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Category: Health

  • Caroline Johnson – 2022 Statement on East Kent Maternity Services – Independent Investigation

    Caroline Johnson – 2022 Statement on East Kent Maternity Services – Independent Investigation

    The statement made by Caroline Johnson, the Parliamentary Under-Secretary of State for Health and Social Care, in the House of Commons on 20 October 2022.

    With permission, Mr Speaker, I will make a statement on the review into East Kent maternity services.

    Few things could be as tragic as the death of a child, yet knowing that that death was “wholly avoidable” comes with its own unimaginable pain. It is thanks to the tireless efforts, courage and determination of families in east Kent that we have been able to shine a light on maternity failings in East Kent Hospitals University Trust. Dr Bill Kirkup’s report, published yesterday, contains some stark and upsetting findings. From examining over 200 births in that trust between 2009 and 2020, he found that, had care been given at nationally recognised standards, 45 babies might not have lost their lives, and many more families might not have experienced such distress at what should have been their time of joy. He also found a toxic culture within the trust, with a

    “disturbing lack of kindness and compassion”

    and victims’ families even blamed for their devastating losses. Before I say more, Mr Speaker, I want to say this: I am profoundly sorry to all the families affected. This should never have happened, and we will work tirelessly to put it right.

    With the report having been published just yesterday, I am sure hon. Members will understand our need to carefully consider all of its details. I will be reviewing all the recommendations, and will issue a full response once I have had time to consider them. However, given the gravity of what the report reveals, I felt it was important to come to the House today and update colleagues on the steps we are already taking to improve maternity services in east Kent and across the country.

    The report itself is a litany of failure that makes for very difficult reading. It details failures of team working, failures of professionalism, failures of compassion, failures to listen, failures after safety incidents, and ultimately a failure of leadership. The review heard about women and family members feeling patronised, ignored or told off, with one woman hearing from a doctor:

    “Some parents just aren’t supposed to have children.”

    Some people felt they were unimportant, or too much trouble. One woman was reportedly told by a staff member that they were sorry for her loss, but that her baby was dead, and that there were other babies who were still living who needed attending to. These kinds of failures showed up at every level of patient care, with no discernible improvement over the whole timeframe of the review. The trust failed to read the signals and missed every opportunity to put things right.

    These are difficult things to hear, and especially hard because I know that so many of us have experienced for ourselves the brilliant care that NHS maternity services can offer. We must take nothing away from the hundreds of thousands of incredible people working day and night in maternity services across the country, yet we cannot pretend that the story of East Kent is a one-off. Reviews from Morecambe Bay and Shrewsbury and Telford paint a more disturbing picture. While they may be some of the most extreme examples—and we must hope that they are—they are certainly not isolated incidents. Colleagues will know that, just last month, Donna Ockenden began her independent review into maternity services at Nottingham University Hospitals NHS Trust.

    We entrust the NHS with our care when we are at our most vulnerable. Everyone has the right to expect the same high-quality care, no matter who they are or where they live. We are already taking a number of steps to improve the quality of maternity care in East Kent and across the country. An intensive programme of maternity support was put in place at East Kent Hospitals University NHS Foundation Trust in September 2019, overseen by NHS England, the Kent and Medway integrated care system and the trust’s board. The trust has been allocated a maternity improvement adviser and an obstetric improvement adviser. We will also continue to ensure the highest standards at national level.

    I am grateful to Dr Kirkup for the extensive recommendations in his report, but it is vital that they are not viewed in isolation. As Dr Kirkup said, since his Morecambe bay investigation in 2015,

    “maternity services have been the subject of more significant policy initiatives than any other service”,

    so his recommendations must be considered alongside existing work to improve maternity outcomes.

    First, there is our independent working group. The group is one of the key immediate and essential actions from the Ockenden review and has begun its important work. The group, chaired by the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists, is advising the maternity transformation programme in England on how it can take forward the findings of both the Ockenden and the Kirkup reports. Next, our new maternity quality surveillance framework is a vital tool for proactively identifying problems in trusts, so that they can get support before serious issues arise. In March 2022, NHS England announced a £127 million funding boost for maternity services across England, to help ensure safer and more personalised care for women and their babies. Even with that essential work, we recognise that there is still a long way to go and much more work to be done to put things right.

    In closing, I want to thank Dr Kirkup and his team. His experience has been invaluable, and I know that his approach of putting families first has been welcomed. I also know that hearing the accounts of families has been a harrowing experience at times, yet, as he said, it is difficult to imagine just how much harder it was for the families as they relived some of their darkest days. I am sure the whole House will join me in paying tribute to those families, whose tireless determination to find the truth and tell their stories has brought us to this important point. Nothing we do can bring back the children they have lost or fill the tragic void of a life never lived, but now we know their stories, we will listen, learn and act, so that no other family should ever experience such pain. I commend this statement to the House.

     

  • Caroline Johnson – 2022 Statement on Independent Investigation into East Kent Maternity Services

    Caroline Johnson – 2022 Statement on Independent Investigation into East Kent Maternity Services

    The statement made by Caroline Johnson, the Parliamentary Under-Secretary of State for Health and Social Care, in the House of Commons on 19 October 2022.

    I wish to inform the House that the independent review into maternity and neonatal services at East Kent Hospitals University NHS Foundation Trust has today published its report, which can be found here:

    https://www.gov.uk/government/publications/maternity-and-neonatal-services-in-east-kent-reading-the-signals-report

    NHS England commissioned Dr Bill Kirkup CBE to undertake an independent review into maternity and neonatal services at East Kent Hospitals University NHS Foundation Trust in February 2020, following concerns about the quality and outcomes of care. On behalf of the Government, I would like to thank Dr Kirkup, the families, and all those who contributed to the report.

    The report details the poor maternity care that over 200 families received at East Kent Hospitals University NHS Foundation Trust between 2009 and 2020. The trust failed to provide safe care and treatment which resulted in avoidable harm for mothers and babies, causing tragedy and distress that no family should have to experience. I am profoundly sorry to all the families that have suffered and continue to suffer from these tragedies. I also wish to pay tribute to the families who have come forward to assist the review.

    In line with the review team’s families first approach, I am pleased to hear that the families were able to see an advance copy of the report this morning ahead of the publication.

    I, and the Government, take the findings and the recommendations from the report extremely seriously and I am committed to preventing families from experiencing the same pain in the future.

    My Department along with NHS England has already established the independent working group, chaired by the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists. The independent working group will help guide the implementation and next steps of the immediate and essential actions from the Ockenden report and the recommendations from the East Kent report. The group has met twice to date, and the next meeting will focus on reviewing the recommendations for the East Kent report.

    In March 2022, NHS England also announced a £127 million funding boost for maternity services across England that will help ensure safer and more personalised care for women and their babies.

    I will be reviewing and considering all the recommendations from the report, and I will issue a full response once I have had time to consider the recommendations.

  • Therese Coffey – 2022 Comments on NHS Car Parking Charges

    Therese Coffey – 2022 Comments on NHS Car Parking Charges

    The comments made by Therese Coffey, the Deputy Prime Minister and Secretary of State for Health and Social Care, on Twitter on 16 October 2022.

    There have been inaccurate reports we are changing free hospital car parking. We have delivered our manifesto pledge to provide free parking for those who need it most at all NHS trusts. This will not change. #ABCD is about putting patients first and I’m determined to deliver it.

  • Eluned Morgan – 2022 Statement on Progress Implementing the Out of Hospital Cardiac Arrest Plan

    Eluned Morgan – 2022 Statement on Progress Implementing the Out of Hospital Cardiac Arrest Plan

    The statement made by Eluned Morgan, the Minister for Health and Social Services, on 14 October 2022.

    On 16 October, we mark Restart a Heart Day. Save a Life Cymru and its partners will be encouraging us to learn more about life-saving cardio-pulmonary resuscitation (CPR), using defibrillators and knowing how to help when someone has a cardiac arrest.

    I want to use this opportunity to provide Members with a further update about progress to implement the Out of Hospital Cardiac Arrest Plan and Save a Life Cymru’s work.

    The Out of Hospital Cardiac Arrest Plan was launched in 2017 and we established the Save a Life Cymru partnership that brings together organisations across Wales to help develop the Welsh public’s CPR and defibrillation skills so people feel confident to help if they witness someone experiencing an out-of-hospital cardiac arrest. Last year we increased the funding for this life saving programme.

    Earlier this month a new save a Life Cymru campaign was launched. ‘Help is closer than you think’ (Cofia, mae help wrth law) which focuses on increasing people’s confidence to intervene in a cardiac arrest emergency by highlighting the importance of calling 999 immediately, as well as the support provided by the call handler to do CPR and locate a registered defibrillator until an ambulance arrives. A TV, radio and social media advertisement went live from Monday 10 October.

    Save a Life Cymru has recruited a clinical out-of-hospital cardiac arrest programme manager who is developing an all Wales CPR and defibrillator framework to help communities become rescue ready and have the right resources in the right place to help someone having a cardiac arrest. It has also recruited four Save a Life Cymru community support coordinators, one of whom is already in post, and it is hoped the remainder will be in post before the end of November. They are also currently advertising for two Save a Life Cymru community support team leader posts.

    Save a Life Cymru is working with a range of organisations to support people of all ages and backgrounds to learn CPR and defibrillation skills, including:

    • Continuing to develop their partnership with the Football Association of Wales to broaden the reach of teaching CPR in Wales.
    • Following a successful pilot, Cardiff University has rolled out its model for all medical students who are trained in CPR to train all first year students.
    • Supporting One Voice Wales, which represents community and town councils, employing a person to co-ordinate CPR and defibrillator activity in communities across Wales, including ensuring defibrillators are registered and in good working order.
    • Appointing, in conjunction with Cardiff Metropolitan University, a post-doctoral research fellow who will develop research projects to initiate improvements in Out of Hospital Cardiac arrest outcomes in Wales
    • Partnering with Ospreys Rugby medical team to help raise awareness of CPR and defibrillation among its audiences.
    •  Producing a bilingual educational leaflet to support community CPR
    • Providing CPR training at the Welsh Government stand in some national events such as the Urdd Eisteddfod and Royal Welsh Show
    • Supporting Betsi Cadwaladr University Health Board (BCUHB) to produce a bilingual Primary School resource, supported by BSL, which teaches children the sequence of CPR through song and dance.

    During 2021/22 I announced a further £1m to purchase 1,000 additional defibrillators which community groups and public organisation across Wales were able to apply for.  638 groups and organisations successfully applied for a defibrillator and so far about 238 have been installed in communities across Wales. There have been some delays in groups being able to purchase and install the cabinets so defibrillators are still being distributed.

    Communities and organisations which already have defibrillators are being encouraged to register them on The Circuit – more than 7164 are registered and now 72% have a guardian. We have seen a significant increase in the number registered and in the percentage with a guardian but there is still more work to be done.

    Additionally, the Welsh Ambulance Service partnered with GoodSAM app to improve mobilisation of clinically trained staff and volunteers to life-threatening emergency calls. So when an emergency call is received by the ambulance service and classified to be of a life-threatening nature, details will automatically be sent through to the GoodSAM app to alert the nearest approved volunteer responder. They will shortly be relaunching the GoodSAM app in Wales, which was paused during the pandemic, and this will open up being a GoodSAM responder to all eligible individuals who have signed up and been approved by GoodSAM and partner organisations. This will be a huge step forward in Wales.

    We have made substantial progress over the course of the last twelve months and have heard stories of the differences this work is making to people’s lives. We know that every second counts when someone goes into cardiac arrest. We can all help raise awareness of the importance of dialling 999 and giving early CPR and defibrillation.

  • Will Quince – 2022 Speech on the Dental Training College

    Will Quince – 2022 Speech on the Dental Training College

    The speech made by Will Quince, the Minister of State at the Department of Health and Social Care, in the House of Commons on 11 October 2022.

    I congratulate my hon. Friend the Member for Broadland (Jerome Mayhew) on securing this debate on the potential merits of establishing a dental training college in East Anglia. It is clear that he has support from his neighbouring MPs—I know that one of them cannot be here this evening, but very much supports this endeavour—and from colleagues further afield and across East Anglia. I also thank him for raising the issue of access to dentistry in rural and coastal areas, particularly the challenges of seeing a dentist in Norfolk.

    As the new Minister for dentistry, I understand that areas across our country, as my hon. Friend has highlighted, have faced difficulties with recruitment and retention, including in his constituency of Broadland and in the east of England more widely. Those challenges have a significant impact on the provision of NHS dentistry and on patients’ ability to receive NHS care. My hon. Friend is right that we cannot ignore the problem, which I can assure him is a priority for me and for the Secretary of State. I hope that it will not have escaped my hon. Friend’s notice that dentists are a key element of the Secretary of State’s ABCD approach and of “Our plan for patients”.

    I am aware that my hon. Friend, alongside my hon. Friend the Member for North Norfolk (Duncan Baker), attended meetings with my predecessor, and I think even with my predecessor’s predecessor, to discuss the construction of a dental school in Norfolk. It is a testament to the character of my hon. Friend the Member for Broadland that he brought the issue to my attention just days after my appointment as a Minister in the Department of Health and Social Care. If I may say so, his constituents are fortunate to have such a passionate and persistent advocate in their corner.

    My hon. Friend set out in his speech to make a positive case for doing something about a long-term problem, and I think everyone in the Chamber this evening will agree that he has done so. He makes the case for a new dental school in Norfolk—a case that I know has the backing of my hon. Friend the Member for North Norfolk, who cannot be here this evening. On the face of it, it is a compelling case and is worth further exploration.

    I think that my hon. Friend the Member for Broadland knows me well enough to know that I am not someone who likes saying no to parliamentary colleagues, although sadly that is a responsibility that all too often comes with the job. On this occasion, it is a no, but it is “No for now, and let’s very much keep talking.” Let me explain why.

    Establishing a new dental school takes several years and would not influence service provision in the short term, as my hon. Friend rightly identified. Notwithstanding the strong case that he makes, it also would not guarantee the ongoing sustained retention of dentists or support staff in the area. Our focus is not just on training more dentists, important as that is, but on the better use of the full dental team and the progression and retention of all dental care professionals in the NHS. There is, of course, an argument about the medium to long term, which is why I suggest that we keep talking, and of course I would be delighted to meet my hon. Friend, as he requests, to further discuss his ideas and plans.

    My hon. Friends the Members for Broadland, for Waveney (Peter Aldous) and for Ipswich (Tom Hunt) all mentioned centres for dental development, the alternative training model identified by Health Education England in its 2021 “Advancing Dental Care” review report—that is a mouthful! The centres for dental development model would specifically benefit localities in which there is a shortage in provision and there are no nearby dental schools—as is the case in East Anglia, as my hon. Friend the Member for Broadland rightly pointed out.

    The premise is that the centres would build on any existing dental infrastructure in the area, bringing together training and the resultant provision of NHS treatment to patients in a co-ordinated way. Things like postgraduate training opportunities are more likely to be compatible than early undergraduate placements, as they would increase access to the more complex and specialist care that we know is often most lacking in certain areas of the country, otherwise known as dental deserts. This would work towards the aim, specified in the “Advancing Dental Care” report, to produce the skilled “multi-professional oral healthcare workforce” that could best support patient and population needs within the NHS. A further advantage of the centres for dental development model is that they would be tailored to suit the local workforce requirements, in addition to the education and training needs of the area, contributing to stronger, multi-disciplinary dental teams and local area workforce retention.

    Given that the centres would focus on postgraduate training or the later stages of undergraduate training, they could provide support in transitions from undergraduate to dental foundation training and more specialised training beyond those, all of which involve—as my hon. Friend mentioned—important decision-making moments in terms of career development and where dentists are likely to base their careers and practices. We believe that a broader range of placements across the country and in different clinical environments would enhance the student experience. The centres could offer a constructive alternative to dental schools, while acknowledging and addressing recruitment, retention and training gaps. I am sure my hon. Friend will be pleased to learn that Health Education England has now moved into its four-year implementation stage through its dental education reform programme—another mouthful!—following the “Advancing Dental Care” report and its recommendations.

    My hon. Friend rightly raised the subject of collaboration. With regard to establishing a centre for dental development in East Anglia—this has been mentioned by my hon. Friend and others—the University of Suffolk and the NHS Suffolk and North East Essex integrated care board have announced plans for a centre in Ipswich. I am informed—this also covers my area, so I have an interest in it as well—that the initial plans include proposals to offer postgraduate educational opportunities as well as wider training opportunities for newly qualified dentists, alongside the training of the dental therapists, hygienists and dental technicians who form a vital part of the dental workforce. I pay tribute to my hon. Friends the Members for Waveney and for Ipswich for the work that they have done in pushing so strongly for that development, along with the integrated care board, which is a trail-blazer in this regard. It would be wrong, at this juncture, for me not also to pay tribute to my hon. Friend the Member for Bury St Edmunds (Jo Churchill). She has pushed strongly for this as well, and, moreover, is—dare I say—a much-missed Minister at the Department of Health and Social Care. She has a passion for dentistry, and, within the Department, she really put it on the map. That is a legacy that I intend to continue.

    I strongly encourage my hon. Friend to meet the NHS and HEE regional teams for his areas, as centres for dental development are very much a local solution, tailored to the existing infrastructure and needs of an area. I, and those in my office, would be delighted to help facilitate such a meeting.

    I have mentioned integrated care systems and integrated care boards. As we make the transition to integrated care systems—this point was made by my hon. Friend the Member for Waveney—commissioning roles for dentistry will be delegated. This will ensure that dentistry decisions are considered at a local level, and that, for example, local workforce as well as local population health requirements are taken into account. I therefore encourage my hon. Friend to meet the integrated care board—I am sure he has already done so, but I think an ongoing dialogue would make sense—to discuss its plans further, and to talk about how they will affect Broadland and the rest of East Anglia.

    My hon. Friend touched on recruitment and retention, which I know is a particular issue in his constituency and more broadly. I have referred to the changes that we have made nationally through system reform, but NHS England in the East of England region has been working closely with the organisations that train dentists to improve the recruitment and retention of NHS dentists in East Anglia, and will continue to help those training organisations to develop the dental workforce. I am pleased to say that, in 2021-22, there was an increase of 539 dentists performing NHS dentistry compared with the previous year. In the East of England, there was a 3.5% increase, with an additional 105 dentists. However, as my hon. Friend pointed out, that is not enough: we need more dentists, and we need more dentists on NHS contracts.

    More broadly, I know that my hon. Friend will want to know what improvements are being made now which will improve access to dentistry for his constituents. He rightly focused on the medium to long term, but I know from my postbag that the pressing concern is often the here and now. We plan for the dental system improvements announced on 19 July as part of “Our plan for patients” to begin to take effect by the end of this year, and some of the improvements in the package have already taken effect and are beginning to bear fruit. The Secretary of State and I are looking at a number of further measures that we can take to aid recruitment and retention—I know that that is one of the key concerns of my hon. Friend and others, and I think my hon. Friend touched on one of the ideas that we are considering—and, in turn, improve access for constituents. As I have said, this is a priority for me, and I hope to share more details with my hon. Friend and the House in due course.

    I am committed to playing my part to improve access to NHS dentistry, particularly for those most in need of dental care, and I know that recruitment and the dental workforce will play a pivotal role in that. I hope my hon. Friend has been reassured that action is being taken to address the challenges in recruitment and retention across the country, and particularly in his constituency. I look forward to working with him as we develop our ambitious plans, and I know he will continue to be a champion for his constituents and hold the Government’s metaphorical feet to the fire as we deliver the improvements in dentistry access that we all want to see.

  • Jerome Mayhew – 2022 Speech on the Dental Training College

    Jerome Mayhew – 2022 Speech on the Dental Training College

    The speech made by Jerome Mayhew, the Conservative MP for Broadland, in the House of Commons on 11 October 2022.

    It would be all too easy to focus any speech on dentistry on a call for the renegotiation of the NHS—[Interruption.]

    Madam Deputy Speaker (Dame Rosie Winterton)

    Order. Could colleagues leave quietly? Otherwise we will not be able to hear what the hon. Gentleman is saying.

    Jerome Mayhew

    As I was saying, it would be all too easy to focus any speech on dentistry on a call for the renegotiation of the NHS dental contract. Every Member of Parliament will know from their postbag the suffering that ordinary people are experiencing every day because they are simply unable to see a dentist.

    The pandemic has caused the loss of 40 million dental appointments—more than an entire year’s worth of standard pre-covid treatment—but covid is not the cause of our problems. Ever since Labour imposed its NHS dental contract on the profession back in 2006, trouble has been brewing. Dentists have been voting with their feet, moving in their thousands away from NHS treatment into private work.

    That trend has only accelerated through covid. Between the start of the pandemic and May 2022, 3,000 dentists have stopped doing any NHS work. Three quarters of those who are left say that they are likely to reduce their coverage further over the next year, so we simply cannot ignore the problem any longer. The pain and suffering are too great. Labour may have created this bad system, which fails to pay for the cost of complex work, but our job is to fix it, and the sooner the better.

    The purpose of this debate, however, is not to moan about the state of NHS dental provision, but to put forward a positive case for solving the long-term problems in Norfolk and the east. Put simply, we have a desperate shortage of dentists of any description. Too few dentists and too few dental technicians—whether NHS or private—are choosing to work in East Anglia.

    Nationally, the General Dental Council says that we have more dentists than ever before, with a national average of 43 for every 100,000 of the population, but in Norfolk and Waveney, that figure is just 38. That is the fifth lowest ratio of the 106 clinical commissioning groups around the country. Dental practices are crying out for new staff, but they simply cannot get them.

    In the town of Fakenham in my constituency, I lobbied successfully for the NHS to award a brand-new NHS dental contract to increase local NHS provision. That was the Government being prepared to pour new money into increasing NHS provision. However, when that contract was advertised, not a single company bid for the work. There simply was not the staff to supply the need.

    That is not just an NHS issue. In the same town, a private dental practice has been advertising for a private dentist for two years, but without success. In the constituency of my hon. Friend the Member for North Norfolk (Duncan Baker), there is a dentist in Sheringham who operates practices both in London and Norfolk. He has not had a newly qualified dentist come to work in his Sheringham practice for 10 years. Job vacancies in London are snapped up, but he simply cannot get them to take the jobs in Norfolk.

    Why can we not produce dentists in East Anglia? The answer is that there is nowhere for them to train. If someone who lives in East Anglia wants to become a dentist, the nearest place they can train is Birmingham or London. None of the 10 training facilities around England is in the east of England.

    That has to change. We know from our experience with the University of East Anglia that graduates tend to stay and build their lives close to where they have studied. Each year, the UEA does a survey of its graduates to see where they go to accept their first employment. If we look at that survey for doctors coming through the medical school of the University of East Anglia, we see that more than 40% end up taking jobs locally every year. That is great for us in relation to doctors and particularly for the Norfolk and Norwich University Hospital, which is based in Norwich. Unfortunately, however, the same problem is true in dentistry.

    Let us look at the number of dentists working near existing dental training schools. As I said, Norfolk has 38 dentists per 100,000 of the population. Devon is a broadly similar county—it is largely rural, with coastal communities and one major conurbation, Plymouth—but there is a big difference: Plymouth has a dental school, which was installed in 2005, and Devon’s ratio of dentists per 100,000 of the population is not 38, but 49.6. If we look at the north-east, where there is a school in Newcastle, we see that its ratio of dentists to the general public is 56 per 100,000 of the population. In Cheshire and Merseyside, there is a school in Liverpool, so the whole area benefits from 58 dentists per 100,000 of the population. We can see from the hard data that people tend to settle down where they have trained.

    So if that is the data, surely the solution to East Anglia’s problems is obvious: first, we need to open a dental school in East Anglia. I raised that need directly with the University of East Anglia some months ago and I have been enormously encouraged and impressed by their response, strongly supported by the NNUH, the region’s training hospital. The University of East Anglia has developed an innovative solution to our dental training problems that would minimise cost and get students out into the workplace from the start of their training, helping with capacity in the short term and dealing with the training deficit in the long run.

    Tom Hunt (Ipswich) (Con)

    As a Suffolk MP, I welcome the idea of an East Anglian training centre. I also want the University of Suffolk to play a role. It recently outlined its plans for a Suffolk centre for dental development. Does my hon. Friend agree that, actually, a dental training college in Norwich could work hand in glove with the new centre in Ipswich to make sure that people are trained locally but, when needed, they are pooled to provide services on the NHS for our constituents?

    Jerome Mayhew

    I am grateful to my hon. Friend for that intervention, and I agree entirely. There can be collaboration between the university in Norwich and the University of Suffolk, which is based in Ipswich. People can start training in Norwich and, once they are qualified, have career and professional development taken care of by the proposed unit in Ipswich. I will come on to that in further detail.

    To return to the plans of the University of East Anglia, its idea is that students would work in the community for at least one day a week throughout their five-year training course. In that way, dental students will increase the capacity of associated NHS practices right from the get-go. Too often, it is suggested that a dental training school is too long term to solve the problems now. In a sense, it is, of course, but under this plan, we would have increased capacity right from the first year of the students’ five-year course.

    There are more benefits, too: students would not only increase the capacity, but develop employment relationships locally, increasing their stickiness, and provide training income to stretched NHS practices. For that reason, MPs from North Norfolk, North West Norfolk, Mid Norfolk, South Norfolk and Norwich North all support the proposal. If there were an East Norfolk constituency, I am sure that that Member would support it as well.

    Peter Aldous (Waveney) (Con)

    I speak as an MP with a foot in both camps: I am a Suffolk MP but I also represent the Norfolk and Waveney integrated care system area. Does my hon. Friend agree, as my hon. Friend the Member for Ipswich (Tom Hunt) said, that it is very important that the two proposals being put together by the University of Suffolk and the University of East Anglia are collaborative and worked on together, so that they come through with a solution for the whole of East Anglia?

    Jerome Mayhew

    I am grateful to my hon. Friend. The only phrase that I would pick him up on is that he has “a foot in both camps”. I do not think there should be two camps. This is an East Anglian solution, whereby the proposals are complementary and, in time, they should both be implemented.

    George Freeman (Mid Norfolk) (Con)

    I commend my hon. Friend and constituency neighbour for raising this issue and highlighting the huge pressures that the dental service in his area and mine is experiencing on the ground. Many of our constituents are struggling and this proposal would not only make our region a leader in the science and technology of dentistry, but help to meet that demand and need on the ground. With new housing, the pressure will only get more acute in the next few years.

    Jerome Mayhew

    My hon. Friend is entirely right. There is a further point to be made about the collaboration between the University of East Anglia and the Norfolk and Norwich University Hospital, because they also have the Norwich research park co-located. I am thinking particularly of the Quadram Institute, the sole focus of which is world-leading research on the gut microbiota. I cannot pretend to know exactly what the gut microbiota are, but I know that they start with the mouth. There is huge capacity for proper, hard research in the area, and it could be assisted by a dental training school in Norwich. That is the first solution.

    The second solution, which is also needed, is for the dental school in Norwich to complement the University of Suffolk’s plans to build a centre for dental development in Ipswich to support further career development in the region, attracting and retaining newly qualified dentists. My hon. Friends the Members for Bury St Edmunds (Jo Churchill), for Waveney (Peter Aldous) and for Ipswich (Tom Hunt) and others have all pushed for that.

    The truth is that we need both to attract qualified dentists in the short term and to find a long-term solution to the wider training problem. It may be that an assessment is made nationally that there is no need for additional dental training seats, but people are human. We have to look beyond the empirical analysis and recognise that training needs to be offered in a location of real shortage. That location is East Anglia, and Norfolk in particular.

    As a Conservative, I believe that people should have power over their own lives and that communities should not be dictated to by national Government. Rather, they should be empowered to come up with their own solutions to their local needs. We know what the problem is, and we have a solution to fix it locally; we just need the Government to trust the people to let us get on and do it.

    We simply need more dentists and dental technicians in East Anglia. We recognise that budgets are tight and that timings may have to be stretched. We accept that short-term fixes are sometimes more powerful arguments in politics than long-term solutions. We simply ask the Minister to agree to meet the University of East Anglia team to learn at first hand how we can make East Anglian dentistry better, and to be inspired by their practical vision.

    Peter Aldous rose—

    Madam Deputy Speaker (Dame Eleanor Laing)

    I cannot quite tell whether the hon. Gentleman wishes to contribute.

    Peter Aldous (Waveney) (Con)

    I will contribute very quickly, Madam Deputy Speaker, if you will give me the opportunity.

    My hon. Friend the Member for Broadland (Jerome Mayhew) has set out a great vision of a future in which East Anglia, Norfolk and Suffolk have high-quality dentistry schools. That is great, but we need a bridge to get to that future, because two dentistry schools will take some time to set up. Does he agree that we need to look at other strands to address the crisis in NHS dentistry in East Anglia, including recruitment and retention in the short term, making it easier for people from overseas to come and work in local dentistry; contract reform, which I think my hon. Friend referred to; a fair, long-term funding settlement; a focus on prevention; and improved local accountability through the fledgling integrated care systems?

    Jerome Mayhew

    I am grateful—

    Madam Deputy Speaker

    Order. Perhaps I am confused, but I thought that the hon. Member for Broadland (Jerome Mayhew) had finished. [Interruption.] Ah, so now he is intervening on the hon. Member for Waveney (Peter Aldous). That is absolutely fine.

    Jerome Mayhew

    Thank you for that clarification, Madam Deputy Speaker.

    Does my hon. Friend agree that all those aspects are very important, but that perhaps there is another proposed solution that he has not mentioned? As we have learned today, there are inducement payments for teachers in special areas that are struggling to recruit. Perhaps we could apply the same approach to dentists in special areas that are struggling to recruit.

    Peter Aldous

    I thank my hon. Friend for that intervention and apologise for hijacking his debate. Yes, I agree wholeheartedly. This is a multifaceted challenge; there is no one solution and no one golden bullet. We need to address all the points, and he is right to raise that one.

    George Freeman (Mid Norfolk) (Con)

    As a former Minister for life science and for science and research, I rise very briefly to highlight the point that my hon. Friend the Member for Broadland (Jerome Mayhew) made about the microbiome and the mouth—the buccal cavity—as a primary diagnostic for our understanding of the role of the biome and of gut flora and fauna, not only in good health but in diseases such as cancer. As a diagnostic tool, it could make our region a leader in the diagnostics of the digestive system and the gut biome, which would have a whole bunch of other important secondary health benefits. For that reason, I commend my hon. Friend’s case to Ministers on the Front Bench.

  • Alison McGovern – 2022 Speech on the Health and Social Care Levy (Repeal) Bill

    Alison McGovern – 2022 Speech on the Health and Social Care Levy (Repeal) Bill

    The speech made by Alison McGovern, the Labour MP for Wirral South, in the House of Commons on 11 October 2022.

    Before I get into the Bill, I want to note some of the remarks made by the Government on their energy package and the speed with which that was brought forward. Given that this is the first opportunity we have to discuss these financial matters, I want to record that it felt during recess as though almost every day in August people were begging the Government to act, and they did not. We waited and waited, while they had an internal debate when they could have acted. For 12 years, in fact, it has seemed that the British economy has had both deep-rooted problems and significant shocks. Given the situation before us and the chaos we face, would not any Government want to act?

    That brings us to today’s Bill, which is essentially a U-turn. As colleagues have said, the Government are showing here that they can U-turn, but what we need now is much more significant action. We can say with certainty that the Chancellor has already made a considerable impression on the economy. He inherited a cost of living crisis and for good measure added a cost of borrowing crisis, an interest rate crisis, a mortgage crisis, a sterling crisis, a Government bond crisis and a pension funds crisis.

    Inflation was already at its highest rate in 40 years, devouring household wages and savings; Shell, ExxonMobil and Chevron recorded their highest ever profits and household energy bills doubled within a year. Thanks to this Government, the pound has slumped to its lowest value against the dollar since Britain went decimal in 1971, and the Bank of England has been forced to launch an emergency £65 billion bond-buying scheme that, as we saw yesterday, has barely stopped the chaos.

    Thanks to this Government, in the blink of an eye the average homeowner now faces a monthly mortgage payment that is £500 more expensive and food bank use has soared to such an extent—[Interruption.] Do not say it is global. The food bank increase is not global; it is a feature of the UK economy, and it has soared to such an extent that volunteers will need either to turn people away or to reduce the size of emergency rations. That is the situation we face, and that is why this Bill must not represent the last U-turn from this Government.

    We have heard from various Conservative Members that they are the party of tradition, so let me commend the Government on respecting a long-standing Conservative tradition in their conduct relating to our economy. Just like on 16 September 1992, Conservative Governments always end up sacrificing family finances to pay for their chaos.

    This Chancellor, in his airy disregard for experts, produced a Budget so complacent, so unfunded and so unconvincing to the markets that the cost of our long-term borrowing soared. His doubters are now not just the members of the Labour party; they include bond traders, the currency markets, the civil service, the OBR, the Bank of England, the IMF and the British public.

    The Conservatives have pierced a hole in the British economy, and the effects are widespread and severe. Pension funds were brought to the edge of collapse and, before the Bank of England intervened, we risked falling into a self-perpetuating spiral,

    “threatening severe disruption of core funding markets and consequent widespread financial instability.”

    To be so ignorant, so high-handed and so willing to risk impoverishing people is unforgivable.

    It is some small comfort that today the Tories are reversing their own rise in national insurance. U-turn follows U-turn and we return to square one. However, this zig-zagging incoherence is not just a waste of parliamentary time and energy, but damaging to our stability and our credibility. No matter whether they raise taxes or lower them, high-quality public services and economic growth will continue to elude the Conservatives. That is because, as has been said so often, economic strength does not come just from the top; it starts in the everyday lives of working people right across our great country. The hon. Member for South Suffolk (James Cartlidge) explained well what is happening right now for people trying to work. Thanks to the Conservatives, record waiting lists see acute conditions becoming chronic and more and more people having to leave the labour market. Do not crow about unemployment being at historically low levels when inactivity—people simply unable to work—is shooting up again, as we found today.

    James Cartlidge

    Just to clarify, what I said was that it was due to the pandemic—not entirely, but everything the Labour party says now is airbrushing out of history the greatest post-war trauma that the country faced, when there was an enormous surge in borrowing, which we all supported, to fund the support for businesses and people in our constituencies. At some point, will Labour recognise the impact that had and the action we had to take, which has led to decisions such as these tax increases?

    Alison McGovern

    The impact of the pandemic on our labour market and our health service has been profound. It should inspire us to see the capabilities of the people within our health service, and it should show us the undeniable truth that there will be no economic health in this country without securing the health of the people of this country. That is what the pandemic shows us. I simply ask that the party in government today, the Conservative party, learns that lesson.

    If we look at what is going on with our labour market, we see that part of the growth plan must be to secure our health service, get waiting lists down and get people back to good health. We have heard that funding for health and social care services will be untouched, so let me assure the Government—already so elastic with their commitments—that their promise on the health service will be under heightened surveillance in months to come.

    The Government say that they have a growth plan to end their cycle of stagnation and to radically overhaul what has been dragging us down, but that plan simply has no credibility. It is delayed and delayed. Until we see what they truly believe can help this country grow, all we see is the cost of borrowing growing, inflation growing, mortgage payments growing, food bank use growing and child poverty growing, while the true opportunities that this country has—its people and their talents—are left wasted.

    Who asked for this? Who nodded happily at higher mortgage repayments? Who wanted public services to be slashed or spiralling inequality? There is no consent for this, as we have seen—not even consent on the Tory Back Benches. The resulting damage to our economy is immediate and sharp, but there is another danger that emerges slower but is just as great: the risk to our relationship with the British people.

    I worry that we have short memories in this place. Only three months ago, more than 60 Ministers fled the Government of the right hon. Member for Uxbridge and South Ruislip (Boris Johnson). For some time, that Government were viewed with real anger by the public, who overcame the pandemic through shared sacrifice, only to feel cheated, insulted and taken for fools by their Government. Well, the British people are not fools, Madam Deputy Speaker. They understand that this winter, whether it is due to soaring energy bills, surging inflation or the war in Ukraine, shared sacrifice is needed again. In return, they are owed compassionate, responsible leadership and a Government who can look them in the eye.

    This is not a time for economic hobbyism—for testing pet theories like schoolboys in the common room—and ignoring the country. Not even two people in every 1,000 voted for the Prime Minister or her Chancellor. Britain did not choose to be experimented on in this way. When the Chancellor delivered his crazy Budget on 23 September, everyone in this country was united in experiencing that act of economic vandalism. When children are hungry, pensioners colder and families fearful, the Chancellor avoided the profits of energy giants and signed off unfunded tax giveaways for millionaires. In waving through bigger bonuses for bankers, he took a torch to our social contract. Instead of shared sacrifice, this gang of fanatics on the Treasury Bench turned to casino economics and gambled away public trust.

    It is an old, old saying that you can judge a person by what they choose to do with power. After 12 years of the Tories in power, the veneer has worn off, revealing the same old ideas that have been tested to destruction in this country: run the country on the cheap, leave public services crumbling and make working people pay the price. The big society—remember that?—has been and gone, one nation conservatism is a painted shell, and the façade of levelling up has been abandoned, as they cut taxes for millionaires and look set to cut benefits for the poor. It does not matter whether it is this Prime Minister or whoever soon replaces her—this is the Conservative project and it has been there all along.

    It is the single greatest privilege in this country to sit on the Treasury Bench. Instead of living up to that honour, the Conservative party is hopeless, reckless, callous and weak. There is no consent for this Government’s ideas, and they should be driven out of office. If they really are such a confident group of free thinkers, surely they have nothing to fear from taking their pitch to the country.

  • Peter Grant – 2022 Speech on the Health and Social Care Levy (Repeal) Bill

    Peter Grant – 2022 Speech on the Health and Social Care Levy (Repeal) Bill

    The speech made by Peter Grant, the SNP MP for Glenrothes, in the House of Commons on 11 October 2022.

    I do not often say this, but I welcome the decision that the Government have taken, which is to U-turn on their increase in national insurance contributions, although I utterly reject any suggestion that it should be coupled with any watering down of the previous commitments on funding for health and social care services.

    I do not think that national insurance is the right name for this tax. It is an income tax—a jobs tax—and we should be honest about what it is doing. It is a jobs tax because if a person has a job, they pay tax on the money that they get paid for doing their job— unless they are earning way below the minimum full-time wage. If they are an employer, they pay tax on the wages that they pay someone for doing the job for them. It is only if a person is lucky enough to be able to make most of their money from owning shares or property that they can earn significant amounts of money without paying national insurance on that income. I have to say that not many of my constituents who are struggling on a minimum wage and part-time jobs are that impressed by the fact that they can get national insurance-free income from their share portfolios, because they cannot afford to buy them in the first place.

    This is a form of income tax—a jobs tax—specifically targeted at working people. It is not even an insurance as such. I pay insurance on my car. If I am involved in an accident, I have a guarantee that the insurance company will pay its share of the costs. People do not get that guarantee just because they have been paying national insurance contributions all their life. Just ask the WASPI women—of the Women Against State Pension Inequality Campaign—how much of an insurance scheme guarantee they actually get from national insurance.

    The legislation that we are being asked to repeal today—and it looks like it will be repealed today without a Division—introduced a form of hypothecated tax, which is not something that I would generally support. Nobody has really mentioned that in this debate, and it did not get much coverage in the debate last year. Other than for very time-limited and precisely defined purposes, hypothecated taxes do not really work. Filling in a small part of the decades-long underfunding in some of our most important public services is neither time limited nor specific.

    Whatever we are going to do to change the tax system to get adequate funding for these services, a single, specific hypothecated tax is never going to be it. I have been consistent on this. I find it interesting that nobody who has spoken in this debate in favour of repealing the levy has explained why they voted for it in the first place last year. I note that sometimes people are allowed to change their minds regularly, whereas at other times people are not allowed to change their minds from eight years ago.

    Our health and social care services are among our most precious public services. Universal healthcare—including free prescriptions—free at the point of delivery, based only on clinical need rather than the ability to pay, is surely an essential part of any civilised society. I would say the same about social care. I am proud that in Scotland we have free personal care for those who need it, regardless of whether they can afford to pay for it. I welcome the steps that the Scottish Government have taken to reduce the financial burden on those who need other forms of social care as well. All of these services are available to everybody and they should be paid for by everybody according to our means through general taxation. I am not ashamed to say that if I had to pay a wee bit extra tax that I could easily afford in order to provide a civilised society for my people to live in, I would do so willingly.

    Those principles are now under direct attack, even more so than they were under the previous Prime Minister, and even more so than they were in the dark days of Margaret Thatcher. We now have a Prime Minister who has chosen to surround herself with people whose links to the NHS privatisation lobby are not hard to find. It does not need to be direct privatisation; it is very easy to privatise the health service by stealth, simply by strangling it of funds so that the waiting list becomes so long that people choose to pay for a health service that they have already paid for through their taxes.

    That is why it is essential that we get a commitment from this Government that not only will there not be a reduction in cash terms in health service funding or in social care funding, but that those budgets will increase by enough to cover the cost of inflation as it hits those services. Historically, inflation in the health service has usually been higher than the headline rate of inflation. The headline rate of inflation is savage enough just now. It is likely that the true cost of inflation to the health service is even higher. I asked the Chancellor about this directly a few weeks ago when he issued his mini-Budget. Scandalously, he refused to give a commitment that funding in the health service will even keep pace with inflation, never mind increasing to meet what we can all see is an unmet demand.

    Part of the reason that the NHS is coming under unprecedented pressure is that the policies and deliberate choices of this Government and their predecessors have forced people into poverty and destitution, and that has an impact on people’s health, which creates additional demand on the NHS. As others have pointed out, having people on health service waiting lists unable to work damages the economy. If the economy is damaged in such a way that it affects the funding of the health service—if, for example, people are given lower wages, are put under financial stress and are unable to afford the cost of living—that in turn damages our health, and to an extent that we perhaps have not properly realised until recently.

    A recent study by the University of Glasgow and the Glasgow Centre for Population Health found nearly 335,000 excess deaths in the UK in the past seven years that were caused by austerity. Deliberate policy choices by this and previous Tory Governments since 2012 have killed more people than the covid pandemic. That is a scandalous thing to happen in any country that claims to be civilised. That is why we cannot fully consider the provisions of this Bill, or the provisions of the Act of Parliament that it seeks to repeal, in isolation from the wider policies of a Government who seem hellbent on plunging even more people into poverty, while lining the pockets of their own billionaire supporters and donors.

    To give just one example, the Chief Secretary to the Treasury was delighted to tell us earlier that the combination of not increasing the national insurance levy and the previously announced changes to income tax thresholds will amount to a whopping £500 per year back in the pockets of my lowest-earning constituents. They are paying between £1,200 and £1,500 a year more just for the heat in their homes compared with last year, so the generous £500 a year that the Government are putting back into their pockets is less than half of what my constituents need just to stand still for electricity and gas prices. That is before they start to pay their increased costs of food, rent and mortgages for those able to buy their own homes.

    That should not be inevitable. My constituents live in a country in which 85% of energy does not come from gas, so why do they see their bills doubling when there is a gas shortage? My constituents live in a country that supplies more energy than it needs and has a commodity that is in short supply, so why are they so much worse off when the value of the commodity that we have in surplus increases on the global market? Those are not questions that Treasury Ministers or other Ministers in this place do not know the answers to; they are questions that they are scared to face up to the answers to.

    Repealing this legislation when the ink is hardly dry on the paper serves to illustrate yet again the total chaos that this Government are in. That chaos has spread to the whole of these islands, and they seem quite happy to inflict it on the financial markets, despite the impact they know it will have on people’s standard of living now and the pensions they will be able to rely on in the future.

    The Government’s persistent refusal to provide a costed plan to ensure sufficient and sustainable funding for those vital services, directly through funding in England and indirectly through Barnett consequentials on the devolved nations, and their persistent refusal to put health and social care services on a proper and sustainable funding basis demonstrate clearly that our national health service can never be safe in the hands of this or any other Westminster Government.

  • Kim Johnson – 2022 Speech on the Health and Social Care Levy (Repeal) Bill

    Kim Johnson – 2022 Speech on the Health and Social Care Levy (Repeal) Bill

    The speech made by Kim Johnson, the Labour MP for Liverpool Riverside, in the House of Commons on 11 October 2022.

    I welcome this decision to repeal the regressive hikes to national insurance, which would have seen those least able to pay with the heaviest proportional tax burden to tackle the crisis in social care. This is the right thing to do, but it should never have happened in the first place. Tax rises on the poorest, especially during a cost of living crisis, are cruel and unnecessary.

    We now need urgent reassurances from the Minister that new funding for adult social care will come from progressive taxation and the pockets of those who can most afford it. We must be clear that a U-turn is not a plan; it is the absence of one. We still have no answers from the Government about how they plan to tackle the crisis in adult social care or where the funding will come from, other than to wait until 31 October for the medium-term fiscal plan.

    Twelve years of Tory austerity have already seen £8 billion taken out of the social care system. Now we are facing a winter of hardship driven by the rampant cost of living crisis. Instead of bringing forward measures that will help the poorest and those most in need, the Government are prioritising tax cuts for the rich and public service cuts for the rest of us. They have removed the triple-lock protections on pensions and are refusing to commit to raising benefits in line with inflation. They have made disastrous economic decisions that have crashed the economy and made the cost of living crisis one of the worst among comparable countries.

    Local governments are being forced to make further crippling cuts, as well as find extra money for energy costs and inflation to maintain their public services. We know that adult social care provision will suffer. Liverpool has lost £465 million of our budget since the start of austerity, which is more than two thirds of our overall budget since 2010. Liverpool, like other cities, has a growing elderly population with increasing complex needs, including dementia.

    We urgently need a big injection of funding to councils’ care budgets alongside a social care workforce strategy to meet rising demands. We are facing unprecedented staff shortages in the health and social care sectors, with more than 165,000 vacancies and a massive staff turnover of 30% a year. In Liverpool, 15% of our social care workers are employed on zero-hours contracts and we have a vacancy rate of over 10%. Without action, the consequences will be devastating. We must be absolutely clear: a shortage of staff costs lives. It is as simple as that.

    We are about to face a second round of Tory austerity, with £43 billion to be slashed from public services that have already been decimated during 12 years of Tory Government. Instead of more cuts, we need a serious injection of cash into adult social care and a plan to bring those services back in-house to end the rampant profiteering of companies backed by private equity funds, which sucks public money out of the system and out of services and straight into tax havens in the Cayman Islands to be hoarded by the super-rich. Decent pay, terms and conditions for undervalued employees must take centre stage of any serious plans to tackle the deep-rooted structural issues in the social care sector along with a long-term workforce strategy and improved quality and standards of care.

    The Secretary of State for Health and Social Care has committed to maintaining the same levels of funding on health and social care despite today’s cancellation of the levy. However, the Prime Minister and the Chancellor are crowing about this reversal to national insurance contributions as a key victory in their tax-cutting agenda, which will see £43 billion slashed from public services. Will the Minister confirm whether the Government will commit to spending the same planned £12.4 billion a year over the next three years that would have been raised by this levy? A simple yes or no answer would be great, thank you.

  • Sarah Olney – 2022 Speech on the Health and Social Care Levy (Repeal) Bill

    Sarah Olney – 2022 Speech on the Health and Social Care Levy (Repeal) Bill

    The speech made by Sarah Olney, the Liberal Democrat MP for Richmond Park, in the House of Commons on 11 October 2022.

    The Liberal Democrats were opposed to this tax to start with. We opposed the national insurance levy when it was introduced last year. Our argument at the time was that it would disproportionately impact lower earners and hit working families at precisely the time when they were struggling to pay their bills and prices were starting to increase in shops. We are really pleased that it is being reversed, and we support this Bill.

    We must not ignore the fact, however, that a great deal of damage has been done in the past six months, during which employees, the self-employed and employers have been charged with this levy. During that time, employees and the self-employed will have paid about £2.5 billion, and businesses about £3.8 billion. One of the main disruptions is that it has been incredibly disruptive to businesses. I speak with some feeling as an accountant who in a previous life spent many hours working on payrolls and forecasting employee costs. I can only imagine what it must have been like for businesses over the past three years. In 2019, a Conservative Government came in promising not to increase any business taxes, but in 2021 they increased national insurance, and now here they are in 2022 reversing that increase. That is an awful lot of change for businesses to have to deal with, and that is quite apart from the increased costs that they will have borne over the past six months.

    Let us think about the impact that that cost will have had on businesses. They will have been thinking, “Which employees can we have? If we want to grow our business, how many employees can we afford to take on?” They will have revised those assumptions in the light of the increased cost of national insurance, so we can only assume that the six-month increase will have stunted the very growth that the Conservatives say that they want to see, and that it will have contributed in part to the economic slowdown, not least because the impact on employees will have decreased their take-home pay, and that, of course, will have decreased their consumption.

    What businesses need above all is certainty and stability, but that has been continually undermined by this Government and their constant chopping and changing of national insurance. This, of course, is happening at a time of a huge increase not just in inflation but, as has been mentioned several times, in energy costs, primarily as a result of Putin’s illegal invasion of Ukraine. That is also having a massive impact on businesses in this country, and the chopping and changing of the costs of employing staff will not have helped.

    It has always been our argument that tax could have been more productively raised by an expanded windfall tax, which we have been calling for since last autumn. We are very pleased that the Government took on board some of our suggestions, but both Shell and BP have said that the Government could have gone further. Potentially up to an extra £60 billion of taxes could have been levied on oil and gas firms, which would have negated the need not just for the national insurance increase but for many of the other unfunded borrowing commitments that the Government made on 23 September.

    Now that we are repealing the health and social care levy, it is important to remember—the hon. Member for South Suffolk (James Cartlidge) made this point very well—that we still have to deal with a crisis in health and social care. The Government must immediately set out their plans. We all anticipate the much-awaited fiscal event on 31 October with a huge amount of excitement but, more than anything, we need to hear from the Government their plans for health and social care, because there is no doubt that the backlog in NHS hospitals is in itself having an impact on growth. I saw figures today that suggested that the number of people suffering from a long-term sickness that prevents them from working is at a record high. We can all see how that has come about from the events of the past few years, but these are people who cannot be available for work and who cannot contribute to the Government’s “growth, growth, growth” agenda; they are not able to take up posts in what we know now is a record number of vacancies simply because they are waiting for treatment. We welcome this reversal, but the Government must state, and soon, what they plan to do to address the backlog.

    Of course, this is not just about health; it is also about social care. There are 130,000 vacancies across our social care sector, and we know that that is caused by chronic underfunding. It cannot offer the kinds of salaries that care workers can find in other sectors. The shortage of care workers and of places in care homes is having a knock-on impact on our hospitals. I was at Kingston Hospital recently and was told that the reason it has problems, and one of the big contributors to its backlog, is that it cannot discharge patients because there is no care package for them to be looked after in their homes. The issue of social care, health and the backlog needs to be addressed urgently. It was not being addressed when the legislation to increase national insurance was first brought in, and it is not being addressed now. We urgently need to hear more from the Government on that.

    I say to the Government that we would support an increase in the windfall tax and that we oppose their plans to reverse the planned increase in corporation tax, which I believe is what is creating the biggest need for the additional borrowing announced on 23 September. The Government urgently need to look at that again and at all the plans announced by the Chancellor on 23 September, and I for one am very keen to see what they come up with on 31 October.