Kirsty Blackman:
I was talking about the food bank situation, and the situation more generally, in Aberdeen. We have three food banks in Aberdeen that publish
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statistics: the Trussell Trust, Instant Neighbour and Community Food Initiatives North East. In the past year, we have seen a massive increase in food bank use in our city. Indeed, between 2012 and 2014, the Trussell Trust saw 240% growth, while the Instant Neighbour food bank saw 120% growth—the growth has been absolutely huge. All three food banks cite late benefit payments and benefit sanctions as reasons for food bank use.
Interestingly, on the topic of getting people back into work, 22% of those across Scotland who go to Trussell Trust food banks say they do so because of low wages.
Michael Tomlinson: Does the hon. Lady welcome the pilot scheme under which jobcentre advisers attend food banks to signpost people in the right direction and to help them get back to work?
Kirsty Blackman: It is good to have all sorts of advisers in food banks, but food banks are filling a ridiculous gap that we should not have in the system. They are going out of their way themselves to do their best for people in terms of advice. They are having to finance these things and to get money from people, including from local charities and organisations, to provide advice. People really need that advice, and I welcome advice from all quarters, but these things should not be happening in the first place.
As I said, Aberdeen is a rich city. How do people get into a situation where they are unemployed and need to go to food banks? I came from a job where I was not earning as much as I am now—obviously, most of us took a bit of a pay rise when we got this job—so the combined income in my household was less than £40,000. People in my peer group, who are not earning the lowest of the low wages are still just a couple of pay checks away from having to go to food banks. The Government say it is really good that we are giving breaks to people with savings, but people do not have massive savings. If the main earner in the house is made unemployed, and they have a couple of months where they have no finances, they are in serious trouble, no matter how careful they have been or what they have done.
In Aberdeen, people cannot rent a one-bedroom flat for less than about £500 a month. People who have been made unemployed, who are struggling and who are having to pitch up to the jobcentre are really struggling to pay their rent.
Chris Stephens (Glasgow South West) (SNP): My hon. Friend will be aware that, in my constituency, we now have not only food banks, but a Christmas toy bank. Food banks, general practitioners and the rest are referring people to toy banks at this time of year. Surely that shows that the welfare system is failing.
Kirsty Blackman: A local organisation, Home-Start Aberdeen, did an Advent book bank and people donated children’s books. Some of the children who received books would not otherwise have got a book at Christmas time. It is absolutely awful that children are being disadvantaged because of those policies.
Some of the people who walk through the door of my constituency office and through the doors of food banks are pitching up because of late benefit payments.
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For example, an adverse decision has been made against them, they have been sanctioned and they have got the decision overturned, but it takes another month for that to get through the system and for the money to come in. How can the Government say that someone will be sanctioned for being 15 minutes late for an appointment when they cannot pay somebody for a whole month? How is that a realistic position? They expect individuals to behave in an impossible way—it is impossible for anybody to be on time for every single appointment and never to be 15 minutes late—when they can happily miss paying people for an entire month, and that is acceptable. It is ridiculous that they expect people to live by rules they cannot live by themselves.
I am really distressed by the benefit sanctions system. I am particularly annoyed about the late payments. I am annoyed that the Government, despite having published the guidelines and policies they expect people to work within, do not even stick to them. If there is an appeal, for example, it would be really good if they could make payments timeously to ensure that my constituents do not have to go to food banks.
3.19 pm
Alison Thewliss (Glasgow Central) (SNP): It is a pleasure to serve under your chairmanship, Mrs Gillan. I congratulate my hon. Friend the Member for Banff and Buchan (Dr Whiteford) on securing the debate, and other Members who have spoken passionately about their constituents and the situations that they have seen. I want to highlight a couple of constituency situations as well.
The sanctions regime for employment and support allowance is particularly punitive, going by my experience in my constituency office. It has put sick and disabled people into serious hardship for unacceptably long periods. I have a constituent in the ESA work-related activity group who suffers from serious clinical depression. As a result he has been totally unable to get to advisory interviews and take part in work-related activity. He should be in the support group but has not been able to advocate that for himself because of his condition, which has compounded his situation. He was sanctioned for an entire year and has been unable to recomply to get the sanction reduced to a fixed period. He should not have been sanctioned at all, but it is clear that the structure of the ESA regime and the increasingly punitive sanctions imposed by the Department for Work and Pensions are targeting the sick and vulnerable.
Despite guidance that states that claimants must be officially notified of sanctions in writing, many jobseeker’s allowance claimants have been sanctioned without an official warning and, as my hon. Friend the Member for Aberdeen North (Kirsty Blackman) said, without any understanding of the reason for the sanction. A constituent of mine lost his benefits from 2013 when he was sanctioned for failing to attend an interview. He was told verbally that he had been sanctioned, and the sanction should have lasted four weeks. He was not given further information about how to challenge the sanction. It is estimated that over the past five years, 28,000 claimants in Scotland have been sanctioned without official notification in writing from the DWP. Following the switch to automatic
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notification of sanctions by the DWP in 2015, my constituent finally received notification of his sanction two and a half years late. That burden of administrative error puts people into situations of great confusion and misunderstanding. They do not know why they are in such circumstances, and that is unacceptable and should not happen.
Michael Tomlinson: The hon. Lady again highlights very effectively some hard cases involving the most vulnerable people. There are examples in my constituency as well. However, just so that I can understand, is it her party’s policy that there should be no sanctions at all? After all, sanctions have been in place for some time. Alternatively, is the issue simply that they are not being implemented correctly?
Alison Thewliss: The sanctions regime as it stands today is unacceptable. The hardship that people are placed in, the stress on their lives and the effect on their children and wider families is unacceptable. The sanctions regime is not fit for purpose. It targets entirely the wrong people and makes things worse.
There is particular concern at the citizens advice bureau in Bridgeton about the question of the first sanction, which was raised by my hon. Friend the Member for Banff and Buchan. People are not challenging that first sanction. They think, “I’ll ride that one out. I can wait a week. I can manage. I can cope,” but if they do not challenge it the system decides that they have accepted the reason for the sanction, and that it was fair and justified. When something else happens—the next time their bus is late, or they have to pick up a child, or they are ill or in hospital, or some other thing happens—the second sanction will be far more punitive and the third one, should there be one, even more so. The first sanction is crucial, and that fact is not getting out to people. I cannot stress enough how much I would like people to challenge the first sanction on every occasion. An awful lot are overturned, because they are not fair.
The last case that I want to highlight puts the tin lid on how ludicrous the system is. I do not know, but I imagine that hon. Members from parties outside Scotland will not have seen the front page of The National this morning. It reports on a case that I highlighted about a constituent who was on universal credit and sought work. He obtained an offer of employment, which was great—that is what we want for people. As with all jobs, a start date was negotiated and agreed; that was fine. However, because of the expectation of compliance with the claimant commitment, which is the core requirement at all times for receiving universal credit, that constituent faced the threat of sanction even though he had a confirmed offer of employment. The new employer of that person will be the DWP. Well done, guys; that is absolutely tremendous. You could not make it up. The Government urgently need to review universal credit, particularly to ensure that the transition to employment is managed properly and is not subject to sanction. It is ludicrous to sanction someone who has complied and done everything they ought. It is crazy.
Michael Tomlinson: I repeat my question on that. Is it the position of the hon. Lady’s party that there should be no sanctions regime at all?
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Alison Thewliss: Does the hon. Gentleman think that he should be sanctioned because he was late for the debate today? I hope he loses a week’s, a month’s or a year’s wages as a result.
Michael Tomlinson: I had good cause.
Alison Thewliss: Did you? Then you should explain it to someone else and see if they consider that fair. That does not happen to my constituents. Why should the hon. Gentleman have a different set of rules?
I have another case I want to raise, although it is not the case of a constituent of mine. However, the lady who told me about it affected me deeply. She was in Central Lobby a few weeks ago, and was so upset; she was in tears and absolutely broken. Her brother had committed suicide. He died with £3.44 to his name because he had been sanctioned and lost his benefits. He committed suicide as a result of the pressure put on him by the policies of the Government. The sanctions regime needs to be resolved and reviewed, and that must happen now.
3.25 pm
Neil Gray (Airdrie and Shotts) (SNP): It is a pleasure to serve with you in the Chair, Mrs Gillan. I congratulate my hon. Friend the Member for Banff and Buchan (Dr Whiteford) on securing the debate, which follows on from one that I secured in this Chamber two weeks ago. The Minister may well be getting fed up with responding to Scottish National party debates about the Government’s sanctions regime, but I warn her that the party will return to the issue and challenge the Government on it until we see fairness in the social security system.
My hon. Friend the Member for Banff and Buchan made an excellent speech and has been a constant campaigner on the issue for some time. I pay tribute to her for that. She highlighted the issue of work capability assessments and people being declared fit for work when they are clearly not. She also highlighted the fact that although there is a need for some form of conditionality, the conditions should be proportionate and fair. She called on the Government to look at the trial of the yellow card warning system, and argued that the very need for it shows that the system is not working. I call again on the Minister, as I did two weeks ago, to tell us about the detail of that trial—when we can expect it to happen, and where and how it will happen. That detail has not so far been forthcoming.
My hon. Friend the Member for Banff and Buchan also highlighted the hardship and destitution resulting from sanctions. The Crisis report gives excellent qualitative evidence on that: 1,000 people were spoken to in a survey, and the impact on their lives was documented. My hon. Friend’s speech, coupled with the Crisis research, reveals the urgent, desperate need for a review of the sanctions regime, and for better protection of homeless claimants and those with mental health conditions against extreme hardship resulting from sanctioning.
My hon. Friend also touched on issues to do with hardship payments, which I hope the Minister will reflect on and deal with. Sanctions have not become a deterrent. That is clear, and my hon. Friend showed it. Indeed, there is a debate to be had about whether a deterrent is needed. The Crisis report set out that homeless
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people accept the need for conditionality. The problem is that they are simply unable to comply with the conditions, because of their unfortunate circumstances.
My hon. Friend the Member for Glasgow North East (Anne McLaughlin) made an incredibly powerful speech on behalf of her constituents, and I must agree with her. Over the nearly eight years I have helped in and represented the constituency of Airdrie and Shotts, I have yet to come across anyone who has shirked the responsibility of looking for work, or anyone who does not want to get work. As my hon. Friend said, there is no bonus for living on social security support. I support her in challenging any of us here to live on £73 a week. Maybe we could do it for one week, but week after week it would be incredibly difficult. No one gets comfortable on benefits. For her to be able to draw on her own experience of living on social security support and applying for jobs, and of the dent to confidence from being knocked back, was powerful testimony to which I hope the Government pay heed.
My hon. Friend the Member for Aberdeen North (Kirsty Blackman) was worried about following my hon. Friend the Member for Glasgow North East, but she did so well. She drew on figures from the Crisis report, such as the one showing that 77% of those sanctioned had skipped meals. That has to be a wake-up call. That figure alone should trouble Members in all parts of the House. Another critical figure is that 60% of those sanctioned found it harder to find work as a result—little wonder, frankly. The rise in the number of food banks in her constituency is reflected in mine, but we should not be relying on food banks and third sector organisations to fill the gaps in the social security safety net caused by Government cuts. I hope that the Minister will reflect on that in her winding-up speech.
My hon. Friend the Member for Glasgow Central (Alison Thewliss) spoke about the case of her disabled constituent who was sanctioned for a year—an absolutely disgraceful example, which we should all be shocked by. She was also quoted in a newspaper report this morning—I have a copy, if the Minister wishes to read it—which highlights another of her constituency cases. My hon. Friend’s constituent had earned employment at the DWP, but was sanctioned while waiting for the employment to start. That sums up the omnishambles of the sanctioning regime.
Michael Tomlinson: The hon. Gentleman, too, is highlighting some of the hard cases. As the SNP spokesman, however, will he confirm whether it is his and his party’s policy for there to be no sanctions system? After all, sanctions have been part of the social security system since 1946.
Neil Gray:
I pay tribute to the hon. Gentleman for his diligence, especially after the put-down by my hon. Friend the Member for Glasgow Central: the hon. Gentleman was himself late for the debate and, had he been on social security support, he would have been sanctioned. I do not believe that many of us could survive for longer than a month or so without our own salary, never mind the £73 a week that other people have to live on. It does him no service to push this. As for our view of sanctions, we believe that there should be conditionality, absolutely, but not the punitive sanctioning that has increased exponentially under this Government
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and the previous one. That is our concern, not conditionality or sanctioning in general. I hope that answers the hon. Gentleman’s question.
As my hon. Friend the Member for Banff and Buchan said, the sanctions regime is causing extreme hardship and is being operated in an arbitrary and unfair way. The Crisis report she quoted shows plainly what is happening to homeless people.
Emily Thornberry: Does the hon. Gentleman acknowledge that the rules were changed in 2012, resulting in the much greater use of sanctions than ever before?
Neil Gray: Yes, absolutely, the Labour spokesperson is right. There is clear, documented evidence of the rate of sanctioning for all social security benefits such as JSA and ESA having risen since the coalition Government came to power.
Homeless people are twice as likely as others to be sanctioned, which must shock us all. I hope that the Minister will advise us of what plans she has to extend the at-risk group to those with mental health conditions and to the homeless, as I called for two weeks ago. I hope she will provide some detail on that.
Angela Crawley (Lanark and Hamilton East) (SNP): The Scottish Association for Mental Health published research that found that 98% of service users had said that their mental health had deteriorated as a direct result of welfare reform. The research confirmed that benefit sanctions had been detrimental to the mental health of service users. Does my hon. Friend agree that sanctions are inhumane? I call for a review of the practice.
Neil Gray: Absolutely. Two weeks ago I called for that same review, and the Select Committee on Work and Pensions has done so as well. I hope that the Minister will respond. It is little wonder that mental health of people who have been sanctioned suffers—their confidence, their ability to find work and their ability to feed and water themselves and their family are all damaged. It is little wonder that we find evidence that people’s mental health is suffering. What benefit does sanctioning give to people seeking work? Very little, if any.
In the Minister’s response to my earlier debate, she stressed the importance of sanctioning to the social security system and to getting people into work. I hope that in her response today she will provide some evidence of the effectiveness of sanctions in pushing people into work. I am genuinely interested to hear what the Department has done to get evidence of how many people have returned to work within three or even six months of a social security sanction. I am interested because there is certainly plenty of evidence to show that the system is not working.
One example of evidence is the academic research conducted by Oxford University and the London School of Hygiene and Tropical Medicine, which my hon. Friend the Member for Banff and Buchan cited. They looked at official data on sanctioning rates, employment rates and benefit off-flow between 2005 and 2014 in 375 local authority areas—a pretty comprehensive and
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wide-ranging study. They found that for every 100 JSA claimants who received a sanction, 42.4 no longer claimed the benefit. That sounds great until we realise that only a fifth of them actually reported having found work. So for every 100 sanctions, we get 8.5 people into work. Also, from those 100 sanctions, 34 people no longer claim the benefit but are not in work. How many of them are self-denying the support to which they are entitled and which they need because they are so scunnered and fed up with the system?
Has the Department carried out a social impact study? Has any work been done with those who have been sanctioned to find out what their experiences were, their destinations after the sanction and the impact on their quality of life? The Government have been quick to dismiss any link between work capability assessments and suicides, in spite of the study from Oxford and Liverpool Universities linking 590 suicides to WCAs. The Government have also been quick to say that the sanctions regime plays an important part in the social security system. As far as I can see, however, neither statement has so far been supported with fact. I hope that the Minister will enlighten us today.
Emily Thornberry: Is the hon. Gentleman aware of another statistic? If people go on the Work programme, they are as likely to get sanctioned as to get a job.
Neil Gray: That is a highly depressing statistic for the Government to reflect on.
I hope that the Minister will give us more detail on the yellow card sanction or early warning system. We heard that it was to be trialled in the new year, but where will the trial be, how long will it last and under what terms will it take place? I asked the same questions two weeks ago and hope that the Minister can now advise us of the answers.
Finally, will the Minister agree to the full independent review of the sanctions regime called for by the Work and Pensions Committee and by my party? With half of all sanctions being overturned on appeal, a sizeable increase in sanctioning rates and documented evidence from Oxfam, the Poverty Alliance, Crisis and many others linking sanctions to increased food bank need, now is the time for the Government finally to realise the damage that they are causing to individuals and communities and to review the sanctions regime.
3.38 pm
Emily Thornberry (Islington South and Finsbury) (Lab): It is a pleasure to serve under your chairmanship, Mrs Gillan.
I, too, did not expect to be back in Westminster Hall discussing benefit sanctions so soon after the previous debate. Nevertheless, I am grateful to the hon. Member for Banff and Buchan (Dr Whiteford) for securing the debate. I am also very grateful to the hon. Member for Glasgow North East (Anne McLaughlin) for speaking from the heart, for speaking the truth and for speaking so powerfully.
The debate has given us another opportunity to hold the Government’s feet to the fire. As the official Opposition spokesperson, I tend to speak second to last, before the Minister, so I do not get a chance to come back at her. We are two weeks on from the previous debate, so I will
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anticipate to an extent what the Minister will say this time. Perhaps that will challenge her on some of the things that I suspect will be in her speech and she might be able to answer some of the questions.
I spent a long time looking at the Minister’s previous speech from two weeks ago. It was interesting, but a number of things seemed odd. She seemed to indicate that the Government had given up even trying to persuade us that their sanctions regime is helping people into work, because she said,
“we know from claimants that there is a positive impact on behaviour” —[Official Report, 2 December 2015; Vol. 603, c. 174WH.]
and that, “sanctions make it…clear” to people that they must “follow the rules”, so they are not about jobs. As is obvious, following the rules in terms of looking for work is not the same as finding work. In fact, it has become increasingly clear that, in many cases, the rules are a set of arbitrary boxes to be ticked that are as likely to hamstring people looking for work as they are to help them.
Sanctions are a major concern in Scotland, as they are in the rest of the country, as today’s debate and the previous one show. I was struck by a case that came up at a recent hearing of the Scottish Parliament’s Welfare Reform Committee on sanctions. A man from the east end of Glasgow described his experience on the Work programme, which included being made to sit in an office from nine to five, cold calling local employers to ask whether they had any vacancies. Of course they did not, so he ended up with a string of rejections, which was deeply humiliating as well as being a complete waste of time. For the Minister to suggest that the rules are about tailoring to the needs and circumstances of the individual frankly contradicts all the evidence and experience, which is to the contrary.
The Minister spoke about the claimant commitment in our previous debate. It is worth saying a few words about that, not least because, by setting the conditions that jobseekers are expected to adhere to, it has become an inextricable part of the wider sanctions debate. What are the conditions? Like the sanctions regimes we have today, the claimant commitment was a bit of a wheeze, cooked up by the coalition Government in what seemed to be more of an effort to score political points than to help people find work. I read the two reports on universal credit published by the DWP a little over a week ago and one thing I found interesting was that only 37% of people surveyed by the Department felt that the claimant commitment set realistic expectations that would help them find jobs.
It is time for a proper evaluation of the claimant commitment. Although that was a key recommendation of the Work and Pensions Committee in its recent report on sanctions, the Government continue to refuse to do that or to give us a reason why. In her previous speech, the Minister referred to her Department’s efforts to “improve” the system by taking on board the recommendations of the two recent reports. One of them, which was by Matthew Oakley and published in July 2014, has been referred to, while the other is the Work and Pensions Committee’s report from March to which I just referred. She said that the Government have
“responded positively to the…Oakley review”,
“accepted all 17 of the Oakley recommendations to improve the process”.—[Official Report, 2 December 2015; Vol. 603, c. 176WH.]
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I found that interesting, so I had a good look into that. However, I am afraid that the Minister has been gilding the lily.
The Government actually said that that they would accept the recommendations
“wherever possible, and subject to detailed feasibility and securing the necessary resources”—
Effectively, they are giving no commitment at all and the reality is that, 18 months after the Oakley report was published, some of its most important recommendations have gone exactly nowhere. Recommendation 11, for example, called on the Government to pilot a system of non-financial sanctions. That seems entirely sensible, particularly for those with a strong record of meeting the requirements placed on them and, for example, may simply have had a wife in labour.
To give another example, recommendations 12 and 14 suggested that the Government end the absurd practice of Work programme providers being required to refer people for sanctions even if the providers themselves do not believe that there has been on offence. The Government rejected that common-sense suggestion and once again gave no reason. Therefore, the Minister claims to have “responded positively” to Oakley, and to have accepted his recommendations “in full”, but, having had a good look at the reality as opposed to the rhetoric, I do not see how they match up.
Similarly, the Minister did not tell us the whole story when she described the Government’s response to the Select Committee report. She said that its Chair had
“welcomed our response and, importantly, our willingness to engage with the Committee to ensure that the conditionality system works as it should.”—[Official Report, 2 December 2015; Vol. 603, c. 176WH.]
Let us have a look at that. By far the most important recommendation was for there to be a full, independent review of the entire system. Inexplicably, the Government refuse to do that and will not give us a reason.
Another of the Committee’s particularly important recommendations was for there to be a thorough evaluation of the new approach to in-work conditionality. We all need to be mindful of what the Government are doing and what they are about to do. They are currently piloting, within universal credit, an expansion of the conditionality regime. That pilot is very shadowy. We do not know where it is, who is being put through it or how many people are on it and, when we ask, the Government do not give us any answers. In-work conditionality means that someone is working, but they are not working enough, so, as far as I understand it—if I am wrong, I would love to hear from the Minister about exactly what is going on—they are told that, even though they are working, they must look for more work and, if they do not, they will get sanctioned. If that is right, we would like to know the details.
We welcomed the recommendation of a review, not least because in-work conditionality is completely untested and unprecedented—it is a new concept within any social security system. The Government’s response to the recommendation was good. I give the Minister full marks for her response. She stated:
“We agree that individuals on Universal Credit and in work will not be subject to the full range of work-related requirements and sanctions beyond existing pilots until we have fully considered the learning from those pilots.”
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However—surprise, surprise—we heard from the Chancellor of the Exchequer in the autumn statement seemingly just a few weeks thereafter that the Government will
“extend the same support and conditionality we currently expect of those on jobseeker’s allowance to over 1 million more benefit claimants.”—[Official Report, 25 November 2015; Vol. 602, c. 1371.]
I do not know whether the Minister knew that. Who are those claimants? What are the Government doing on this? We have a shadowy pilot and we are told that it will be looked at properly before it is extended, but then the Chancellor of the Exchequer says that it will be expanded to another million people and we do not know what the circumstances are. This is completely new. The current sanctions regime is bad enough and if the Minister is now to expand that to those in work, we need to know why and how.
Neil Gray: Does the hon. Lady share my concern that the conditionality and sanctioning regimes are just a fig leaf for social security cuts?
Emily Thornberry: With great respect, I think that is a simplistic argument and that it goes further than that. Those who have been subjected to a large number of sanctions lose confidence and end up “economically inactive” and, when they are asked why they have become economically inactive, we find out that it is because they have been discouraged. For many people, that means sleeping on the sofa, asking mum for a loan and begging. Many people are falling out of the system and a large number of them are very young, but that allows the Prime Minister to get up at Prime Minister’s questions and say that the number of claimants is going down. It is more cynical than cuts. Cuts is bad enough, but that takes things further.
The Government have not made clear exactly what they will do, but our assumption is that the 1 million people must include those on universal credit. I respectfully suggest that, for the Government to say one thing to the Select Committee and then the exact opposite in the Chamber just four weeks later, it does not look like the Minister’s promise to have “engaged” with the Committee in any positive way.
More troubling still are the implications of that U-turn for the future of sanctions policy. The sanctions regime is broken, but the Government will not look at it or allow an independent review. They are bashing on regardless and now they want to increase it to include those in work. During the previous debate we seemed to be fairly close to reaching cross-party consensus on the fact that it is broken. The only differences that arose were in relation to the scale of the problem. It does need fixing.
For the Government more or less out of the blue to suggest that they intend to expand the scope of sanctions is quite extraordinary. I hope that, this afternoon, the Minister will answer some of the questions rightly asked by the Opposition to hold the Government to account, because it is silly for us to have to keep coming back time and time again to Westminster Hall to ask them.
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3.49 pm
The Minister for Employment (Priti Patel): It is a pleasure to serve under your chairmanship, Mrs Gillan. I will endeavour, in the time I have, to cover as much ground as possible.
It is fair to say that I am always happy to come to the Chamber to participate in debates on this important issue. Today’s debate has given all Members the opportunity to give their constituents’ views and their personal views on the sanctions and benefits system. It has also provided opportunities for Members of the House to discuss how we can support and encourage people back into work. On a day when we see figures showing record numbers of people in employment, we should welcome all the support put in place through our jobcentres and work coaches to help people into work. It is somewhat disappointing that we have not heard much from Members in this afternoon’s debate on the support available to help people into work.
Conditionality is a key part of the approach that has helped to deliver record-breaking levels of employment, labour market improvements and the lowest claimant count since 1975. As we have debated not only today and in the debate a few weeks ago but continuously, sanctions have been part of the welfare system for a considerable number of decades.
Neil Gray: Does the Minister accept that since her Government and their predecessor, the coalition, came into power, the sanctioning rate has increased for not only ESA but JSA? Can she give any reason for that?
Priti Patel: I do not accept what the hon. Gentleman says at all. Sanctions have been a part of the welfare system for a considerable number of decades, and successive Governments of all parties have acknowledged the principle that there should be a link between benefits and engagement with the labour market. That principle has been at the heart of the system, and it is important to recognise that that is exactly how the system works right now; we engage claimants and ensure they are being supported in their work searches, while ensuring fairness and balance in the system.
The claimant commitment clearly sets out the consequences of failing to meet the requirements of the claim. As I have stated in previous debates, the claimant commitment is discussed at length with the claimant and, of course, takes account of any barriers to work, health conditions, disabilities or caring responsibilities.
Anne McLaughlin: Will the Minister give way?
Priti Patel: I will not, because I have many comments to make and we are short of time.
Two weeks ago, in the previous debate on sanctions, a number of Members quoted from reports and gave statistics to support their claim that the system is broken. We have heard similar quotes today, but we should be clear that much of what has been quoted is not fully representative of the system. We have heard extensive quotes from Oxford University and the London School of Hygiene and Tropical Medicine report that suggests only 20% of JSA claimants find work after a sanction has been imposed. That is misleading, because it makes the assumption that the 80% of people who leave JSA with unknown destinations do not enter work. In fact,
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many people do not inform Jobcentre Plus of their post-benefit destination because they are getting into work.
Statistics published by the Office for National Statistics put a clear disclaimer on the data, stating that the destinations data are unreliable and that it should not be assumed that all movements into employment are accurately reported. It would have been more accurate for Members to quote from the comprehensive DWP destinations survey that found that 68% of those leaving JSA move into work.
Members have rightly raised the issue of sanctions for people with mental health conditions. Less than 1% of ESA WRAG claimants with mental health conditions are sanctioned each month. The latest available data show that the number of sanctions across ESA WRAG claimants has decreased over the past year, including for those with mental health conditions. That is because, as we have continuously stated, we are seeking to support people with health conditions and, in particular, mental health conditions into employment.
The Government have just pledged more than £40 million to develop a proper and robust evidence base on which approaches are effective for people with mental health conditions. Over the next three years, that investment will enable us to have informed pilots that are based on evidence, to see exactly what kind of support works for those people and whether cognitive behavioural therapy for people on ESA, JSA and UC makes a difference. We are now working in a more integrated approach with the Department of Health on the use of talking therapies in our jobcentres and other community locations.
Several hon. Members mentioned the recent Crisis report, but they did not highlight that the report found there was support for a system of conditionality among the respondents interviewed.
Priti Patel: Let me finish my point. The report noted that
“the sanctions regime does prompt some behavioural change”.
Scottish National party Members have secured this debate; I congratulate them on that, but they have had their say. They have been giving very inaccurate reports about the sanctions regime. As I have said at least six or seven times on the Floor of the House, if individuals Members want to raise their cases with me, I am happy to look into them. If they want to raise cases about jobcentres in their constituencies or the conduct of work coaches, I would like to pick those up with them. Members who have raised such cases have not done so previously, but I give them the opportunity to do so.
Emily Thornberry: I appreciate that the Minister has a lot to get through, so I will speak very fast. One of the Work and Pensions Committee’s recommendations was that the DWP should monitor the destinations of people leaving jobseeker’s allowance. Currently, the Department only does that on an ad hoc basis. That is one of the recommendations that the Government refused to apply.
Priti Patel: That, of course, is part of our ongoing work and, along with the sanctions system, it is always subject to review. We will continue to work with the system and learn from the data we receive.
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To return to the Crisis report, it is not entirely clear how the respondents to the study were selected, and the conclusions appear to apply to only a subset of the overall homeless population. That is why we are quite cautious about the degree to which the views and responses included represent those of the broader population. We know that the most important priority for homeless people is to secure accommodation, and to secure support not only in getting into accommodation but in dealing with barriers to work and any particular conditions they may have. It is important to note that support is always, rightly, based on individual needs and circumstances, and is there to help homeless claimants find suitable living accommodation, which in turn helps to remove barriers to employment.
I return to the role of our work coaches. They are able to treat certain homeless claimants as meeting their job-seeking conditions if they are receiving the right support to find living accommodation. Work coaches are also able to suspend conditionality temporarily if the claimant’s circumstances constitute an emergency. We recognise that homeless claimants may not be covered by our current list of vulnerable claimants for the purposes of hardship payments, and I emphasise that we are considering expanding the list to include those who are homeless.
We understand that homelessness is highly complex, and no one should generalise about the circumstances or backgrounds of homeless individuals. It is our priority to ensure that they get the right support. That is why the Government have made more than £1 billion available since 2010 to prevent and tackle homelessness and to support vulnerable households. In the spending review, we announced an increase in the Department for Communities and Local Government’s centrally funded programmes over the next four years to tackle homelessness. I would like to think that all Members here would welcome that.
References have been made to sanctions statistics, and it has been suggested that according to the Government’s March figures, 50% of sanctions imposed have been overturned on appeal. The official statistics say something different: in the year to June 2015, only 14% of original adverse JSA sanctions and 23% of ESA decisions were overturned by decision makers. Those decisions were based on new evidence being brought forward that was not available at the time of the original decision.
Anne McLaughlin: Will the Minister give way?
Priti Patel: I come back to my point that if individual Members want to raise specific cases with me, they are very welcome to do so.
I do not have time to touch on the overall improvements to the sanctions process, which I know we have discussed before, or the Work and Pensions Committee. We keep the operation of the sanctions system under constant review—as we do all our policies— to ensure that it continues to function effectively and fairly. We will continue to do that.
I will touch on the pilot of the yellow card system, which gives claimants an additional period of time to provide evidence of good reason before a decision is made. That will help to strike the right balance between fairness, conditionality and individual circumstances.
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Our intention is that the trial will operate in Scotland from March 2016, running for approximately five months. It will be carefully designed and delivered, with a clear process, training and guidance provided for all staff involved. The trial will be evaluated in full to assess the impact on the individual behaviours and understanding, and we will carefully monitor all the relevant data to consider the extent to which the warning system trial affects sanction decisions. We will make the findings available from autumn 2016. There are already a number of opportunities for people who are sanctioned to present more evidence, and of course, that will be part of an ongoing system of review. We are working with our work coaches to develop that.
As today’s debate was secured by members of the SNP, I would like to raise some particular points about the situation in Scotland. First, I am pleased to say that today’s employment figures show that Scottish employment is up significantly, by 178,000 since 2010, and that Scotland has an employment rate of 74.3%, which is higher than the UK average. We are seeing very strong levels of employment growth in Scotland. Unemployment has fallen by 63,000, with the number of people in work in Scotland now close to a record high. That is not just because of economic policies, but because of employers expanding their businesses and doing more to support the economy. There are plenty of figures on that, but I do not need to quote them. Members in all parties can access today’s employment figures.
However, I want to touch on something that has not been raised today. When it comes to welfare provision in Scotland, we have the Scotland Bill, and the devolution package in Scotland will make the Scottish Parliament one of the most powerful devolved Parliaments in the world. The Bill will also apply to welfare provision in Scotland, which will be tailored to local circumstances. Powers will include: a power for Scotland to create its own employment programme to help the long-term unemployed and disabled people into work; the power to create to new benefits in any area of devolved responsibility; powers in universal credit to determine how and when claimants are paid and how much some claimants get for housing support; and the power to legislate for top-up payments to people in Scotland who are entitled to a reserved benefit.
This of course puts more power in the hands of the Scottish Government, and Members of the Scottish National party can now be up front with the public in Scotland on what they will do with this new devolved power and how they will apply the new powers to their welfare system.
Although we have had a full debate today, I think it is fair to say that sanctions are not a punitive measure, contrary to what the Scottish National party Members—[Interruption.] They are sitting there giggling right now, but I would not trivialise the support that has been put in place by this Government to help people into work; I think that is quite insulting, actually, to many of our work coaches and the people who work in the welfare area providing support for individuals.
This is part of a wider framework of policy to provide support to encourage claimants into work. Today’s labour market figures show that. Not only are we seeing high levels of employment, but the claimant count rate
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is at its lowest level since 1975. Conditionality and sanctions have played a role in that, and it is only right that we continue to keep under review the policy of sanctions, and continue to work to do more, to do better and to provide the support to help people get back into work. That is why we have the new joint health and work unit, set up by the Department for Work and Pensions and the Department of Health between them, and why, during the autumn statement, my right hon. Friend the Chancellor announced a new work and health programme. That will come in in 2017 to support individuals with significant barriers to work and, in particular, help them to get back into work, through the welfare system, with support. Of course, universal credit is part of that. It gives people the help that they need to increase their earnings, move away from welfare dependency, and importantly, make sure that work always pays.
Thank you for chairing the debate this afternoon, Mrs Gillan, and I thank all hon. Members for their contributions.
Alison Thewliss: On a point of order, Mrs Gillan. I was going to say this in an intervention, but the Minister was not taking interventions. I wanted to correct the record on the person I mentioned who died. It was not suicide; it is actually a lot more sad than that. He died from diabetic ketoacidosis from not taking his insulin. He had no electricity for the fridge in which it was stored.
Mrs Cheryl Gillan (in the Chair): Well, that is not a point of order for the Chair, but I appreciate that the hon. Lady now has that on the record, and has set the record straight. Dr Whiteford, you have two minutes for a brief wind-up.
4.5 pm
Dr Whiteford: Thank you, Mrs Gillan. I am glad to have the opportunity to sum up what has been a very wide-ranging debate, but nevertheless, the questions that have been posed in this debate have been very focused. They have been put repeatedly to this “Conservatist” Government, because they need answering. They were posed by the Work and Pensions Committee in the previous Parliament on more than one occasion, and some were posed in the Oakley review. Most of the questions relate to the impact of conditionality on the most vulnerable claimants, because there is mounting evidence that the sanctions regime is hitting those people disproportionately and that the measures that have been taken are not going far enough to mitigate the impact on people who should definitely not be sanctioned.
[Sir Roger Gale in the Chair]
We have heard powerful speeches this afternoon from my hon. Friends the Members for Glasgow North East (Anne McLaughlin), for Glasgow Central (Alison Thewliss), for Aberdeen North (Kirsty Blackman) and for Airdrie and Shotts (Neil Gray), and indeed from the Labour Front Bencher, the hon. Member for Islington South and Finsbury (Emily Thornberry). There is clearly a case to answer, because the detrimental impact of sanctions on the mental health and material wellbeing of people in the benefit system, particularly those in receipt of
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jobseeker’s allowance and employment and support allowance, is giving huge cause for concern across all our constituencies.
My constituency has one of the highest rates of sanctions in the UK, despite having one of the lowest rates of unemployment. I can only attribute that high rate to our rurality, the very poor and costly internet access, the limited transport links that people have, and the large numbers of people in seasonal, part-time and casual jobs. However, the questions that have been put to the Minister have come from right across these islands. They are about why people are using food banks in the 21st century, why people are being found fit for work when they are clearly not, and why the system is not providing a safety net.
I am glad that the Minister was able to give a bit more detail today about how the so-called yellow card system will work in practice, but is Scotland just one big constituency now? Which bits of Scotland will it work in? How will that be reported? How will that come back to this House? We still do not know the structure of that scheme, and we need to know.
My most important questions today were about how the conditionality regime becomes worse for the people on the receiving end of it under universal credit. The Minister did not touch on those questions at all, or on my questions about hardship payments. Instead she simply reiterated points that were made in the written statement—we know those; we have got that information. What we are looking for is more information about how the measures are going to be rolled out in practice.
I was also a bit surprised when the Minister mentioned the Scotland Bill, given that her Government voted down the amendments that we put to the Scotland Bill that would have devolved responsibility for these matters. I know that the Scottish Government have been committing £100 million a year to mitigate the impact of what is happening and to mop up the mess that the Government have created. Buried in the Blue Book, however, were some small lines about how the Work programme is to be cut drastically before it is devolved. That will significantly limit the amount of action that the Scottish Government can take. A set of powers are being devolved that are going to disappear before we get them.
I know that my staff in my constituency office work closely with very hard-working advisers in our benefits offices. I have paid tribute to them in this House before. They hear it and know that we appreciate what they do and the support that they give—
Sir Roger Gale (in the Chair): Order.
Motion lapsed (Standing Order No. 10(6)).
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Primary Care: Tottenham
4.9 pm
Mr David Lammy (Tottenham) (Lab): I beg to move,
That this House has considered primary care in Tottenham.
I am grateful, Sir Roger, for the opportunity to introduce the debate. It is now 67 years since my party introduced the national health service. At that time, living to 100 would have been a newsworthy event, but today more than half the children being born in our country can expect to reach that age. This is clearly a sign of great progress and the quality of our healthcare system. However, that progress has not been the same across the board. There remain in this country huge discrepancies and a postcode lottery that determines the quality of healthcare people can expect to receive. I am particularly worried that the life expectancy of many children in Tottenham is nowhere near the national average.
The current situation paints a worrying picture. Today, average life expectancy for a male in this country stands at more than 80 years, but in my constituency, in the wealthiest city in one of the richest countries in the world, a male can expect to reach an average age of just 74. That is some five years lower than the national average, lower than Cuba where the average wage is £15 a month, and lower than Slovenia, Colombia, Bosnia and Peru. Perhaps most worrying, it is more than eight years lower than the life expectancy of men just a couple of miles away in Crouch End, in a wealthier part of the London borough of Haringey. That is a troubling and stark difference within the same London borough, and the same is true for women.
Primary care is the first point of contact in the healthcare system. In this country, that usually means GPs. They are the very front line of our health services, the entry point for all our healthcare needs and the means by which we access a whole array of treatments. Primary care is, therefore, the linchpin of our healthcare system. In fact, it accounts for 90% of patients’ interaction with the NHS. Because of that, NHS England’s five-year forward view stated that in future a much higher proportion of its budget would be spent on GP services.
Both this Government and their coalition predecessor claimed to understand the importance of primary care, and to some extent matched their words with funding. For example, £550 million was earmarked in March 2015 to improve GP access, to modernise facilities and to provide better care outside hospitals. Then in May 2015, the Prime Minister announced the “seven-day NHS”, proudly stating that by next April 18 million patients will be able to see a GP in the mornings, evenings and at weekends, with everyone being able to do so by 2020. One would therefore be forgiven for thinking that primary care provision on an average weekday is securely in place, given the £8 billion of extra funding earmarked in a time of austerity to provide additional services outside the current working week. That may be true in some areas of our country, but it is not true in mine.
Recent research paints a stark picture of primary care in Tottenham. The data come not from NHS England or from the Department of Health, which does not seem to be monitoring the situation adequately, but from a small local organisation, Healthwatch Haringey. With no extra funding or support, it went out and listened to local people about the problems they were
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facing in accessing primary care, and it found something quite disturbing. Some 86% of the patients at one GP surgery were either unhappy or very unhappy with their surgery. That surgery is ranked in the bottom 10 practices in England, with 41% of patients reporting they were unable to get an appointment.
That is apposite because, on Monday this week, Rob Clarke in my constituency tried to access his surgery, Bridge House surgery, with his three-year-old. He tried repeatedly for many hours and was ultimately told to go to A&E. That is not what we want in Britain, where A&E is always overrun, and it was appropriate in that circumstance for the child to be treated at the GP surgery.
Across Tottenham, there are currently 1,300 too few appointments a week, which equates to 52,000 appointments a year fewer than the NHS benchmark. In just one ward of my constituency—Tottenham Hale—there is a shortfall of 18,000 GP appointments a year. Tottenham Hale is undergoing significant regeneration and now has several large blocks of apartments, a sizeable retail park, 500 more properties under construction and a further 1,900 planned for the medium term. It is one of the Mayor of London’s designated housing zones, but despite the influx of thousands of new residents, no new GP surgery was planned. It was only when the desperate need was pointed out by Healthwatch that NHS England’s task and finish group eventually arrived to complete a planning exercise. I note that a final decision on a new surgery will be made on Friday 18 December.
Our treasured national health service has been fractured by this Government and their coalition predecessor, but even with the best will in the world and even when clear need is established, nothing can be achieved quickly. I want to press the Minister on how fast we can and need to move in the circumstances I am outlining. It will have taken over a year for a decision to be made and, if that decision is positive, nearly 18 months for the surgery to finally open. During that period—I put this starkly—people are dying as a result of not being able to get an appointment, and children are being born unregistered. They are the truly dispossessed in our city. Will the Minister look closely at the issue and do all in his power to make the process as swift as possible?
The issues surrounding primary care in Tottenham relate not just to the number of GP places, but to quality and accessibility. According to NHS England, three quarters of GP buildings there do not meet legal compliance, and there are not enough consulting rooms. Some of the facilities in use in the fifth largest economy in the world are shocking. Healthwatch found that 20% of young mothers were not registered with a GP at all.
The consequences of not being able to obtain a GP appointment are stark: more avoidable deaths from cancer, worse life chances for children, and a lack of antenatal and postnatal care when women and, of course, their infant children are at their most vulnerable. My constituency is where Victoria Climbié and Baby P met their tragic end. The ability to obtain an appointment is important if we want to safeguard children. If people cannot do so, it raises serious concerns for mothers and their unborn children, and has led to the grave situation of three unregistered births in my constituency, one of which was of a disabled child whose mother gave birth at home with no one to help her.
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Furthermore, Healthwatch discovered clear health inequalities between the west and the east of the Haringey borough, where my constituency is located.
Catherine West (Hornsey and Wood Green) (Lab): My right hon. Friend is making an excellent speech with some good points about the disparity between those who live well and live long lives in the London borough of Haringey and those who do not. Does he accept that it is not solely Tottenham where there is a lack of primary health care? Parts of my constituency—for example, Noel Park—have similar problems with provision of basic, high-quality primary healthcare. Will he give that some consideration?
Mr Lammy: My hon. Friend is absolutely right. Her constituency includes Wood Green, and there are pockets of deprivation across Crouch End and Muswell Hill. She is absolutely right to make that point. In a way, this debate stands in both our names, because the crisis affects the borough of Haringey. It is not a coincidence that life expectancy of a male in the far west of the borough and the east correlates with the statistics that I have given, especially when so many mothers of infants are unable to register children in the constituency.
None of us should accept the situation. It is the sort of thing we associate with parts of urban America where there is no universal health provision. In the UK, we have a proud history of our national health service with its own constitution, which states clearly that people have the right to access NHS services. I fear that that is not the reality for many of my constituents.
These issues are not a reflection on the doctors in Tottenham, the vast majority of whom do an excellent job on behalf of the local community. I have recently met, for example, Dr Muhammed Akunjee of West Green surgery and Dr John Rohan of Lawrence House surgery, and I am very grateful for the work that they and their colleagues do in the constituency. As usual, the problems arise much higher up the chain of command. However hard GPs in Tottenham work, there are simply not enough of them and not enough facilities to serve our growing community. That leads me to wonder what it will take for the Government to address the crisis.
We know that there is a well documented link between poverty and ill health; we know that social conditions such as unemployment, overcrowding and inadequate housing make illness more likely; and we know that deprivation increases health problems and therefore pressures on the health system. Given that, I ask the Minister why one of the poorest constituencies in the UK receives significantly less health funding than wealthier areas nearby. Given the greater pressures, it should be receiving more. It is clear that the way to alleviate the GP crisis in Tottenham is to attract new GPs to the area and to retain the ones we already have. However, it is impossible to do that, because despite the huge workload, the urgent pressures and the ceaseless demand, GPs in my constituency are paid significantly less than those in wealthier areas just a few miles away.
For example, a GP in Holborn and St Pancras, the 126th most deprived constituency in the UK, receives £154.64 per registered patient, whereas their counterparts in Bethnal Green and Bow, the 36th most deprived community, receive less—£144.48 per patient. Despite the huge pressures on GPs operating in Tottenham,
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the 23rd most deprived constituency in the whole country, they receive only £124.94 per patient. That is a full 20% less than in Holborn and St Pancras. Clearly there are fundamental problems with the Carr-Hill formula, which is used to calculate GP funding. There are also real concerns about the impact that withdrawing minimum practice income guarantee payments has had on GP practices in deprived areas such as my constituency. I urge the Minister to look at what he can do to incentivise new GPs to come to areas such as mine.
If the GP situation in my constituency is to improve, GPs in Tottenham must be paid at least the same as their colleagues working nearby. That is an urgent need, given that one third of GPs in the borough are over 60 and therefore due to retire. Things could get considerably worse before they get better. Clearly, younger GPs are being attracted to work in other London boroughs because of the price differential.
It was this Government who wanted the NHS run on market principles, yet they have failed to grasp the obvious problem that for a GP to set up a business in Tottenham, he has to do more work, in worse facilities, for lower pay. Any 12-year-old fan of “The Apprentice” knows that that is not the way to run a successful business. It clearly demonstrates the inherent problem with trying to force a market on the health service, yet we are stuck with this Government’s NHS market framework, so I ask the Minister this: will market rules be applied so that GPs are given proper incentives to set up practices in Tottenham? Also, will he ask the chief executive of NHS England to finally take an interest? I am not clear whether it is Simon Stevens I should talk to or his London lead, but I would quite like the London lead at least to come down to the constituency for herself. I would have thought, given the work that Healthwatch has done, that she would have sought to do that.
I understand that following Healthwatch’s report, NHS England has started to take the problems in Haringey seriously and has produced a detailed 10-year capacity plan, which sets out how many full-time GPs and clinical and treatment rooms are required. Growth is predicted in four key areas: Green Lanes, Northumberland Park, Tottenham Hale and Noel Park, which is in the constituency of my hon. Friend the Member for Hornsey and Wood Green (Catherine West). Three of the four areas are exclusively within my constituency. NHS England has identified a need for five extra GPs in the Green Lanes area, six in Northumberland Park, 16 in Tottenham Hale and eight in Noel Park over the next 10 years. That is 35 extra full-time GPs, 27 of whom are needed exclusively on my side of the borough.
There are a few questions that I want to ask. Does the Minister agree that it is unacceptable that 20% of my constituents in Tottenham Hale do not have access to a GP? Is he concerned that the gaping holes in primary care provision in Tottenham have contributed to the fact that the average life expectancy of a man in Tottenham is just 74—below that of Cuba? Will he explain how, within the NHS market framework, he will attract more than 27 GPs to my constituency, where, despite the far higher workload, GPs are paid significantly less than those in leafy areas just a few miles away?
Will the Minister give me his word that there will be a transparent process to increase the funding per patient in Tottenham by 20%, so that it is brought up to the
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level of its far wealthier neighbour, Camden? Does he agree that it is disgraceful that the Government have committed themselves to providing a “seven-day NHS”, with weekend GP appointments for 18 million patients, many of whom are in the richest areas of the country, whereas in my constituency 20% of new mothers and their infant children have no access to a GP at all? I look forward to hearing what the Minister, the Government and NHS England, which I hope is paying attention, have to say.
4.26 pm
The Minister for Community and Social Care (Alistair Burt): It is a great pleasure to serve under your chairmanship, Sir Roger. I congratulate the right hon. Member for Tottenham (Mr Lammy) on securing the debate and thank him for his great courtesy in sending me and my officials a copy of his speech, which will enable me to address in my remarks some of his questions. I appreciate that.
I have some knowledge of the area. I was a member of Haringey Council between 1982 and 1984. I represented Archway ward at that time, and I was on the governing body of a school in Tottenham, so I have some feel for the area and I am grateful to it for giving me a start. I sat on benches opposite the right hon. Member for Islington North (Jeremy Corbyn). I think I am now the only Member of Parliament who served on the council with him, so we have a long-standing relationship and friendship. My time in Haringey taught me that it was an outer London borough with inner-London characteristics. I saw at that time colleagues on the Labour-run council wrestling with very difficult issues and problems and I have never forgotten that.
I will tackle some of the issues that the right hon. Member for Tottenham raised. I do not follow all his argument. Yes, there is some element of market principles in the NHS, but I think Mr Blair had something to do with that as well as us. If the right hon. Gentleman would really like to reorganise the national health service completely, I am keen to hear the proposals from those on the Labour Front Bench in relation to that. The structure that we have is one we will have for some time. It does not stop the work being done but enhances the localisation of making sure that the right things are done.
The right hon. Gentleman is right on poverty and inequality. The tragedy of the United Kingdom is that this is not a short-term issue. If we laid a map of poverty in Victorian Britain over a map of the United Kingdom today, we would find remarkable similarities between the two. The issue that all Governments wrestle with is that Government in, Government out, and socialism in or liberal capitalism in, we still have not cracked all the issues of inequality that we want to crack, and everyone has given it a lot of effort. We have to do better and we have to try different things. That is at the heart of some of the different things that the Government have been trying in health service reform. It is a process that will go on, but none of the issues that the right hon. Gentleman mentioned—length of life and inequality issues—has arisen in the past six years. They are long-standing issues that go back many years, which is why it is always essential to work at new initiatives and look for things that are different, to try to make a difference.
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The right hon. Gentleman raised very straightforward and serious issues. All of us in the Chamber pay tribute to those who work in front-line services—the primary care staff. GPs are the first point of contact. Of course, it is not just GPs, but nurses, physiotherapists, occupational therapists, pharmacists and many other healthcare professionals who play a part in delivering high-quality care to patients in practices and in the community every day through the NHS.
In relation to the right hon. Gentleman’s constituency, he quoted extensively from the report by Healthwatch Haringey. Healthwatch nationally is actually funded and part-supported by Government. It is part of the monitoring process that the Government use. I understand that the report “GP Access in Tottenham Hale”, published in September 2014, highlighted a number of serious issues around accessing GP services in that part of his constituency. I thank Healthwatch and all associated with it for all the work that they do.
I am aware that access to GP services is a long-standing issue for local people. I am also aware that many local practices are single handed, and that some premises are not suited to the needs of primary care in 2015. Haringey clinical commissioning group has developed a primary care strategy to address just the sorts of issues that we have heard about this afternoon. That strategy focuses on encouraging practices to work together to run services more effectively, funding initiatives for practices to improve their appointment and triage systems, and encouraging a mix of professionals to work together as part of local networks: for example, welfare advisers, nurseries and healthcare assistants.
A number of practical steps to improve primary care locally have already been taken. In north-east Haringey, a shared call centre has been set up so that staff can respond to patients more quickly. In the south-east of the borough, GPs have worked together to provide telephone consultations for patients between 6.30 pm and 8 pm. In central and western areas of Haringey, Saturday clinics have been established. I understand that the CCG plans to have Saturday clinics and evening appointments available across the whole of Haringey in the new year. The CCG has funded two part-time practice managers to support practices that are struggling to meet access demands, and it is working to increase the number of practice nurses in Haringey through a recruitment programme to enable nurses from other settings to transfer into primary care.
On the important matter of GP premises, I am advised that the CCG and the local council have worked with NHS England to develop a strategic premises plan. The right hon. Gentleman is correct in saying that those have not been adequate, and he is right—as was Healthwatch—to draw attention to that. The premises plan was completed in July 2015. It highlights a shortfall in GP provision and in premises capacity in Haringey. The shortfall was particularly noted in Tottenham Hale and, to a lesser extent, in Northumberland Park. The plan makes a number of recommendations for short and medium-term action.
To date, NHS England London has appointed a local provider of temporary services for up to 6,000 patients in Tottenham Hale. It has also, together with Haringey CCG, sought national approval to use capital funding
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from NHS England’s primary care transformation fund to purchase the temporary premises. It has done so because capital funding is seen as representing best value and minimising annual revenue costs. As the right hon. Gentleman said, NHS England London and Haringey CCG hope to obtain approval for capital funding of the premises on 18 December, which is Friday of this week. However, I understand that, in the event of NHS England not agreeing to provide funds from the primary care transformation fund, the purchase of the premises will still be secured by means of revenue funding. NHS England will continue to work with Haringey CCG to find a permanent site for the practice in Tottenham Hale.
The new GP practice in Hale Village is due to open in the new year. It will start with a zero list and will have the capacity to register up to 7,000 new patients. That development has been welcomed by Healthwatch Haringey as representing a positive outcome for local residents. NHS England has also asked CCGs to set out an overarching estates strategy to ensure that estates resources are used across all of health and social care. As part of that work, Haringey CCG is looking closely at how else it can help to ensure that GP local premises are fit to meet current and future primary care needs, particularly in the light of the regeneration in Tottenham that the right hon. Gentleman mentioned and projected population growth in the area.
The right hon. Gentleman made clear his concerns about the levels of primary care funding in areas of relative deprivation. The national formula is currently under review, and the possibility of giving greater weight to deprivation is one factor being considered. I can reassure him about GPs’ salaries, however. GPs are not paid differential salaries in different areas. The capitation is different, because capitation covers things other than GPs’ salaries, but clearly it could not work if GPs in one area were deliberately paid less than those in another. That is not at the heart of the problem. When it comes to capitation and things that are considered in the national formula, deprivation is being considered as an issue to be looked at further.
Getting more people into primary care is really important. The Secretary of State set out in June details of a new deal for general practice, in line with the five-year forward view, recognising the pressures that GPs are under. We are training, and plan to train, more GPs. In the last Parliament, we increased the number of GPs working and training in the NHS by some 1,700, which is a 5% increase, but we still need more. That is why we have announced plans to increase the primary and community care workforce by at least 10,000 by 2020. That figure includes an estimated 5,000 more doctors working in general practice. That will be a 14% increase in the overall number of GPs working and training in the NHS.
We have established some work to try to reduce the level of workload. Having visited a number of practices in urban deprived areas and others, I can say that there is very much a sense in some practices that GPs are worn down, that they are on a treadmill and that they are worried about bringing new people in. In others, however, sometimes not very far away, GPs are trying something different. They are working with the Prime Minister’s challenge fund pilots or the vanguard sites on different ways of providing their services. Such work can often be the trigger for more doctors being interested in coming into work.
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There is a different side to the pressures on GPs. I am clear that, in practices that are very much under pressure, by reducing bureaucracy and working with them to provide support, we can lift them up from their present difficulties. The transformation fund of £1 billion that will be used to improve premises over the next few years will also make a difference, and it will ensure that premises are fit for purpose when it comes to what we want from primary care in future.
If we are to address the health inequalities that the right hon. Gentleman rightly mentioned at the beginning of his speech, it will be essential for that work to be carried out in the most deprived parts of the country, as in any other. It has been interesting to visit those pilots and look at what has been done. The reorganisation of resources in primary care and the establishment of more contacts with those who provide allied health professional services—relieving some of the pressure on GPs—can have a marked impact, as can the closer integration between the NHS and local authority services in the same area.
We are all trying to lever up standards and deal with the inequalities, as the right hon. Gentleman has mentioned. There are plans, proposals, new initiatives and new ideas, and some of those are demonstrated in London. I hope some of the practices involved, particularly the new ones, will take those opportunities to do something different where they are and try to meet the challenges that they face.
To conclude, as well as the investment in primary care that I have detailed, a number of approaches are making a difference to access to GP services: longer opening hours, to increase the sense of access; better use of telecare and health apps, which are really working and beginning to have an impact on populations that are much more used than some others to using such things; and more innovative ways to access services by video call, email or telephone. Schemes are integrating services in order to offer a single point of contact to co-ordinate patient services across health and social care. Some 2,500 practices have taken part in the access fund schemes, covering more than 18 million patients, so a third of the country will have benefited from improved access to primary care by March 2016. We want to continue to roll out such initiatives to 2020, investing in primary care and making sure that investment is made in the areas where most work is needed. It is clear from what the right hon. Gentleman said that Haringey is right up there.
Mr Lammy: Can the Minister get NHS England to take a greater interest, at leadership level, in Tottenham?
Alistair Burt: I will ask exactly that. I do not doubt that it is doing that already. Clearly, the right hon. Gentleman needs to be reassured, and we shall do so.
Sir Roger Gale (in the Chair): Order.
Motion lapsed (Standing Order No. 10(6)).
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West London Coroner’s Court
4.39 pm
Sir Roger Gale (in the Chair): Before I call Mr Berry to move the next motion, I want to make it plain that it is neither my intention nor my desire to curtail debate. However, I have to advise colleagues that inquests, which are the subject of the House’s sub judice resolution, may not be referred to directly in this or, indeed, any other debate. Investigations that are under way by the Judicial Conduct Investigations Office are not subject to the sub judice resolution, but I ask Members to exercise good sense in referring to such investigations. I will be as tolerant as I can, but I may have to draw the line. Looking at the number of Members present, I would be grateful if speakers apart from the opening speaker would curtail their remarks to no more than about three to four minutes.
4.40 pm
James Berry (Kingston and Surbiton) (Con): I beg to move,
That this House has considered standards of service at West London Coroner’s Court.
It is a pleasure to serve under your chairmanship, Sir Roger, and to see so many colleagues here who have been so vocal on this important issue for their constituents and mine. Two years ago tomorrow, my father died unexpectedly. It was a devastating experience for my family, as death is for every family, but the seamless service from the local council and the coroner made the whole experience just that bit more bearable. Although the registration process itself was clinical, because it was efficient it did not compound our distress as a family. Sadly, the same cannot be said for the experiences of many bereaved relatives of those living in Kingston, Richmond, Hounslow, Ealing, Hillingdon, and Hammersmith and Fulham, which are the boroughs that comprise the jurisdiction of West London coroner’s court.
Since I was elected in May, I have received numerous complaints about the standards of service at West London coroner’s court and about the senior coroner there. Those complaints come not only from bereaved constituents, but from the council itself and, indeed, from our local newspaper, the Surrey Comet. The complaints include: long delays in issuing death certificates; inordinate delays in bringing on inquests; a telephone service that is never answered when relatives call for advice; crass errors on death certificates, such as getting the age or sex of the deceased wrong; and general rudeness to boot.
It is important to note at the outset—I note your guidance, Sir Roger—that I do not intend to criticise the senior coroner personally, because I know that there is a complaint against him by a number of councils, and that that is under investigation. I would not want to impede that investigation, but there are three issues that I would like to consider in some detail: delays, burials for certain faiths, and deprivation of liberty safeguards.
West London coroner’s court has one of the worst records for delays in the country. It takes almost double the national average time to process inquests. The delays are a shocking abrogation of the state’s responsibility to bereaved families, including those in my constituency. The estimated average time taken to process an inquest
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in England in 2014 was 28 weeks—a figure that has been effectively stable over the past five years. However, in west London and in inner south London, the average time taken to process an inquest is 50 to 53 weeks. The figure of 53 weeks is the worst in the country. In West London coroner’s court, the figure is 50 weeks—the second worst in the country.
In my borough, Kingston upon Thames, the target for registering a death is five days from the date of death, or seven days in a case where a post mortem is required. In 2013-14—the period during which the coroner was appointed, as he was appointed in November 2013—Kingston was meeting that target in 70% of cases. In this year, 2015-16, if we continue on the current trajectory, Kingston Council will meet its target in only 11% of cases, and that is because of delays at West London coroner’s court.
In terms of post mortems, prior to the appointment of the current senior coroner in November 2013, the waiting time in Kingston from a death to a post mortem was two to five days, yet between June and September 2015, the average waiting time was four to six weeks. I understand that the situation has since improved somewhat. Those statistics speak for themselves and do not need labouring, so I will return to the bereaved families who are at the heart of the debate.
For most people, an inquest is a new and somewhat unsettling experience at a very vulnerable time in their life. In most cases, bereaved relatives simply want to bury their dead as soon as possible. In a small number of cases, they want answers or an inquest is required by law, but in all cases, they want to have the system explained to them, and to be kept informed of the reason for and the length of any delays.
Ronke Phillips from “ITV News London” has done a lot of work exposing the problems at West London coroner’s court. In October, ITV London brought a number of families affected by services at West London coroner’s court to Parliament to speak to their MPs, a number of whom are here today. The accounts those families gave of the distress they had been caused were quite moving. There were unexplained delays, no updates, and a telephone service that was never answered and turned out not to be manned at all.
Mr Dominic Grieve (Beaconsfield) (Con): I am sorry to interrupt my hon. Friend’s flow, but I do not want to take up the House’s time by making a speech. He highlights some of the issues very well. My constituent, Mrs Doreen Garcia, had what was essentially a completely straightforward issue in relation to her husband’s death. She needed to get a death certificate because it was essential for the administration of the estate, yet she had to wait more than a year for an inquest that, in the end, was a hearing on the papers because of the complete inefficiency of West London coroner’s court.
James Berry:
That experience is by no means unique. In terms of the telephone service, when I called up on behalf of a constituent very early on in my role as a new MP, I had to wait on the telephone for more than 45 minutes, and then it became clear that the call was never going to be answered. Frankly, that plumbs the depth of poor service for bereaved families. As I understand
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it, the senior coroner’s position is that he inherited a backlog from his predecessor in 2013. Be that as it may, he has not cleared that backlog since November 2013, and has compounded the situation with an ill-conceived staff reorganisation and shocking failures to communicate with bereaved families.
Dr Tania Mathias (Twickenham) (Con): On the point about the attitude towards bereaved families, I would like to put on the record that twice I have had people in tears in my constituency surgery over inaccuracies on post mortem certificates, as my hon. Friend the Member for Kingston and Surbiton (James Berry) described. It is extremely distressing for MPs not to be able to improve the situation. I absolutely agree with everything he said.
James Berry: Finally on the delays at West London coroner’s court, it would be easy to blame the situation on cuts, but they are not to blame. I wrote to the chief executive of Hammersmith and Fulham Council, which is responsible for funding the coroner service in west London. He made it clear that although the council has had to make cuts to various areas, the coroner service has been protected from those cuts. The responsibility for sorting out this shambles lays squarely with the senior coroner for west London. He needs to get his house in order for the sake of bereaved families living across the boroughs represented here.
Andy Slaughter (Hammersmith) (Lab): I am grateful for the comment that the hon. Gentleman just made. I have been copied into the letter that he received from the chief executive of Hammersmith and Fulham Council, dated yesterday, which points that out. I am sure it was done in good faith, but on the hon. Gentleman’s website, he has said that the situation could be the council’s fault. I hope that he will correct that. One of the issues that we will deal with is putting blame for this matter where it lies.
James Berry: I do not intend to go into the technicalities of the Coroners and Justice Act 2009, but it is a matter of interpretation as to whether the local council or the police are responsible for providing administrative staff. However, the council is quite clear that there have been no cuts to the funding that it believes it ought to be providing.
Moving on to the subject of religious burials, Jewish and Muslim families have to bury their dead in a matter of days, and the pressure on those doing so is compounded by the situation at West London coroner’s court. I need not say any more about that, because I can simply welcome the Minister’s recent announcement of a review into the interaction that some faiths have with the coroner service across the whole country. I simply observe that in diverse communities, such as those served by the West London coroner’s court and by MPs here, a reliable out-of-hours process for death certificates that are required over the weekend would seem to be the most sensible way forward.
The third point I would like to make is on the matter of national application—the requirement to hold an inquest when someone dies while subject to deprivation of liberty safeguards. Section 1 of the Coroners and Justice Act 2009 requires that a coroner holds an inquest in certain defined circumstances such as a death in state
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detention, or a violent or unnatural death. In other cases, the coroner has discretion as to whether to open an inquest, depending on the facts.
Since the Mental Capacity Act 2005 came into force, the definition of whether someone is detained or deprived of their liberty has been tested in the courts on numerous times. In March 2014, the Court of Appeal considered the cases of P v. Cheshire West and Cheshire Council, and P and Q v. Surrey County Council. In those cases, the Court of Appeal gave a very broad definition of deprivation of liberty. The result of that decision has been that authorisations now have to be sought for deprivation of liberty in many more cases than they used to. That includes most cases where a person suffering from dementia lives in a care home and would be prevented from leaving if they attempted to. An inquest must be held in each of those cases because the individual is deemed to be in state detention. In my constituency, we have a nursing home in which 90% of the residents are subject to the deprivation of liberty safeguards. On the current interpretation of the law, there would have to be an inquest into each and every one of those individuals’ death, even if they died entirely predictably in their sleep.
I am not saying that there should be no inquests at all into deaths where the deceased is subject to the deprivation of liberty safeguards—far from it. I am arguing that inquests should be opened at the coroner’s discretion; they should not be mandatory. It was certainly not the intention of this House in passing the Coroners and Justice Act or the Mental Capacity Act to mandate an inquest in every case in which the deprivation of liberty safeguards apply, nor was it the Court of Appeal’s intention in the P and Q cases, so far as I can work out; the issue was not canvassed before the Court at all because the case did not concern inquests.
In support of my point, the Chief Coroner of England and Wales highlighted the problem in his 2014 annual report to the Government, and highlighted the massive increase in the number of deprivation of liberty safeguards from 11,300 in 2013-14 to some 83,000 in the first three quarters of 2014-15, which will inevitably lead to a huge number of additional inquests. I ask the Minister to find legislative time, as a matter of real priority, to exempt people who die while they are subject to deprivation of liberty safeguards from the mandatory requirement to hold an inquest. That change would reduce the pressure that is building on coroners across the country. It would help, but by no means resolve, the problems at the West London coroner’s court, to which I return in closing. It is clear that something must be done to improve the terrible standards of service in that coroner’s court.
Boris Johnson (Uxbridge and South Ruislip) (Con): I congratulate my hon. Friend on securing this debate and on what he is saying. In the few months that I have been back in this House, I have received an amazing volume of complaints about the West London coroner’s court. Can the issues regarding the role of the West London coroner be properly remedied by the Chief Coroner, or should there be a formal investigation by the Ministry of Justice? We need to get to the bottom of what is going on.
James Berry:
That encapsulates the sentiment of many MPs on this subject. I am pleased to have received reports that the telephone service at West London coroner’s
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court has improved—that has been confirmed by the leader of Hammersmith and Fulham Council—but the inordinate delays in issuing interim and final death certificates and in bringing on inquests must be addressed now. If that means sitting at the weekend, as judges did after the riots, or if it means appointing additional assistant coroners to help clear the backlog, so be it. By whatever means, the senior coroner, for the sake of bereaved families in our constituencies, must get a grip of the situation now.
4.53 pm
Andy Slaughter (Hammersmith) (Lab): I will be brief, not least because this matter, although it is not sub judice, is potentially subject to an investigation by the Judicial Conduct Investigations Office, which is the appropriate body to deal with it. Indeed, in answer to my parliamentary question on 9 November, the Minister confirmed that that is the case. The chief executive of Hammersmith and Fulham Council sent a letter to the hon. Member for Kingston and Surbiton (James Berry), whom I congratulate on securing this debate on a subject of great concern to all MPs in the six boroughs, stating that the council expects to hear back from the JCIO in the second week of January on whether it will launch a full investigation, but clearly that is already under consideration.
Like everyone here, I have had complaints about the West London coroner’s court, and this week I have corresponded with my constituent Angelita Rodriguez about the sad death of James Rodriguez, her late brother, which exhibits many of the problems that the hon. Gentleman identified. It is not necessarily appropriate to go into the individual details of these cases today, but it is not sufficient to blame others for what is going wrong in the coroner’s office. Whatever is going wrong and causing the problems we have heard about, it ultimately falls at the coroner’s door to resolve. I am not impressed by the fact that, at different times, the local authority, administrative staff, the coroner’s officer, the Metropolitan police and even the previous coroner have been passed the buck. I declare an interest, because I chaired the panel that appointed the previous coroner, Alice Thompson, some 15 years ago—I was then the leader of Hammersmith and Fulham Council. She had more than a decade of distinguished service and conducted some of the most difficult and complex inquests.
This is a matter that concerns literally millions of people across west London, because the six boroughs have a population in excess of 1.5 million people. The coroner’s court deals with people at a time of great stress and in extremis. It is often considered a bit of a Cinderella service. I am very glad that we managed to persuade the coalition Government not to abolish the post of Chief Coroner before it was introduced, and Peter Thornton is doing a very good job. Coroner services can and do go wrong from time to time, but they are an essential and ancient part of our judicial system. It is vital that those services work well, so I hope we will see a full investigation in the new year. I am pleased to hear that there has been some improvement, and I know that the borough council, which is the providing authority for these purposes, is taking the matter seriously in respect of its responsibilities, and I am sure the Metropolitan police are doing the same. In the end, the buck does have to stop with the West London coroner.
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4.56 pm
Stephen Pound (Ealing North) (Lab): I echo the feelings of everyone here today in thanking the hon. Member for Kingston and Surbiton (James Berry), and I express our sympathy for his personal loss. He understands, as do many of us, but perhaps not to the same degree, how much pain can be caused by even casual incompetence. Just under 18 months ago, a very talented and beautiful 14-year-old girl in my constituency, a neighbour of mine, died. I will not refer to the case directly, but we now know that the case papers were left on a train—I can scarcely imagine the pain and agony caused to that family, who suffered again.
Like all Members here, I have a catalogue of complaints about the operation of the coroner’s office, and they tend to fall into two categories. One is the most basic administrative errors. A constituent of mine, Roniel Mulchan, died on 28 November last year. His mother had some very basic and simple questions to ask of the coroner. We wrote in February 2015, in March and in June—no answers did we receive.
I hear from the hon. Gentleman that the telephone system has improved, and I would like to say that to my constituent Sally McMahon, whose mother died very recently, God rest her soul. My constituent tried to ring the coroner’s office and was told that it shut at 4 o’clock —this was at 3.20 pm. I rang on 10 December and received the same message at 3 o’clock in the afternoon saying, “We are only open until 4 o’clock.” That is casual incompetence of a degree that piles Pelion on Ossa when it comes to the suffering of individuals.
In another particularly unpleasant case, the absence of information was so awful that I wrote to the Judicial Conduct Investigations Office in July 2015 on behalf of Dr Batten, whose relative, a constituent of mine, had died. The complaint started with the typical waiting for 45 minutes, rudeness and that sort of stuff, which could almost be discounted. However, as part of the response I received from the Judicial Conduct Investigations Office—my hon. Friend the Member for Hammersmith (Andy Slaughter) is familiar with this, as I am sure the Minister is, but I had previously been unaware—I learned:
“The Coroner’s Office is not run directly by the Coroner, staff and resources are provided by the Local Authority for the area and the Police service. Therefore, if you wish to further your complaint about your experience with the Coroner’s Office…you may wish to contact the Police Service and the Local Authority”.
Sir Roger, you are a distinguished Member of Parliament and you have probably dealt with more casework than anybody else in the room. When you receive a letter such as that, I am sure your reaction is precisely the same as mine, which is, “How on earth can we operate a system where the buck is passed with such dizzying speed that it is more like an ice hockey puck, and it cannot be slowed down in court?”
However, in many ways the most unpleasant, the most egregious and the most disturbing case that I know of relates to the daughter—the child daughter—of my constituent, Mr Seefat Sadat. His daughter died on 17 April 2013. After six months, he came to see me to ask why the inquest had not yet taken place, and I wrote, and I wrote, and I rang, and I wrote, and I wrote again. I then contacted the then Minister, the right hon. Simon Hughes, and received a response from the right hon. Member for Epsom and Ewell (Chris Grayling) in April 2015. Two years after this child’s death, the inquest
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had not taken place, and we were told that there were various reasons for that. The right hon. Gentleman—I place no blame whatever at his step—said that the West London senior coroner, who has been referred to obliquely today, telephoned my constituent, as he says,
“on or around 1 April”—
“explaining the problems within his area that have caused this long delay and that he now expects the inquest to take place in June”,
And saying that the coroner was going to reallocate the case on Morwa Sadat’s death. The right hon. Gentleman then went on to point out some structural difficulties and problems within the system.
That simply is not good enough—it is not good enough. We are talking about people who are in agony, who are grieving and who are in pain, and they are hanging on the telephone. They are being fed nonsense, and a child’s death remains unexamined for two years—two years—and I have to bring in Ministers in the coalition Government and even Ministers in the present Government. Fortunately, thanks be to God, it has now been resolved.
How on earth can we say to our constituents, “Trust the system, trust the coroner’s office”, when we have this constant, almost ceaseless, list or catalogue of incompetence? Even when the incompetence is almost casual incompetence, the reverberations it causes throughout a family are so awful.
Dr Mathias: I have had experience of very similar situations, and what is distressing for us as MPs is that people’s grieving process is unnecessarily extended and made worse, so there are not just administrative consequences.
Stephen Pound: The hon. Lady speaks from a privileged position, because in her profession before she entered this place she obviously had closer dealings with the coroner’s office than many of us do. The fact that she says that certainly adds weight to the point, and I am even more concerned given that she makes those comments.
Mr Grieve: The case that I cited was unusual, because, as the hon. Gentleman will appreciate, my constituency does not fall within the area of the coroner in question. I was therefore particularly startled to receive the information from my constituent about the difficulties she was having with that coroner’s court, because it is so completely at variance with my experience of the other coroner’s courts that I have had to deal with. I would be most interested to know what is so particular about west London as to cause these immense problems, if indeed they are outside the coroner’s hands.
Stephen Pound: The right hon. and learned Gentleman also speaks from a position of great authority. It is not for me to say; I hope that the Minister, when she responds to the debate, will indicate some way in which we can ventilate these issues further. I do not believe that west London is unique; I do not believe that it has more problems than, for example, east London. What I think we are talking about here is a structural failure. There is a failure of leadership, without a doubt. The problem is that we have a failing structure, and the leadership required to take the matter forward is absent.
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I am conscious of your strictures, Sir Roger, and I want to allow other people to speak. I will simply close by again congratulating the hon. Member for Kingston and Surbiton on securing this debate and expressing my sympathy to him. I add that the finest tribute in remembrance of his father will be if we, today and in this place, can improve the situation not only for individuals here today but for all our constituents now and in the future. Quite frankly, anything else would be wholly and utterly unacceptable.
5.4 pm
Dr Rupa Huq (Ealing Central and Acton) (Lab): I am a new MP. I have only been here since May, but even from that short time, the vivid stories that Members from all parties have described are depressingly familiar to me from doing surgeries once a week for two hours.
I completely understand that it is not helpful to bring up individuals and hang people out to dry, and it is not my intention to do that today. However, I will highlight a couple of cases to see whether lessons can be drawn from them whether we can find ways forward.
I received an email in the summer from Sharon Hennelly and her sister, about their brother. They said:
“We have been contacting the coroner’s office for a year trying to find out when we will get an inquest. We have phoned on numerous occasions and been kept in a queue for up to 2 hours. Our emails now go unanswered. We have no information about the circumstances of my brother’s death. He was hit by a train at Barons Court tube…It is now 19 months later and we are completely at a loss”.
Their brother died in 2014, so we are approaching the two-year mark since it happened, since when they have been dealing with the case.
There appear to be common problems, including the length of time it takes for cases to appear in the coroner’s court in question. A report from 2015 in the Kingston Guardian says that at another inquest in April, the coroner himself confessed that he was “deeply embarrassed” by the length of time it took for cases to appear in his court, and that cases should not be taking 18 months to appear in court. He said:
“In future they will not.”
However, it seems that things have continued since then.
Communication problems seem to be common, including the speed at which communications are made. My hon. Friend the Member for Ealing North (Stephen Pound) described such problems. We have all heard stories about people being made to wait for hours on the phone and then, when that draws a blank, physically turning up in person, only to receive rather brusque treatment. The appropriateness of the communications is a problem in what are obviously sensitive situations. The hon. Member for Twickenham (Dr Mathias) is a medical professional. People talk about “bedside manner” in the medical profession, but the bedside manner of the coroner has been found wanting on many occasions.
My hon. Friend the Member for Hammersmith (Andy Slaughter) mentioned that the interpretation of what constitutes west London seems to be quite generous. There are six boroughs. My borough alone, Ealing, has 350,000 people, and the population of the six boroughs put together is getting on for a couple of million people, so maybe we should examine that unmanageable area. In one of his communications with me, the coroner
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referred to the time when the coroner’s court in Uxbridge was in operation. I do not know what happened there, but perhaps such a wide geographical area is unmanageable for one coroner.
There are several cases that I could cite. Theresa from east Acton was administering funeral arrangements for a 97-year-old deceased friend who had no relatives. She waited for four months, and it was only when the funeral director, W Sherry & Sons of Acton, intervened that it was found that the case did not require a post-mortem. There was no need for a coroner, so that sped up the process and the burial could take place. However, we hear horror stories of bodies waiting in fridges and people being left in limbo.
I must say that the communications that I myself have had from the coroner’s office have been completely defensive and displayed a complete inability to accept any kind of criticism, even though constructive criticism could be helpful as we move forward. One of the emails I received said:
“This office, under pressure, attempts to deliver a standard of service that befits all the deceased”
and that is “faith-neutral”. The hon. Member for Kingston and Surbiton mentioned that Muslim burials in particular are meant to be expedited quite soon after the death. Perhaps sensitivity could be shown in such situations, and if the coroner’s office is under pressure, perhaps there are things we can do to help.
As my hon. Friend the Member for Ealing North mentioned, the notoriety of some of the cases in question has spread beyond west London and they have become cases of national interest. Leaving an important case file containing sensitive information on a train is not good practice; I believe that case has now been transferred to Westminster coroner’s court. As far as I understand it, it is a rare occurrence to have a case completely transferred.
I will chop my speech because we have limited time. This coroner has said in his communications to me:
“The Coroners Court is a court of law. It is the oldest Court in the country. A judge can only make determinations based on evidence.”
The evidence seems to be that standards at this coroner’s court are falling short of what people in west London, across six boroughs, expect. We need to improve that experience.
People never know when they will need a coroner’s services. As Members have said, it will be at a moment when people are raw, grieving and going through a healing process, so heavy-handedness is not what is needed. Most people have a positive experience. I have been an Ealing resident for 43 years. My father passed last year. It was not a controversial death, so there was no cause to contest anything, but for those who do have problems, we need to make the experience better.
5.10 pm
Ruth Cadbury (Brentford and Isleworth) (Lab):
It is a pleasure to serve under your chairmanship, Sir Roger. I thank the hon. Member for Kingston and Surbiton (James Berry) for securing the debate and speaking at a time that may not have been easy for him. I concur with what other Members have said about the memory of his father and about seeing whether there is anything we can do to help the many people—our constituents and
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their families—who are going through such pain. I also thank him for doing the research on comparative examples to let us know that what we are experiencing is not normal.
Delays in death certificates cause huge disruption and pain to those coping with the death of a loved one. We must not underestimate the problems that the delays at the West London coroner’s court have caused, especially for those planning religious burials, as has been mentioned. I want to share two examples from casework in my constituency, which illustrate two different aspects of the administrative problems being experienced.
First, a constituent of mine sadly passed away at his home in Chiswick in April this year at the age of 85. He had not seen two doctors in the preceding months, so his body was taken to the mortuary and referred for an autopsy. In order to make arrangements for the funeral, the family rang the coroner’s office to establish timings for the release of his body. They were held in a queue for more than 50 minutes without reply and directed to send an email. Two weeks later, the family were still waiting. They had not received an acknowledgement of the email and no phone calls were answered or returned. They did eventually get an answer, but for 16 days, the family had no idea whether the remains would be subject to autopsy or when the body would be released back to the family. That is a common situation.
Secondly, Cheryl Hounslow is the ex-wife of Raymond, who died and an inquest was needed. Although estranged, she was the next of kin. He died in April 2014, and she waited 15 months for an inquest that only went ahead, so far as I understand, after my intervention. It turned out that the person handling the case had all the files ready to present to the coroner within two months, but for some reason they were not passed on. I understand that the staff member may have left, but the case could have been passed on for inquest in June 2014. Every organisation should have a procedure for what happens when staff leave, and files should not disappear when someone leaves an organisation. Cheryl could not get through on the phone and got no response to five emails. It was only when my staff got involved that the case was looked at again. In fairness, when the coroner found out that the paperwork had not been passed on, he expedited the hearing and allowed Cheryl to choose the date of the inquest. He blamed the local authority and the Met police for the poor customer service. With that inquest being brought forward quickly, it will have meant someone else waiting longer.
In any organisation, someone somewhere must be responsible for performance standards. I spent 25 years in local government, and we had systems, processes and accountability. That seems not to be the case in this example. The coroner is a public service that people need when they are at their most vulnerable. I hope that the Minister can respond with a plan of action for us and our constituents.
5.14 pm
Jenny Chapman (Darlington) (Lab):
It is a pleasure to serve under your chairmanship, Sir Roger. I am astounded by the humanity, sensitivity and care with which Members have presented cases on behalf of their constituents. I cannot think of anything more distressing for someone having lost someone dear to them than having to deal
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with such poor administration as some constituents have had to endure. I congratulate the hon. Member for Kingston and Surbiton (James Berry) on securing the debate and on the incredibly sensitive manner with which he presented his argument. I was also struck by my hon. Friend the Member for Ealing North (Stephen Pound), who normally speaks with great humour and characteristically puts a lot of anecdote into his speeches. There was not one shred of humour today, such is the seriousness of the case he was arguing.
We seem to be having three different problems with West London coroner’s court: errors on certificates; delays; and, rudeness, lack of care and poor communication with families. I will not go into specific cases in detail, but some of the comments that the families have made are useful in illustrating the problems. One said:
“After months of emailing I finally got a reply but my complaints were not acknowledged. In July this year I finally got the post mortem report riddled with mistakes. Talking about my daughter and referring to my mum as ‘miss’. It was harrowing enough reading but the mistakes made me feel that my mum was just another body.”
Another family said about a very young child:
“My granddaughter’s baby boy died on the 3rd of January this year. And she still has not had a death certificate or told why he died. He was 11 weeks old and she is still devastated.”
“This was after they had put my late father’s place of birth as my mother’s home address. We still haven’t been getting full responses to emails and it’s only been 4 1/2 months since my father died, so I expect they won’t have the inquest in the next year, let alone get a full death certificate. They are an utter disgrace.”
Some people know more about this issue than MPs: funeral directors. I cannot imagine the frustration that funeral directors must be experiencing. One said that
“my heart sinks when we have to call them. To stand a chance of getting a reply we call at 7am and they answer around 3pm! It’s awful when other calls come in and all people can hear in the background is ‘your call is number ** in the queue’!”
It is maladministration, it is bad practice, and it is insensitive. It is not good enough and it should not be happening in this country in 2015.
As my hon. Friend the Member for Ealing North said, we are looking at a structural failure and a failure of leadership. It is surprising to families when they discover that it is difficult to know where to complain. There are many organisations with a hand in the issue, such as the council and the Metropolitan police. It is unfortunate that the hon. Member for Uxbridge and South Ruislip (Boris Johnson) has had to leave, because I would have been interested to hear an intervention from him.
Dr Huq: The hon. Member for Kingston and Surbiton (James Berry) referred to the ITV News investigation. One of the emails I have from the coroner says that
“this complaint is fuelled by the recent unbalanced ITN news items.”
That is what I mean by the inability to take criticism—someone who is grieving has been pooh-poohed by the coroner saying that it is media manipulation.
Jenny Chapman:
I was not aware of that as I am from the north-east and I do not watch the local news when I am down here. What my hon. Friend says gives a good
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indication of the lack of care and sensitivity that has been experienced by families who have to access the service at such a devastating time. It seems odd to me that councils and the Met provide admin staff support, but do not have responsibility for the overall service. That confuses families at a time when they should not be expected to find their way through some web of the civil service.
I will not speak for too much longer, because I want to give the Minister as much time as possible to explain what she intends to do to put that right. As my hon. Friend the Member for Hammersmith (Andy Slaughter) has indicated, the council has called for the JCIO to investigate.
Stephen Pound: I want to put something seriously on the record, bearing in mind what my hon. Friend has just said, before the Minister responds. The debate is more in sorrow than in anger. It is not an attack on the Government in any way, shape or form. We are absolutely united here. The tone struck by my hon. Friend is exactly the right one. We are not seeking to blame the Government, but we are looking for some hope from the Government on how this situation can be resolved with the greatest expediency.
Jenny Chapman: That is exactly right. I know the Minister will care deeply about this and will want to respond and put this matter right as quickly as she possibly can.
The JCIO will let us know in January whether it intends to conduct a full investigation into matters in west London. I sincerely hope that it agrees to do that, and I hope that it is done in a timely fashion so that families who are currently experiencing delays can have their cases heard as quickly as possible, and so that the wider community can have confidence in the service. That is something the Minister will care deeply about and will want to put right. I will stop now so that she has as much time as possible to let us know exactly what she intends to do.
5.21 pm
The Parliamentary Under-Secretary of State for Women and Equalities and Family Justice (Caroline Dinenage): It is a delight to serve under your chairmanship, Sir Roger. I congratulate my hon. Friend the Member for Kingston and Surbiton (James Berry) not only on securing this important debate, but on the incredibly diligent work that he has done. I took on this role earlier in the year and already I am aware from my own postbag of all the issues that he has raised, namely the standard of service at West London coroner’s court, the provision of coroners’ out-of-hours service to facilitate religious burials, and the need for inquests into those who died while under a deprivation of liberty safeguard. All those matters are of concern to many people.
My hon. Friend wrote to me in September to bring my attention to the case of his constituent who had to wait nearly two weeks for a death certificate from the West London coroner’s office after her husband died. Other hon. Members have today raised issues of their own—disturbing and heart-breaking stories in many cases. I am grateful to them for doing so, as I am sure their constituents will be.
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Andy Slaughter: The Westminster coroner is not here to defend himself, so I will cite the case of James Rodriguez that I mentioned earlier. The post mortem was carried out on 30 April. By the coroner’s own admission, five months later they had not chased up the results, and he says now to the bereaved relatives, who have no death certificate at this stage, nine months later,
“I will not guess at this stage”
when that will happen. That is not in dispute, and that is the level of service we are dealing with.
Caroline Dinenage: I am grateful to the hon. Gentleman for bringing that to my attention. I am absolutely clear that the needs of bereaved people should be at the very centre of all coroners’ services. That was supposed to be the main aim of the coroner reforms that we implemented in July 2013.
The West London coroner’s office in Fulham is very busy. It covers a large geographical area, as we know. In 2014 the office received 3,437 reports of deaths and 383 inquests were held. However, that is no excuse for poor, inefficient, rude and insensitive services, or, in some cases, a lack of communication, particularly at such a difficult time when people are grieving. My hon. Friend the Member for Kingston and Surbiton is not the only Member whose constituents have been unhappy with the level of service they have received from the West London coroner’s office, particularly with regard to the responsiveness of the office. Several Members have written to me detailing individual cases of constituents who have encountered delays, lack of engagement and rudeness from the coroner’s office, and other Members have raised that today.
My officials and the Chief Coroner’s office have also been alerted to problems. These include bereaved families not being able to access death certificates in a timely manner; delays in holding inquests, which is particularly stressful for bereaved families when they are already going through a very upsetting time; and not having staff at the end of the phone to deal with queries and concerns when they are needed. I understand that a number of complaints have also been lodged with the London Borough of Hammersmith and Fulham and that my hon. Friend the Member for Kingston and Surbiton has written to the council’s chief executive on this matter as well.
Earlier this year, the Chief Coroner went to Fulham to visit the senior coroner and his staff. Along with him were representatives from the local authority, which provides the funding and infrastructure for the local coroner service, and also representatives from the Metropolitan police, which provide the coroners officers, who are the front-line staff who deal with bereaved people. The senior coroner, the local authority and the police all have a role to play in improving the service. They discussed the issues together and looked at ways to resolve them, and an action plan was agreed. I am pleased to note that, as a result, we are beginning to see signs of a more positive picture emerging from west London. The office has reached its full complement of administrative and investigative staff, including a coroner’s officer manager and six new coroner’s officers. There is now a new way of managing the telephone system so that administrative officers deal with all phone calls in the first instance to relieve the burden on the coroner’s officers, thereby allowing them to focus on progressing
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cases. However, I take on board the recent instances that the hon. Member for Ealing North has raised about his own experiences with the telephone service. I have made a note of them and my officials will certainly deal with that, because that is not acceptable.
Members will be pleased to hear that west London has now reduced the backlog that it inherited. The senior coroner inherited 400 outstanding inquests when he took up post. That has now been reduced to 70 cases and it is anticipated that these final historic cases will be cleared by the end of February, which will allow staff to focus fully on new cases. The senior coroner has attempted to clear the backlog by making sure there are two courts running in parallel with his assistant coroners hearing cases alongside him.
As the Minister with the coroners portfolio, I share the wish of all Members in the Chamber to resolve matters as quickly as possible. As they have already articulated, the process is not straightforward. The Ministry of Justice has overall responsibility for coroner policy and law, but the responsibility for the delivery and funding of coroner services is a local matter for the appropriate local authority, in this case the London Borough of Hammersmith and Fulham. It is for it to decide how to run and fund the coroner services.
Ruth Cadbury: The Minister has outlined where the funding lies and where responsibility for the overall policy and strategy lie. Where does overall responsibility for the monitoring and reporting of performance of coroners’ courts lie?
Caroline Dinenage: That would lie with the coroners themselves and with the Chief Coroner, whose post was created in 2012. We now have a Chief Coroner who is responsible for overseeing all such matters, but where there are cases that need to be investigated, it is up to the Judicial Conduct Investigations Office. It is currently investigating the conduct of the West London senior coroner, including the case that the hon. Member for Ealing North referred to earlier. That case has been transferred to the inner west London coroner, Dr Fiona Wilcox, who will now be dealing with it. In cases where performance has not been as expected, it is up to the JCIO to carry out investigations.
Ruth Cadbury: The Minister referred to standards. Is there a set of standards for how coroners have to deal with cases? What are the measures against which we know that delivery is getting better or worse, or is adequate, satisfactory or inadequate?
Caroline Dinenage: That was all included in the coroner reforms. If the hon. Lady gives me just a little time, I am about to talk about them.
As I said earlier, bereaved people must be at the heart of the coroner service, and that was the key aim of the reforms in the Coroners and Justice Act 2009. The coalition Government implemented those reforms, including the rules and regulations that underpin the Act. The provisions came into force in July 2013 and introduced the role of the Chief Coroner. In September 2012, his honour Judge Peter Thornton QC was appointed as the first Chief Coroner. He has already played a central role
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in providing guidance for coroners on the new national standards for coroners set out in the legislation. Coroners are now required, for example, to conclude an inquest within six months of a death being reported to them, or as soon as practicable afterwards. They are also required to report coroner investigations that last more than 12 months to the Chief Coroner, who is in turn required to report on that to the Lord Chancellor and to Parliament in his annual report.
For bereaved people and families, the most significant development under the 2009 Act was perhaps the “Guide to Coroner Services” booklet, a document published by the Ministry of Justice that sets out the standards of service that people can expect from coroners’ offices and what they can do if they feel that those standards are not being met. It is vital not only that coroners know what the standards are, but that bereaved people understand how a coroner’s investigation is likely to proceed. The guide is accompanied by a shorter leaflet that sets out the key aspects of an investigation. We have sent hard copies of the guide and the leaflet to every coroner’s office in England and Wales so that they can be given to every bereaved person or family. The guide is also available on the gov.uk website.
Jenny Chapman: What the Minister is saying is very interesting, but we are talking about a service that has failed. It has been failing, persistently, for some time. It has been flagged to any authority that anyone can think of, yet we have seen the failure continue. What does she think she might need to do to ensure that we do not have this kind of delay in taking action should such a situation arise again in future?
Caroline Dinenage: A lot of the reforms that were part of the changes over the past two or three years will begin to take effect soon. There are obviously a number of issues at play here. We are dealing with a situation where someone is already under investigation. That may well continue, so there are a number of things to consider.
I shall make some progress because I want to address in full the concerns raised by my hon. Friend the Member for Kingston and Surbiton about the provision of out-of-hours coroner services. I am aware that faith communities, particularly the Jewish and Muslim communities, are concerned about the lack of an out-of-hours service because that can delay the timely burial of their loved ones required by their faith. As part of our commitment to improve coroner services, we have recently completed a post-implementation review of the coroner reforms that we implemented in 2013, seeking views on, among other things, the availability of out-of-hours services. We have now received all the responses, which are being analysed, and I hope to come back to the House with a report in spring next year.
While the review was ongoing, we also worked with London local authorities and the Metropolitan and City of London police to develop a pan-London out-of-hours service. The police and local authorities are now also planning to commission a more general review of coroner services in London to see how resources can be better shared and managed to streamline and improve both in-hours and out-of-hours services in the hope that that will also address some of the issues raised by Members today.
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On deprivation of liberty safeguards, my hon. Friend the Member for Kingston and Surbiton raised concerns about additional distress caused to families and the pressure put on coroners’ workloads by their having to conduct inquests into the deaths of those who were under a deprivation of liberty safeguard when they died. The safeguards frequently occur in care homes or in long-term hospital care, even when someone quite plainly dies of natural causes. That is because of a Supreme Court decision last year that held that such individuals are effectively in custody when they die, which is a category of case that coroners are under a statutory duty to investigate. With that in mind, I have been speaking to the Minister for Community and Social Care. We agree that we need to do what we can to solve the problem as a matter of urgency. My officials, together with their counterparts from the Department of Health, are looking at how we can remove the burden while maintaining the protections put in place for those who truly are in state custody.
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I am grateful to my hon. Friend the Member for Kingston and Surbiton for all the matters he raised today and to all those who have raised concerns about the West London coroner’s court, out-of-hours services and the deprivation of liberty safeguards. I have welcomed the chance to hear more details about such concerns. I have set out measures that will lead to improvements across the country, but we will continue to monitor and will be grateful for feedback as we move forward.
That this House has considered standards of service at West London Coroner’s Court.