Let us get back to the reality. This Queen’s Speech was the dullest one I have seen in my 27 years in this place, and I think everyone would agree on that. I sat down and I said to myself, “How can I liven it up? What if it was my Queen’s Speech? What if I jumped on the bike of my hon. Friend the Member for Bolsover (Mr Skinner)—although it has been pinched—and got into Buckingham palace to ask them to take my speech to the House of the Commons instead of the one they were going to read out?” My first Bill would be on the national minimum wage—I would put a Bill through to increase it to £10 an hour. My second Bill would be on a shorter working week—32 hours without loss of pay. My third Bill would call for full employment with no redundancies. There would be a repeal of all anti-union laws, and the reintroduction of collective bargaining.

9 Jun 2014 : Column 326

My next Bill would restore health and safety for workers. The health and safety budget has been cut by 35%, so we need a Bill to put that right for working people.

My fifth Bill would bring an end to privatisation. There would be no more privatisation of the trains or the buses—[Interruption.] Never mind about the increases and the costs; this is my Queen’s Speech, not Labour’s. There would be no more asset stripping of public facilities. Bill No. 6 would be to get rid of Trident, which would make me popular, especially with the Scottish nationalists.

My seventh Bill would put the buses and trains back into public ownership. It would try to stop the privatisation of the east coast main line, but I very much doubt that we can stop it now, as this Government are hell bent on getting rid of it before they go out of power. But we will restore it to public ownership—at least I hope we will; I hope that our Ministers are listening, and that we will restore it.

My eighth Bill would bring education back under local democratic control. We have heard in the statement today how out of control things are. Local authorities are wavering. Their spending has been cut, and they have very little say over the academies or the free schools. Anything could happen in the education service now, because we no longer have that local watch, so we need to bring it back.

My ninth Bill would be about the national health service. I want free public health care for all. That would be a big Bill and it would cost a lot of money, but we need to stop this creeping privatisation. I would get that money from one place: I would go to the City and tell all those spivs and bankers, “Your bonuses are stopped, because of all the money you have spivved off the working people of this country.” It is the working people who have had to pay for the austerity measures. I would tax those people and get the money for the Bills in my Queen’s Speech.

7.2 pm

Gordon Birtwistle (Burnley) (LD): The health service is very close to everyone’s hearts, and there are a lot of political gains to be made from it. I have to say that, as the Member of Parliament for Burnley, my election chances were boosted when Labour’s Secretary of State closed down our A and E unit. I am delighted to say that the coalition Government have now delivered us a brand new emergency centre in Burnley, which shows that the coalition Government have delivered good things, especially for the people of Burnley.

There is one issue that I really want to talk about today. I have been a councillor for 31 years—I stood for election only last month and increased my majority over Labour in my ward—and the issue that has become very close to my heart is the care of elderly people. I am talking about elderly people who are on their own. People from companies call on them in the morning to get them out of bed. They stay for 10 minutes to make sure they are up and have had some breakfast. They then come back at lunchtime to make sure they have eaten some lunch, and then again in the afternoon to make sure they have had their tea. They come back in the evening. As one elderly man said to me, “They come back at 8 o’clock and tell me to get ready for bed.” He said, “I don’t want to go to bed at 8 o’clock in the evening. I am 87 years old. I fought for this country,

9 Jun 2014 : Column 327

and now they are telling me that I have to go to bed at 8 o’clock. I don’t want to do that.” What he wants is for someone to come and see him in the morning and talk to him. He is housebound, and he does not have a family. He is not the only one in that situation. There are many more like him in Burnley.

We are a poor town and people cannot afford to pay for private services. These people want to talk to somebody in the morning when they get up; they want a bit of conversation. They do not want staff running in with their meals-on-wheels food in a foil container saying, “We’ll come back and see you later.” They want to talk to someone. They want to know that there is somebody who cares for them; somebody who is interested in listening to them. This elderly man has some fantastic stories about his life; I have seen him many times. When the staff come back in the evening, he is not asking them to stay all night. He is asking them to show a little bit of interest in him, and he certainly does not want to go to bed at 8 o’clock at night. He has never gone to bed at that time and for someone to tell him that he has to do so, “or he’ll be on his own” is wrong. I am not being political here. All I am saying is that we should care more for the elderly people of this country. I am talking not about people who are in their 60s, but about people who are in their 80s and 90s who, unfortunately, have been left on their own. They might be elderly ladies whose husbands have died. These are people who have worked for this country all their lives and fought for this country, and are now, certainly in my constituency anyway, being left alone. I find that hard to accept. I might be unusual. There might be people who think it is tough and bad luck, but I do not think that. We should be looking after these people and showing them some compassion. We are a wealthy country. Apparently, we are the fourth or fifth wealthiest country in the world, and the contribution that these people have made over their lives has helped to put us in that position.

Burnley is an industrial town; we had the pits and the mills. Now we have high-tech industry where young people work and create wealth. Fortunately these days, they are able to put something aside for their pension, which will help to look after them in their old age. The elderly people from the ‘70s, ‘80s and ‘90s could not do that; they were on poor salaries. In the main, the wives did not work. My mother never worked. My father brought up our family, and my mother never worked. All right, my mother and father are dead, but there are still people around who were in the same position. Many have lost a partner and in the main their children are out of the area, and they need us to care for them. Is it a lot to ask for someone to turn up and say, “Hello, Mr Jones. How are you?”

Lyn Brown: The whole House is listening very quietly to what the hon. Gentleman is saying because it resonates. My father is 87. He pays for carers to come in from an agency. What has upset us is the fact that his life savings are paying the wages of people who drive Lamborghinis, who employ people on the minimum wage and who provide very poor care to the people the hon. Gentleman is talking about. This Government need to act to ensure that the care offered to our people, which they pay for out of their meagre savings, is of the quality that they deserve.

9 Jun 2014 : Column 328

Gordon Birtwistle: I am grateful to the hon. Lady for her intervention. I do not know of a company that delivers services in Burnley that has an owner who drives a Lamborghini. In fact, I do not know anyone in my neck of the woods who has a Lamborghini. I do not know many people who can spell the word Lamborghini. At the end of the day, the hon. Lady is right: there are companies that are taking money, particularly from the state, and giving a very poor service. I do not want this to be a political point. What I want is to plead with the Minister and with the people in control—I am not in control, so I cannot deliver this—and say that we are living in an age where people are getting old and need looking after. Why can we not do a little bit more to look after these people? The people who get the sums of money to deliver this service should be a little bit more considerate and compassionate. They should not just walk through the door with a metal tray with a bit of food on that no one wants to eat, because it does not feel like the proper food they used to eat. Can we not just do a little bit more?

My message today is: can we do a bit more for our old people—the people who have put us where we are today, who have delivered the prosperity of this country over the years; and who have fought for us in wars? Can we not show them a bit more consideration? If those companies with Lamborghinis exist, can we lean on some of them to train people properly to ensure that they have a bit more compassion?

Paul Burstow (Sutton and Cheam) (LD): I hope my hon. Friend will forgive me for turning my back to him, but I want to tell him through the Chair that one of the places that is trying to do what he is talking about, and which I visited recently, is Wiltshire, which is using its relationships with contractors to drive out 15-minute contracting and drive up training standards, which is making a difference. That is happening now, and it needs to happen in more places.

Gordon Birtwistle: I am delighted to hear that, and I would like Wiltshire to become a standard that everyone else copies. I would hope that my constituency and the rest of Lancashire copies that. There are great companies—I know a few good companies that really care about the customer. These elderly people are customers: if Tesco treated people like some of those carers, they would shop somewhere else. Unfortunately, elderly people cannot go anywhere else, because a contract has been organised, and they have to use it. I urge the Minister to consider those suggestions and look at ways of improving the service that we deliver to our old people. I would be very happy if he did so, and I am sure that he would be too.

The Minister of State, Department of Health (Norman Lamb): I completely agree with what my hon. Friend is trying to achieve. I hope that he is reassured that the Government have effectively introduced compulsory minimum training for all care assistants for the first time. I think he will welcome that.

Gordon Birtwistle: I do welcome it, and I am delighted to have heard that. I just hope that we make it a major condition of all Government and local authority contracts that all companies deliver that service to our elderly people. We will all become elderly—I am catching up very quickly—so who knows how soon it will be before

9 Jun 2014 : Column 329

someone comes to my house to say, “Gordon, it’s bedtime. It’s 8 o’clock—it’s toilet time.” That’s the worst thing I think I have ever heard—someone coming in and saying that it is toilet time. An old man said to me: “I do not want to go to the toilet, but I am told that it is time to go to the toilet.” It is just not acceptable to do that to an elderly man. I am delighted to hear what the Minister said, and I hope that we ensure that it continues in future so that we really respect and care for the people who have put us where we are today.

7.12 pm

Angus Robertson (Moray) (SNP): It is an honour to follow the hon. Member for Burnley (Gordon Birtwistle). The House was listening raptly to a speech full of humanity and compassion. I pay tribute, too, to the right hon. Member for Cynon Valley (Ann Clwyd), who read out a lot of examples of what everyone will agree was shocking treatment. I genuinely hope that Ministers listened closely to those speakers and to many others who have made important points.

In the limited time available, I should like to draw attention to the obvious point that this is the last Queen’s Speech before the historic and exciting independence referendum in Scotland on 18 September. It is worth making the point that this Queen’s Speech and Westminster governance—the choices that the Government have introduced—can and should be seen through that prism. There are 100 days left before people in Scotland are able to determine whether we should become a normal country making all the normal decisions that successful democracies make.

Today, we have been encouraged to speak about health, so I was pleased to find a recent international health watchdog report issued only a few days ago in Canada, which said:

“Imagine a land where a patients’ charter of rights and responsibilities is in place that includes wait-time guarantees; over 90% of patients requiring elective care are treated within 18 weeks from referral by a family physician to start of treatment/procedure including all diagnostic testing and specialist consultations. Over 98% of in-patient procedures and day-surgery cases are treated within 12 weeks of agreement to treat. Over 90% of patients are seen within four hours in the emergency department (i.e., admitted, transferred or discharged). Citizens can access the most appropriate member of their primary care team within 48 hours. Up-to-date statistics and reports on wait times and health system performance indicators are publicly available. In addition to providing timely access, this land has been successful in improving other dimensions of quality of care (e.g., significantly reducing levels of hospital acquired infections, reducing the level of inappropriate care), and performance in all of these dimensions is being tracked through the measurement and reporting of performance targets available for use by patients, providers and system managers alike. Fortunately, this land already exists—Scotland.”

That report was issued only a few days ago by the physicians watchdog in Canada.

I pay tribute, as did the Health Secretary, to the work of health professionals, who make a tremendous difference to people in the NHS system in England and, no doubt, to the NHS system in Wales and Northern Ireland. I pay tribute to all of them, and in particular to those who work in NHS Scotland. I am proud of the difference that the Scottish National party Government have made since taking power in 2007. Staffing has increased under the SNP by more than 6.7%.

Tom Blenkinsop: Will the hon. Gentleman give way?

9 Jun 2014 : Column 330

Angus Robertson: I have very little time, and I would like to make progress. The Government in Scotland have protected the front-line NHS budget—Labour said that they would not—and there is high patient satisfaction in the NHS. Obviously, there is always much to do, but 87% of people are fairly or very satisfied with local health services, which is an increase of 7%. We have seen the abolition of prescription charges in Scotland, which is extremely welcome. Prescriptions still need to be paid for in England, and I encourage the UK Government to consider following the example of the Scottish Government. A Scottish patient on a low income saves £7.85 per prescription, compared with a similar patient in England, and people with long-term conditions save £104 per annum compared with a patient in England, where there is provision for a pre-payment certificate.

Free prescriptions are not the only advantage. Free personal care, which was championed by the former Labour First Minister in Scotland, Henry McLeish, has been introduced, and there is pride across the political spectrum in Scotland about that. Free personal care for the elderly improves the lives of over 77,000 older vulnerable people in Scotland, where personal care is free for people over 65 who need it. That kind of service would be beneficial for the kind of constituents about whom the hon. Member for Burnley talked so movingly. Of course, patients in England are not entitled to free personal care.

Those are examples of better decision making and better outcomes, because in Scotland we have the ability in our Parliament and through our Government to pursue the policies that we wish to pursue, as opposed to those that are pursued by Governments whom we have not elected, such as those pursuing privatisation in the NHS in England. There is a concern about protecting budgets in Scotland against further cuts from Westminster and the austerity agenda that it is driving, which is why people are now talking about full financial responsibility. I looked closely at the Queen’s Speech to see how that might take place: all three UK parties have now said that they wish to see the transfer of further powers, notwithstanding the fact that only a few years ago there was a line in the sand. There were to be no more transfers but, lo and behold, when the SNP won with an absolute majority and a referendum was in sight, suddenly everyone was in favour of more powers. However, there were no specific proposals in the Queen’s Speech—reinforcement of the reality, if anyone needed it, that to have the powers to make a difference in people’s lives and build on the successes of devolution, we have to vote yes.

I would wish the Queen’s Speech to include a series of measures that were not included: building and enlarging free child care; abolishing the bedroom tax; halting the further roll-out of universal credit and personal independence payments to create a fairer welfare system; simplification of the tax system to reduce compliance costs; negotiation of the removal of Trident nuclear weapons from Scotland; protecting the value of the state pension and putting more money into the pockets of pensioners; supporting enterprise in the economy by increasing personal tax allowances; making sure that the minimum wage increases at least in line with inflation; the creation of an oil fund so that we do not see the wasting of that natural resource, which can be there for future generations; and negotiating directly with the European Union to get a better deal for farmers and

9 Jun 2014 : Column 331

fishing communities. The list goes on. Those are all measures that could have been in a Queen’s Speech in Scotland if Scotland were in charge of all the normal powers that normal democracies are in charge of.

This Queen’s Speech was totally empty of any of those proposals—proposals popular with the electorate in Scotland, proposals that can be brought forward if we use the power that is in our hands on 18 September. Between 7 am and 10 pm on that day the people of Scotland will have the power of Scotland in their hands. The simple choice for them will be whether we keep it or hand it back. I will be voting yes and I believe the majority of people in Scotland will do so too.

7.20 pm

Dr Phillip Lee (Bracknell) (Con): I shall take this opportunity in what is nominally the health debate on the Queen’s Speech to speak more broadly about the national health service. I welcome the fact that there is not much in the Queen’s Speech on health policy, because what we have done already under this Government needs to bed down.

I have always tried to build cross-party consensus in the Chamber. At no point have I sought to make any party political points in relation to health care, primarily because, as a clinician who still practises in the health service and who has an extensive network of friends from medical school who are all approaching consultancy, I have been aware of the challenges that the NHS faces and have therefore always believed that there needs to be an understanding across the Benches for us to find the appropriate solutions.

We need to get a grip of the NHS challenges that we face. Significant changes are afoot in our society—changes in attitude and behaviour, and patients’ expectations change as each generation passes away. A stoic wartime generation is being replaced by arguably much softer ones. Their experience of pain and their approach to suffering are different, in my clinical experience. Each generation is becoming more and more obese. As I have already said, the society we live in is ageing. There have been some poignant contributions to this debate. That is fine and I share the concerns, but let us not kid ourselves: more than 20% of the population is now aged over 60. The proportion of people paying tax compared with the proportion of people who have retired is diminishing. We cannot lose sight of that reality, and we need to recognise that change is inevitable.

There are some welcome advances in medicine—in drugs, technology and the application of that technology to the care of patients—but these have invariably been expensive. The National Institute for Health and Care Excellence does a pretty good job of the cost-benefit analysis, but we are now saying no to drugs that enhance people’s lives. We need to reflect on that.

The NHS was introduced in 1948 by Nye Bevan, who represented a constituency that I sought and, funnily enough, failed to take in 2005. At that time, the budget was £437 million, the equivalent of £9 billion in current money. We are approaching or may have touched above £110 billion per year. He said that there would be an initial expense when he introduced the service and that costs would then fall as the population became healthier. I am sorry—Mr Bevan might have been right to introduce

9 Jun 2014 : Column 332

the service, but he was wrong in thinking that the costs of that service would diminish with time. Clearly, they have not.

What is there to do? I would say there are four things. First, we need to find a way of reducing demand on the services. This morning I attended an induction as I am about to start working at an urgent care centre in my constituency. It was striking to note who was coming through the door. The demand is great and it is growing, and we need to deal with it.

Secondly, we must improve the physical structures in the system. Our hospitals are 19th and 20th-century buildings and we are trying, and at times failing, to deliver 21st-century care in those environments. We need to improve them and to do it fast. In order to secure an appropriate plan for our nation, I suggest that we need some sort of cross-party committee and cross-party understanding of where those acute hospitals will be in the future. We will have fewer of them, but we will have more community-based hospitals delivering chronic care. Let us not forget that over 80% of the NHS budget is now spent on chronic care. We need to make sure that that care is delivered closer to patients’ homes.

In the future we will have telemedicine, which will deliver care in patients’ homes. This is the reality. It is already being piloted in Scotland, with some very good outcomes.

Angus Robertson indicated assent.

Dr Lee: We need to recognise that, but with that will come changes in hospital infrastructure and, yes, extremely difficult politics. We have heard about the difficult politics in south-west London, west London and elsewhere. That will be replicated irrespective of who wins next year’s election. The problem is here and now and we need to deal with it. All parties should put skin in the game and make a decision on where those hospitals should be.

The third element is funding. This is the most emotive topic to discuss. Colleagues on the Labour Benches have proposed co-payments. From those on the Government Benches, there have been suggestions of health accounts and supplementary insurance schemes. There is a plethora of ways of funding health care—one only has to look abroad. In Norway people pay to see their GP; in Denmark they pay for their drugs at cost; in Germany there are supplementary insurance schemes; in France there are means tests, and the list goes on.

I have not 100% decided what I think would be the right thing in future in this country, but the debate is needed. I cannot see how we can go above 10% of GDP on health care spending and balance the books across the whole of Government. Perhaps there are people who think we should spend north of 10% on that—fine—and approaching almost 20% on welfare if we include pensions. We are approaching £1 billion a day expenditure on these two areas. I do not think that is sustainable, but I know that if it is to change we need a cross-party debate on the matter. It is not easy.

Finally, the political cycle does not help. We have heard how it helped the hon. Member for Burnley (Gordon Birtwistle) get elected at the last election, and I am sure this will be replicated on both sides of the House in future. There is no avoiding it. I have walked the walk in my constituency: I stood at the last election calling for the closure of my local hospital, because I

9 Jun 2014 : Column 333

know that if we consolidate services in my region, we get better outcomes. People live who otherwise would not live. People suffer less. I did not think it was appropriate for a clinician who had worked in the region in which he was seeking to represent a constituency to say otherwise. I thought it appropriate that I stood on that. I continue to stand on it and I continue to stand for the consolidation of acute services in my region and for chronic care to be offered locally to people.

In conclusion, this country is very privileged to inherit a health care system that is pretty good. It is approaching first class by global standards, but it is a legacy that we must protect. Our grandparents have given it to us and we need to protect it in future, which means that we need to be open-minded about the changes required. I think the solutions will come from more than one political party and more than one expert group, but the time is now and we all need to work together.

7.28 pm

Ms Karen Buck (Westminster North) (Lab): It is often in the specific and the particular that we understand how public policy is most effective, far more than in mission statements, PowerPoint presentations and the sub-sections of the legislation that we pass. That is particularly true of the NHS. We have heard two striking examples of that already in the contributions from my right hon. Friend the Member for Cynon Valley (Ann Clwyd) and the hon. Member for Burnley (Gordon Birtwistle) talking about social care. It is also true of the reconfiguration and change in the health service, which I shall address in the few minutes available to me.

In many respects we understand across the piece what changes need to take place, yet we find that so many of the changes that have taken place at a higher level of public policy, particularly those implemented by the Government through the Health and Social Care Act 2012, have made it harder rather than easier to bring about the change that we need to deliver. In London in particular, an exceptionally complex environment, we saw that set out very clearly by the King’s Fund in its report last year, which made it clear that the Government’s reorganisation of the health service, carried out at considerable expense, had made it harder rather than easier to deliver the fundamental changes that we need by fragmenting its structure and undermining its capacity to introduce strategic leadership.

In north-west London, which we have already heard mentioned today, we are facing one of the most fundamental changes in the delivery of health care since the establishment of the national health service. The “Shaping a healthier future” agenda is rooted in a set of principles with which most of us could agree. We want to reduce the number of accident and emergency attendances and, in particular, to reduce the number of accident and emergency admissions when patients can be better cared for elsewhere, particularly within primary and community services, and we want to reduce the length of stay, particularly for elderly patients who would be better and much happier to be cared for with appropriate social care support in their own homes. Those are undeniable facts that are supported by the general principle that in many cases the higher level of acute care is more efficaciously provided in larger and more specialist units. Those things go together and they are worthy objectives.

9 Jun 2014 : Column 334

It is in the detail of the implementation that we have a major problem. NHS England is apparently seeking to have a total of 780,000 fewer patients admitted to A and E over the course of the next two years. The “Shaping a healthier future” agenda translates into a reduction of 15% in the number of A and E admissions to be achieved in north-west London. As the King’s Fund’s health economist John Appleby has said, that is “not realistic or feasible”. The problem is not that it is not desirable or that we do not want to see it achieved over time, but that we are in the middle of a period of rising demand for A and E and the capacity simply is not there, either elsewhere in the acute hospitals sector or in community and primary care services.

Only a few months ago, Imperial College Healthcare NHS Trust, at the heart of the “Shaping a healthier future” agenda, said:

“We are yet to see any impact of primary care and community Quality, Innovation, Productivity and Prevention…schemes and therefore are planning to maintain the level of emergency care we provided”

over the course of this winter. So, a hospital is saying that it cannot rely on the primary and community services being in place to divert people from A and E, yet almost in the same week the Secretary of State’s letter confirmed that the closure of the accident and emergency units at Hammersmith and Charing Cross, as we understand them, will go ahead as soon as possible. We now have a date in September, and his letter stated that

“the process to date has already taken 4 years causing understandable local concern”.

Mr Slaughter: My hon. Friend has written a devastating critique to the new chief executive at Imperial about the fact that Hammersmith A and E in my constituency as well as other A and Es are being closed before there is appropriate provision to replace them. I would not hold my breath for a reply if I were her. I am still waiting for one to the letter I wrote to the clinical commissioning group on 26 April on the same subject of failure to provide primary care.

Ms Buck: I am grateful to my hon. Friend, who reinforces my exact point.

Since the Secretary of State’s letter and the decision to proceed with the Hammersmith and Charing Cross closures, it has been reported in the Evening Standard that Imperial is having to use winter pressure beds routinely to cope with patients displaced by the planned A and E closures, admitting that there are “risks” of over-crowding, and warning that ill patients will have to spend longer in ambulances. This is a demand for winter pressure beds in the middle of the summer. The expectation is therefore that there is already insufficient capacity years before the construction of a planned new and improved A and E unit at Imperial hospital. The closures are going ahead and Imperial clearly cannot cope. An Imperial official said:

“We have extra acute beds at St Mary’s Hospital, normally used during the busy winter period to ensure we can quickly admit those patients”

in need. That is fine, but what will happen if and when we have a winter crisis or simply during the additional winter pressures? That capacity will not be available to help deal with them.

9 Jun 2014 : Column 335

None of this is meant to suggest that there are not fine people in clinical and managerial practice focusing their attention on ensuring that services are in place to assist with that transition, but the scale of the challenge appears to be beyond what can be achieved realistically within the timetable. In the middle of all this—and no doubt connected to it—there came halfway through the year a letter from the west London clinical commissioning groups announcing that they have

“made an important decision to put funding into a central budget…£139 million…which means CCGs with a surplus will be supporting those with a deficit…We also agreed to explore how to bring together commissioning of primary care services across organisational boundaries”.

That seems to me to be perilously close to the end of clinical commissioning groups as far as we understand them. My understanding was that clinical commissioning groups were designed to be rooted in their local communities, to work in effective local partnerships and to reflect the local service providers, particularly primary care service providers and patients, at a local level. That has all gone with the wind in west London and I am extremely worried about it.

I am all the more worried because the whole transition programme is predicated on the delivery of improved social care, and it is social care with which we are now struggling to cope. In my local authority area, 1,000 fewer residents are getting social care than in 2010, and there will be a further £2.9 million cut this year. It is no surprise that the chief financial officer at Imperial trust, Bill Shields, has said:

“The cynic in me says”

that the proposal to take money away from the national health service to fund social care

“is a way of taking money from the NHS and passing it on to the local authority…this will allow them to make good the cliff edge they have been through in the last few years and rebuild the local government public finances.”

It would also mean

“a significant real-terms reduction in NHS income…going forward”.

Mr Slaughter: My hon. Friend makes a point about this panicked attempt to find more money in the primary care budgets and slosh it around west London at any consultation, and that is exactly the issue on which I am still waiting for an answer. This is chaos in the health service and is a reaction to closure programmes that have been carried out on financial grounds and that have now reduced the health service in west London to a chaotic and dangerous state.

Ms Buck: It is extremely worrying because the whole thing is shrouded in a lack of transparency and a lack of effective communication about what is going on. The local authority is cutting its own social care funding and needs money to fill its black hole, whereas the trust at Imperial says that that is exactly what it is worried about. It says it is concerned about the transfer of money because that might not give it the increased local community services that would allow it to reduce emergency A and E admissions, which is what we want. In fact, those things are so far from being effectively integrated in a common purpose that the different sectors of the health service appear to be at war with each other financially, if not in any other way.

9 Jun 2014 : Column 336

The problem is that the fragmentation and delay caused by the reorganisation in the national health service since 2010 have undermined what should have been a sensible method of progressing and building up community services to reduce the pressure on the acute sector. Meanwhile, today and in the coming weeks my constituents will find that their hospital is at capacity but is expected to deal with the extra demand from the Hammersmith and Charing Cross accident and emergency closures, whereas the constituents of my hon. Friend the Member for Hammersmith (Mr Slaughter) face the loss of their accident and emergency units without any appropriate provision. It is a shambles, I am extremely concerned, and I hope it is not too late to ensure that we can put something in place to prevent a true winter crisis this winter that would be of the Government’s own making.

7.39 pm

David T. C. Davies (Monmouth) (Con): Living in and representing a constituency on the border has given me a unique insight into the different systems that have now grown up in the NHS in Wales and the NHS in England. One thing has become absolutely clear—not just to me but to any independent organisation that has looked into this—and it is that the standards of care being delivered by this coalition Government are far higher in England than they are in Wales, where the NHS is run by members of the Labour party.

The reality is that, judged on virtually any single indicator that one would care to look at, standards of treatment are better in England than they are in Wales. The waiting times for cancer have not been met in Wales since 2008; the four-hour accident and emergency target has not been met in Wales since 2009; the ambulance response times targets have not been met in Wales for 21 months; and in Wales the funding for the NHS from Labour, which claims to be the party of the NHS, has been cut by 8% while NHS funding has been ring-fenced in England.

That has led to all sorts of situations. For example, an Opposition Member talked earlier about cancer in England. In England, of those people being diagnosed with cancer less than 2% have to wait longer than six weeks for their diagnosis, while in Wales 42% of people being diagnosed with cancer have to wait longer than six weeks to receive a diagnosis. The treatment times are also different; in Wales, people wait around 26 weeks, whereas in England the wait is just 16 weeks.

Behind these dreadful statistics are a range of human stories. I was grateful to the Secretary of State for Health for allowing me to meet him with a constituent of mine, Mariana Robinson. She had been trying unsuccessfully to get treated in Wales for months and there was absolutely no interest in helping her. She wanted to be treated in England; she was one of many people who would rather be treated by this coalition Government in England than by the NHS in Wales. Finally, after a great deal of correspondence and after receiving advice from the Secretary of State in London, the NHS in Wales has finally relented in this instance, and Mariana will now be treated in Bristol. I am grateful to the Secretary of State for his help.

Even this afternoon, while I was waiting to speak, I had yet two more e-mails from people who are totally dissatisfied with the treatment they are receiving in

9 Jun 2014 : Column 337

Wales at the moment and who would be prefer to be treated in England. I was contacted by an 88-year-old veteran who had served in the Korean war in the Fleet Air Arm of the Royal Navy. He is in constant pain at the moment and unable to sleep because of a problem with wisdom teeth. He has been told that he will have to wait nine months for treatment in Wales. I do not believe that such a thing would be allowed to happen in England, but he has been told that he cannot seek any treatment in England; he has no right to transfer his health care to a place where it can be provided more efficiently.

Labour Members talked about the privatisation of the NHS. The Conservative party will never privatise the NHS; we have always believed that treatment should be free at the point of service. It is members of Labour in Wales who are responsible for supporting private health care, because they are putting patients in Wales in a situation where the only chance they have of being treated is to go and seek private health care. The 88-year-old veteran of the Korean war was told that if he wanted to have something done about the constant pain he is suffering, he would have to go private.

I was also contacted today by a lady, the retired head teacher of a school in my constituency, who found a lump in her breast. She expected to be seen by someone almost immediately, as she would have been in England, but she was told that the first appointment she will have will be some time in late August.

That is the reality of what is happening in Wales under a Labour-run NHS, and the Leader of the Opposition has said that we should “take lessons”—this is to quote him—from how the NHS is being run in Wales and try to implement them in England. My message today is to warn everyone, particularly Government Members, not to let these people be in charge of the NHS, because what we will end up with in England is longer waiting lists, slower ambulance response times, people not being diagnosed properly and no cancer drugs. Apparently, 150 people in Wales have died while waiting for heart treatment. It is an absolutely disgraceful situation.

I have talked to Government Members about a suggestion that I made in relation to the Government of Wales Bill, which is to let these people put their money where their mouth is. If they think they are doing a good job with the NHS in Wales, they should allow patients in Wales and England to opt to go wherever they want to for treatment. At the moment, we have two totally separate NHS systems, so patients in Wales do not have the right to access treatment in England and, of course, patients in England could not go to Wales. A lot of patients in Wales want to be treated in England. I do not believe there are any patients in England who would want to be treated by the Labour-run NHS, but perhaps there are some out there who fancy waiting longer to be diagnosed and then waiting longer again to get the treatment that they have a right to expect.

Let us see Opposition Members supporting a change to legislation that would allow patients in England to be treated in Wales, with the money required being added to the block grant given by the Government to the Welsh Assembly every year, and patients in Wales who want to be treated in England having the right to access that treatment in England, with the money required being deducted from the block grant that is handed over to the Labour party in Wales every single year. And let

9 Jun 2014 : Column 338

us see the direction of movement, because I know that an enormous number of people will immediately opt for the lower waiting times, the better diagnosis and the wider access to drugs that are available to people in England.

Geraint Davies: Does the hon. Gentleman accept that there are only 3 million people in Wales, and that when we compare Wales with a lot of the English regions and hospitals we do just as well? In London, we obviously have international centres of excellence. In Wales, we spend more cash per head. There is a sparser population and more nurses per 1,000 people, and we have better results on cancer than elsewhere, so there is a mixed picture. He is being completely political and undermining the morale of people working in the health service in his constituency; it is disgraceful.

David T. C. Davies: It is not a mixed picture at all and we should be very clear about that. People wait longer for treatment in Wales than they do in England. People wait longer to be diagnosed in Wales than they do in England. People wait longer for an ambulance in Wales than they do in England. Money for the NHS is being cut in Wales and it is being ring-fenced in England, because the NHS will be a priority.

The real disgrace is that Labour Members have always prided themselves on being the party of the NHS and have gone out of their way to do so. Because they have that reputation, they know that in Wales, and possibly in England too if they ever end up running things, they can get away with making cuts and with cosying up to the unions because they feel that people will trust them.

I say to anyone independent and impartial who wants to know what it would be like for NHS patients if Labour Members ever get into government, they should look at what is happening in Wales right now.

Andrew Gwynne rose—

David T. C. Davies: I will give way to the hon. Gentleman even though he did not extend that courtesy to me or to anyone else from Wales.

Andrew Gwynne: Of course, people only needed to see the NHS at its highest satisfaction levels in 2010 to know what Labour in Westminster would do. I will correct the record on cancer waits, because of course Wales has a better record on cancer waits than England does: 92% of people in Wales are seen within 62 days, as opposed to 86% of people on this side of Offa’s Dyke.

David T. C. Davies: That is a fairly minor difference—[Interruption.] Oh yes. However, what the hon. Gentleman has forgotten to say, of course, is that those people in Wales will have waited far longer for the diagnosis of cancer than people in England. That is why he is not being entirely straight in putting his facts across. When he is winding up, I challenge him to say whether he thinks what is going on in Wales at the moment is good and something that Labour Members would like to aim for. Is what is going on in Wales what they aspire to?

I urge anyone in the Opposition to look at The Guardian, which recently did an exposé of the NHS systems around the UK and showed that people in Wales have the longest waiting times of anyone in the

9 Jun 2014 : Column 339

United Kingdom, and that is the vision for the NHS that Labour Members want to impose on the people of England. I advise people in England to look at the figures before they decide to vote for Labour Members.

I ask the hon. Member for Denton and Reddish (Andrew Gwynne) if he would be prepared to allow patients in Wales to be treated in England, and patients in England to be treated in Wales if they wish to do so. I doubt very much whether he would support such a thing.

Andrew Gwynne: I am grateful to the hon. Gentleman for giving way again. He is obviously not aware that the number of English patients being treated in Welsh hospitals has increased by 10% since 2010.

David T. C. Davies: I am well aware of that, but the hon. Gentleman might not be aware that those patients have no choice. [Interruption.] He is laughing, but he does not understand how the system works. There are many patients on the English side of the border who are treated in Wales, but they have no choice about that. They have set up a pressure group, Action for our Health—he can look it up on one of his smart phones—because they are so disgusted with the service that they are getting in Wales that they want to be treated in England. The point is that they do not have a choice, and I believe that they should. Those English patients are very angry about the fact that they are treated in Wales and not given the choice.

When the Secretary of State was talking about some of the things that have gone wrong in the NHS, I heard an Opposition Member shout, “He hates the NHS.” My right hon. Friend does not hate the NHS, but he does believe in putting patient choice and patient voice first. He believes in standing up for patients against vested interests, wherever they may be. I fully support him in that and commend him for what he has done. My only criticism of Ministers in this Government is that they have improved services in England so much that I have an enormous mailbag of letters from people who want to access the services that they have put on offer. If anyone wants to find out what would happen if Labour ran the NHS in England, they should look at the facts and figures for Wales.

7.50 pm

Barbara Keeley (Worsley and Eccles South) (Lab): As this is carers week, I want to talk first about the impact that legislation and financial policy have on the one in eight people who are unpaid carers. We know that being a carer can have a significant impact on a person’s finances, career, relationships and, of course, health. Full-time carers are more than twice as likely as non-carers to have poor health, but sadly the pressure on them is increasing. Surveys last year told us that six out of 10 carers reported suffering depression, and nine out of 10 felt more stressed due to their caring role.

Since 2010, local government budget cuts have led to funding on adult social care falling rapidly. By this March, local authority spending on adult social care had fallen by £2.68 billion in four years—a 20% fall. Those Government Members who have talked about funding today have nothing to be proud of when they

9 Jun 2014 : Column 340

reflect on that. Nine out of 10 local authorities now set their eligibility for social care at “substantial needs” or higher, compared with less than half of that in local authorities in 2005-6. Therefore, fewer people are receiving publicly funded care—300,000 fewer since 2008. Of course more of the care work load therefore falls on unpaid family carers, who in turn report suffering more stress and depression.

Carers UK reports that the ever-increasing need for care and support in our ageing population will outstrip the number of family members able and willing to provide it. A carers week survey found that fewer than three in 10 people believe that they will become carers, but about six in 10 of them will have caring responsibilities at some time in their lives. Between the last two censuses, the number of over-65s providing care grew by 35%. Among carers aged 60 to 64, 54% of men and 36% of women who were caring were also in paid work. Therefore, the pressures on men and women juggling work with caring have intensified.

Carers UK has found that one in five carers surveyed have had to give up work because either they were unable to secure flexible hours or their employer lacked understanding of their caring work load. Many carers then build up significant debts and have to cut down on basic expenditure, even on heating and food, to manage. This afternoon, I met a couple of carers at a speed networking event downstairs who told me exactly that. They had had to give up their jobs to care.

Dr Jamie Wilson, a dementia physician, has said that

“the financial welfare of carers should form part of a holistic assessment of needs. The combined effects of loss of income, additional costs of care and declining state benefits have led to an increasing impact on the resilience of carers and their ability to maintain the health of their loved ones.”

The Care Act 2014 represents a wasted opportunity, because it places on local authorities a duty to assess a carer’s support needs, but it places no similar duty on the NHS. The Act makes it clear that a local authority can charge for the support provided to carers. I feel that the Government are failing carers in two ways. Giving carers new rights to assessment is meaningless when the support available is dwindling as a result of higher eligibility criteria and increased charges. A right to a local authority assessment is of little help to carers who have no contact with their local authority.

At the meeting downstairs, I spoke with a carer called Caroline, who had come in with Macmillan Cancer Support. She has a multiple caring work load but has never been referred by her GP, or by any doctor she had ever met, to any sources of support. She only found Macmillan Cancer Support through a website. That is why identifying carers is so important. Macmillan’s survey of over 2,000 carers found that over 70% came into contact with health professionals during their caring journey, yet health professionals identify only one in 10 carers, with GPs identifying less than that. We cannot be smug or self-satisfied about that situation.

The need for NHS bodies to identify carers and ensure that they are referred to sources of advice and support was raised at all stages of debate on the Care Bill in the Commons, but the Government did not accept amendments on the issue, so now we will need further legislation. Another weakness of the Act is that it restated the option for local authorities to charge carers for services. Carers’ organisations have repeatedly

9 Jun 2014 : Column 341

asked the Government to make it clear once and for all that local authorities should not charge carers for the support they receive. However, Ministers did not consider it appropriate for the Act to remove that discretion, which I think is a shame. The Government are failing carers in a number of ways, as I have outlined. This carers week, it is time to show carers that we do value their caring.

Let me touch briefly on a further aspect of health policy that relates to the attitude of NHS staff towards patients, as highlighted in the Francis report. An important source of improvement in that area is the social media campaign #hellomynameis, run by Dr Kate Granger. The campaign started 10 months ago, after Dr Granger’s admission to hospital, when she noticed that many health professionals did not introduce themselves when treating her. She spoke movingly at the NHS Confederation conference last week on the importance for patients and their care of getting the small things right. She pointed out that, in patient relationships, health professionals have most of the power, but they can make things more equal if they introduce themselves and explain what they are doing. She also explained the impact on her when doctors and nurses described her only as “Bed 7” or “the girl with DSRCT”—a rare cancer. As she rightly says, health professionals should always try to find out the patient’s name and how they like to be addressed.

The #hellomynameis campaign has had great success on social media, but it deserves much wider backing. With 1.6 million people working for the NHS, we need to spread the message about the importance of treating patients as people. It should become routine for health professionals to think about a more courteous and human connection with their patients. I hope that shadow Health Ministers and Health Ministers will do all they can to support the campaign.

Finally, in the short time remaining, I want to refer to my concern about issues caused for my constituents by measures in the Infrastructure Bill to allow fracking or shale gas exploration under properties without permission or appropriate compensation. The measure will have negative consequences for people with homes, farms or businesses adjacent to shale gas wells. We have had an exploratory shale gas well at Barton Moss in my constituency since November 2013. I have heard from businesses adjacent to the site that are losing money as a result and from constituents who have been trying to move but are finding it impossible to sell their homes. I have to tell the Minister that the offer of a £20,000 community payment seems paltry by comparison with the losses that my constituents have already suffered, even during the six-month exploration. The Government seem more concerned about a rush for shale gas than about the communities affected by the industrialisation of land caused by this process. We must have more caution and more consideration for our communities.

I will end with a story that explains the difference between the NHS in 1997 and 2010. In the run-up to the 1997 general election, I met someone in Wythenshawe and Sale East who had been waiting two years for cardiac surgery and was worried that he would die while waiting. In 2010, in my constituency, I met someone who within one week went to his GP, was diagnosed and had specialist cancer surgery that saved his life. That is the difference a Labour Government did make and could make again.

9 Jun 2014 : Column 342

Several hon. Members rose—

Madam Deputy Speaker (Dawn Primarolo): Order. I regret to inform the House that more Members wish to speak than time allows under the current time limit. Therefore, to ensure that everybody gets in, I must now reduce the time limit to seven minutes. Even that is really tight, so Members might like to be sparing with their interventions, so that they do not slow us down.

7.59 pm

Anne Marie Morris (Newton Abbot) (Con): The Gracious Speech was an extremely fine speech, but I would have liked more work on the care agenda. The Care Act 2014 made a very good start, but there is more to be done. This concerns me particularly because Devon has the highest number of over-65s in the country, and my constituency has a very large chunk of that population.

By 2035, 25% of the population will be over 65, 620,000 will be in care homes, 50% will have a sight impediment, and 75% will have a hearing impediment. Today, one in five over-80s has dementia, and that figure is set to double within the next 30 years. The demand is not going to diminish, while the supply is a real challenge for our society as a whole. Seventy-five per cent. of current need is met informally through the voluntary sector and by families. We must give thanks for that, but we then need to think about the financial contribution from the state. The NHS budget, which is now 8.4% of GDP, is in absolutely the right place—that is exactly what we should be spending given the current state of our finances—but the social care budget is decreasing and has decreased by 10% in real terms since 2010, if Age UK’s figures are correct. The reason is cuts in council funding. In my rural constituency, council budgets have been seriously hit, and I see the consequences day in, day out. Day centres in Devon are facing closure and support for supported living is being ripped out. This is a matter of great concern that must be addressed quickly.

I welcome the 2015-16 better care fund of £3.8 billion, but will it be enough and will it be too late? Age UK says that £3.41 billion more is required if we are really to meet the need. I am a great believer that we do not solve everybody’s problems through money, so we must look at what we need to do. There is nothing more important than health and dignity in the ageing population. We need to look at what we, in a civilised society, believe good care should look like. We need a proper debate about who pays. Is it the individual, their family, or the taxpayer? We need to look at who delivers it. Is it the family, the voluntary sector, or the state? Clearly, it must be all those.

The Care Act made a good start. It provided uniformity in the funding structure, consolidated the assessment process, capped costs, recognised carers and the need for support, put a duty on local authorities for care and well-being of our older population, introduced safeguarding adult boards and the star rating system—very good steps forward—and recognised that prevention is better than cure. In some ways, however, it was a missed opportunity. The commissioning process that decides what is ultimately purchased is not overseen. We still have a postcode lottery against which people’s only recourse is an individual appeal. We still have a conflict of interest in that our councils can commission and

9 Jun 2014 : Column 343

provide care, as many do. That has to change. On quality, star ratings are a good move. Let us remember that this is about relativity, not absolute quality. What are we paying for—brass or platinum? There is, as yet, no reassurance that wherever anybody lives they will get the fair share of care that they deserve.

Staffing issues were not addressed. Best practice as regards staff and patient numbers is a ratio of 1:5, but the reality is more likely to be 1:7 given the budgetary constraints. No thought was given to trying to deal with some of the training concerns. Skills for Care is a voluntary programme. If we are going to make something really work, there has to be some stick and some carrot. I am pleased that we have a studio school in Torquay that meets some of the training needs and that the University of Surrey will introduce a proper foundation degree in 2015, but more is needed.

Integration could have been addressed. This is not just about money; it is also about health and wellbeing boards. The King’s Fund suggested that there should be a requirement that providers are engaged in health and wellbeing boards. At the moment, only 30% are so engaged, and that needs to change. I am very pleased that in Newton Abbot we have a pilot on the frail and elderly that deals specifically with integration.

There has been a missed opportunity for change, and change must come soon. We need to think about how to fund smartly. How can we increase the amount available to councils? After all, prevention is better than cure; otherwise A and Es and the NHS pay the price. How can we better support families to care for their elderly as we help them to care for their children? What can we possibly do in terms of time, flexibility and tax support? How can we support the voluntary sector? There is not an inexhaustible supply of volunteers, and they are fed up with the form filling that makes their lives burdensome. How can we reduce the capital burdens that councils face when having to deal with providing care? The capital cost of the homes and day centres is driving the closures. Let us work with social enterprise, housing associations and others to look for a better model.

Let us improve quality and remove the postcode lottery. Let us, as we can under the Care Act, ask the Care Quality Commission to review the whole commissioning process. Let us look at what is provided by our county councils, what value for money we get, and whether it is the same across the country. What are we paying for? Are we finding that people in one county are getting bronze and those in another, where more money is allocated, are getting platinum? That cannot be right. Let us look, once and for all, at splitting purchasers from providers as we have in the NHS. Let us get rid of the potential bias that exists in this regard. Let us review the make-up of health and wellbeing boards and make sure that providers serve on them.

Without proper resource, and that means people, we cannot get this right. We need to ensure that more nurses are trained and that they get the respect and the pay that makes them want to work in social care as much as they want to work in the NHS. Let us produce a proper career path that drives respect and reduces the fear they live in that they are going to be criticised for trying to do their best in an impossible situation. Let us enforce the best practice ratio of 1:5. Let us look at how we are going to fill the gap whereby unless one gets to a

9 Jun 2014 : Column 344

level of substantial need one will not be funded by the state. There is so much to be done and so little time. This has to be a priority for Government this year.

8.6 pm

Hywel Williams (Arfon) (PC): As a Plaid Cymru MP, it is something of a problem to respond to the Queen’s Speech on health matters, not only because it contained little about health in the first place but because health is largely devolved. Some time ago, when Alan Milburn was Health Secretary, I asked him about nurses’ pay, and he responded that he was eternally glad that he had no responsibility for things Welsh. He was wrong at the time, but now nurses’ pay is devolved. That is the measure of the problem that I face.

On the whole, the content of the Queen’s Speech was rather thin, with little attention given to the growing challenges we face of rising inequality, regional disparities, and an economic recovery that is built on fairly precarious foundations. The impacts and consequences for Wales are fairly obvious because of our higher rates of sickness and disability, higher proportion of older people, and greater needs in respect of poverty. Hon. Members may have seen today’s report on child poverty, which paints an alarming picture and casts doubt on the Government’s ability to reach the 2020 target of eradicating it. I think that that is now beyond reach, unfortunately.

Given the nature of the Queen’s Speech, I fear that the coming year will be a matter of treading water. For Wales, we have the continuation of the Wales Bill, but we also have missed opportunities. There are matters of particular concern to Wales, not least the funding of the Welsh Government. I also fear that we will see further dismantling of the principles of the welfare state, dismantling of public services, and a failure to address the deep structural economic weaknesses that we have, with a recovery that is driven by an increase in personal debt and spiralling house prices in the south-east and in London, and continues, I am afraid, the UK’s long-term imbalance that has devastated the economy in Wales, in parts of England, and indeed in Scotland.

Plaid Cymru put forward an alternative Queen’s Speech with Bills that we would have liked to be included. The Bills have principles central to Plaid Cymru’s vision for Wales, which is built on equality, prosperity for all, and social justice. We have 10 ambitious and workable Bills founded on strengthening Wales’ economic position and its position in terms of democracy, and on improving the lives of our people, not least in respect of health outcomes.

When the pension tax Bill is before the House, we will call for proper consumer protection for people who will have large pots of money at their disposal, as the sharks are already circling. We are extremely glad that the Government are introducing the modern slavery Bill. We also welcome the legislation to strengthen the law in relation to child neglect and organised crime.

We particularly welcome the Bill to strengthen the complaints procedures for the armed forces. We have campaigned for a very long time on veterans’ issues, particularly post-traumatic stress disorder. We support the proposed measure and hope it will prevent ex-service people from suffering mental distress and psychiatric conditions, which have resulted in so many of them ending up in the prison system.

9 Jun 2014 : Column 345

Other Bills are appealing at first glance. A case in point is the heroism Bill, which seems likely to garner good headlines in certain sections of the press, but I share the TUC’s fear that it will have a bad effect on health and safety legislation and working conditions in particularly dangerous industries.

Turning briefly to our own propositions, we would have liked an economic fairness Bill aimed at levelling up the growing wealth inequalities that exist on both an individual and geographical basis in the UK, which is the most unequal state in the European Union. Such a Bill would mirror that part of the German constitution that commits to regional equalisation and prioritises poorer areas for infrastructure and foreign direct investment.

We would also have liked a Bill to ensure that Wales is fairly funded on the basis of need. It is a long-standing complaint that Wales is underfunded to the tune of £300 million to £400 million, as identified by the independent Holtham commission. Every year, Wales loses that amount of money. The cumulative total has had a clear, bad effect on our economy and it is an ongoing injustice. More than that, it actually constrains the Welsh Government and what they can achieve, forcing them to choose between essential spending on health, education, economic development and many other desirable targets of expenditure. The effects of underfunding are seen throughout Wales, not least in our health service, but on this issue the coalition Government in London are deeply compromised as they chastise the Welsh Government for their undoubted failings in health, while at the same time denying them the resources and means to address those failings.

We were greatly disappointed, though perhaps not surprised, that the Government botched the chance to end zero-hours contracts, particularly in the care sector. We would have liked an employment rights Bill to adopt measures to protect and empower workers.

I will catalogue the other measures we would have liked to see, including a natural resources Bill transferring responsibility for all of Wales’s natural resources from the Crown Estate and Westminster to Wales. We would also have liked more direct support for the tourism and hospitality industry and, lastly, a Welsh-language provision Bill to strengthen the requirements to provide services in Welsh, particularly by private organisations working without Wales into Wales. In respect of this debate, I point specifically to private organisations providing health care in England.

8.13 pm

James Duddridge (Rochford and Southend East) (Con): Sometimes we in Westminster get obsessed with the minutiae and detail of Bills and Committees, but our constituents do not have the same obsessions. As the Institute of Directors has argued, it is better to focus on a small number of Bills. A Volkswagen car salesman gets obsessed with the latest VW model, but the general public just appreciate better, cheaper cars. An engineer gets obsessed with a new widget, but the general public just want the machines to work. Our constituents do not get obsessed with Bills, how many of them there are, or whether they are nuanced towards the left or right. What they care about is that we get things right—and we are getting things right. One could argue that things are not happening quickly enough, but 1.5 million new

9 Jun 2014 : Column 346

private sector jobs is a darn good start. Is the reduction of the budget deficit by a third enough? No, it is not, but it is a darn good start.

This debate is a little bizarre, in that it is on health, even though health was not in the Queen’s Speech. The people on the doorsteps of Rochford and Southend East have not said to me, “Mr Duddridge, what we need is a new Bill on the health service.” In fact, I would wager that one or two constituents in every constituency would say that we have had far too many Bills on the national health service over the years, including recently. Having set out on this strategic direction in the NHS, it is right that we stick to it, bringing GPs closer to the broader care of individuals and bringing together social services and more traditional NHS care.

The NHS is a great British institution. When I was a teenager I attended religious education classes with a vicar, who asked: “If you didn’t know whether you were going to be born to a rich or a poor country or to a rich or a poor family, whether you were going to be fully able or disabled, or whether you were going to be healthy or suffer from ill health, where would you want to be born?” I say to this House that I would want to be born here in the United Kingdom, and one of the reasons for that is the national health service. When my son and grandparents were ill, they would not have received care anywhere near as good elsewhere. Yes, one or two places might have a slightly flasher health service—at double the cost—with shinier bells and whistles, but when a member of my family was ill I remember being told: “Internationally, the hospital in the States is very good, but the hospital your family member needs is the one they are going to, because it is the best in the world.” I think we are all grateful for that.

My hon. Friend the Member for Bracknell (Dr Lee) made an eloquent speech and he knows far more about the health service than I do, but he seemed to want politicians to coalesce and form a view that one Member’s hospital should close and another’s should be extended. That is part of a responsible debate in the House, but we truly need to trust health professionals. Southend has a particular problem with its stroke unit, which has historically been very good. The Basildon stroke unit started off from a lower base point, but stroke doctors across south Essex tell me that what south Essex needs is a single, hyper-acute stroke unit. We need to trust health professionals across the board.

I was going to make a speech about pensions on Wednesday, but I am making a speech about health today because I am going to meet the chief executive of Southend hospital on Wednesday. Despite health being one of the two ring-fenced areas, there are serious pressures. My hon. Friend talked about changes in pain threshold and people’s demands, but we cannot meet all those expectations. We need to have a balanced national debate about what we can do and the best way to do it.

Turning to other provisions, I welcome the private pensions Bill. If the Whip on duty is listening, I would very much like to serve on the Committee. I cannot imagine that many Members will volunteer and suspect I have already secured my place. More than 12 million people have underfunded pensions. It is a serious issue. The Chancellor has made some useful first moves on annuities, allowing greater choice for people coming out of pensions, but greater clarity is needed for those going into pensions.

9 Jun 2014 : Column 347

Having previously worked in the investment and pensions industry, I know that all too often Government tinkered with the system and layered in cost for people who had only a small amount of money to invest. People often discuss the pensions of those on fat cat salaries, but most people’s pensions amount to managing only thousands or tens of thousands. A clearer, collective instrument that shares risk—greater risk can be taken when shared by a number of people—will be worthwhile.

I am not going to rewrite the Queen’s Speech like the hon. Member for Blyth Valley (Mr Campbell). I am not sure whether he was being real Labour, old Labour or a socialist, but I saw Members on the Opposition Front Bench give him welcome looks when he said that his speech was not Labour party policy. It would in many ways have helped Conservative Members if it had been Labour party policy.

One small change that I would have liked is a help to rent Bill. There are 15 million spare rooms in the United Kingdom. I am not talking about Opposition Members’ incorrect use of the term, but of spare rooms in houses that are owner-occupied and perhaps under mortgage. Not everyone wants to rent out a spare room to somebody, but the spare room relief of £4,250 has not been changed since 1997. Rather as we are doing with council and housing association property, we could release some of the spare rooms in owner-occupied houses by making it more financially advisable to rent out a room. There is nothing wrong in taking in a lodger—

Madam Deputy Speaker (Dawn Primarolo): Order.

8.20 pm

Mike Gapes (Ilford South) (Lab/Co-op): For the first time in my life, I live in a majority Labour council in the borough where I was born. On 22 May, Redbridge—

Chris Ruane (Vale of Clwyd) (Lab): Aptly named.

Mike Gapes: Yes, it is now. That is true.

In a borough established in 1964, for the first time we have 35 Labour councillors, with 25 Conservatives and the Liberal Democrats declining to just three.

I want to highlight an issue that I had hoped the Secretary of State for Health would have been on the Front Bench to hear in person. I do not think that he appreciates its seriousness, given that this leaflet might have changed the result in the ward where it was distributed. The leaflet said:

“Official announcement from the Health Secretary

Whilst calling on residents over the last few weeks it has become clear that the most important issue is the proposed closure of King George Hospital A&E. Lee Scott MP together with the Conservative Councillors have pressured the Health Secretary into clarifying the situation. Please read his statement overleaf. The position is now very clear:

KING GEORGE HOSPITAL IS NOT CLOSING

KING GEORGE A&E IS NOT CLOSING

Ruth Clark, Vanessa Cole, Thane Thaneswaran”.

They were the candidates of the Aldborough ward of Redbridge borough in the Ilford North constituency. On the other side is a statement issued by the Secretary of State for Health.

9 Jun 2014 : Column 348

I heard about the leaflet because the local newspaper, the Ilford Recorder, put on its website a story with the heading, “King George A&E to remain open beyond 2015, says Health Secretary”. That was published on 20 May. Members know the rules about purdah very well. I immediately phoned the Department of Health and asked whether a press statement had been issued by the Secretary of State that day. I was eventually referred to somebody in the press office—it took a little while—who said, “We have made no statements of any kind today.” I said that it had been reported by the Ilford Recorder that there was a statement by the Secretary of State for Health. I had not seen the leaflet at that point, but I got a copy of it later.

The press office said that it would refer me, if I so wished, to somebody in the private office who would call me back. I did not get a call from the private office—I did not really expect one—but I decided to get to the bottom of the matter. I have written to the permanent secretaries in the Cabinet Office and the Department of Health to ask for an inquiry into whether any officials, civil servants or Ministers were involved in the leaflet issued in Redbridge.

I hope that the Minister will convey to the Secretary of State that I give notice that I shall write directly to him after this debate to ask, under freedom of information legislation, for all the information about what contacts, if any, there were between officials, advisers or SpAds—special advisers—in the Department with councillors in Redbridge or anybody else about the publication of the leaflet before the election. As it turned out, Labour won all three seats in Aldborough ward and it was successful in winning control of the council, but it is clear that the leaflet was designed to influence the result of the election.

When I raised this matter in the business statement last week, I was told by the Leader of the House that there “was no announcement”, and that the leaflet was just a restatement of existing policy. When I made a point of order earlier, I could not quite hear what the Secretary of State said, which was why I raised it again. I will have to read tomorrow exactly what he said, but I think that he said that the leaflet was a statement of existing policy. If so, why was a leaflet put out that said:

“KING GEORGE HOSPITAL IS NOT CLOSING”?

Under the existing policy, enunciated on the Government Front Bench in 2011, both the maternity and accident and emergency departments at King George hospital were to close in about two years’ time. Maternity services closed last year. The A and E closure was supposed to be by 2014, and then it slipped to 2015 because of the chaos, the deficit and the fact that the Barking, Havering and Redbridge University Hospitals NHS Trust, covering both Queen’s and King George hospitals, has been put in special measures, and we now have yet another chief executive to add to the litany of chief executives over recent years who were supposed to have solved the problem. It is a shame that the hon. Member for Monmouth (David T. C. Davies) is not in the Chamber, but perhaps he could come to Redbridge to appreciate what services are under a Conservative Government.

The reason the A and E department has not been closed is that it cannot cope with the existing pressures, and it would not be safe to close it. We have a growing population in north-east London, with very large numbers of young people and children, and a large migrant population. There are therefore enormous demands on

9 Jun 2014 : Column 349

services. We have relatively poor GP services—we still have single-handed GPs in some areas—so we cannot expect people to go to a GP. Many people are not registered or are temporary, and they therefore turn up at the hospital. These fundamental and deep-seated problems must be resolved before we can start to take away services. The people of Redbridge understand that, which is why there is a campaign to save our A and E at King George hospital.

I will continue to pursue this issue until I get to bottom of the complicity of someone in the Department in issuing the leaflets that were designed to mislead the public in the few days before the election. I assure the Minister that this will continue until I get the whole truth.

8.27 pm

Dr Sarah Wollaston (Totnes) (Con): May I start by paying tribute to my predecessor, Anthony Steen, for his tireless work in bringing in a modern slavery Bill?

Today, however, is for talking about health, which is a great passion for me in this place and outside it. The NHS touches people’s lives 1 million times every 36 hours, which is a staggering figure. I believe that the NHS is worth every penny of the nearly £110 billion that we spent on it in the last financial year. I am very proud that this Government have protected the health budget, but that does not of course mean that there are not enormous financial pressures. We are now in the fifth year of effectively near-flat funding, and the issues set out by the hon. Member for Ilford South (Mike Gapes) are part of those pressures. We know that whichever Government were in power, there would have been serious challenges.

If the NHS is to be sustainable, we need to listen to the new chief executive of NHS England, Simon Stevens, who has called on all staff members to think like a patient and act like a taxpayer—we must do that to get every ounce of value out of our NHS—and to address issues of patient safety and of how we keep people out of hospital in the first place and get on with implementing the measures. The nature of the challenge has been set out in exhaustive detail; now we need to get on with the measures that have been put in place to help to prevent hospital admissions, to treat people at the right time in the right place, and to integrate health and social care. I want us to look carefully at the better care fund and the plans for getting best value out of it, and at the issues of patient safety that were mentioned earlier.

Given the absence of much legislation in the Gracious Speech, there is one regret that I want to point out: the absence of the Law Commission’s draft Bill on the regulation of health and social care. I hope that in summing up this debate, the Minister will give some reassurance that he can use secondary legislation to bring forward at least some of the measures in that draft Bill. It covers issues that touch 1 million people across 32 professions that are covered by nine regulatory bodies. Unless we clarify the language so that there is a common language in respect of patient safety across all those regulators, it will be difficult to implement some of the core messages from Francis and to act quickly in response to emerging threats to protect the public.

Every year for three years, the Health Committee has called on the Government to allow the General Medical Council to appeal panel decisions that clearly have not

9 Jun 2014 : Column 350

protected the public. Likewise, the Nursing and Midwifery Council would like powers to reopen cases in which it has been judged there is “no case to answer” if serious new evidence emerges. Alongside that, the General Pharmaceutical Council would like to implement transparency and to be able to take enforcement action. Those are all simple measures that I hope the Minister will mention in summing up. I also want the unacceptable level of delays to be addressed.

Norman Lamb: I want to give a quick confirmation that we will do what we can through secondary legislation to do what the hon. Lady requests.

Dr Wollaston: I am very pleased to hear that.

There will not be an absence of debates on health in this place. Two Bills will probably come here from the Lords in this Session: the Medical Innovation Bill and the Assisted Dying Bill. I will briefly put some of my concerns about the Medical Innovation Bill on the record while there is time for it to be amended. I have no doubt that it was introduced with the best of intentions to bring forward innovative treatments. However, I fear that it will have the reverse effect: it could undermine research and open the door to the exploitation of people when they are at their most vulnerable.

Currently, clinical negligence law provides redress for patients who have been harmed as a result of treatments that would not be supported by anybody of medical opinion. There is insufficient evidence that doctors are not introducing new treatments or are put off from doing so because of the fear of litigation. The NHS Litigation Authority has made it clear that doctors are protected from medical litigation in that respect. However, the briefing note for the Saatchi Bill talks about a doctor being able to use a novel treatment if he is “instinctively impressed” by it. In other words, doctors will be able to use an anecdotal base for treatments, rather than a clear evidence base. There are dangers in going down that route.

There have been some amendments to the Bill. Lord Saatchi has accepted that a doctor should have to consult colleagues and their medical team, but not that they should consider a body of opinion or consult ethics committees. I fear that we could be turning the clock back. We should rightly be proud of the advances that we are making in the field of medical research. We should rightly be proud of the push towards greater transparency, particularly in respect of open data and drug trials. However, I fear that if we allow people to access innovative treatments that have no evidence base, we will open the door to the purveyors of snake oil, rather than those who want to allow patients to enter controlled trials to establish a clear medical evidence base.

We should not underestimate the extent to which the purveyors of snake oil are out there. I put on the record my congratulations to Westminster city council and its trading standards department on fighting two successful prosecutions under the Cancer Act 1939 against two individuals, Errol Denton and Stephen Ferguson, for peddling so-called nutritional microscopy to people who were at their most vulnerable—cancer patients and patients with HIV—and telling them that it was an alternative to evidence-based treatments.

9 Jun 2014 : Column 351

We must therefore be careful in how we move forward with such legislation. We should take more notice of the concerns of the Medical Research Council, the Wellcome Trust and the Academy of Medical Royal Colleges, who feel not only that the Bill is unnecessary, but that it could turn the clock back on evidence-based medicine. I hope that the Government will look at the concerns that have been expressed about the Bill in its current form.

Finally, Lord Falconer’s Assisted Dying Bill would enable competent adults who were terminally ill to have assistance to end their lives, but it would require the involvement of a medical practitioner. Although the Bill comes under the responsibility of the Ministry of Justice, it would have profound implications for end-of-life care and medical practice. It would fundamentally change the relationship between doctors and patients. There is a risk that the right to die would slide into a duty to die. I have seen how often patients who are towards the end of their lives fear being a burden on their families, and they often go through periods of profound depression. I do not feel that this Bill is the way forward.

8.35 pm

Lyn Brown (West Ham) (Lab): It is wonderful to follow the hon. Member for Totnes (Dr Wollaston), and I totally and utterly agree with her concluding remarks.

Some may say that the absence of any reference to health legislation in the Queen’s Speech is a blessing; after all, the unwanted top-down reorganisation foisted on the NHS by the coalition and the previous Secretary of State is said by many to have put such a strain and stress on the NHS that it has been brought to its knees. Many Members present will know from their casework, inboxes, surgeries and personal experience that there is a rising tide of public concern about the NHS because of the lack of accountability and because decisions are being made upstream from local services. Our constituents may well view the absence of any mention of health in the Queen’s Speech as evidence of complacency, disinterest and unconcern. I have to say that I would agree with them. The Government have taken away the local means to secure improvements in services, and in this Queen’s Speech they have missed an opportunity to bring back local focus and accountability.

I want to look first at GP provision. One of my constituents wrote to me in April out of “sheer despair” at her inability to get an appointment at her surgery for an issue that she has said is not urgent. She has a busy job, is at work at the times she needs to call the surgery, and cannot leave work at the drop of a hat should she be offered an on-the-day appointment. As she put it,

“the current system is an absolute joke, to put it mildly…this current NHS system is completely useless”.

My constituent needs and deserves Labour’s GP access guarantee. Is there anything like that in the Queen’s Speech? The short answer is, “No, there is not, but there should have been.”

My constituents do not have the same access to GPs as people in other areas. Building on NHS England’s most recent survey, the Royal College of General Practitioners shows that 16.82% of patients in Newham were not able to get a GP appointment when needed, compared with 5.36% in Bath and North East Somerset.

9 Jun 2014 : Column 352

The Government should adopt the GP access guarantee to address those inequalities, and the Queen’s Speech would have been the right place to introduce such proposals.

Before its abolition, Newham primary care trust had a clear plan to tackle and improve the challenging local situation, of which I was an active and enthusiastic supporter. Today, I am far less sure that mechanisms are in place locally that have the capacity and motivation to root out poor practice and promote the best. My misgivings were confirmed when I asked who now decides what to do when, for example, there is a vacancy at a GP practice in Newham. The answer came back—I still find this astounding—that the decision rests with NHS England. What is more, I was told that the London office of NHS England has a small number of people who deal with the provision of GPs, dentists, opticians and pharmacists. They must struggle to keep up with the paperwork, let alone have any capacity to look at proactive work on quality, improvement and service development.

What local knowledge can NHS England have about what is happening on the ground in Newham? How can that make any sense, and how is NHS England accountable to Newham’s people and its clinicians? What does it say about the reality of this Government’s commitment to localism? It is surely a matter of great regret that the Secretary of State did not seek to use this Queen’s Speech to address some of those very real issues.

In his response, the Secretary of State will no doubt include fine rhetoric about control being in the hands of GPs locally through the clinical commissioning group. He will laud to the skies their skills, commitment to patients and the NHS, and their virtue in all respects. I have talked at length to my CCG in Newham and worked closely with it, and I assure the Secretary of State that I share his opinion of its estimable qualities. In fact, I would add more approving words to his glowing testimony. I also know, however, of the CCG’s absolute frustration at the straitjacket that the new NHS structure requires it to wear, and I share its recognition that the reality of local empowerment is very different from that described by the Secretary of State and enforced with the diktats of NHS England.

The new structures leave decisions in the hands of NHS England. Surely the current Secretary of State can see that that is nonsense. In his calm, perhaps even reflective moments, I think that he knows and would admit that, if only to himself. What a shame that he did not use the Queen’s Speech to intervene and turn his rhetoric of localism into more local control over NHS decisions.

8.41 pm

Valerie Vaz (Walsall South) (Lab): It is a pleasure to follow my hon. Friend the Member for West Ham (Lyn Brown). I am pleased to speak in this debate, and let me clarify if I stray slightly off topic that it is a tradition that one can be wide-ranging in one’s comments, but I will return to the NHS.

In my view the British people do not deserve the Gracious Speech as delivered. The first sentence contains a contradiction. It states that the Government

“will continue to deliver on its long-term plan to build a stronger economy and a fairer society.”

9 Jun 2014 : Column 353

What is the evidence so far? So far there has been a tax cut to 40% for those earning more than £150,000, while at the same time some are struggling to pay the extra rent for the bedroom tax or a spare room. Those are among the most vulnerable people in society.

Added to that is a continued assault on the public sector, and as we start the new Session, there are still unanswered questions about the Royal Mail privatisation. There are plans to privatise the Land Registry, for which there is no case to answer, in addition to other cuts in the public sector. The Land Registry, the possibility of the east coast railway, the Forensic Science Service, the scientists at Kew Gardens—all that is the Government interfering with services that are profitable, safe and should be left alone to carry on with their expertise for future generations. Even the chief inspector of Ofsted has said that he will end its contracts with third-party services and employ school inspectors directly, because he thinks it is too important. So are all those other services and so is the legal system, but that does not seem to bother this Government. This is a giant jumble sale of the public sector.

The Gracious Speech contains a statement about selling off-high value Government land—land and assets that belong to the British people will be gone for ever. Members may remember the selling off of cemeteries for 3p by the former leader of Westminster council. The Government do not need to sell off high-value Government land for housing because that can be done by building on land where there is already planning permission. People in this country can use their creativity to find new ways to design new homes and build them, such as the programme developed by Walter Segal where people on the housing waiting list in Lewisham were taught how to build their own homes. That gave them expertise and empowered them, and the houses were sustainable.

My hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) is right when she says that the Gracious Speech will allow fracking under people’s homes whether they want it or not. There is no definitive evidence that fracking works. Some 75% of the chemicals used in fracking are toxic and 25% are carcinogenic. There are concerns about its effects on the environment and on public health.

As many Members have pointed out, it is no coincidence that the Gracious Speech is silent on the NHS. Instead, the Secretary of State wants to punish the very people who have borne the brunt of the reorganisation that, by conservative estimates, amounts to £3 billion. He says they cannot have a 1% pay rise. He is withdrawing funding from front-line services, such as GPs’ minimum practice income guarantee, which affects surgeries in places such as Tower Hamlets and some rural practices, and which will be withdrawn from Wales a year later. The Secretary of State cannot blame the Welsh Assembly Government for that.

There is a lack of doctors in A and E because they are going abroad. Where is the long-term plan to end that crisis? Where is the Secretary of State’s response, other than leaving it up to NHS England? The lack of accountability, which was pointed out by my right hon. Friend the Member for Leigh (Andy Burnham), has been exposed since the implementation of the Health and Social Care Act 2012. Nothing has been done. Instead, we get announcements about community hospitals without consultation with local people about which

9 Jun 2014 : Column 354

hospitals are needed and where they should be placed. The Government want to use public money in their own way, but they do not want to be accountable for it.

There is a provision, as other Members have pointed out, for redundancies to be capped. The revolving door and merry-go-round of people being made redundant and then rehired as consultants has been exposed time after time by Her Majesty’s Opposition. That public money could be used for my constituent Grace Ryder, aged 9, who was recently diagnosed with type 1 diabetes. She wanted to draw attention to this and raise money for charity, so on Saturday she helped to organise a fair at Delves Baptist community church. This courageous girl has to wear a cannula in her stomach for the delivery of insulin. There is an alternative—a pod that has no tubes—but it is not available on the NHS and the family cannot afford the £90 per week that it costs. Instead of these vast redundancy payments, money should be spent on the courageous Grace Ryder and other children to help them lead as normal a life as possible. I would ask the Secretary of State, if he only bothered to listen, whether he is as courageous as Grace Ryder. Can he make this insulin pump available on the NHS?

To promote a fair, just and more equal society we need to tilt the balance back to the British people. The Government should look again at the scaling back of the Equality and Human Rights Commission and the equalities agenda. The organisation was there to help and to provide evidence for some of the myths that abound that may explain why some communities are not tolerant of each other. Her Majesty’s Opposition will repeal the Health And Social Care Act, which has caused chaos, insecurity and inequality in the NHS and repeal section 75, which forces competition, not collaboration, wasting millions of pounds on legal advice. We will also build affordable homes like those built under the vision of Walter Segal, which became a reality in Lewisham. Equality, opportunity, justice and tolerance should be the foundations of the Gracious Speech and our society.

8.48 pm

Mr Andy Slaughter (Hammersmith) (Lab): I am sorry that this debate began with a speech that was smug and complacent even by the standards of the Secretary of State for Health. I thought we had reached a low point until I heard the hon. Member for Thurrock (Jackie Doyle-Price) using a speech on the NHS to promote the tobacco industry. I am glad that those speeches have been balanced by those we have just heard from my hon. Friends the Members for Walsall South (Valerie Vaz) and for Westminster North (Ms Buck). Indeed, the speech from the shadow Secretary of State, my right hon. Friend the Member for Leigh (Andy Burnham), reaffirms Labour’s commitment to the health service, which is fairly lacking from this Government.

I am going to speak about the crisis in the west London health service, partly because it is such a major crisis and partly because I think it indicates the way the Tories are dealing with the health service generally. It began two years ago, almost exactly, with the announcement of the biggest hospital closure programme in the history of the NHS. Since then we have had sham consultations with 100,000 people petitioning and being ignored, U-turns, confusion, incompetence, refusal to answer

9 Jun 2014 : Column 355

questions and political chicanery to make what happened in Ilford, as we heard from my hon. Friend the Member for Ilford South (Mike Gapes), look like a model of probity. Now we have the contamination of the whole NHS locally, including the primary care sector.

When the closure programme began, the medical director of North West London NHS said, candidly, that if it did not close four A and Es and two major hospitals, it would literally run out of money and go bankrupt. Those are the words he used. I suppose we should be grateful to him, because those statements galvanised the population of west London to engage in “save our hospitals” campaigns, and they have been campaigning for two years in rain and snow. Despite huge disinformation paid for by the taxpayer, by a Conservative council and indeed by the NHS, when I now stand in Lyric square in Hammersmith on a Saturday, I can be sure that 99% of my constituents know what is actually happening. I pay tribute to those campaigners from all political parties—including a lot of ex-Tories, as well people from minor parties, Labour supporters and others. They have really made the running on this issue.

Yes, there were changes. Initially, for example, we were going to lose the whole of Charing Cross hospital. Now there will be a local hospital on the site. When that was first mooted, a senior member of the local Conservatives and a Cabinet member said:

“This is an enormous teaching hospital with a 200-year history. You can’t make the Charing Cross hospital into a local hospital. It’s absurd. People won’t put up with that.”

Within weeks, they were spending ratepayers’ and taxpayers’ money putting out leaflets saying that Charing Cross hospital had been saved. That was compounded last October when the Secretary of State for Health stood here and effectively said, “Oh, it won’t just be an urgent care centre. It’ll be a second-tier emergency department.” Let me clarify the three differences between those two: recovery beds, X-rays and GPs. I thought we had GPs on duty in urgent care centres, but apparently not; we can just have nursing cover. It is an urgent care centre by any other name; to call it an A and E is misleading. It will lead to people with serious medical conditions going there and risking their and their family’s lives—as we have already seen at Chase Farm and elsewhere. Charing Cross and Hammersmith will not have blue-light emergencies—except for heart attacks in the case of Hammersmith. We will not have a stroke unit; we will not have the 500 emergency beds; we will not have intensive treatment. This is a second-class, second-tier health service.

The worst transgression happened in only the past few weeks during the local election campaign. I am not making this up, Madam Deputy Speaker. After the postal votes were opened and the Hammersmith Conservatives saw that we were ahead in some of their safe wards, the Prime Minister was brought down at short notice and locked in the basement of the Conservative party offices with a local journalist and came out with this pronouncement:

“Charing Cross will retain its A&E and services”.

I believe that the Prime Minister is an honourable man, and that he was misled into making that statement. The statement is demonstrably false because the NHS has

9 Jun 2014 : Column 356

clearly said that most of those services—other than treatment services, primary care services and elective surgery—will not exist at Charing Cross hospital under any analysis.

I thus went to see Imperial. It was the day after the election and I had been up for 30 hours and was not in a terribly good mood. I went to see the new chief executive of Imperial, and I tried to persuade her that Charing Cross should stay open. I said that I would take the new Labour leader of Hammersmith council to see her, as he might be able to persuade her better than I could. I then left and went home. That evening, she e-mailed to say, “Oh, I forgot to tell you when you were here: we are closing the other A and E in your constituency on 10 September. It was just a short meeting and I did not have time to tell you about it.”

At the same time, as my hon. Friend the Member for Westminster North said, the CCG is writing to tell us that it is good news that in year—in the middle of a financial year—it has decided to pull together £140 million from the CCGs around north-west London and to redistribute it into primary care. In other words, they are panicking and having to take desperate measures because the primary care services are so short of money and cannot pick up the slack from the closure of A and E services. We might think, “At least they are doing something”. A substantial proportion—they will not say how much—is going out of my CCG and into other CCGs because, they believe, that is a fair way to distribute money. We are losing not only both A and Es, but our primary care funding and, with the closure of Hammersmith A and E—if we cannot prevent it from going ahead in September—Imperial has admitted in its own board papers that there is insufficient capacity at St Mary’s hospital.

Lyn Brown: Has my hon. Friend conducted any analysis that could reveal whether the redistribution of funds among the CCGs will take money from the more deprived areas and give it to those that are better off?

Mr Slaughter: I thank my hon. Friend for that intervention. In exactly the same way, the Government are choosing to close the A and E department at Hammersmith hospital, which is slap bang in the middle of one of the most deprived areas of London, covering White City, Old Oak, Harlesden, north Kensington and east Acton. That means that 22,000 people who rely on those A and E services every year will have to travel to St Mary’s hospital in Paddington. They will not be directed to Central Middlesex hospital, which will be closing on the same day, and they will not be directed to Charing Cross hospital, because the plan is to close that within a year or two. They will be told to go to St Mary’s, where there are not enough beds and not enough capacity in A and E to cope with the current demand. That is contrary to undertakings given in the House that there would be no closures of A and E services until alternative services were provided. There will also not be enough acute services to provide a training base for students at Imperial college.

Two weeks ago we won the election in Hammersmith, against the expectations of, at least, the Conservatives, and we won it on this issue. If the Government will not listen to the 100,000 people who petitioned, perhaps they will listen to the people of west London who, on

9 Jun 2014 : Column 357

the issue of the NHS, overwhelmingly voted Labour and against the policies that are being pursued by the Conservatives. They should listen, and they should think again about hospital closures that will cost the health and the lives of my constituents.

8.56 pm

Mike Kane (Wythenshawe and Sale East) (Lab): I am delighted to be called tonight. As a by-election winner just 16 weeks ago, I felt the pressure of being 650th in the order of seniority, but, following the Newark by-election, I am now 649th.

This was my first Gracious Speech, and I am prompted to echo the words of my hon. Friend the Member for Ilford South (Mike Gapes). I was born and raised in Manchester, 95 of whose 96 councillors are now Labour, while the 96th is Independent Labour. That reflects people’s serious concerns about health, the establishment of Healthier Together in Greater Manchester, and what has happened to Wythenshawe hospital’s accident and emergency services over the past few years.

I pay tribute to the Leader of the Opposition and the Prime Minister for their kind words about Paul Goggins. He was an extraordinarily dedicated public servant, and the Prime Minister was very gracious in dedicating the legislation on child neglect to his memory. My constituents and I are grateful for that, and I know that Paul’s family will be as well.

It often occurs to me that the NHS will really be 90 years old next year. Aneurin Bevan’s father died in his arms, of pneumoconiosis, without the benefit of any health care provision. Bevan felt that the pain of one was the pain of millions, and he decided on that day that he would build the extraordinarily fantastic service that became the NHS, which he created years later in 1948.

I thought about why the Conservative-Liberal Democrat coalition partners did not want health to feature in this year’s Queen’s Speech in terms of electoral strategy, which was probably wrong. The key to any electoral strategy is not about two competing answers to the question, but about who gets to frame the question in the first place. The coalition partners want to ignore the health service because they know from Aneurin Bevan’s legacy, from the fact that we are leading in the polls, and from the way in which my right hon. Friend Member for Leigh (Andy Burnham) pounds the Government on these issues day in, day out in every part of the country that it is ground that Lynton Crosby wants them to avoid.

The top-down reorganisation cost £3 billion, and what has it done for my constituency? The Government downgraded the A and E centre at Trafford general hospital, the first NHS hospital to be opened by Bevan in 1948. They shut the Wythenshawe walk-in centre, and there was then a crisis of pressure in Wythenshawe hospital’s A and E department. Fourteen weeks ago, I asked the Secretary of State to meet me to talk about that. I later sent him a personal note, but he has still not contacted me about such a meeting. His own MPs want to be involved in that meeting. MPs on all sides of the political divide want to sort that out. I am demanding that the Government meet local MPs to discuss the continuing pressures at the hospital. Those pressures are expounded day in, day out by surgery work.

9 Jun 2014 : Column 358

Last year, my constituent Emma Latham lost her husband Steven, aged 43. They had to wait 40 minutes for an ambulance. In February this year, she experienced breathing difficulties. The call was categorised as a red 2, but she still had to wait 40 minutes for the ambulance service to arrive. Tony Gunning, another constituent of mine, who has liver and heart failure, waited over an hour for his ambulance and for dialysis. He is often bundled into a taxi home by Arriva, the private sector provider, when it can organise one for him. John Ireland, another constituent of mine, has a heart condition. He has been told it will be two weeks before he can see his local GP.

That is not good enough. The Government might not want this to be the agenda in the next 12 months but Labour Members will highlight every case, every hospital, every downgrade and every closure, and we will make the case clear to the British public next May. The NHS will last as long as there are folk to fight for it. We on the Labour Benches will fight for it.

9.1 pm

Steve McCabe (Birmingham, Selly Oak) (Lab): It is great to address the packed Benches on the Government side of the Chamber. This Queen’s Speech ought to be remembered as the last Queen’s Speech of the first coalition Government since 1945. I confess I am one of those who thought that it might never happen, but to their credit the coalition Government have put aside their differences and come up with a plan for a Bill to levy a 5p charge on poly bags. That would normally earn them a place in history, but this Queen’s Speech has been overshadowed, as we saw again today, by the row between the Home Secretary and the Education Secretary. Since the theme of today’s debate is health, let me say to the Education Secretary that trying to humiliate that lady could be very bad for his health—ask the Police Federation! Perhaps he should try to recruit a retired counter-terrorism officer to mind his back.

This has always been a Government built on hype. It has been there from the beginning, when they claimed that trebling tuition fees and slashing public spending were all for our benefit and would eliminate the deficit within five years. That much heralded and rebranded long-term economic plan aims to cut the deficit by the same amount as my right hon. Friend the Member for Edinburgh South West (Mr Darling) would have achieved. What has become long term is the prospect of continuing cuts and a deficit stretching years into the future.

We were led to expect a Bill to regulate health and social care professionals, but that is absent, despite Winterbourne, the Francis report and the latest Anglia Retirement Homes scandal. I regret that, because there is little doubt that we need to regulate those professions and provide greater assurance and security to patients, residents and relatives. I want to be able to tell my constituent whose elderly relative was induced to give a loan of several thousand pounds to her carer to buy a car that something will be done and that such crooks will not get away with it. I want to be able to tell the family of Ms Jones that, if they see the call button by the bedside disabled or find their elderly relative naked from the waist down and covered in excrement, something will be done. I want to know that the people who are doing the caring have been properly vetted and have

9 Jun 2014 : Column 359

suitable qualifications and training, are supervised and will be given the time to provide the care that their patients need.

Of course I would have liked an admission that section 75 of the Health and Social Care Act 2012 was a disaster. Far from putting GPs at the heart of decision making, it has reduced clinical commissioning staff to second-rate auctioneers. At a time when Simon Stevens is calling for more local and community services to provide care for the elderly, section 75 requires doctors to act like second-hand car salesmen. The way forward is to construct models that bring together statutory and voluntary services. We need the local state working alongside bodies like churches, community groups and even neighbours. Clinical commissioning groups should be creative and imaginative; instead they are stymied by the Government’s market dogma.

As this is carers week, I would have welcomed a law that recognised the rights and needs of the users of health and care services, that empowered them so that joint commissioning bodies were not allowed to close respite care facilities because accountants advised them it was an easy saving. I am battling to protect the Kingswood bungalows in my constituency, a purpose-built facility less than 15 years old, but targeted by those whose priority is to manage the books, not the interests of patients; and my constituent with severe autism who has lived in a specialist autism community for over 17 years. It is his home, but just as we have seen the crass contempt for people’s needs with the bedroom tax, we are seeing people like him threatened with eviction because the accountants and the joint commissioning administrators think they have found a way to save a few quid. I would have liked some legislation to regulate and enforce action against those who look after their own interests while wrecking the lives of others.

I welcome the promise to raise the number of apprenticeships, because if there is one issue that threatens the health and well-being of a generation, it is the spectre of unemployment and the denial of a future for our young people, but how many will be real apprenticeships targeted on the 16-to-19 age range? As with every other bit of hype, too many of the current apprenticeships go to those over 25 and are often just an existing job that has been redesignated. This is, after all, the Government who think they can send a young graduate already engaged in productive voluntary work to Poundland to learn how to stack shelves.

A Bill promising proper training, relevant qualifications, a chance to build a portfolio of skills, real employment opportunities and the full engagement of employers: that is what young people need. If we are living in the age of micro-businesses, and self and portfolio employment, then let us give young people the training that allows them to make a go of these things, rather than leaving them to be ripped off and exploited.

Sadly, this is a Queen’s Speech with none of those relevant interests served.

9.8 pm

Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab): Over the space of a few weeks from this April, my constituency has been overwhelmed by a

9 Jun 2014 : Column 360

perfect storm of cuts and closures pushed through by NHS England and the local clinical commissioning group, all the result of this Government’s agenda.

People in the rural East Cleveland part of my constituency need NHS services and support seven days a week, and that is why the last Labour Government proudly introduced NHS Direct and walk-in centres, but East Cleveland now faces a triple whammy. The South Tees clinical commissioning group wants to end minor injuries provision at East Cleveland hospital and Guisborough hospital. It has also decided to cease walk-in provision at Skelton medical centre at the end of June, while NHS England wants to abolish GP provision at Skelton medical centre.

Ending minor injuries provision does not, in the words of the CCG consultation letter, provide

“better care for the vulnerable and elderly”,

and I fear that the CCG is trying to disguise cuts to vital minor injury provision. This leaves no urgent care services in East Cleveland.

That is particularly problematic for the villages of East Cleveland, where public transport links are poor and an ambulance service provided by the North East Ambulance Service trust “cannot cope”, as its chief executive admitted. Over six months last year, the North East Ambulance Service recorded 10,599 delays, 196 of which were for more than two hours. Paramedics are left unable to respond to waiting 999 calls, and a regional BBC programme only last week showed that the situation is worsening. I have raised this matter in the House on many occasions.

Both the two small hospitals I cited were once run by the local primary care trust, but after the coalition NHS reforms were pushed through they were passed on to the main hospital trust for our area, the South Tees Hospitals NHS Foundation Trust, which runs the excellent James Cook university hospital in Middlesbrough. The trust is already facing a £30 million to £50 million black hole in financing, having had only a £5 million deficit last year; it is being investigated by Monitor and has to make drastic cuts. It is little wonder that what might be seen as easy targets in ancillary units such as these two small local hospitals come up on the trust’s radar.

In addition, we have had the CCG and NHS England turning their big guns on another NHS facility in East Cleveland: they are looking at, and have announced as a fait accompli, the total closure of the Skelton health centre and medical walk-in centre. That proposal is part of a national coalition approach that has been targeting walk-in clinics set up by the last Labour Government. If the closure goes ahead, Skelton will lose one of its GP practices, a nurse practitioner clinic and the attached pharmacy. The clinic serves people from the poorer areas of the ward such as Hollybush, the Courts and north Skelton.

Like local people, I feel that NHS England is basing its views on old numbers which we feel are suspect. The provider, LivingCare, which owns the practice, is gobsmacked, as closure letters to people on the surgery list went out before they were told about the possibility of closure. In certain instances not enough letters were sent to people actually registered with the GP practice. Skelton as a town is undergoing vast expansion, with new housing going up and more planned. More than 1,000 new homes have been built in the past three years, with the new local plan indicating a further 400 homes on open land to the east of that new estate.

9 Jun 2014 : Column 361

LivingCare was hit by a further blow when NHS England then announced the imminent closure of another GP facility it runs in my constituency. Unlike the earlier closures, this was not in rural East Cleveland, but in deep urban south Middlesbrough, on the Park End estate. I know the area well as my mother was for many years a teacher at the St Pius X Roman Catholic primary school on the estate, and I have relatives who still live there. The estate has profound social needs, with associated poverty and high indices of ill health. The cuts occurring locally in my constituency will increase the likelihood of people going to A and E, even when that is not appropriate. Our A and E has struggled to cope with demand over recent years, so these cuts are a false economy.

The mess of the Tory-Lib Dem NHS reorganisation, and the human tragedy it brings in its wake, deepens by the day. The coalition has already wasted £3 billion on a reorganisation and £1.4 billion on redundancies, and it is leaving the NHS weakened and confused. Locally, through this consultation, we are beginning to see the consequences on our constituents’ doorsteps. The approach being taken flies in the face of the call by NHS England’s new chief, Simon Stevens, for a marked change in policy and a shift away from big centralised hospitals. The health service chief executive says that we need new models of care built around smaller local hospitals and that, combined with comprehensive walk-in and GP care, is what my constituents need, deserve and rightly demand.

I have not been idle on these issues, but all my efforts have been stymied by a combination of bureaucratic blocking and ministerial indifference, resulting in Ministers’ responding to my requests for meetings with refusals, despite earlier friendly patter. Despite an outcry from local people, a full-page protest poster in the local newspaper Coastal View & Moor News and a massive petition, I managed to organise a meeting with NHS authorities that was unhelpful to say the least. Instead of a commitment to examine the clinical arguments and the issue of closures putting more pressure on the A and E unit at James Cook university hospital—a hospital with one of the longest waiting times for A and E in the region, if not the country—the NHS reps at the meeting retreated behind the protection of contractual timetabling, based on funding cuts issued by the Department of Health, because the “Darzi clinics”, as they were at the time, are coming to the end of their five-year contracts. I can say now, without equivocation, that such an approach will inflame my constituents, as I have seen already on the doorstep.

I still want to offer Ministers the option to meet me to talk about this issue, because I really fear the consequences for East Cleveland, and for Park End in particular, of these services being taken away. There is absolutely nothing in the consultation offering the individuals there any other option. There is no plan to put people in other GP practices. My fear is that we will have a time lag, and about 2,000 to 4,000 people not knowing where to go for primary care and ultimately ending up in the A and E unit—again.

9.14 pm

Geraint Davies (Swansea West) (Lab/Co-op): The first line of the Queen’s Speech said that the long-term plan was to deliver a strong economy and a fair society. Failure to deliver in that regard is contributing to aggregate

9 Jun 2014 : Column 362

health costs in Britain. The question is how we use the existing budget to deliver better health, as opposed to increasing the aggregate amount of money that we spend on health to the levels that are enjoyed in the European Union and the United States. The answer must be to reduce some of the drivers of health costs and the conditions that are causing those costs in the health service.

Obviously, the first driver is smoking. The Government have an opportunity to change packaging, stop children smoking in cars and accelerate the rate of transfer to e-cigarettes. There could be great savings there. At the moment, it costs us £5 billion a year to treat people for smoking-related diseases.

The second driver is obesity. The Forsyth report suggests that, by 2050, half the UK population will be obese. There are issues about school meals and exercise. There is an option—I do not know whether the Minister is interested in this because he is looking at his iPad—to put a 20% tax on sugary drinks, which is seen in New York, Mexico, France and Norway. Oxford university thinks that such a measure would reduce the numbers of obese people by 180,000 and of overweight people by 285,000, and generate about £250 million of revenue, which could be hypothecated to fund cheaper fruit and vegetables for poorer communities.

The reality is that only 10% of young people under the age of 18 consume their five fruit and vegetables a day, but children under the age of 10 are consuming 19 grams of sugar. There is a case for a sugar tax. Coca-Cola contains 11 spoonfuls of sugar, and there is 50% more sugar in sugary drinks than is advertised. We need to discriminate between certain ingredients, such as fructose versus glucose, because of their medical impact. It has been noted in America that fructose creates a different sort of fat cell in the liver and the heart, which causes much higher mortality rates. We need to focus in on the fact that there are different sorts of fat. Ironically, the EU, which I normally support, has suddenly agreed with the fructose lobbyists that fructose should be called healthier because the high from it is not as quick, but the damage is much greater. The same goes for palm oil, which is a big killer in America.

Some of these issues are about taxing ingredients in processed foods. Madam Deputy Speaker, if I gave you a potato and told you to make some money out of it, you probably would not—or you might because you are a good person—just sell that potato. The way to make money out of the potato is to smash it up, add fat, salt and sugar, reform it as Dennis’s dinosaurs, put some packaging around it and a jingle on it and get children who are poor into the habit of consuming a large amount of it, so they die an early death. We should be aware of that, and we should be the guardians of the budget and of the people.

The same is true of advertising. If one looks at the back of a cereal packet, it will say low fat, but what it means is 50% sugar, and sugar is fat. Sugar is converted to fat if it is not energised through exercise and the like. We should be here to protect people from that, but we have dismally failed to do so. In fact, the opposite has happened. The Government’s economic policies increase stress and poverty, which are drivers of poor health and cost.

Britain now has the worst child mortality rates of the western world, bar Malta, with one in 200 children dying under the age of five. According to Washington

9 Jun 2014 : Column 363

university, that is linked to welfare cuts, which have driven people into using food banks. We just have to look at the situation on employment. We are told that there are all these jobs—I can see the Minister trying to ignore me—but 1 million of them are on zero-hours contracts. People are moving from benefits into zero-hours contracts, which leads to discontinuity in their benefits. They are having to go to food banks. They are under stress and feeling hungry, which leads to ill health for them and their children. Research suggests that 45% of people in debt have mental health problems—

[Interruption.]

I can hear my hon. Friend the Member for Cardiff West (Kevin Brennan) listening to this. Research in the EU has shown that recession leads to suicide. Two thirds of people on whom the bedroom tax has been cruelly inflicted are disabled.

The Government are responsible for many of the costs, which will become intergenerational, long lasting and profound. That is part of a process of saying that the health service is too expensive for the poor, so we should privatise it. Aneurin Bevan famously said:

“Illness is neither an indulgence for which people have to pay, nor an offence for which they should be penalised, but a misfortune, the cost of which should be shared by the community.”

I should like to see a future in which that community is one nation—not the weakest crushed by the strongest—so that that cost is shared more evenly and is lower and Britain is healthier for it. We look forward to a more equal Britain in opportunity and outcome, where the health of the nation is better and the salvation of the health service is once more in our hands, with a Labour Britain next year.

9.20 pm

Mrs Emma Lewell-Buck (South Shields) (Lab): Our national health service is undisputedly one of the greatest achievements of any Government, yet the crisis that the NHS has experienced under the Government’s disastrous privatisation, threatens the survival of services and the quality of patient care. I am proud that it was a Labour Government who created the NHS, and I am proud it is a Labour Government who will reverse the damage done by the Health and Social Care Act 2012. In our health service, more than 4,000 senior nursing posts have been lost since 2010. Accident and emergency performances in the year following the Government’s reorganisation were the worst in a decade. Last year, South Tyneside hospital in my constituency had to cancel operations because of unprecedented demand for A and E services. Only two weeks ago, it emerged that the NHS in England had failed to meet a performance target for cancer waiting times for the first time ever.

The Government’s failed reorganisation has increased wasteful spending. The NHS now spends more on senior managers and management consultants than ever before, and it is increasingly bogged down in competition law, forcing it to spend money on lawyers that could have gone towards patient care. The pressures on our health service stretch well beyond hospital waiting rooms, as demand for NHS services is affected by trends in public health and the quality of social care. In those areas, we have seen massive cuts to local authority budgets of £2.7 billion. Faced with cuts of that scale, local authorities have been left with impossible decisions

9 Jun 2014 : Column 364

and have been forced to cut services, knowing that in doing so they would increase pressure on the health service.

Those who are lucky enough to be entitled to care find that their care worker can only stay with them for 15 minutes. These workers are poorly paid, with over 300,000 on zero-hours contracts. A third do not receive proper training. Unsurprisingly, staff turnover is high, so many clients do not manage to build a relationship with their carer. The Care Act 2014, which was passed in the last Session, presented an opportunity to address some of those issues, but unfortunately it was an opportunity that the coalition parties did not take. They rejected Labour amendments on low pay and zero-hours contracts that would have improved the standard of care that people receive. They also ignored charities that warned that the new eligibility criteria for support would exclude hundreds of thousands of people from the care system.

Of course, there are challenges facing social care, but we do not solve the problem by cutting support for those with moderate needs, only for them to end up in hospital. Last year’s QualityWatch report showed that about one in five hospital admissions could be prevented by better social care. The ultimate goal should be an integrated system like the one argued for by my right hon. Friend the Member for Leigh (Andy Burnham). The Government at least pay lip service to that idea, but in practical terms they have done very little. The better care fund announced last June was meant for that purpose, but it was actually just money diverted from existing NHS services, proving that the Government are not serious about promoting integration.

Underlying all of that are broader questions about public health. Poverty and ill health often go hand in hand, and malnutrition in particular has become a frighteningly normal part of life in Britain today. I know parents who skip meals so that their children can eat, and people for whom food banks are the only thing standing between them and starvation. Malnutrition affects an estimated 3 million people in the UK, which is a scandal in the fourth richest country in the world.

The previous Government left office with fewer people in poverty than when they arrived. Child and pensioner poverty fell even after the financial crisis took hold, and we were well on our way to eliminating child poverty by 2020. But under the coalition, this trend has been reversed, and instead of eliminating poverty by the end of this decade the Child Poverty Action Group estimates that the number in poverty will have risen to 4.7 million.

The coalition has allowed this crisis to develop, and the Queen’s Speech needed to recognise families’ desperation by delivering help with living costs such as food, energy and rent. Poverty, and food poverty especially, has a knock-on effect for our health system. Experts have warned that there is a public health emergency. We are beginning to see diseases such as rickets returning as children no longer receive the balanced diet they need. The symptoms of poverty pose serious challenges to our health service in the long term.

Our national health service survives in spite of this Government, not because of them. It is strong because of its work force and because of a public who resolutely believe in it and value it. In communities around the country, families are fed not because their country’s Government have helped them to find decent work, but

9 Jun 2014 : Column 365

because their fellow citizens give up their time to lend a helping hand. Our country faces some of its biggest challenges for generations, and people feel that Britain is no longer working for them. Worse yet, people feel that politics has no answers to the difficult questions of our time. All these challenges need a Government who are willing to be bold, but this Queen’s Speech gave no hope of that. It was more of the same from a coalition that has long outstayed its welcome.

Madam Deputy Speaker (Mrs Eleanor Laing): And the prize for patience goes to Nic Dakin.

9.26 pm

Nic Dakin (Scunthorpe) (Lab): Thank you, Madam Deputy Speaker. It is a pleasure to speak in this debate.

There is unanimity across the House on the importance of the NHS in our lives and the lives of the people we serve. The vast majority of people working in the NHS do fantastic work day in, day out, often in difficult conditions, to deliver a health service that is the envy of most parts of the world. In our desire to make that even better, we sometimes forget the very good things that are there, but when the NHS fails us, it is important that we tackle those failures effectively.

One thing I have noticed when talking to health professionals at whatever level in my constituency in Scunthorpe is that they, to a man and a woman, feel that the reorganisation that was thrust upon them by this Government after promising no top-down reorganisation has distracted attention and added work load, when there is already a challenging work load to tackle without having to deal with that. There is a big enough challenge anyway.

“Healthy Lives, Healthy Futures” is the consultation that North Lincolnshire clinical commissioning group is undertaking to find out whether to take forward health provision locally. That is an important endeavour, but the growth in the number of people turning up at A and E and the ageing population create great challenges for everyone. It is interesting that the financial challenges that are faced compound that. The PCT legacy debts were provided for and CCGs had further money taken out of their budget for that. A further £2 million was taken out of the CCG budget locally, although its budget is about £100 million, to deal with the pressures in specialist commissioning. The challenges involved in specialist commissioning need to be tackled. That might have been included in the Queen’s Speech.

One of the oddities of the Queen’s Speech is how little there is in it about the things that are most important to us—nothing about standard cigarette packaging, despite the Minister saying that she would introduce regulations, nothing on smoking in cars, despite the Minister saying that she would introduce regulations, and nothing to make it easier for people to see their GP. In its consultation with local people, Healthwatch North Lincolnshire identified access to a GP as one of the big issues locally. I had hoped that something would be done on that. I am pleased that the shadow Health Secretary made it very clear that Labour will at the first opportunity repeal the Health and Social Care Act 2012 and by rolling back the costs of competition and marketisation will guarantee an appointment at the GP’s surgery within 48 hours. That is something to be proud of.

9 Jun 2014 : Column 366

Another missed opportunity was to do something to end the abuse of older people. Why not respond to Age UK’s call to make it an offence to neglect a vulnerable adult and to ensure that directors of organisations that provide health or care services can be held accountable for neglect or abuse? Why not do something about that? There is so much that could be in this Queen’s Speech and is not but, as my hon. Friend the Member for Birmingham, Selly Oak (Steve McCabe) said, at least we have the 5p plastic bag Bill and we should be grateful for that.

Let me turn to another issue that could have been tackled in the Queen’s speech: the need to up the game on our work on antimicrobial resistance. Take for example tuberculosis, caused by bacterial infection through the air. If left untreated, it becomes deadly and BCG vaccinations are not as effective as they should be. Many people think that TB has been wiped out, yet London has the highest rate of TB of any capital in the western world. An increasing percentage of those cases are resistant to TB drugs and TB has always affected the poor. No new front-line drugs have been developed in 50 years, so why not tackle this disease, which is a real threat and is already here?

TB can be prevented by relatively low levels of investment in proactive diagnosis, outreach and good social and clinical care. It is a complex disease that can be made more complex by our health services, which often fail to diagnose it on first sight. Some doctors unfortunately prescribe antibiotics, which feed the AMR and do nothing to help patients with TB. We need to raise awareness of the disease and make sure that patients get the right support from health services that are properly staffed and equipped. We need comprehensive outreach for TB, with screening, diagnosis and treatment of people before their health deteriorates and before they can pass the disease on to others. In short, we need a preventive approach to TB and other infectious diseases like it.

We need to invest now to save later, and my point about TB is illustrative of the many other things on which we need action. Instead of that action, in this Queen’s Speech we have more of the same inaction and inertia. It is not good enough. I mark this Queen’s Speech low on its approach to health issues, and I look forward to hearing the responses from the shadow Minister and the Minister.