I am proud of my city council in Southampton, which has faced cuts of £71 million in the past three years, but by heroic efforts and enormous ingenuity has
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nevertheless kept the libraries open across the city, road repairing schemes up and running, and all children’s centres open, yet it faces further shortfalls in its budget that it will have to plug every year over the next period. We know where the cuts of £3.5 billion announced by the Chancellor for the next period are almost certainly going to fall—on local government and thereabouts. That will exacerbate the shortfalls that local government faces, not just in Southampton, but across the country.
We also face a business rates revolution, which at most can be described as half-baked because of the ill thought-out way it will come to the aid, if at all, of local government. This change in business rates will result in local government having to rely entirely on business rates and local taxation by 2020, but no thought has been given to changes in small business relief. We do not know how changes to business rates will be distributed. We do not know whether the change from the retail prices index to the consumer prices index will mean a substantial reduction in the pot for local government, relying as it does on business rates.
In short, the Budget does nothing to come to the aid of local government at a time when that is needed by people who rely on local government services now and in future. The Budget has failed those people and, unless rapid changes are made, it will continue to fail them.
9.13 pm
Robert Neill (Bromley and Chislehurst) (Con): I could not disagree more with the hon. Member for Southampton, Test (Dr Whitehead) about the impact of this Budget on local government. The Budget should be welcomed by all in local government with self-confidence and belief in their own communities. The opportunities offered by the devolution of business rates and other financial measures are real and should be seized.
The business rates devolution is particularly welcome. I note that in opening the debate the Secretary of State properly recognised that where, as a result of national policy, the tax base is reduced by increasing the reliefs on small businesses, that will be compensated for by the section 31 grant. I hope the Minister replying to the debate will take on board the importance of that being uprated on any future changes of Government policy, so that the tax base of thrifty and effective local authorities is not thereafter eroded.
The second point I want to make is on the setting of the baseline for the retention of the business rate, on which the Department’s is currently conducting a six-month consultation. That is a complicated matter. It is nonsense to suggest, as one hon. Member did earlier in the debate, that business rate-rich areas such as Westminster will retain everything. There is always an element of redistribution, but we have to get the system right, because we do not want too frequent resets—there has to be a long-term run to give local authorities a real incentive to invest.
I hope we will use the ability to calculate the baseline to do greater justice to authorities such as mine in Bromley that have a long record of efficiencies. In the past, we have tended to calculate local government finance settlements on the basis simply of a needs-versus-resource matrix. That does not take account of the fact that some local authorities have been more effective and
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efficient than others in using their resource. When we look at the baseline, I hope we will find a measure that recognises and rewards councils with records of historical efficiency. It is perfectly possible—indeed, it has already been demonstrated—that we can achieve comparable unit costs for services in similar authorities. We need to look at that carefully in setting the baseline, because it will give a further incentive to authorities that use their money well. That is an important step forward.
Finally on business rates retention, I welcome the news that the Greater London Authority will have 100% retention advanced to 2017. The logic is surely—I hope the Minister will confirm this—that that should apply to the London boroughs too, because they are the collecting authorities for both tiers of business rates, and they often participate together in funding the kinds of ambitious devolution project in London that we are keen to bring forward. The logic, therefore, is that all of London should, rightly, have 100% retention at the earliest opportunity.
9.16 pm
Mrs Sharon Hodgson (Washington and Sunderland West) (Lab): In the time allotted, I cannot cover all the items that make up this ultra-shambles of a Budget, but I will set out a few.
The Government believe that the complete academisation of our schools by 2020 will help to address the widening gap in educational outcomes for the most disadvantaged in our schools. Yet there are many concerns about what that will mean in reality, especially for children with special educational needs and disability.
Since the publication of the Department for Education White Paper, many parents and organisations have contacted me regarding their concerns about what the proposals will mean for children with autism, dyslexia or other special educational needs or disabilities. Evidence has shown that academies have higher rates of exclusion of children with SEND, who are then pushed into local authority maintained schools. Once all schools are academies, who will take the excluded children with SEND? Those children are as worthy as any others of receiving a high-quality education, and I hope the Government will ensure that we continue to have an inclusive education system and that children with SEND are not sidelined or excluded in the fully academised school system they are creating.
Other announcements by the Chancellor failed to recognise the need for further investment in the north-east. That was seen clearly when he announced £80 million for Crossrail 2 in London and the next phase of high-speed rail—High Speed 3—which will go only as far as Leeds. Some of us live more than 100 miles further north, in the north-east, and I wait with bated breath for the day when HS4 or HS5—or will it be HS 67?—reaches us in the north-east.
The Chancellor obviously sees himself as the King in the North, with his northern powerhouse project, but he needs to realise that there is a lot more of the north before he gets to the wall—that is Hadrian’s wall, not the one in “Game of Thrones”. If he truly wants to be the King in the North, and we all know he has—or should I now say had?—ambitions for higher office, he needs to realise that there is a large section of the north
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between Yorkshire and Scotland called the north-east and to ensure that investment is directed to our region too.
However, there is still something the Chancellor can do now—invest in the future of the Tyne and Wear Metro. The rolling stock has not been updated in its 36-year history. However, for an estimated £400 million, a much-needed completely new fleet could be built, which would future-proof the network into the 21st century, with options for dual voltage giving it the ability to procure vehicles suitable to support future route extensions, such as the expansion into Washington via the Leamside line, which I have campaigned for more than 10 years. That would help not only to drive economic growth, with improved connectivity to other parts of the region, but provide the vital jobs we need through the building of the new fleet.
9.19 pm
William Wragg (Hazel Grove) (Con): It is a pleasure to be able to speak, albeit briefly, in this debate, and I thank you, Madam Deputy, for accommodating as many speakers as possible.
The Budget contains welcome measures to improve our schools so that all children get the best start in life. It includes extra money to every school in England either when it becomes an academy or when it is in the process of conversion. That process is relevant to the DCLG, as the role of local education authorities will be reduced. The academies programme is transforming education for thousands of pupils across the country.
My closeness to the issue and my personal experience as a teacher mean that I sympathise entirely with many of the frustrations that teachers sometimes express towards LEAs, but I do not want to speak with vitriol—quite the reverse. I do not think that LEAs have been all bad. In many circumstances, they have empowered staff and they will play an important role in continuing school improvement over the next four-year transition period. I emphasise that it is important that the Government get the policy clear, and I hope it will be implemented in a considered way, without rancour from either schools or local authorities.
Most importantly, this Budget accelerates the move towards fairer funding for schools, which I welcome after a long campaign. Indeed, last December I presented to the House a petition calling for a fairer school funding formula, which was signed by hundreds of local parents and teachers in my constituency. I am delighted, on behalf of my constituents, that their voice has been heard.
My right hon. Friend the Chancellor confirmed on Wednesday that the arbitrary and unfair system of allocating school funding will be replaced by a fairer national funding formula. Under the proposals, every school and local area, no matter where they are in the country, will be funded fairly, according to need.
The starkness of the current discrepancy in funding was brought home to me when I visited a school in Stockport on Friday. The Pendlebury Centre pupil referral unit works with some of the most vulnerable students from my constituency, yet its per-pupil allocation is several thousand pounds lower than that in neighbouring authorities. I therefore congratulate my right hon. Friend the Chancellor on this bold and important policy.
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I also welcome the new £20 million-a-year northern schools strategy, which will help transform northern schools and tackle the discrepancies in school performance that have resulted in educational progress in some parts of the north lagging behind that in the rest of the country.
In conclusion, I welcome many elements of the Budget, particularly those to which I have referred, but I will add my voice to those welcoming the rethink by Her Majesty’s Government over disability benefit matters. It is important to keep our country on the right track to recovery and to continue to grow faster than any of our European neighbours. It is also important that we take the right decisions to make people better off, protect the vulnerable, help business, boost jobs and invest in our children and the next generation.
9.22 pm
Norman Lamb (North Norfolk) (LD): There are moments when events have a profound effect on politics, and I believe that this Budget and the subsequent resignation of the Secretary of State for Work and Pensions is one of those moments. He said that this is a “deeply unfair” Budget and that we are
“drifting in a direction that divides society rather than unites it”.
“it just looks like we see this as a pot of money, that it doesn’t matter because they don’t vote for us”.
That strikes at the very heart of any sense from the Conservatives that we are all in this together. It also reinforces the public’s view of the Conservatives that, ultimately, they will not govern for the whole of the country. This is a profoundly dangerous moment for the Conservatives.
The Budget is unfair in two particular respects, both relating to the rich and poor. It cuts taxes for better-off people while striking at those with a disability. At the same time, it completely protects the interests of better-off older people while putting all of the burden of welfare cuts on those of working age. That is not fair. The former, well-respected Conservative Minister, David Willetts, has talked about the break in intergenerational fairness, and this Budget is an example of that.
In the time available to me, I want to focus on the NHS and care. Of course, they were not mentioned at all in the Budget, but it seems to me that we are sleepwalking towards the edge of the precipice. It is accepted by everyone that we are looking at a gap of about £30 billion in the NHS budget by 2020, and a gap of about £6 billion in social care, according to the Independent Health Foundation. That does not take into account another £1 billion for the increased cost of the minimum wage. We are due to spend a reducing percentage of our national income on health and care between now and 2020, at a time when demand is rising massively. If we are to have any chance of achieving the objective of genuine equality for those who suffer from mental ill health, investment is required, but such investment is not forthcoming from the Government.
I repeat my plea to the Government that we should work together on this. Partisan politics have failed to come up with a solution. We need a cross-party commission to get to grips with the problem and come up with a long-term settlement for the NHS and for care—a Beveridge report for the 21st century.
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9.25 pm
David Mowat (Warrington South) (Con): I want to speak about two issues: the northern powerhouse and devolution. Neither of those initiatives is perfect, and I have some thoughts and suggestions on both, but they are an awful lot better than anything we have seen for the last 20 years. The Opposition might want to remember that.
I also want to talk about the direction of travel of the Budget. When we came into office, £1 was being borrowed for every £4 that was spent. We are trying to fix that. Labour Members are right; it has taken us longer than we thought. Perhaps they wanted us to cut harder. This evening, however, we have heard that as well as the bedroom tax being wrong, every single cut that has been made was wrong. The NHS apparently needs more, and the police need more. We have even heard from the right hon. Member for Birmingham, Hodge Hill (Liam Byrne)—this is a new one—that the pension age should not have been changed. The hon. Member for Harrow West (Mr Thomas) has told us that the schools funding formula is wrong. I was waiting for an intervention, but it did not come. The hon. Member for Copeland (Mr Reed) talked about the need for credibility. Labour Members would be credible if they occasionally said, “That cut is reasonable”, instead of just saying, “It is all wrong.”
Robert Neill: Does my hon. Friend agree that the real lack of credibility is in the failure to recognise that some public services can be based only on sound economics, and that unfunded costings and more and more debt constitute cruelty, not compassion?
David Mowat: It comes back to credibility. The hon. Member for Copeland made a plea for credibility from his Front Bench team—a plea that, I fear, has fallen on deaf ears. It is true that we have had to make cuts, and I do not think that anybody likes to do that. I do not think that the cuts are ideological, but they are necessary to get from that 4:1 ratio to something close to balanced. It looks as though we made a mistake in this Budget; that has been acknowledged, and it will be fixed. The Labour party’s contribution has not been to say, “That was a mistake”, but to say, “Everything is a mistake.” That is an extraordinary position.
We had a lecture this evening from the Scottish National party, which was particularly interesting, because it is the progressive party in this place. We heard about what the Scottish Government are doing on homelessness, and how much better that is than what we are managing in England. If the SNP was progressive, and if it really cared about homelessness in England, its members would look at the Barnett formula and say, “We will go for a formula based on need. We will not just take everything that we can get, as our major policy initiative, and still call ourselves the progressive party.”
Before I move on to talk about the northern powerhouse, I have a point to make about tax cuts. “Tax cuts for millionaires”—we have heard that, have we not? Capital gains tax has been cut from 28% to 20%. I do not particularly approve of that, but at 20% that rate is still 2% higher than it was for the entire period of the last Labour Government. One could not make it up.
I said that I was going to talk about the northern powerhouse. I will not talk about it for very long, other than to say this. The problem that the northern powerhouse is trying to fix is the difference in gross value added
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between the north of our country, the English regions, and London, in particular. We are very London-centric. That difference reached a peak in 2009, in the last year of the previous Labour Government, when the City was allowed to run berserk. It is right that that has been fixed. I see that the Secretary of State is in his place, and I have got time to make one final point. I would like clear metrics to be assigned to the northern powerhouse initiative for GVA and transport infrastructure. It is rather hard to equate the money being spent on Crossrail 2—£28 billion—with any sort of real intent around the northern powerhouse.
9.29 pm
Helen Hayes (Dulwich and West Norwood) (Lab): In the short time available, I would like to make just a couple of points about what I believe to be a cynical and desperate Budget. It is cynical because it is designed to deliver appealing messages to some parts of the electorate, while hoping that no one will notice how these benefits are being delivered. It is desperate because the context is the Chancellor’s failure to meet any of the targets he has set himself and he is scrabbling around throwing all common decency out of the window to safe face.
The proposal to deliver cuts in corporation tax and capital gains tax, overwhelmingly benefiting large firms and well-off individuals, by cutting personal independence payments to disabled people was a despicable plan. Further cuts to support for disabled people are straightforwardly unacceptable. Making such cuts to precisely the type of support that enables many disabled people to have greater control and lead more independent lives is as incompetent as it is cruel. People across the country have made their outrage at this proposal clear. I am relieved that the Government have U-turned on this plan, but quite frankly it beggars belief that the Chancellor ever thought it was acceptable.
I am compelled to draw attention to the announcement in the Budget relating to homelessness. The Chancellor was so pleased with this announcement—£115 million to tackle rough sleeping—that he leaked it to the Evening Standard the day before the Budget. The Communities and Local Government Committee, of which I am a member, is currently undertaking an inquiry into homelessness. Last week we visited The Connection at St Martin’s, which supports rough sleepers just a few hundred metres from this place. Its dedicated staff told us how the number of rough sleepers is increasing, how they struggle to keep up with the demand for their services and how Government policies, across a range of different areas, are contributing directly to making the problems worse.
Homelessness has increased by 36% since 2010 and rough sleeping in London has doubled. In Lambeth alone, there are over 1,800 households in temporary accommodation, including almost 5,000 children in one single borough living without the security of a permanent home. Additional funding to help rough sleepers is of course welcome, but while £115 million sounds like a big number it is a sticking plaster on a severed artery.
Melanie Onn:
There are an additional five housing measures in the Budget, all of which raise more money for the Treasury. Does my hon. Friend think that they
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will have an impact on homelessness, because they relate to some of the core fundamentals of providing housing in this country?
Helen Hayes: The Government’s approach to housing is broken from top to bottom. The Government must recognise, as the previous Labour Government who reduced homelessness by 62% recognised, that tackling the causes of homelessness is within their gift. The single biggest cause of homelessness in London is now the ending of a private sector tenancy, yet the Housing and Planning Bill will do nothing at all to reform the private rented sector. Even to the Chancellor, it should be crystal clear that rough sleepers cannot afford starter homes and will not benefit from lifetime ISAs or the cut in capital gains tax. The growth in homelessness in London in the 21st century is this Government’s shame. In that context, it is imperative that the Government rethink the Housing and Planning Bill and ensure that sufficient public sector resources are being directed into the building of the genuinely affordable homes that are so badly needed.
This is a cynical, desperate Budget and I think the Chancellor has been found out. I hope the Government will take the opportunity that has been presented to them this weekend to rethink the Budget comprehensively, and that the Chancellor himself will come back to the House with a fair deal for disabled people, a fair deal for our councils, and a plan for addressing the causes of homelessness, not just the symptoms.
9.33 pm
Kirsty Blackman (Aberdeen North) (SNP): We were told earlier by the hon. Member for Telford (Lucy Allan) that this was a Budget for Telford. Well, it is certainly not a Budget for disabled people, young people or low-income families. It is not a Budget for businesses either. A Budget that projects a systematic reduction in funding for the Department for Business, Innovation and Skills cannot be good for businesses.
I am aware that I have a very short time, but I want to briefly mention city deals. The Aberdeen city deal, with £125 million from the UK Government, was announced earlier this year. That is roughly a third of what Manchester got per head, so I suggest that the UK Treasury is not particularly for Aberdeen either.
It has been suggested that the lifetime ISA, which was mentioned earlier, will be helpful for families, but the technicalities mean that it will not be helpful for anybody not looking either to buy a home or to support themselves in their retirement. For example, the money could not be withdrawn to support a couple who have just started having children.
As a Member for Aberdeen, I might be expected to talk about oil and gas, and we welcome the changes made, such as the effective abolition of the petroleum revenue tax and the halving of the supplementary charge, but there are still major issues for the oil and gas sector in relation to banking. It is difficult for companies to find finance at the moment. I am talking not about large infrastructure projects, for which there is the opportunity for loan guarantees, but about day-to-day business. Given the oil price just now, it is really tough for companies, and they are struggling to find finance. Some of the banks, although they are saying nice words to parliamentarians, are not actually lending to oil
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companies. They are pretty much saying, “Nah”, to supply chain companies, for example, which are the companies we need to be supporting just now.
I welcome the measures on decommissioning, but the UK Government will have to shell out about 62% of the cost of decommissioning oil rigs, so the longer it can be pushed out, the better for the UK Treasury, and this would be a benefit. It is very important that the UK, as one of the first fields to reach maturity, learns fast and becomes good at exporting that expertise. We need to support that.
Patrick Grady (Glasgow North) (SNP): My hon. Friend commented on the lack of time available. Does that not speak to the wider concerns expressed several times, not just about the budgetary process but about the estimates process in the House? Does she agree that this is an urgent matter for the Procedure Committee to consider?
Kirsty Blackman: I thank my hon. Friend, who is a member of the Procedure Committee, for bringing that up, because it plays nicely into my next point, which is about how the Budget process works. We have had very little time for speeches today.
The Budget and the documentation we are provided with contain a total lack of clarity about Barnett consequentials in relation to the budget lines. For example, there are budget lines around cathedrals and cultural investment but no clarity, even in the statement of funding policy, about whether those things will generate Barnett consequentials and, if so, what the percentage of comparability is. It is very difficult for MPs to scrutinise these matters. The Tax Law Review Committee said:
“the House of Commons has neither the time nor the expertise nor, apparently, the inclination to undertake any systematic or effective examination of whatever tax rules the government of the day places before it for its approval”.
That is partly because of the complexity of the tax rules. Obviously, tax is levied on individuals personally, and then tax reliefs and benefits are provided to families, so it is quite a complex thing to work out. MPs lack the time—we have hardly any time to discuss it today—and the information to scrutinise the Budget effectively. This process needs to be improved as a matter of urgency.
9.37 pm
John Healey (Wentworth and Dearne) (Lab): Indefensible, deeply unfair, distinctly political—my words for the Budget but also the words of the recently departed Secretary of State for Work and Pensions. It is Labour’s judgment of the Budget, but it is also the judgment of many fair-minded Government MPs and, most importantly, of the British people, the large majority of whom, when polled over the weekend, said the Government had got their priorities wrong.
If this is a political crisis, it is one of the Chancellor’s own making. It was the same failure of political judgment that led him to slash working tax credits, before being forced to backtrack, and the same failure of political judgment that led the ex-Secretary of State to say:
“It…looks like…it doesn’t matter because they don’t vote for us”.
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The IFS and the Resolution Foundation both say that this is a starkly regressive Budget, with the rich getting the most and the poor getting the least. We saw a tycoon tax cut of over £3 billion benefiting the very richest; an income tax cut of £2 billion benefiting the better-off; and alongside that, a cut in disability benefits worth over £4 billion. Well, that was Wednesday; and today, five days later, we have heard from the Secretary of State for Work and Pensions that there will be no more welfare cuts. The Chancellor’s long-term economic plan—his long-term fiscal plan—therefore lasted just five days, and if we take the new Secretary of State for Work and Pensions at face value, the Chancellor of the Exchequer still has a £4.4 billion shortfall to meet his deficit plans.
While we are on policy confusion and fiscal chaos, the Secretary of State for Communities and Local Government, who opened this debate, told the House that none of the costs of the business rates cuts would come out of local government funding. All will be compensated for in full by section 31 grants. He tried to tell the House that line 15 on page 84 of the Red Book explained that, but it details the cuts to business rates, not the source of the compensation, and there is no other reference in the Red Book. That leaves the Chancellor of the Exchequer with a further, fresh fiscal shortfall of £6.7 billion over five years, or it means that the Secretary of State will have to find that money from savings in his own budget.
The Chancellor may have caused a political crisis for the Conservative party, but much more serious are the fiscal and economic problems he is causing for the country. These were laid bare in the Budget—downgraded growth, downgraded pay, downgraded productivity, and the Chancellor’s new fiscal mandate broken already, as the OBR confirmed that the debt-to-GDP ratio is rising, saying that there is only a 50:50 chance that he will hit his deficit target. Never mind omnishambles: this is the ultra-shambles Budget. It really comes to something when No. 10 Downing Street briefs over the weekend to play up the Conservative party’s splits on Europe because its splits on fiscal and social policy are even more damaging.
I do feel for the 27 hon. Members on both sides of the Chamber who have spoken, being limited first to five minutes, then to four and finally three minutes. To be quite honest, the loyalists were out in force on the Government Benches, although I would like to have heard more from the hon. Member for Hazel Grove (William Wragg) about his belief that local education authorities have an important role and how they have not been, as he said, all bad. I would like to have heard more from the hon. Member for Milton Keynes South (Iain Stewart) about the National Infrastructure Commission, a good idea—a Labour idea—that I am glad to see the Government are putting into practice.
I would like to have heard more from the hon. Member for Blackpool North and Cleveleys (Paul Maynard), who said, quite rightly, that we have to be ultra-careful not to write off those who cannot work. As he said, there is no hierarchy of human value. I would also like to have heard more from the hon. Member for North West Norfolk (Sir Henry Bellingham) about his deep opposition to mayors, imposed by the Chancellor as a condition of all devolution deals.
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On our side of the Chamber, the House should have heard more from my hon. Friend the Member for Jarrow (Mr Hepburn). The Budget has fallen apart like the Chancellor’s reputation, he told us—quite right. I would like to have heard more from my hon. Friend the Member for Bury South (Mr Lewis), who warned the Chancellor about the flawed devolution deal for Greater Manchester, especially when it comes to skills, school improvement, social care and council funding; or from my hon. Friend the Member for Batley and Spen (Jo Cox). As she said, without the funding commitment to make them work, infrastructure announcements were actually re-announcements—quite right.
My hon. Friend the Member for Copeland (Mr Reed), who is no longer in his place, made an important point about how the Chancellor is unable to make his sums add up in this Budget. He is failing my hon. Friend’s constituents; he is failing the country. My right hon. Friend the Member for Birmingham, Hodge Hill (Liam Byrne) reinforced that, saying that this is a Budget that is failing the young generation and this is a Chancellor who is failing Britain’s youngest city, Birmingham.
My hon. Friend the Member for Halton (Derek Twigg) was quite right when he talked about the Chancellor’s creative accounting. My hon. Friend the Member for Harrow West (Mr Thomas) said that the Chancellor is making the challenges facing the public services in this country much more difficult to meet, and he was right. My hon. Friend the Member for Southampton, Test (Dr Whitehead) described this Budget as continuing the punishment of local government that we have seen over the last five years. My hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson) rightly said that when all schools are being forced to become academies, the House should be deeply concerned about pupils with special educational needs.
My hon. Friend the Member for Dulwich and West Norwood (Helen Hayes) was dead right about the Chancellor’s failure to meet his own targets, and also about his failure on housing. The Secretary of State for Communities and Local Government, who opened the debate, clearly lacks the clout to be able to argue his Department’s case with the Chancellor, for the Budget had nothing to say about housing and did nothing to reverse six years of failure, from rising homelessness to falling home ownership. What a contrast with the Labour Government’s record! We more than halved homelessness. There were 1 million more home owners during our time in office, and 2 million were homes built.
When it came to housing, there was a huge hole in this Budget. There was nothing about new affordable homes to rent and buy, nothing about investment, and nothing about tackling the causes of rising homelessness. In particular, there was nothing to ease the housing pressures in London, where housing is the No. 1 issue. The Budget has completely exploded the claim of the wannabe Mayor, the hon. Member for Richmond Park (Zac Goldsmith), who has said “I can get a good deal from this Conservative Chancellor.” It makes more urgent, and more clear, the case for electing a Labour Mayor, my right hon. Friend the Member for Tooting (Sadiq Khan), who will be a Mayor for all Londoners.
This was billed as a Budget for the future. There was big talk of big infrastructure schemes, but the small print showed small sums, mostly for design and feasibility
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studies throughout the rest of the Parliament. I say to Members on both sides of the House, “Do not listen to what the Chancellor says; look at what he does.” In 2009-10, the last year of the last Labour Government, infrastructure investment was 3.2% of our wealth—3.2% of our GDP. In 2010-11, the Chancellor cut that to 2.5%. By the end of that first Parliament, the figure was 1.9%, and now the Chancellor is doing it again: at the end of this Parliament, it will be just 1.5%.
In truth, the Chancellor is too tightly bound by his own misjudged fiscal rules for the good of the country. His plan to achieve a £10 billion total budget surplus by 2019-20 will prevent him from doing what is needed most, and investing for the future: investing in good homes, good jobs, and good infrastructure projects. In the debate that followed the Chancellor’s statement, the right hon. Member for Chichester (Mr Tyrie), the Chairman of the Treasury Committee, said:
“He has altered his plans of only four months ago, and so long as the rule remains in place, he will have to do so again after the next fiscal event. That is…why the Treasury Committee concluded… that it was ‘not convinced that the surplus rule is credible in its current form.’”—[Official Report, 16 March 2016; Vol. 607, c. 976-77.]
We have fiscal policy without credibility, and a Chancellor without credibility. What we were given in this Budget was a downgraded economy from a diminished Chancellor who was speaking to a divided party and for a damaged Government. This is a black hole Budget: a Budget which, like the Chancellor, does not deserve support from any party in the House.
9.48 pm
The Economic Secretary to the Treasury (Harriett Baldwin): The right hon. Member for Wentworth and Dearne (John Healey) had certainly prepared his soundbites earlier.
In every region of the United Kingdom, the policies announced in the Budget will bring the economic security that Britain needs. They are the commitments that we set out in our manifesto last year, and the Budget will help to deliver them. Over the past six years, we have worked hard and made the tough decisions. That has brought our country’s economy back from the brink, and growth and jobs are now delivering greater economic security for everyone. Today, I am proud that, here in the United Kingdom, a record number of people are in work, the deficit is down by two thirds and we are well on the path to surplus. Our whole economy is set to grow faster next year than any other major advanced economy in the world. However, with the pace of growth in the global economy showing signs of weakening, now is the time to redouble our efforts, and that is precisely what the Budget does.
Today’s debate is about devolution and local government. The foundations of our long-term success are laid in each and every corner of this country. Every region makes a distinctive contribution to the UK’s economic success and every region benefits from this Budget’s programme for growth. Hon. Members should listen to the facts. Employment is growing quickest in Wales, and it is a shame that we did not hear Welsh voices today. Youth unemployment is falling quickest in the west midlands. The right hon. Member for Birmingham, Hodge Hill (Liam Byrne) said that we were not delivering a budget for the next generation, but the next generation is finding work in the west midlands, which I am sure he will welcome. The number of people claiming
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unemployment benefits is falling fastest in Yorkshire and the Humber. Through a combination of greater devolution, greater investment and targeted support, the Budget will allow our regions to continue growing from strength to strength.
The Budget also delivers for the devolved Administrations. To help Scotland, there are tax breaks worth more than £1 billion to support the North sea oil and gas industry through challenging times and a freeze in duty on Scotch whisky. The Scottish National Party had three demands for the Budget—action on oil and gas, action on fuel duty and action on Scotch whisky—and we have delivered on all three fronts. To help Wales, there is a £1.2 billion deal for the Cardiff capital region and a 50% reduction in tolls on the River Severn crossings in 2018. To help Northern Ireland, there will be enhanced capital allowances for investors in the Northern Ireland Executive’s pilot enterprise zone near Coleraine. For all three of our devolved Administrations, the Budget delivers the benefits of being part of a strong, successful United Kingdom, with the opportunities that come with devolution.
For the cities and regions of England, this is a Budget that creates fresh opportunities and opens new doors. For the north, there is greater devolution to Liverpool and Manchester, a schools strategy for the northern powerhouse, more than £700 million extra for flood repairs and resilience, and the go-ahead for HS3, bringing Leeds and Manchester closer together. For the midlands, the midlands engine investment fund will get £250 million, and there is a new devolution deal for Greater Lincolnshire and a strong statutory body to help provide the transport that the midlands needs.
For East Anglia, we have another new devolution deal, and I can confirm to my hon. Friend the Member for North West Norfolk (Sir Henry Bellingham) that the £30 million is indeed new money and that an elected mayor will be the single point of accountability. I can also confirm for my hon. Friend the Member for Milton Keynes South (Iain Stewart) that we plan to make the most of the Oxford-Cambridge-Milton Keynes corridor. For the south-west, almost £20 million will help young families on to the housing ladder. For London, the green light has been given for Crossrail 2. In addition, policies such as the cut to businesses rates and our reform of commercial stamp duty will revitalise high streets up and down the country, including those in Bury South.
This is a Budget for a nation of shopkeepers whether they are in Cardiff or Cornwall or Chester or Chelmsford. We have heard from 27 Back Benchers from all over the country in tonight’s debate: North West Norfolk, Glasgow Central, Rugby, Jarrow, Telford, Sheffield South East, Blackpool North and Cleveleys, Bury South, Poole, Batley and Spen, Milton Keynes South, Copeland, Bolton West, and Birmingham, Hodge Hill.
Mr Betts: Will the Minister give way?
Harriett Baldwin:
I will not as I have very little time, but I will get to the hon. Gentleman’s point. The list continues: Chesham and Amersham, Henley, Harrow West, Wealden, as well as Southampton, Test, and Bromley and Chislehurst, Washington and Sunderland West, Hazel Grove, North Norfolk, Warrington South, Dulwich and West Norwood, and Aberdeen North. A number of common themes came up in those speeches.
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Almost everybody welcomes the business rates cut and the help for the self-employed. This is a Budget that puts our small business job creators front and centre. Many points were made about northern infrastructure, so I draw everyone’s attention to page 77 of the Red Book. I am not referring to Mao’s little red book on this occasion. Page 77 gives a list of projects, including £130 million of road repair funds to deal with the damage caused by Storm Eva and Storm Desmond, in Cumbria and elsewhere.
A number of colleagues mentioned devolution and the impact on business rates. I can confirm that local government will be compensated for the loss of income as a result of the business rates measures announced in the Budget with a section 31 grant. The impact will be considered as part of the Government’s consultations on the implementation of 100% business rate retention in summer 2016.
Mrs Gillan: Will the Minister give way?
Harriett Baldwin: I would love to give way, but I have not got time to do so. The NHS was discussed by a number of colleagues, and I am sure that they welcome the record amount of cash going into our NHS, thanks to our strong economy. A number of colleagues welcomed the fairer funding for schools and the ultimate devolution of power to academies. I can confirm that an extra £1.6 billion is going into schools, with no change at all to the special educational needs obligations on schools. [Interruption.] We have heard a fair number of rants, whinges and lectures from the Opposition tonight, but we will take no lectures from the party that crashed the economy in the first place. We will take no lectures from the Labour party, whose plans, had we followed them, would have led to—
Mrs Gillan: On a point of order, Mr Speaker. I wonder whether you could advise me on something. I have asked the Minister, who is speaking so ably and fluently at the Dispatch Box about a Budget, certain elements of which have been well welcomed on both sides of the House. I have asked her to give way on two specific points that I raised in my contribution to this debate. Could you advise me whether it is in order for the Minister to decline, on account of the amount of time left for speaking, when a considerable number of minutes are left until 10 o’clock?
Mr Speaker: It is a matter for the judgment of the Minister, but the discontent of a former Cabinet Minister has been registered.
Harriett Baldwin: In that case, I will simply commend this Budget to the House.
Ordered, That the debate be now adjourned.—(Julian Smith.)
Debate to be resumed tomorrow.
Mrs Gillan: On a point of order, Mr Speaker. I wish to seek your guidance on the next item on tonight’s Order Paper. I gather that Standing Order No. 9(6), which deals with sittings of the House, states:
“After the business under consideration at the moment of interruption has been disposed of, no opposed business shall be taken, save as provided in Standing Order No. 15 (Exempted business).”
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As I read it, the Order Paper contains a sittings motion on the business of the House on the High Speed Rail (London - West Midlands) Bill and if it comes to the Floor of the House after 10 pm, it does not have to be debated. It is possible to object to that business of the House. Of course, Mr Speaker, you will appreciate that I raised a point of order earlier—[Interruption.]
Mr Speaker: Order. It is fairly uncharacteristic of one of the Whips on duty, the hon. Member for Croydon Central (Gavin Barwell), who normally behaves in a most seemly manner, but the amount of noise he is making prevents me from attending to the right hon. Lady’s point of order, which I am keen to hear, so she will doubtless now continue.
Mrs Gillan: If this motion is heard after 10 o’clock in this House, I want to confirm that there is no debate, that a Member can object to it and that the Government can bring it back and put it on the Order Paper on the following day. It is important that we understand that anybody who chooses to object to this piece of business on the Order Paper is not impeding the Government at all, as it is perfectly in order for them to bring it back on to the Order Paper tomorrow, and indeed, if it is objected to tomorrow, it can be put on the Order Paper the following day, but without the penalty of taking time out of the very valuable debate that I have been trying to get extended and would want to protect in terms of the measly three hours the Government have given us.
Mr Speaker: The interpretation by the right hon. Lady is entirely correct. I trust that she is satisfied with that matter.
Business without Debate
business of the house
high Speed Rail (london – west midlands) bill
That, at the sitting on Wednesday 23rd March, the following provisions shall apply to proceedings
1. (1) Proceedings on Consideration shall be taken in the order shown in the first column of the following Table.
(2) The proceedings shall (so far as not previously concluded)
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be brought to a conclusion at the times specified in the second column of the Table.
Table
(3) Proceedings on Third Reading and proceedings on the Motion in the name of Secretary Patrick McLoughlin relating to carry-over (No. 3) shall (so far as not previously concluded) be brought to a conclusion three hours after the commencement of proceedings on Consideration.
2. (1) This paragraph applies for the purpose of bringing proceedings to a conclusion in accordance with paragraph 1.
(2) In relation to proceedings on Consideration and Third Reading, the Speaker shall put the following Questions in the same order as they would fall to be put if this Order did not apply—
(a) any Question already proposed from the Chair;
(b) any Question necessary to bring to a decision a Question so proposed;
(c) any Question on any amendment, new clause or new schedule selected by the Speaker for separate decision;
(d) the Question on any amendment moved or Motion made by a Minister of the Crown;
(e) any other Question necessary for the disposal of the business to be concluded.
(3) On a motion made for a new clause or a new schedule, the Speaker shall put only the Question that the clause or schedule be added to the Bill.
(4) In relation to proceedings on the Motion mentioned in paragraph 1(3), the Speaker shall put forthwith the Questions necessary to dispose of the proceedings.
3. Standing Order No. 15(1) (Exempted business) shall apply so far as necessary to proceedings to which this Order applies.
4. Standing Order No. 41A (Deferred divisions) shall not apply in relation to proceedings on the Motion mentioned in paragraph 1(3).—(Julian Smith.)
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Mid Yorkshire Hospitals NHS Trust
Motion made, and Question proposed, That this House do now adjourn.—(Julian Smith.)
10.1 pm
Paula Sherriff (Dewsbury) (Lab): Let me start by paying tribute to the doctors, nurses and all the staff working in the Mid Yorkshire Hospitals Trust. As a Member whose constituency is covered by the trust, a local resident and indeed a patient, I have nothing but praise for their hard work, dedication and professionalism. Lord knows, the NHS may be up against it—and this trust perhaps more than most—but I am continually humbled by the quiet and determined way that all the staff at Dewsbury and District hospital, Pontefract hospital and Pinderfields hospital go about providing care and support in the face of what must seem at times like overwhelming odds.
Jo Cox (Batley and Spen) (Lab): I congratulate my hon. Friend and neighbour on securing this critical debate on our local hospital. I back her in what she says and recognise that doctors and nurses and other staff at the hospital have been working in crisis mode for 15 months now. It is difficult to overstate how hard it must be for staff to go to work every day, knowing that they will miss key targets and not be able to give the care and attention that they so want to give.
Paula Sherriff: I thank my hon. Friend for her intervention. I absolutely agree with her. We must also pay tribute to our incredible junior doctors.
Whatever difficulties the trust is facing, there can be no doubt that those working there on the frontline are blameless, and deserve our full backing. As Members of Parliament, we owe it to them to make sure that they are given all the support they need.
The trust and its staff have to work in a challenging environment. In the area covered by the trust, the overall health of the population is below the average for England. Deprivation is higher than average, and nearly 20% of children are living in poverty. Life expectancy is lower than the national average for both men and women.
The Care Quality Commission inspected the trust in July 2014, with a follow-up inspection in June 2015. An unannounced inspection of Pontefract hospital emergency department took place in July 2015. A second unannounced inspection took place in August 2015 at Pinderfields hospital, focusing on staffing levels, with a follow-up visit to Pinderfields in September.
Although there were some improvements between the two main inspections of 2014 and June 2015, there were also areas in which the trust’s performance had worryingly deteriorated, and there were still serious concerns about staffing levels. The CQC noted that there was still a significant shortage of nurses, which was having a knock-on effect on patient care, particularly on the medical care wards, in community inpatient services, in the specialist palliative care team and in end of life services.
Two weeks ago, my hon. Friend and I met the trust’s new interim chief executive. We were both very grateful to him for his candour. He told us that the leadership team has effectively been in crisis mode for the past
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14 months. He said that the trust had recently put in an additional 120 beds across the trust to cope with increasing demand, but the 100 extra staff who should have accompanied that expansion are nowhere to be seen. The posts simply have not been filled.
Sue Hayman (Workington) (Lab): Does my hon. Friend agree that the NHS’s problems in recruiting and retaining staff is one of the most critical issues facing our national health industry and our ability to manage our hospitals properly?
Paula Sherriff: I thank my hon. Friend for that intervention. I will come to that point later.
To make things more complex on the administrative side, the monthly staffing reports are found to be overly detailed, generally running to over 100 pages, making it difficult to identify the most urgent risks. Likewise, there are concerns that policies and procedures for the escalation of staffing risks were not always followed when they were identified. The trust aims for a ratio of one nurse to every eight patients on adult in-patient wards. The Royal College of Nursing recommends 6.7 patients per nurse on adult wards as a maximum, so one to eight is not too far wide of the mark, though not ideal. However, the CQC found that even the one-to-eight ratio was very inconsistently met. During its unannounced visit to Pinderfields hospital in August, of the 17 wards only one was staffed to safe staffing levels. Ten were at minimum level and six were actually below the minimum. Indeed, records show that in August 2015 only 71% of nursing hours were achieved. Staff on the trust’s spinal injuries unit at Pinderfields are constantly reallocated to other wards, in essence robbing Peter to Paul. A nurse even told a patient that because they were so short-staffed, if two patients got into respiratory difficulties, which is not uncommon on a spinal injuries ward, the nurses would have to choose which patient they were to save.
The problem is particularly acute at the community in-patient sites at Monument house and Queen Elizabeth house, where between May and June last year 96% of shifts used at least one non-permanent member of staff, either agency staff or staff redeployed from other areas of the trust. Indeed, two shifts had only a single registered nurse on duty. The trust as a whole breached the Department’s cap on charges for agency staff, on average, 132 times a week during December. While it is absolutely right to prioritise patient safety over the Government’s financial targets, that is a clear indication that there has been a failure in long-term workforce planning and that it is struggling to attract and retain appropriately qualified staff.
To give credit where it is due, the trust has been making efforts to address the staffing issue. After the unannounced inspection, a risk summit was held under the leadership of NHS England to look at the actions the trust needs to undertake and the support needed from the wider healthcare community. The high number of registered nurse and care staff vacancies is now noted on the corporate risk register. The trust is looking at a range of different structures for nursing teams to get the best out of the available staff. It has invested in safety guardians to provide support and safeguarding for patients with mental health issues, freeing up time for registered nurses. It is putting extra effort and resources
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into filling gaps by looking to recruit nurses both locally and from Europe, proactively recruiting rather than waiting for staff to leave.
The CQC rated the safety of services provided by the trust as “inadequate”, largely due to the shortage of staff. For instance, between May 2014 and April 2015, 258 serious incidents were reported, of which 206 were cavity-like grade 3 pressure ulcers. That sort of thing is indicative of nursing staff being rushed off their feet, unable to provide the level of patient care that they would like. Concerns were also raised about patients who required one-to-one care not receiving it, and fluid balance monitoring and nutritional assessments not being properly completed, with charts often not kept fully up to date. In January, 81.4% of accident and emergency admissions were seen within four hours; the target is 95%. More than 2,000 patients waited on A and E trolleys for more than four hours, including six who waited more than 12 hours at Pinderfields.
When looking at such statistics on patient care, we have to be very careful to remember that each number—each percentage point—represents real people. They are people who may be in pain, or vulnerable, worried or nervous. They may be upset or distressed. By any reckoning, the NHS is our nation’s most prized institution, and when people have to make use of it, they rightly expect a certain level of service. NHS staff want to give that level of service, and when they cannot the result is more than just a delay in treatment—the dignity of patients is also compromised.
A few weeks ago I received an email from one of my constituents. Her 84-year-old father had been admitted to Dewsbury hospital with stroke-like symptoms. He was on a trolley in A&E for 14 hours. After he had been admitted to a ward, his daughter came back to visit him. She found that his bed was a complete mess and covered in food, and her father was naked from the waist down. When she asked why he had on only a pyjama top and was sitting on an incontinence pad, she was told that it made it easier when he needed to urinate. When she came back later that afternoon, his bedding had still not been changed, which in the end she did herself. That is a basic outline of one case, but it is by no means the only such correspondence that I have received from concerned constituents. At the moment I receive similar emails more than once a week, which is alarming.
All that, of course, has an inevitable knock-on effect on staff motivation. The results of the 2015 NHS staff survey show just how low morale has sunk. For every key indicator the results are depressing and fall well short of national averages. Only 54% of staff felt that the care of patients was the trust’s top priority, compared with a national average score of 73%, and 55% felt that the trust acts on concerns raised by patients, whereas the national average is 72%. Just 41% of people would recommend the trust as a place to work. Perhaps most damningly of all, only 46% of people would be happy for a friend or relative to receive care at the trust.
The amount of disciplinary action being taken against staff has risen in recent months, which is generally due to staff making minor mistakes or not being able to follow procedures through fully for want of time. That is a symptom of the shorthandedness that has been experienced on the wards, and it contributes to the
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general air of despondency as staff are effectively penalised for not being able to be in two places at once. I have spoken to a number of past and present members of staff in the trust, who informed me that they have failed to whistleblow for fear of retribution.
The feeling of being worn down is affecting staff at all levels. I was told by the interim chief executive last week that the board has effectively been operating in crisis mode for the past 14 months, which, of course, is now taking its toll. There is a general feeling of chaos, tempers are fraying, and there is severe instability in the personnel in management teams—a sure sign that the trust is struggling to get its problems under control, which is a challenge in itself.
To be fair, there have been some slight improvements recently. The CQC’s follow-up visits noted that staff were more confident than they had been previously, and that senior management were taking some concerns on board and trying to get to grips with the issues. However, that feeling was by no means universal, and that slight improvement from such a low base is hardly a cause for celebration.
On the underlying causes of these problems, the Government must take the lion’s share of the blame. Going right back to slashing nursing training places in 2010, they have failed to ensure that the NHS has the levels of staff it needs to provide a safe and caring service. Thousands of nurses who should have begun training between 2010 and 2012 and would now be qualified—thereby helping to alleviate the difficulties in Mid Yorkshire—are just not there. Applicants for nursing courses outnumber the available places by more than two to one.
The whole ethos of the NHS has been warped from one of service and care to one of financial management. Of course the health service must keep on an even keel, but when a cash-strapped trust feels that it is appropriate to hire city consultants such as Ernst & Young, alarm bells should start ringing. Thankfully, that contract finally came to an end last September, but not before the trust had stumped up more than £15 million. Given that staff are still struggling to keep their heads above water, they could be forgiven for questioning whether that was money well spent.
Jo Cox: My hon. Friend makes a powerful and personal case. Does she agree that the Government have responsibility for this issue? They have cut public health funding, and there is a social care crisis locally and problems with the junior doctors contract. The Government must take responsibility for this crisis and not pass the buck to an embattled NHS trust.
Paula Sherriff: I absolutely agree that the buck must stop with the Government, and we must see action, not platitudes.
I have now been told several times that the solution to the problems lies in the plans to downgrade Dewsbury’s A&E and maternity services, which will be centralised at Pinderfields. I say that that is putting the cart before the horse. Nearly 70% of in-patient beds will be lost in Dewsbury, and the simple fact is that this will put lives at risk. Leaving aside the arguments about whether the proposed reforms are necessary, it is just not safe to attempt this sort of major restructuring right in the middle of a major staffing crisis.
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Once again, financial considerations are overriding clinical concerns. The trust is currently consulting on proposals to bring forward the reconfiguration. I say absolutely unequivocally that, while the trust is in a state of flux, discussions must focus solely on improving safety and quality. I urge the board to abandon these plans.
I have written to the Secretary of State about the serious worries in relation to what is going on at Mid Yorkshire Hospitals NHS Trust. The Minister has kindly agreed to meet me and other concerned MPs next month to discuss this in more detail. However, I want to reinforce the point that we are in danger of forgetting the lessons learned from the Mid Staffordshire situation about the absolute priority that must be given to safe staffing levels. Unless we can crack this by getting the qualified staff we need, no amount of reorganisation will make up for poor care. We must break the spiral of demoralisation and overwork so that we can help both the patients and the staff who are currently getting the short end of the stick.
On this day exactly 70 years ago, Nye Bevan announced his plans for a national health service. His vision of universal healthcare free at the point of delivery and funded collectively is just as valid today as it was then. Bevan said:
“The NHS will last as long as there are folk left with the faith to fight for it.”
We must stand together now for the NHS, and we must support the staff who go above and beyond for the NHS every day. It is our duty as parliamentarians to continue the fight for those who, yet still, have faith in those founding principles—an NHS for all, based on clinical need and free at the point of delivery.
10.16 pm
The Parliamentary Under-Secretary of State for Health (Ben Gummer): I thank the hon. Member for Dewsbury (Paula Sherriff) for bringing this matter to the House and for her powerful introduction to her constituents’ concerns. I also thank the hon. Member for Batley and Spen (Jo Cox), who intervened. They make a powerful double act in Mid Yorkshire. I have felt the pressure of the concerns they have quite rightly raised with me privately, and I hope that they will be able to do so again in the next couple of weeks.
I very much like the fact that the hon. Member for Dewsbury ended by mentioning this important anniversary. We are a few weeks away from the 70th anniversary of the Second Reading of the National Health Service Bill, as it then was, on 30 April. At that time, Nye Bevan made two points about the introduction of the NHS. The first is the one we all know, and of which we are equally proud, which is that it should be a service free at the point of need.
However, Nye Bevan made another point, which for him was as important in the establishment of a national health service—it has been forgotten by politicians on both sides during the past 70 years—which is the principle of universalising the best. He made a very powerful argument at the time, which was that the reason for a universal NHS was to ensure not just that people could approach the service without having to worry about money, but that someone from a part of the country that traditionally did not have good hospital care could rely on the same quality of service that they would expect in a wealthier or better served part of the country.
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In establishing the first part of Nye Bevan’s dream, we have done well, but in establishing the second part, we have not yet succeeded. The hon. Lady’s constituents have, in part, been at the rough end of that. For years, under Governments of all kinds, we have not done well enough in universalising the best across the service. As we discussed when we had our meeting, there are hospitals not far from hers that are delivering exceptionally good and consistent levels of nursing care. They have been able to do so while under similar pressures to those in her own hospital—as she has correctly identified, similar pressures apply across the service.
Clearly, there are historical problems in Mid Yorkshire, and they will be difficult to grapple with. I completely understand why the hon. Lady feels that commissioners might not yet have a full enough grasp of the problems in her area. That is why she questions the basis of the reconfiguration. I understand that the assurance exercise into the reconfiguration is nearing its end, and we will publish that at some point in the near future. I hope that that will provide assurance that the accelerated reconfiguration can take place. I take into account the completely legitimate points that the hon. Lady made about the readiness of the reconfiguration of social care services in the area, but I think we should cross that bridge when we get to it. I am mindful of the fact that I have no power to change reconfiguration decisions—and neither does the Secretary State.
Jo Cox: As the Minister will be aware, the Mid Yorkshire Hospitals NHS Trust has the third highest number of admittances to A&E in the country. In that context, I share the concern of my hon. Friend the Member for Dewsbury (Paula Sherriff) about the planned reorganisation and downgrade of the Dewsbury hospital. It is a serious matter for local residents and some of my constituents. It would be wonderful to have a commitment further to discuss whether now is the time to move forward with that plan.
Ben Gummer: Of course I understand why it is a matter of concern. I must say what I have also said privately, which is that I must respect the opinion of clinicians and commissioners. That is why I want to hear what they say. Ultimately, there is the approval process that this reconfiguration has already gone through—namely, that of the Independent Reconfiguration Panel. I will, of course, speak to the hon. Lady whenever she wishes. It is not kindness on my part, but my duty to her as a Minister responding to an elected representative.
I spoke today to the director of nursing at the Mid Yorkshire Hospitals NHS Trust and also to representatives of the local trust development authority, and I was glad to be assured on some points. I was pleased to hear that they were co-operating with Lord Carter’s review of safe staffing ratios, which should provide a promising foundation for ensuring that we have the right kind of staffing ratios at the appropriate acuity of patients. This will be good in every hospital where it eventually applies, but for those with very challenged staffing ratios at the moment, the ability to look carefully at the rostering of staff across the service with the kind of skills and international experience that Lord Carter will bring will, I think, be helpful. Unfortunately, I was not made aware of the meeting that the hon. Lady had with the chief executive. I am disappointed about that because she clearly had a robust discussion. I have seen the contents of the letter that she sent to the Secretary of State.
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Paula Sherriff: Given that Ernst & Young’s services were used, at some considerable cost, and that some of the matters it considered were staffing issues and staff forecasts, it is relevant to point out the contract has now ended after about four or five years. Does the Minister agree that it is quite worrying to find ourselves in this position after spending somewhere in the region of £15 million?
Ben Gummer: As a constituency MP, I, too, have been frustrated by consultancy contracts, both before and after the 2010 election. Across the service, we have managed to bear down on consultancy spend considerably. It is for the hon. Lady and her consultants to determine whether the trust has got good value for money. It is not for me to pass comment on that, except for the fact that all hospitals should account to their local people and to the trust and local authority responsible for making sure that money is being spent wisely.
I completely agree with the hon. Lady in that behind the statistics of poor performance that she identified, there are people who are not receiving the care they require. That was picked up by Professor Sir Mike Richards in his report into the quality of care provided at the hospital. He was very clear about it, saying
“we found medical care, end of life services and community inpatients either hadn’t improved or had deteriorated since our last inspection.”
He found areas of significant staffing shortages affecting patient care, especially on the medical care wards, community in-patient services and in the specialist palliative care team. He said that there was a shortage of medical staff for end of life services. He came to the same conclusion as the hon. Lady did.
The difference here is that I hope we have made progress since the Mid Staffs tragedy that the hon. Lady identified, and are now able to be more open about this. There will not be a culture of denial from the Government Benches about problems where they exist. Clearly, there is a problem here; it has been identified by the Care Quality Commission. The distressing story of the hon. Lady’s constituent that she raised with the Secretary of State in the Chamber and in the letter and again just now has been supplemented with additional stories that her colleagues have brought to the attention of the Department, and these make it clear that things need to be done in Mid Yorkshire.
What, then, is the solution to the problems that the hon. Lady has identified? The first is a local one, and all these problems have to be addressed locally, but I of course take the hon. Lady’s point that the Department has to take a degree of responsibility. Of course the Secretary of State and I take responsibility for everything that happens in the health service—that is ultimately our duty—but we cannot micromanage every hospital. It is for the local team to ensure that they are universalising the best and implementing the kinds of changes in their trust that have made such a success of hospitals not very far from the hon. Lady’s own. If they are able to do that, they will already be able to bring considerable improvements to the quality of the care that they can provide.
I can obviously do additional things as a Minister to give the local team the tools to do the job, as I can for other hospitals across the country. That includes ensuring that they have the best guidance to enable them to
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roster their staff properly. Lord Carter’s review is being conducted with the Care Quality Commission and with NHS Improvement. It is a tripartite review of safe staffing ratios that will give hospitals cutting-edge support to roster their staff according to the acuity of their patients to ensure maximum safety and efficiency, learning from best practice across the globe. Salford Royal Infirmary has already been looking at this particular model in one guise.
Paula Sherriff: My hon. Friend the Member for Batley and Spen (Jo Cox) and I share considerable concerns about the senior leadership at the trust. We have regular monthly meetings, but we were made aware only at the last meeting—we now have an interim chief executive—of some of the chaotic things that were going on at the trust, although we had been aware of anecdotal stories. We would therefore appreciate some support from the Department of Health team to ensure that communication channels between us as elected Members are as effective as possible.
Ben Gummer: I shall certainly impress that upon NHS Improvement, which will be taking over the functions of the NHS Trust Development Authority in the next few days. I expect that it will keep an even beadier eye on the quality of management than has been the case so far. It will do so under the watchful eye of Jim Mackey, its chief executive, who ran one of the best hospitals not only in England but in the world. He is now running NHS Improvement and I know that he will be able to provide the support that the hon. Lady wishes to see. I will tell him later this week about the discussion that we have had tonight and I will ensure that he provides hon. Members with the kind of resource that they are asking for so that they can ensure that their local leadership is doing the right thing.
On the wider issue of staffing, the fact is that the nursing numbers in the service, which were found wanting at the time of the Mid Staffs scandal, could have been addressed only by significant changes in commissioning levels not two, three or four years ago but 10, 15 or 20 years ago. The service has failed under successive Administrations to predict the number of staff that it needs for the future. One of the more extraordinary functions that I possess is to have to sign off every year the commissioning of staff that will be required in 20 or 30 years’ time. My officials are a wise and brilliant group of people, but no one can behave like Nostradamus and expect to know what the service will require after that period of time.
That is why we have come to the conclusion that we need to increase significantly the number of places commissioned. Within the current spending envelope, however, it is simply not going to be possible to achieve the numbers that we wish to see. I think that Governments from both sides would have found that very difficult—in fact, impossible. That is why we came to the conclusion that we should release those places by transferring nurse graduates on to a loan system. I know that that is unpopular with Labour Members, but I hope that they will understand the rationale behind our doing so. It will allow us to add 10,000 additional places between now and the end of this Parliament. Those are 10,000 places that we will then be able to feed into additional nursing places, which will in time solve the underlying issues that parts of the country such as the hon. Lady’s have suffered for decades.
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One final aspect that I wish to bring to the hon. Lady’s attention, which I hope she will be pleased with, is that of the new role of nursing associate. It is supported by the Royal College of Nursing and to some extent by Unison, although it has reservations—a consultation is starting soon on this. It will provide a ladder of opportunity to healthcare assistants to move through an apprenticeship level up to the midway point of a nursing associate, and then on to being a full registered nurse. At present that is a course that healthcare assistants cannot take; it is not open to them.
I know that other parts of Yorkshire have no problem at all hiring healthcare assistants, but find it very difficult to hire registered nurses. That is a particular local difficulty. What I have proposed is a mechanism to give an opportunity to healthcare assistants to progress themselves, which they have many times missed out on because they did not have access to the decent formal
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education that we aim to provide now under the reformed education system. We are now offering, through an apprenticeship route that would not be open to them otherwise, a ladder of opportunity to a much wider group of people in the NHS, and at the same time helping to solve staffing issues where there are traditional, historic difficulties in hiring nurses.
I hope that with those general measures we will be able to do far more in the long term to solve the issue that the hon. Lady has identified. On the specific issues, I will ensure that she gets the reassurance she requires, not just on the reconfiguration, but on the leadership of her trust. I thank her and her colleagues for bringing this important matter to the attention of the House.