review is committed to improving stroke care.
In addition to the extra funding that has gone to all primary care trusts, we are providing £105 million of central funds over three years from 2008 to 2011 to support implementation of the stroke strategy. Some £77 million is being used to accelerate improvements in acute and community services. Another £16 million is being used for stroke-specific training for nurses, allied health professionals and other staff, as well as additional training for stroke physicians, and £12 million is being used to improve public and professional awareness of the symptoms of stroke and the need to act quickly.
The national awareness campaignAct FASTwas launched in February. It cannot have failed to catch hon. Members attention, and many have commented on its success. I am therefore confident that I should not need to remind hon. Members that FAST stands for face, arms, speech and time to call 999, if the person shows any of those signs. The effectiveness of the campaign is now being assessed, but we already know that it has been seen in one medium or another by 92 per cent. of the population.
Sir Nicholas Winterton (Macclesfield) (Con): I am very impressed by what the Minister is saying, and I have a deep interest in the issue. She is talking about Act FAST, which is an essential policy if people are to suffer the minimum rather than maximum damage from strokes. However, is she satisfied that people are getting treatment fast, both when symptoms are showing and, sadly, after a stroke has taken place?
Ann Keen: There is more work to be done in particular areas. The reconfiguration of some areas still has to be decided, but the understanding of how essential it is to act fast, go to the appropriate clinical facilities and be seen by physicians with expert training is paramount. The number of lives that have already been saved and, in particular, the number of severe disabilities that have been prevented show the progress that we are making.
Barry Gardiner (Brent, North) (Lab): I welcome everything that my hon. Friend has been saying. On the issue of speed, she will know of the consultation that Healthcare for London has just concluded on the future location of stroke centres in outer London. Does she agree that it is critical that the locations chosen for those centres should have ease of access, so that people can get to them as quickly as possible, and, in the light of that, that Northwick Park hospital, which already serves a growing elderly population and a highly multi-ethnic population, is an ideal candidate for such a centre?
Ann Keen: My hon. Friend raises some interesting points about the recent consultation, which was completed only on 8 May. Announcements will be made in relation to the London strategic health authority on about 20 July, and I know that Northwick Park hospital is held in high esteem for the service that it gives.
Mr. Shailesh Vara (North-West Cambridgeshire) (Con): I am most grateful to the Minister for giving way. She is being very generous indeed with her time. We are all agreed that treatment in a specialist unit is the preferred option. However, some 81 per cent. of all stroke patients are initially admitted to a generic admission unit. We all want that figure to be much lower. Can the Minister therefore give us some indication of the Departments timelinesay, over five to 10 yearsfor ensuring that more than simply 19 per cent. of people are admitted to a specialist unit, which will of course be far better for them?
Ann Keen: Our strategy is timed to run over a 10-year period. We are well past the first year, and great improvements have been made. As we are speaking, primary care trusts are working, particularly in London, which I am more familiar with, to see how some of those services can be brought forward, particularly through the training and education of staff, because we need expertise in this area. We have made very good progress on cardiac conditions by channelling patients in a particular specialist way, so we know that once we have the evidence to say, We will save lives and correct disabilities if we do it in a particular way, it will be our duty to speed that up to the best pace that we can.
Mr. Iain Duncan Smith (Chingford and Woodford Green) (Con):
I rise because there are concerns in my area in north-east London, which are shared, by the way, across the Floor of the House by the hon. Members for Leyton and Wanstead (Harry Cohen) and for Walthamstow (Mr. Gerrard), who are both with me on this. We believe that the process by which decisions are made on hyper-acute services is not at all transparent or clear. We have tried to press those responsible on whether the process is set in stone. They say that it is, but then they change it. For example, the Royal London hospital received a decision on hyper-acute services on the basis that it had a cardiac centre aligned, yet its scores were no better than those of Whipps Cross hospital. Queen Elizabeth hospital got a decision because of its neurological service, but it has no cardiac service aligned, while others are ruled out on the basis that, somehow, they have neither of those things. It seems that decisions are made on the basis of picking winners, rather than on having a set, transparent form that says, If you have these things, you are likely to get it and we will adjudicate
you accordingly. Will the Minister look at that carefully and ask Richard Sumray and his group how they reach such conclusions? Does she think that they are fair?
Ann Keen: I acknowledge what the right hon. Gentleman has said, particularly in relation to the specific case that he raises. I would be very happy if he would write to me about that, so that I can take it forward, because it is our duty to get things right clinically and in the right area. Everybody is agreed on that. The Royal College of Physicians has congratulated us on how we are managing most of our consultation. However, if there are flaws in it that the right hon. Gentleman wants to raise with me further, I will be happy to look at them.
Mr. Andrew Lansley (South Cambridgeshire) (Con): My point is not about London. To return to what the Minister said about the rapid response associated with the FAST test, the way in which the ambulance service responds is very important. We know from the original work in Newcastle that ambulance staff are entirely capable of making as good a judgment as GPs can about whether somebody may have had a stroke. However, a recent report in the Emergency Medicine Journal showed that the software used by ambulance staff to triage calls was missing up to half of potential strokes, that only one in four stroke patients were given a category A ambulance response and that in a minority of cases3 per cent.potential strokes were given category C responses. Is it the Governments view that we should seek to improve those figures and, in particular, to give possible strokes a category A response?
Ann Keen: The hon. Gentleman raises an issue that I need to look at. I need to see the figures that he has presented and take the matter up, along with my ministerial colleagues who have responsibility for the ambulance service. I am very happy to do that, becauseI cannot say this enoughwe have to get it right. All our knowledge to date is saying that we are progressing in that direction. However, if there are problems in some areas that we need to address, which the hon. Gentleman has highlighted, it is my responsibility and the responsibility of my ministerial colleagues to take them seriously and to take them up. Again, I would be very happy if he would like to bring the matter to my attention in a way that I can take up.
Although we can never measure the real achievements of a campaign such as the FAST campaign, it is more than likely that outcomes have already been improved for many people and it is possible that lives have been saved too. The campaign is ongoing, and it is likely to return to television later this year. Many people have phoned and written in to refer to the life that they have saved, having seen the campaign and been made aware, when they were out at social or sporting events. There have even been people who saw the advertisement in our country and, when travelling abroad, were able to notice the symptoms and make people aware, and they have also saved lives.
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