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Even in the face of recession, my party supported home owners to stay in their homes. Because of our actions, the current repossession rate is half that of the
last recession of the early 1990s, preventing about 300,000 families from losing their homes. In 2004, local authorities met Labour's target that no family should be in bed-and-breakfast accommodation for more than six weeks. When we prepared to tackle the issue in 2002, up to 4,000 families were housed in such accommodation. Conservative Members say, "Well, you didn't do enough", but we did a great deal for people who were in substandard housing. About 55,000 affordable houses were also built.
I turn to the cuts themselves. The Government say that they have to be made to reduce costs, but contrary to the Secretary of State's assertion that Labour Members are scaremongering and coming up with facts and figures that are not borne out, it is Shelter that has stated that £120 million more will have to be spent on families who are made homeless as a result of the cuts. It is not Labour party members or MPs who have said that.
The cuts will cause big cities such as London to become like Paris. I know that the Secretary of State said that that was another piece of scaremongering, but it is not. There will be dispersal-we all now accept that word, as we know that people do not want to use the word "cleansing". It will inevitably follow the cuts that if someone lives in what is considered to be an expensive part of town, where rents and rates are higher, after the cuts they will have to move out of their accommodation. That will effect social engineering, because only well-off people will be able to live in good areas of big cities. It will basically get rid of poorer people to the outer margins of the big cities and towns, into the poorer areas.
Pete Wishart: The hon. Lady seems to be suggesting that she is against any cap on housing benefit. I am with her on that one, but can she persuade her Front Benchers to come with us? I still do not know what the Labour party policy is on a housing benefit cap. Does she have any clearer understanding of that?
Of course, the increase in rents and rates is not the result of people choosing to live in expensive areas. We have to remember that many people have been living in their areas for the past 20, 30 or 40 years. It is not their fault that over the years house prices and rents have gone up. That does not mean that they should be sent 60 or 100 miles away where they have no family, relatives or friends and be completely disconnected from their community.
Shelter has stated that the Government have not examined the impact of the proposals on many claimant households that will be shifted from around or just below the 60% median income line into severe poverty. The proposals will push an additional 84,000 households below £100 a week per couple, and those households include 54,000 children.
On average, the impact of the local housing allowance on my constituency of Bolton South East will be £52 per month for a two-bedroom flat, with an average loss of £39 on properties that have more than two bedrooms. That may not seem like a vast amount of money to some hon. Members here-
Mr David Lammy (Tottenham) (Lab): I hope that all of us across the House can agree that the best kind of community is a mixed community-a community of young people, old people, people on middle incomes and people on large incomes; a community that is ethnically diverse. That is why, when we think about the proposals in relation to London, hon. Members have described them as something akin to what we have seen in Paris. Most London MPs will recognise that those claiming housing benefit in London largely come from the ethnic minorities. They are families from Somalia, Turkey and Africa. I am deeply concerned that the Secretary of State has not yet produced an equality impact assessment of how the proposals will affect those families. He should be able to tell us that the effects of his proposals are not discriminatory, but he cannot do that. He should also be able to tell us how they impact on women and disabled people, but he is not able to do that.
There is a real concern that the proposals will drive people from central London to outer London. My constituency has some of the highest homelessness figures in London. We have 19,000 people on the housing register and 5,000 people in temporary accommodation.
Members on both sides of the House agree that we have not built enough affordable housing. In the past year in London, under the leadership of Boris Johnson, the Mayor of London, many local authorities failed in that regard, and overwhelmingly they were Conservative. I have the list: 83 affordable homes built in the London borough of Kingston-upon-Thames; 100 built in Kensington and Chelsea; and 200 in Westminster. Given such a backdrop, an exodus from inner London to outer London will exacerbate the problem.
My father arrived in this country in 1956. Like most other West Indian immigrants at the time, he lived in a doss house. This was a London that was still experiencing the effects of the war; there was a shortage of houses and money. Many immigrants huddled together in bedsits. My father lived with four others in a small bedsit in Finsbury Park. He often talked about how he had to huddle around a paraffin heater because of the cold.
I am concerned that these proposals will lead to even more excessive overcrowding in London. I warn the Minister that what we saw in Paris was serious social unrest as a consequence of overcrowding. That is why it is unacceptable to hear the rhetoric about social cleansing, but not to produce an assessment of the effect of the Government's proposals, which is now a statutory duty as a result of the previous Labour Government.
There is a caricature of the fecklessness that leads people into this situation. Londoners will find themselves in this situation largely for two reasons. The first is that house prices have gone up. For my constituents, they have gone up by over half in the past 10 years. A person needs to be earning £60,000 a year to afford a house in the London borough of Haringey, which is way beyond the reach of most people. Secondly, it is not to say that people are on welfare and that welfare is bad, as was said by one Government Member. Welfare is a safety net for people on low incomes. These are the people who will clean the Chamber long after we have left tonight, and these are the people whom we are letting down as a result of these proposals.
So of course we stand against this motion-[Hon. Members: "For!"] I mean we stand for the motion because of the paucity of evidence backing up the Government's proposals. Given that the Minister has aligned against him senior members of the Church in this country and given the deep concerns in the city of London and, as we have heard, elsewhere in the country among ordinary, hard-working people, including the 2 million pensioners who rely on housing benefit, he should think again.
Jim Shannon (Strangford) (DUP): I want to make some constructive comments, and I hope that the Minister will take on board some of the issues I raise. I will ask some questions from a Northern Ireland perspective, because the housing benefit changes will affect us as well-we cannot divorce ourselves or walk away from them.
I should set the scene, because Northern Ireland has some very particular circumstances: the Department for Social Development has responsibility for social security benefits, and the Department for Employment and Learning has responsibility for training and employment programmes, in contrast with the rest of the United Kingdom and the Department for Work and Pensions. DEL has significant differences with its steps to work programme, as against the job guarantee fund here. There are issues to be clarified, therefore, and I want to ensure that the changes in benefits will not impact adversely on the people of Northern Ireland.
Northern Ireland has had the local housing allowance since 2008, but it has not been formally assessed. I had hoped that it would be, because it would have given us an idea of how successful it has been. I am concerned, however, that the proposed changes to the allowance lack a firm evidential base. Will the Minister comment on that? I think that the proposals will adversely affect recipients in Northern Ireland.
I am gravely concerned about the Budget plans to reduce the initial award of the benefit by 10% in April 2013 to those claimants who have been receiving jobseeker's allowance for longer than 12 months. I make that comment because the unemployment rate in Northern Ireland between April and June was 6.6%. Worse still, the working-age employment rate remained well below the UK average, and was the lowest of all the 12 UK regions. The changes put forward tonight will adversely affect the people of Northern Ireland because of our position in relation to benefits.
I have concerns about the introduction of a measure that utilises sanctions that are neither helpful nor beneficial. The proposal appears to be based on the assumption that a reduction in housing benefit will motivate working-age claimants to find work, but it is clear that even if every working-age claimant was so motivated, there would still be significant numbers of long-term unemployed people in Northern Ireland beyond 2013. Perhaps the Minister will comment on that. We have to find a balance. How do we distinguish between those who are genuinely seeking employment and those who perhaps are not?
I mentioned earlier that the focus of housing benefit has to be on providing low-income families with access to good-quality housing. The housing benefit cap rates may have a knock-on effect on the social housing sector, as private rented accommodation becomes harder to access for those on low incomes and the demand for social housing increases. A great many people are in a Catch-22 situation: they do not have enough money to rent a house privately, yet there is not enough social housing for them.
Sammy Wilson (East Antrim) (DUP): My hon. Friend makes an important point, but does he accept that in the absence of cap rates-or, sometimes, where the rates are fairly generous-private sector rents become inflated? Landlords simply look at what the rate is, and if it goes up they put their rents up. It is almost like a perpetual cycle: the rates go up, so rents go up, and then the rates are pushed up again, and the only people who gain are the landlords.
Members have mentioned fuel poverty. One of the spin-offs of losing housing benefit will be fuel poverty. In my former position, I sat as a Member of the Northern Ireland Assembly. One of the inquiries that we undertook was on child poverty. Fuel poverty and housing benefit both came up in that inquiry into child poverty, but all those things were part of the jigsaw of how people survive. Take away one part of it and we have a problem. I have some concern about that.
One Member mentioned the discretionary housing payment, and I would certainly be keen to find out from the Minister what he intends to do if the pool of funding that is set aside runs out. He said that it was impossible to separate housing benefit from housing and social development policy in general, and there are some examples of that in Northern Ireland where housing has been designed to bring mixed communities together, such as in Loughbrickland in County Down and Ballynafeigh in south Belfast, which are also examples of how we have moved forward. I would like to express some concern over the removal of housing benefit from people where it will drive them towards poorer areas. For some people who are already in poorer areas, they will not move beyond them, and I have concerns about that.
I am conscious of the time, but another concern of mine relates to applications by carers for disabled people-I do not think that the issue has been mentioned fully yet, although some Members may have partially touched on it. A carer for a disabled person might want to apply, but the only person who can do so is the claimant's
spouse or partner. Would it not be more beneficial to ensure that the rest of the family members, who are perhaps those who are more affected, may also apply? I look forward to hearing the Minister's response to that. I also believe that some consideration needs to be given to single parents who have shared custody of children. I am not sure whether that issue has been addressed, so I would ask the Minister to look at that, too. Where custody is established, benefit entitlements should be granted to the parent to support the family unit. I do not believe that the proposals do that. Again, I ask the Minister to consider that point.
Other Members have touched on the issue of large families. It would not apply so much in the area that I represent, but I believe that it none the less applies right across the United Kingdom. Has particular consideration been given to ethnic families in other parts of the United Kingdom, where larger, multi-generational households are perhaps more common? I ask the Minister to consider that as well. There should be more innovative and positive incentives, which are far more preferable in making housing benefit entitlement reflect family size in the social rented sector from 2013. The Government position is bereft of detail, and I ask the Minister to consider my points.
Caroline Flint (Don Valley) (Lab): We have had a good debate, and I congratulate my hon. Friends the Members for Manchester Central (Tony Lloyd), for Glasgow North East (Mr Bain), for Aberdeen South (Miss Begg), my right hon. Friend the Member for Greenwich and Woolwich (Mr Raynsford), my hon. Friends the Members for Houghton and Sunderland South (Bridget Phillipson), for Sheffield South East (Mr Betts) and for Sedgefield (Phil Wilson), my right hon. Friends the Members for Coatbridge, Chryston and Bellshill (Mr Clarke) and for Holborn and St Pancras (Frank Dobson), my hon. Friends the Members for Stockton North (Alex Cunningham), for Streatham (Mr Umunna), for Hampstead and Kilburn (Glenda Jackson), for Scunthorpe (Nic Dakin), for Hayes and Harlington (John McDonnell) and for Bolton South East (Yasmin Qureshi), and my right hon. Friend the Member for Tottenham (Mr Lammy) on their measured contributions to the debate. They focused on facts and their constituents, and they raised concerns about the impact of the policies and the lack of evidence to clarify them. They asked the coalition Government to consider how their policies may lead to unfortunate consequences for their constituents in many ways. They came forward with ideas for reform. They raised concern about ending up with more polarised communities, and they talked about equality. Most importantly, they tried to address the issue.
The hon. Members for Cardiff Central (Jenny Willott), for Colchester (Bob Russell), for Wells (Tessa Munt) and for Strangford (Jim Shannon) made meaningful contributions. They, too, raised their concerns about the effect of the policies on their constituents. I am sure that the hon. Member for Brighton, Pavilion (Caroline Lucas) would have made a similar point about the people she represents.
Those colleagues-I call them colleagues because the substance of their speeches suggest that they may join us in the Lobby tonight-may be interested to know that the Minister for Housing referred to the Hull city council leader, Carl Minns, who is a Liberal Democrat, as a "motormouth" when he raised concerns about the impact of some of the Government's policies on people in Hull. Lord Shipley, a former leader of Newcastle city council, said that the private rented sector had been a "cornerstone" in stopping the use of bed and breakfast in Newcastle and that he did
"not wish to return to the days when we did...My concern is that the local housing allowance changes may restrict access to private rented accommodation and therefore limit the capacity of councils generally to resolve future housing need."
It is a shame that not one Minister from the Department for Communities and Local Government is on the Benches at the end of these proceedings. Clearly, the Minister for Housing does not believe that it is worth while sitting alongside his colleagues from the Department for Work and Pensions to consider how to address reform of housing benefit and housing supply, which many of my hon. Friends and a few hon. Members raised. That is a great shame.
We are not opposed to reform. My right hon. Friend the Member for Paisley and Renfrewshire South (Mr Alexander) made that very clear. We are not against caps in the housing benefit system, as long as they do not make people homeless or cost us more in the long run. We do not have an objection to asking younger single adults on housing benefit to live in a shared house or flat, but we must be sure that there is enough supply to accommodate everyone, and to recognise that some single people may have particular needs that require them to be accommodated in a different way. We will look at how non-dependant deductions can be made, provided they do not result in people suddenly finding themselves unable to live in their homes with an elderly relative, for example. We are willing to consider some temporary changes to the uprating of benefits so long as that does not permanently break the link between the rent that people pay and the help that they receive.
We also believe that cutting the local housing allowance to the 30th percentile will have a huge impact, which is not to be desired. About 700,000 of the poorest people, in work and out of work, will be on average at least £9 a week worse off. We recognise the need for reform but, as in other areas, such reform should be staged over a number of years and be more limited.
Bob Russell: During the 13 years of the previous Labour Government, I put forward various proposals to them in more than 50 parliamentary questions. Does the right hon. Lady accept that, had the Government in which she served listened to and acted on those proposals, we would not be in this situation now?
Caroline Flint: I am closing this debate on behalf of the Opposition and we want to consider some points that hon. Members have made. We also believe that housing should be looked at in the round, in regard not only to benefit reform but to housing supply.
Let us look at some of the other points that have been raised. We heard from the Government that housing benefit was out of control, but it was not. The housing benefit bill did go up as a result of the economic downturn because, as people lost their jobs or were forced to work reduced hours, they needed more help to prevent them from becoming homeless. In the past two years, there have been 250,000 new cases of people in work claiming local housing allowance. Overall, however, as a proportion of total Government spending on benefits and tax credits, housing benefit has stayed stable at 14% for the past 20 years.
We have also heard from the Government that their plans will save money. However, if they do not think their policies through and consider their impact on people, they could end up costing more than they save. The Government say that the cap will save £65 million. Others say that its consequences-uprooting families, forcing them out of their homes and into temporary accommodation-could cost nearly twice that. We have heard that the Government intend to increase the amount for discretionary housing payments, but I seemed to hear them say that they would use that money to pay the people who they say should not be in those homes to stay in them. Instead of using housing benefit for that purpose, they are going to use discretionary housing payments. That is a smokescreen too far.
The Government like to say that these reforms will help people into work, but pricing hundreds of thousands of working people out of whole swaths of the country, often where most of the jobs are, will make it more difficult, not less, for people to find work and keep their jobs.
Reducing people's housing benefit when they have been out of work for a year does not help them to get a job. It punishes them for not having one, and we reject that entirely. The Government say that reducing housing benefit will bring rents down. Landlords themselves tell us otherwise, however, with 90% saying that they will be less likely to take on people on housing benefit. That means that there will be more people chasing fewer homes, which will drive rents up, not bring them down.
The Secretary of State might say that, but I find it difficult to understand, given the question marks over the impact on rents of the Government's plans, why they are not doing a more thorough job of getting the evidence to prove that their policies are right. I have heard the Minister for Housing-who is
not here tonight; he obviously does not think it worth while-say on a number of occasions that he has evidence to back up his idea that rents will go down, but he has refused to provide that evidence. We have seen no sign of it.
My right hon. Friend the Member for Greenwich and Woolwich and my hon. Friend the Member for Sedgefield made strong points about the rented sector. They said that the Government's policies on housing benefit reform and their lack of a plan for housing supply would do nothing to tackle the issue of rents. Let us be honest about this: the Government have completely rejected the findings of the Rugg review, which we initiated to tackle some of the problems in the private rented sector.
Much has been said about our record on housing, so let me say something about that. Two million more homes were built, there are now 500,000 more affordable homes and 1 million more homeowners, and 1.5 million homes have been brought up to a decent standard. Homelessness was cut by 75%, and no family spends longer than six weeks in a bed and breakfast. In the face of the global financial crisis, the worst of its kind for 70 years, Labour did not walk by on the other side. We took action and supported families to stay in their homes. We prevented 300,000 families who might otherwise have lost their homes-and who would have lost their homes had the Tories been in power-from doing so. That is the reality. That is our record, and it stands in contrast to the mess the Tories left us.
Many thought that bringing so many homes up to a decent standard in such a short space of time would prove impossible. It did not. However, it did come at the cost of not building as many homes as we would have wanted. I agree with the hon. Member for Colchester and some of my hon. Friends who have referenced that tonight. Let us not forget that the reason why we had to focus on decent homes and bring them up to standard was the desperate situation we inherited from the last Conservative Government in 1997.
Caroline Flint: The Under-Secretary of State for Communities and Local Government, the hon. Member for Hazel Grove (Andrew Stunell), who is not in his place, helpfully points out on his website that there were 400,000 fewer homes after the Tories' 18 years in power. Of the stock that did remain, the last Conservative Government knowingly, wilfully and shamefully allowed so much of it to get into such a state of disrepair that when we came to office in 1997, we faced a maintenance backlog of £19 billion, with 2.3 million homes below a decent standard. Pensioners were unable to heat their homes, and children were made ill because of the damp, mouldy and overcrowded homes they were forced to live in. That is the Tories' record, and we are not going to let them forget it.
Caroline Flint: Conservative plans today are no better. The Minister for Housing likes to say that his Government will build more affordable homes every year than we built in 13 years. [Hon. Members: "Give way."] I will give way to the hon. Member for Spelthorne (Kwasi Kwarteng).
Caroline Flint: The hon. Gentleman should look at Hansard. I said quite clearly that we are not against looking at caps, and we are prepared to look at regional variations as well, but that would have to be planned and done properly over time.
Let me tell the Housing Minister that last year, in the teeth of recession, we built more homes in one year than the Government will build in any of the next five years. Since this Government came to power, local councils have ditched plans for new homes at the rate of 1,300 every single day. In the comprehensive spending review, the housing budget was demolished by devastating cuts of more than 50%. As a result, according to the independent National Housing Federation, once the homes Labour started building are completed, no new social homes at all will be built in the next five years.
Mr Duncan Smith: In response to the right hon. Lady and the hon. Member for Perth and North Perthshire (Pete Wishart), she has said for the first time in this debate-her right hon. Friend the shadow Secretary of State has also said it-that Labour Members are in favour of a cap. Will they please explain something to us? We have put our proposals forward. What level of cap do they now favour?
Caroline Flint: We have said quite clearly-not just today, but in a speech my right hon. Friend the Member for Paisley and Renfrewshire South made last Friday and in an article that I wrote last week-that we will look at the issue of caps. What we have said is that whatever cap is chosen on whatever basis, it must be planned, phased in and must ensure that people are not turfed out of their homes, put into bed-and-breakfast accommodation or made homeless. The Tories have not been able to answer any of those questions.
The fact is that one part of Government is working on one track for housing benefit reform, but there is no joined-up thinking with the Department for Communities and Local Government on housing supply. That is not a plan of action for housing, but a recipe for chaos and it does nothing to help cut the housing benefit bill. It is not only Labour Members who say that; dozens of Tory MPs have been to see the Secretary of State to tell him why these plans will not work. We have heard about the Conservative Mayor of London and we know that Tory council leaders across the south-east have warned that the dispersal of people that these policies will create will place an unbearable burden on services that are already stretched to breaking point.
There is a better way of doing this. We want to reform housing benefit, but in a way that is fair and that does not end up costing us more than it saves. I urge
Liberal Democrat Members and perhaps a few on the Tory Benches to join us in the Lobby and speak up for their constituents.
The Minister of State, Department for Work and Pensions (Steve Webb): This has been a worthwhile debate. We have learned a number of things. Most of all, we have learned that no Labour MP actually read the manifesto on which they stood. [Interruption.]
Housing benefit will be reformed so that we do not subsidise people to live in the private sector on rents that other ordinary working families could not afford. When we do that, Labour Members are against it. When we propose a cap, they are in favour of it -until we set a figure, and then they are against it. When we propose to cut non-dependant deductions they are in favour of that-unless it actually affects anyone. The shadow Secretary of State said that he wanted regional caps, when the cap would principally affect central London, because he does not want a cap that actually caps anyone. What we need are credible Opposition propositions, not opportunism.
Three main themes have emerged from the debate. The first is that the impact of these changes has been grossly exaggerated. As my right hon. Friend the Secretary of State said at the beginning, talk of highland clearances and the final solution is a disgrace. My hon. Friend the Member for Wolverhampton South West (Paul Uppal) pointed out how offensive such language is to people, but even in this debate we have heard talk of highland clearances, and of Paris.
The right hon. Member for Tottenham (Mr Lammy) does not seem to appreciate that in substantial parts of central London-in the borough of Southwark, for example-48% of properties are in the social rented sector, and will not be affected by either the cuts or the percentiles. The suggestion that central London will be devoid of people on low incomes is complete nonsense. If the right hon. Gentleman wants to correct himself, he is welcome to do so.
We have heard talk of the impact of these changes. I appreciate that it is a shame to introduce facts at 9.45 pm, but I shall give it a try. As was pointed out by the Chairman of the Select Committee, the hon. Member for Aberdeen South (Miss Begg), this is not just a London issue, but obviously the impact of the cap will be felt particularly in London. There are 400,000 people on housing benefit in inner London, which ought to be
where the impact will be greatest. Of those, 313,000, or 77%, will be unaffected because they are in social tenancies, and a further 30,000, or 7%, will be unaffected because they are in the non-local housing allowance sector. That adds up to 84%. A further 6% receive local housing allowance, but will not be affected. That means that 90% of people on housing benefit in central London will not be affected at all, while another 3% will be affected by less than £10 a week.
The mistake made during the debate is that people have assumed that any shortfall is equivalent to homelessness. That is a ludicrous leap. We know that people experience shortfalls in a number of ways. Of all the people on housing benefit in central London, 7% will experience shortfalls of more than £10 if there is no change in rents.
Mr Raynsford: Will the Minister confirm that he has just misled the House? Tenants in social housing will be subject to increased non-dependant deductions. The housing benefit of those who have received jobseeker's allowance for 12 months will be terminated or reduced by 10%, and the benefit of those who are deemed to be occupying accommodation larger than they need will be reduced as well. All those social tenants will be affected by the Minister's changes. Will he now admit that?
The impact of the cap, the impact of the 30th percentile and the impact of the removal of the £15 excess have been elided in the debate. The hon. Member for Houghton and Sunderland South (Bridget Phillipson) mentioned the figure of 20,000 pensioners in her constituency-most of whom will not be affected by any of the changes. As I was explaining, less than 10% of people receiving housing benefit in the area most likely to be affected-inner London-will experience shortfalls of more than 10%.
The exaggerated impact has been made clear. However, one point has not been made clear. It has been suggested that the private rented sector is somehow an oasis of stability and settled communities, but there is massive churn in that sector. I want to give an example of that. The people affected by the caps and the 30th percentile are on local housing allowance. Local housing allowance was introduced in April 2008, so pretty much all those people did not even move into their current properties until April 2008; in the vast majority of cases they have lived in them for less than three years. The idea that we are suddenly churning up some settled permanent community is complete nonsense.
Emily Thornberry: The hon. Gentleman is saying that a huge proportion of people will not be affected, but let us say, for example, that we are doing our best to move a woman in Islington from a three-bedroom house into a smaller flat. Would she lose her secure tenancy if she moved?
When there are specific instances of vulnerable people about whom local authorities have concerns, those local authorities have discretion to do something about the situation. But when people might
reasonably be expected to move, that, of course, is part of the equation. If everybody went on staying exactly where they were at the same rent, there would have been no point to the policy.
On the basis of the debate so far, Mr Speaker, you would imagine that this year's £21.5 billion housing benefit budget was about to be slashed. [Interruption.] Labour Front Benchers are saying that it is.
Steve Webb: Sorry; the shadow Secretary of State is disowning the right hon. Member for Greenwich and Woolwich (Mr Raynsford), who got it wrong. In 2014-15 the housing benefit budget will have been "slashed" from £21.5 billion to £22 billion. We are not slashing. We are making changes.
It has been said that we are being too hasty. The Labour party has decided that after 13 years of making the problem worse, doing something about it is "hasty". Labour was so unhasty that it never got round to doing anything about the problem before it lost office. We are getting a grip.
First, we have established that the impact of the changes has been grossly exaggerated. Secondly, we have established that rents will not stay as they are. During the debate it has been suggested that the fact that the British taxpayer is putting more than £20 billion a year into housing benefit has no impact on the market. We, the taxpayers, pay housing benefit towards 40% of private rented tenancies. It is a long time since I studied economics, but I reckon if we pay for 40% of the tenancies and we put £20 billion a year into the market, we might just be having some impact.
Sheila Gilmore: The hon. Gentleman is using the figure of 40%. Recent research done both in Scotland and England is completely different. It produces a figure of 20%. In fact, in Scotland it was 17%; the report was produced for the Scottish Government. Only 8% of that was for housing benefit. We need to see the evidence that differs from the research that the Government themselves commissioned.
As my right hon. Friend the Secretary of State pointed out earlier, people have said in this debate that rents will not fall. There is an assumption that rents have to go up. I have news for those people: since November 2008 private sector rents have fallen by 5%, while LHA rents have risen by 3%. So there is a void. That is further evidence. Opposition Members have asked for evidence, and here is clear evidence that LHA is driving up rents.
My hon. Friend the Member for North East Hertfordshire (Mr Heald) pointed out how LHA is inflating the market. LHA rents are on average 10% higher than the housing benefit rents that have carried on from the previous system-more and more evidence that we,
through our taxes, including taxes on hard-working families, are inflating rents. That is not benefiting tenants. During the debate it has been suggested that we are against the tenants, but we are actually against our taxes being spent on inflated rents, because that is not what the money should be for.
We have established that if we can get a grip on the rents, that will benefit tenants and help people in lower-paid work to pay those rents. There have been exaggerated stories about the impact, an assumption that rents will not fall, although we believe that our changes will have an impact, and thirdly-
"Proposals of this sort risk creating 'ghettos' where low-income tenants are forced to move to accommodation in lower rent parts of town, whilst those who are better off continue to rent the best properties."
Steve Webb: That is interesting. I wonder whether the hon. Gentleman still supports the housing benefit cut taking away the £15 excess that the Labour party was going to introduce before the general election. If I remember rightly, Labour delayed that cut by one year-until after the election. Does the hon. Gentleman still support that Labour cut in housing benefit? I suspect not.
It is important that we have a discussion about fairness. My hon. Friend the Member for Colchester (Bob Russell) raised the situation of vulnerable people, particularly families with children. We are clear, first, that the impact of the changes as a whole is much narrower than has been assumed; secondly, that they will have an impact on rents, which will reduce the shortfalls and the number of people who will have to move; and thirdly, that there will be individual vulnerable cases. My hon. Friend is right to say that the position of families with children is very important. That is why we have trebled the money available to local authorities for discretionary housing payments specifically to help the most vulnerable. I recently had a conversation about a London authority that estimated that it would need to double its discretionary housing payments to cover these costs. We are trebling them, which we believe will enable local authorities to address the situation of the vulnerable households about which my hon. Friend is rightly concerned. I am grateful to him for raising that point.
The issue of fairness was raised by other Members too. My hon. Friends the Members for Hastings and Rye (Amber Rudd) and for South Thanet (Laura Sandys) rightly pointed out that many low-paid workers cannot begin to afford the sorts of rents we are paying for housing benefit recipients. The Labour party used to agree with us on that. Since they became the Opposition, however, they have stopped agreeing with themselves. There is a fairness issue therefore, and as we bring down rents we will improve the fairness of the system.
One of the key issues is housing supply, which my hon. Friend the Member for Colchester and others also raised. The shadow Communities and Local Government Secretary, the right hon. Member for Don Valley (Caroline
Flint), rightly raised that issue as well. However, the housing shortage was caused by the Labour party, which failed to build sufficient numbers of houses when in office. Many Labour Members said that they wished the situation was different. Well, they had 13 years to make it different. It is no good their wishing in opposition that houses had been built. As they held the levers of power and they did not pull them, they have to accept and live with the consequences. That is why I welcome what my ministerial colleagues at the Department for Communities and Local Government are doing to generate new social house building so that there will be diversity in the social housing sector, with the most subsidised rents and also near-market rents-80% of market rents-which will provide the resources needed for the significant increase of 150,000 new social homes. We desperately need that increase during the course of this Parliament.
Many Members raised issues about the disincentive effects of the housing benefit system, and I want to draw attention in particular to the remarks of my hon. Friend the Member for Enfield North (Nick de Bois). He made some powerful points about the fact that once people are in work and on housing benefit-I do accept that there are people in work and on housing benefit-the benefits systems then traps them, because if they want to do extra work they face very high marginal withdrawal rates. My hon. Friend highlighted the situation of people who are in work and do not want to do more hours because they will just find that their housing benefit is withdrawn. That is a crazy system: we, the taxpayers, pay £21 billion a year to subsidise rents, and put inflation into rents, and then we expect people to do low-paid work, and as soon as they do more work we claw the money back.
That is going to change. This Government are doing to do something about it. On Thursday my right hon. Friend the Secretary of State will announce plans to take forward the proposition of a universal credit, whereby for the first time people will be guaranteed to be better off in work.
That the draft Asylum (First List of Safe Countries) (Amendment) Order 2010, which was laid before this House on 12 October, be approved.- (Mr Goodwill.)
That the draft Apportionment of Money in the National Lottery Distribution Fund Order 2010, which was laid before this House on 14 October, be approved.- (Mr Goodwill.)
Mr David Burrowes (Enfield, Southgate) (Con): It was in January 2007 that I last secured a debate on clostridium difficile, or C. diff as it is commonly known. It was the first time that the House had debated the subject, and I recall how at the time Mr Speaker's office questioned what C. diff was. Indeed, many hon. Members had never heard of it. Since that time, however, sadly the impact of this cruel and often unremitting infection has demanded the public's and, indeed, the Government's attention. All hon. Members will probably know of someone in their constituency or family who has suffered from C. diff. Indeed, in that regard I welcome the attendance of Mr Deputy Speaker, who has a deep and personal interest in the issue, following the loss of his mother as a result of C. diff.
I gladly acknowledge that there has been much progress in the three or so years since I last raised this subject. However, C. diff still leaves thousands of people each year suffering great discomfort, loss of dignity and, sadly, loss of life. The media spotlight comes on to the subject when there is an inquiry into a hospital trust and then moves on but, away from its glare, the terrible and often tragic effects of this infection have not gone away.
I know that the Minister will provide me with an answer, which is the primary purpose of this debate-namely, an assurance that the Government take C. diff very seriously and are working hard not only to reduce it but to eradicate it. Much has changed since 2007, not least with the Government's plans to revolutionise the national health service and empower patients and general practitioners. I hope that this debate will help to identify the challenges and opportunities to tackle C. diff, not only in the hospital setting but in the community.
Some things, or rather someone, have not changed since the previous Adjournment debate in 2007. I refer to the active involvement and national leadership on the issue of C. diff of my constituent Graziella Kontkowski, who has attended the debate this evening, as she did back in January 2007. Tragically, Graziella's grandmother died as a result of the C. diff infection. Graziella describes being
"helpless, watching my grandmother die a slow and painful death without being able to do anything to help her-it was the worst thing I've ever experienced."
Since then, she has used her experience and remarkable passion and energy to ensure that other families are able to face and fight C. diff and its terrible effects. Alongside her brother Mark, Graziella set up the online C. diff support group, which can be found at www.cdiff-support.co.uk, to make it possible for people who have been infected by C. diff, or whose loved ones have suffered from its effects, to share their experiences and advice with one another. The C. diff support group has about 1,500 members and continues to make a valuable contribution to the public debate on C. diff and to the lives of many who are struggling in similar circumstances to those that Graziella and her family went through.
Graziella also helps to support the work of the Centre for Healthcare Associated Infections, which is based at the university of Nottingham. With the danger of bacteria
mutating to become more resistant to antibiotics, its efforts towards the development of new vaccines and rapid diagnostic tests for the detection of the infection are to be commended. Its research can truly be described as life saving, and I encourage members of this House, and members of the public, to consider supporting its work.
Richard Harrington (Watford) (Con): I congratulate my hon. Friend on the work that he has done on this very difficult subject. I would like him and his constituent to know that there is a device in America called Zimek, which I have observed. It is the most fantastic system that disperses disinfectant and has eradicated C. difficile in hospital wards. It is undergoing clinical tests in Northwick Park hospital, which is just next to my constituency and where many of my constituents are being treated. I urge the Minister to take note of this. I would be delighted to send him details showing the fantastic effects that the device has had in America, very cheaply and in a way that I believe could save millions of lives in this country.
Mr Burrowes: I am grateful to my hon. Friend. He makes the case for that proposal very well. Indeed, there are several innovative developments, not only in the hospital setting but in trying to look at prevention. Prebiotics is another area that is worth considering. I ask the Minister to look at supporting the centre I mentioned and at how we can support research in this field.
A C. diff infection exacts a great cost from the patient who suffers from it and the family who witness it. It is also financially expensive. In 2008, the Department of Health released a report called "Clean, safe care: reducing infections and saving lives", which noted that treating one patient with a C. diff infection cost the NHS more than £4,000 per patient. By this estimation, and considering the number of infections reported last year, C. diff cost taxpayers close to £1 billion in the past 12 months.
It is true that C. diff has received a far more coherent and concerted response from the NHS in the past three years than it had previously. It is equally clear that this focus has had a positive effect on the quality of care and on survival rates in our hospitals. Last year the infection was noted on fewer than 4,000 death certificates and was considered to be responsible for deaths in 1,712 cases. That is less than half the rate in 2007, when more people died as a result of C. diff than as a result of road accidents. However, as the Secretary of State for Health has said:
"There is no tolerable level of preventable infections."
I am grateful to his Department for making it clear that a zero-tolerance approach to health care-associated infections is a priority for the Government. During the week beginning 26 September, 190 new cases of infection were reported by hospitals in England and Wales-an average of 27 cases a day, or more than one every hour. There is no room at all for complacency.
One problem of which we need to be aware is the number of incidents of recurring C. diff symptoms in patients. I am greatly concerned that hospitals are releasing those who have suffered with the symptoms of the infection too early, which leads to many having to
return to hospital with the same problem. I am glad that the Department has recently made it clear that hospitals are responsible for the care of a patient for up to 30 days after they have been discharged.
Mr Burrowes: I am glad that the Minister fully shares my concern. It is good to know that hospitals cannot expect any additional payment for treating those who have suffered a recurrence during those 30 days. However, I ask him whether there could be any sanctions on trusts that sadly fail to reduce the rate of infection.
Along with the Department of Health, my constituent Graziella has produced a leaflet, which my hon. Friend the Minister helpfully distributed just before the debate. It is called "C. difficile-now you are going home", and it sets out the best ways for patients to protect against the infection spreading. It is intended to be given to patients so that they can be aware of the risks and know how to prevent other vulnerable people from catching the infection. However, although both Graziella and I would like to see this leaflet distributed by every hospital and GP, there is no requirement that that happen. Many patients return home without the information in that fantastic leaflet about how best to protect themselves and others. Will the Minister consider requiring-or, in the more localising language that Conservative Members prefer, incentivising-hospitals to provide the leaflet or similar information to all patients leaving their charge who have had the infection?
Although improvements have been made in acute trust hospitals such as my local North Middlesex university hospital, it is important that we do not lose sight of the need to pay attention to what is happening in our primary care trusts. In fact, in every month of last year, PCTs reported far more cases of C. diff than acute trusts. Enfield PCT, which is by no means extraordinary in this regard, reported 144 cases in patients aged over two in just the past year.
Nick de Bois (Enfield North) (Con): To pick up on my hon. Friend's point about Enfield, as he knows, at our local hospital, Chase Farm, there has been an extraordinary improvement in recent months, particularly since August. That is essentially down to a massive concentration of effort on this one problem, and there, in part, lies the solution.
Mr Burrowes: I am grateful to my hon. Friend, and I support the work that has happened. It has very much been prompted by Graziella, who has been going from ward to ward to ensure that what people say is being done is, in fact, reflected in their actions.
We also need to get to grips with the problem of C. diff in the community. In the past, there has been too little interest in what happens to a patient once they leave the hospital walls, and too little attention to the problem of infection being spread between hospital and home, or worse, between hospital and care home. Sadly, many of my hon. Friends will have witnessed that situation. That two-way corridor of infection must be addressed, as must the associated lack of care that care home residents can sometimes receive, as they are sadly away from the public eye.
Given the clear danger of allowing infections to spread within an enclosed community of elderly and vulnerable people, I would be interested to know what the Department is doing to monitor cases within the care home setting, and specifically to monitor whether cases are being reported consistently and dealt with promptly and according to the most recent hygiene code.
As we move boldly to a health care system that puts the patient and their recovery at the heart of every decision, it is essential that health care-associated infections such as C. diff are on GPs' radars, especially as they take on responsibility for commissioning in their area. There needs to be an assumption in favour of testing for the infection when patients are suffering from diarrhoea. GPs must also be properly aware of the need to check up on patients, and avoid prescribing them certain drugs that are known to increase the risk of infection and the likelihood of patients suffering from severe symptoms. The C. diff support group has identified a number of worrying cases of GPs prescribing antibiotics. I also ask colleagues to look on its website and check out Imodium, which is known negatively to affect patients suffering from C. diff.
"all cases of diarrhoea among people in the community aged two years and above should be investigated for C. diff unless there are good clinical reasons not to."
Such good practice needs to be extended to all GPs. Does the Minister know what more the Government can do to ensure that GPs are fully briefed on C. diff and that they are responding to this knowledge efficiently and consistently?
Perhaps the Minister would consider enabling the NHS computer systems in both hospitals and GP surgeries to tag an alert to Imodium and other drugs that are known to increase the risk of C. diff in vulnerable patients. Doctors intending to prescribe such drugs would be reminded to consider whether the patient might have the infection before doing so.
As for the careful monitoring of patients in the community, I would be interested to know what, if any, guidelines GPs follow with regard to the treatment of patients with C. diff. Perhaps the Department would be willing to provide such advice to doctors. Doctors could perform a simple blood test on elderly patients in the community to provide an early warning against the possibility of renal failure.
I very much welcome the Health Secretary's attendance today and his commitment to comprehensive, trustworthy and easy-to-understand information on how to look after patients' health. The data on C. diff infection rates already exist and can be found online, but they are often inaccessible in their format. They can be sketchy and incomplete at best.
Yesterday, NHS Choices listed 12 hospitals within five miles of one of the postcode areas in my constituency. Of those 12 hospitals, data on the prevalence of C. diff cases within the last 12 weeks were available for only two of those hospitals-North Middlesex University hospital and St Ann's hospital. On the same day, the Department published business plans with a focus on transparency. To ensure that we see even more marked improvements in the next three years, will the Minister
tell us what he intends to do to ensure that "easy to understand" information is available, especially on those websites that patients are most likely to use and at those locations that they are most likely to frequent?
Finally, I look forward to the time when the Minister can declare to the House that preventable healthcare-associated infections such as C. diff can be eradicated. However, I am conscious, as the Minister will be, of George Bush's regret when he prematurely declared "mission accomplished" and there is much to be done before we can get near to such a declaration. I hope that this debate, which supports the great work of campaigners such as my constituent Graziella Kontkowski, can move us closer to a time when we have no need to raise this important issue in the House again.
The Minister of State, Department of Health (Mr Simon Burns): I congratulate my hon. Friend the Member for Enfield, Southgate (Mr Burrowes) on securing this debate on C. difficile. He has shown a strong interest in this issue for a very long period. Let me make it clear that the NHS should aim for a zero-tolerance approach to all health care-associated infections. I hope that what I say in my speech tonight will reassure my hon. Friend that we as a Government regard C. difficile as a priority and we will use all the levers at our disposal to support further significant progress in reducing this problem in our hospitals, care homes and other health facilities.
For most of the last decade, we saw unchecked increases in the number of MRSA and C. difficile infections, causing misery for thousands of patients and their families. However, in more recent years, the NHS has improved its infection prevention and control practices, which has led to a significant reduction in both C. difficile and MRSA bloodstream infections. I should like to take this opportunity to congratulate all NHS staff who were involved in turning the tide for their hard work in achieving that. From a high of around 56,000 infections in 2006, C. difficile infection has fallen to just over 25,000 in 2009-10. From almost 8,000 infections in 2004, numbers of MRSA have also fallen substantially to fewer than 2,000 in 2009-10. However, despite the progress that we have made, we can go further.
Mr Burns: I would be grateful if my hon. Friend allowed me not to, because I have very little time in which to say a lot in answer to the questions from my hon. Friend the Member for Enfield, Southgate.
Despite the progress made, we can go a lot further to reduce infections, particularly of C. difficile. The previous Government's approach was to introduce a rather crude national target for reducing infection rates that placed no specific obligation on individual organisations to improve their prevention and control systems or to reduce their own infection rates. We therefore find ourselves in a situation where, despite significant reductions at a national level, many organisations have made little or no improvement on their position years ago. The job of controlling C. difficile infections in the NHS is far from complete, and the NHS, in both secondary and primary care, must continue to prioritise reducing these infections.
We will expose those poor-performing organisations that were able to ride on the coat tails of others, and force them to put their house in order.
My hon. Friend asked about monitoring care homes. I can assure him that, as part of our commitment to a whole-health economy approach to infection prevention and control, last month the adult social care sector became subject to the code of practice on the prevention and control of infections. Adherence to the code is a statutory requirement, and we expect to see improvements in infection prevention and control practice in the social care sector as a result of its introduction, in the same way as has happened in hospital settings. In addition, we have strengthened Care Quality Commission powers to ensure that, where required, appropriate action can be taken to address poor practice. Care homes should report single cases of suspected C. difficile to the resident's general practitioner, and a suspected outbreak should be reported to the local health protection unit. I am confident that this additional strengthening of the measures will go some way to help reduce the problem in care homes.
The Government expect the NHS and social care organisations to take a zero tolerance approach to health care-associated infections, as I said at the beginning of my remarks. When patients have the relevant information, they can be the most powerful agents for change. In line with this, one of the first things we did was to publish weekly MRSA and C. difficile infection numbers by hospital, and the data are now available within weeks rather than months, giving a far more accurate picture of what is happening at a particular hospital. Patients can now clearly see and take account of this when choosing where to have their treatment.
My hon. Friend asked about making more information available. I can reassure him that one of the key parts of the White Paper on health reform in the NHS is on empowering patients by providing even more information relevant to them from independent sources. That means it will be reliable and accurate. It will also be provided in a way that is easily understandable, so that patients can see the areas of health care-in whatever shape or form-that are of particular interest to them. I would encourage anyone to respond to the consultation on the information revolution document that my right hon. Friend the Secretary of State published recently, so that we can consider all views on how to get this right and empower patients with information.
We also made it clear in the coalition agreement that we will use quality outcome measures, including HCAIs, to drive improvements in the areas that really matter to patients. In the near future, I want all organisations to be operating at the level of the best today. The challenge, therefore, will be greatest for those who have so far made the least progress. We have also decided to extend mandatory surveillance beyond MRSA and C. difficile, to provide a fuller picture of HCAIs within the NHS, which the previous Government resisted. As my right hon. Friend the Secretary of State announced last month, we will extend mandatory surveillance to include MSSA-meticillin-sensitive staphylococcus aureus-with infections such as E. coli to follow in due course, based on expert advice.
I know that my hon. Friend the Member for Enfield, Southgate has a strong interest in the different settings where C. difficile infections occur. For some years, such infections were essentially seen as a hospital problem, with hospitals being the focus for both central and local efforts to tackle them. However, that focus is not sufficient, as he mentioned. An unfortunate outcome of the previous focus on hospital-acquired C. difficile infections is a lack of awareness of the risks in primary care. Although we have seen substantial decreases in C. difficile infections in acute trusts, those occurring in primary care trusts-referred to as community-associated infections-have decreased at a far slower rate.
The origin of community-associated cases is not clear and needs further investigation. A significant proportion may be due to previous contact with previous health care facilities. In other cases there may have been no known links to health care, while others may be associated with antibiotic treatment in the community by GPs. GPs have a vital role to play in reducing the inappropriate use of broad spectrum antibiotics-those that attack a wide range of bacteria, but which can increase the risk of contracting C. difficile. GPs need to consider C. difficile when prescribing antibiotics, particularly to at-risk groups such as those who have recently been discharged from hospital or the elderly, as my hon. Friend rightly mentioned. Because such antibiotics can increase the risk of contracting C. difficile, prudent antibiotic prescribing is key. Although only a small number of C. difficile infections emanate from general practice, this is not an excuse to do nothing-not when the impact on individuals can be so great.
We will increase GPs' awareness of the impact of antibiotic prescribing on contracting C. difficile infections and increasing antibiotic resistance. As part of that, we will use antibiotic awareness day on 18 November to focus attention on the need to reduce the unnecessary use of antibiotics. As my hon. Friend showed in his speech, we have produced leaflets and other materials that GPs, pharmacists and other professionals can use to raise the issue with patients and the public. Those materials make it clear that everyone has a role in improving prescribing and patient outcomes. To improve the evidence base, we are considering how to improve the monitoring of community associated cases. That links into our concern about the large number of readmissions to hospital within 30 days of discharge, which my hon. Friend also mentioned. The action that my right hon. Friend the Secretary of State took in the summer to alleviate the problem will, I believe, go a long way towards helping to find a solution to it.
Let me now turn to some of the questions that my hon. Friends have asked in this debate. I am grateful to my hon. Friends the Members for Watford (Richard Harrington) and for Enfield North (Nick de Bois) for drawing to my attention the equipment, which came from America, that is currently being tested in Northwick Park hospital. As they may be aware, the Department has established a mechanism, known as the rapid review panel, by which new products can be evaluated for their effectiveness against infections. As they said, the equipment is currently being tested at Northwick Park hospital. We await with interest the results of those tests, to see whether the equipment would be useful in the constant battle against such infections.
My hon. Friend the Member for Enfield, Southgate also asked what more the Government could do to ensure that GPs are fully briefed on C. difficile and respond to such knowledge efficiently and consistently. As I mentioned with social care, the forthcoming application of the code of practice to primary care will give a significant boost to improving GPs' awareness and knowledge of infection prevention and control. We will publish the code shortly, and although primary care will not be subject to the requirements of the legislation until April 2012, the registration process with the Care Quality Commission will start much earlier, with all the benefits that this will secure, through increased focus and awareness. I trust that that will go some way towards reassuring my hon. Friend.
My hon. Friend also spoke about requiring hospitals to provide information to patients leaving their care. As he said, Graziella, with the Department of Health, has produced a leaflet on C. difficile, which he has seen. The best way to protect patients against the infection spreading is to provide them with information. The intention is to give the document to patients so that they are aware of the risks, and know how to prevent other vulnerable people from catching the infection. However, although both she and I would like the leaflet to be distributed by every hospital and GP, there is no requirement for that, and many patients are sent home without the information that they need to protect themselves.
We believe, as does my hon. Friend, that it is important for patients to have access to information. I certainly expect hospitals to provide that information to all relevant patients on their discharge. It is important to ensure
that such leaflets are available for the NHS to use, and copies are available on the Department's Clean, Safe Care website, but we must be careful not to be prescriptive on decisions about patients' care that are best made at local level. I trust that many practitioners and hospitals at local level will recognise the importance of the leaflets and ensure that patients have them drawn to their attention.
Time is running out, and on the questions to which I have not had the opportunity of replying I will write to my hon. Friend so that he receives answers. I say again that we treat the matter seriously, and in the short time remaining I shall answer the final question about careful monitoring of patients in the community. Guidance, entitled "Clostridium difficile infection: how to deal with the problem", has been published by the Department of Health and the Health Protection Agency, and provides evidence-based advice on how to treat C. difficile. We will take the opportunity in the forthcoming publication of the code to reiterate the value of that to GPs in their decision making, and I hope that my hon. Friend will find that reassuring and helpful.
When patients enter a health care setting, they expect to be taken care of and to be made better, not to contract a potentially fatal infection. I hope that I have reassured my hon. Friend that the Government share his deep concern and are determined to see significant progress in reducing C. difficile infections further.