14/09/2016 House of Commons


14/09/2016

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Order! I had hoped to be able to announce today the timetable for the

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election of vacant chairs of select committees. It is my understanding,

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I may of course be wrong, that discussions on these matters in the

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usual channels have concluded, but the government has still to table

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the various motions required. I very much hope that they will be tabled

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very soon. It may be helpful to members to know that, if the House

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agrees to those motions, it is my fervent hope and expectation that

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the elections for chairs may take place on Wednesday 19th of October.

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Order. We will come to the honourable gentleman. I know that it

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may be on that matter but there is something else I want to see first.

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It is always good to keep the honourable gentleman in reserve, it

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builds up a sense of eager anticipation in the House. Order.

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Michael Carpenter, speakers Council, retires from how service at the end

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of September. You were seconded from the Treasury solicitors department

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in October 2000 as counsel for European legislation and

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subsequently became an employee of the House. Michael became Speaker's

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Council in October 2008. He has served this House and, if I may say

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so, colleagues, he has served me magnificently. I shall always be

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grateful to him, and the House should be thankful for his sense of

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duty, for his immense ability and for his stoicism and fortitude under

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pressure. I am sure that the House would wish to send its best wishes

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to Michael and his family, following his retirement. Hear, hear. I am

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pleased to announce that, following fair and open competition, Sarah

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Solini will take on the role of Speaker's counsel in October. She's

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currently solicited the Deputy Church Commissioners, role that she

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has held for five years. Before that she was a member of the office of

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the Parliamentary Counsel for eight years, and she comes to us with a

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detailed knowledge of the legislative process. I am sure that

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the House will want to wish Sarah well in her new and important role.

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Yes, OK, I will take those points of order now before we come to the

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urgent questions. I saw the honourable member for Wellingborough

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first under am certain that he will burst if he doesn't have is

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opportunity ere long. Mr Peter bone. Thank you, Mr Speaker. On the issue

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he raised, obviously the two whips' departments will be working hard to

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ensure that this House has the opportunity to set up Select

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Committees to scrutinise the government. As they are having some

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sort of trouble, is there any possibility we could do something in

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this House to ensure that it happens before we go into recess, and so it

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would be really useful if we could have the election on the day that

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you say, because that's my birth date! It seems to me a very good

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reason to make expeditious progress on this matter in any case. I'm sure

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that there was absolutely no hint of underlying sarcasm in his

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observation when he expressed the confident expectation that the whips

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on both sides would want to make progress in the establishment of the

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new committee and in the election of the vacant chairs or all of the

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committees, because of course, they will want the government to be

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subject to proper and thorough scrutiny. There is very good reason

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to proceed expeditiously anyway, but the fact that October the 19th is

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also the honourable gentleman's birthday, provides an added

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incentive and the short answer is, I am doing what I can, not very

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subtly, to indicate that the usual channels really ought to progress

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this matter, sooner rather than later, and so for as I am concerned,

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that means by tomorrow. -- so far as I am concerned. My best wishes to

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Michael and Sarah, as well, as they take up their new roles. With the

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changes to the Select Committees we see a change from the old business

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committee to business energy and industrial strategy committee and

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old business committee was one of the constituent committees on arms

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export controls. I wonder whether it is your view that the new committee

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will take over the role of the old business committee as well of the

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constituent committees and that he would not be correct as has been

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suggested in some quarters that then new international trade committee

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should take over sole responsibility for scrutinising arms export

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matters. The honourable gentleman is an ingenious fellow and has

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regularly demonstrated that since his election to the House. I don't

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blame the honourable member for seeking to shoehorn in his own

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current preoccupation when we are discussing the timetable for the

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election of chairs all they can committees. However, the proper

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answer for me to give the honourable gentleman is that it is not a matter

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for the Chair. It will be a matter for the committee itself to decide.

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Now, if the honourable gentleman were afflicted by a sudden bout of

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self-doubt or reticence, causing him to be reluctant or unable to express

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his view on this matter, I would be concerned. But he won't be, and

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therefore I have got. -- I am not. I noticed the Leader of the House is

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in his place. Would it be in order for the benefit of a House if the

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leader rise at the dispatch box and put the House out of its misery in

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relation to the government's plans for the dates of the selection of

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committee chairs. The Leader of the House isn't under any such

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obligation. It has to be said, normally, and I speak with some

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authority on this matter, as I have known the Leader of the House for 30

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years, and we have been in constituency terms, next door

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neighbours for the best part of 20, the right honourable gentleman is

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the most accommodating of colleagues, and I've got a feeling

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that he's about to prove the point. The Leader of the House of Lords Mr

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Speaker, if it may help the House, as you might said, Mr Speaker,

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agreement was reached among the usual channels earlier this week as

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to the reconstitution of Select Committees following the changes to

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government departments. It was clearly right that we sought to get

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full cross-party endorsement for these changes. That has now been

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attained. I have therefore given instructions immediately for the

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necessary resolutions and changes to standing orders to be drafted and we

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shall certainly table those as rapidly as we can get those to the

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House authorities. I think that's very encouraging. I don't want to

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embarrass The right honourable gentleman, but he's in some danger,

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if not careful, being held aloft by members in all parts of the House.

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We will leave it there for now. And I thank the Leader of the House of

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Lords EZ, which I think is encouraging. Urgent question,

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Rebecca Long Bailey. I asked the Chancellor of the Exchequer if

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you'll make a statement on the abilities and activities in relation

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to tax credit investigations made on behalf of HMRC into Concentrix. I

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want to be very clear. The government recognises the importance

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of tax credits to individuals and families. We all recognise that it

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is important that this support reaches the people who really need

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it. That is why HMRC work hard to check they are making the trek

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payments and tackle any fraudulent claims. We must acknowledge that

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fraud exists in the system and should invest to ensure that

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taxpayers money is spent directly. As part of this, Concentrix Ltd was

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engaged to help check people's eligibility. ?300 million worth of

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incorrect payments have been identified. I want to reassure the

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House on two key points. First, Concentrix were only paid for making

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the right decisions. They would not receive payment for taking someone's

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money away wrongly. And secondly, that Concentrix were not allowed to

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engage in fishing expeditions or pick on vulnerable claimants at

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random. But, where there was evidence to suggest a claim might

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not be correct, Concentrix would like to claimants to confirm their

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edge eligibility. I realise, and I know this as a constituency member

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myself, that it can be stressful for someone to receive such a letter,

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that it is right that investigate the full picture with claimants

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themselves to make the right payments. That is why both

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Concentrix and HMRC, where does the same work, always sends a letter

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giving claimants 30 days to provide information before taking any

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further action and it is important that people do indeed respond and

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get in touch if they are struggling to respond to any other questions.

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Despite the best efforts of the staff manning the phones, with a

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high volume of calls in recent weeks, Concentrix have not been

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providing the high levels of customer service that the public

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expect, and which are required in contract. HMRC have given notice

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that this contract will not be renewed beyond its end date in May,

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2017. HMRC is no longer passing news cases to Concentrix but working with

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them as a matter of urgency to improve the service they provide to

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claimants and to resolve outstanding cases. I can confirm to the House

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that 150 HMRC staff have been redeployed with immediate effect to

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help them resolve any issues people are having with their claims, as

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quickly as possible, and, Mr Speaker, I realise that colleagues

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on all sides of the House are concerned to get difficult cases

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resolved and assist vulnerable constituents appropriately. In

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addition to the additional resources I have referred to, I have arranged

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a members dropping in at palmistry between 9:30am and 11am tomorrow at

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which we can offer guidance to colleagues, should that be helpful.

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-- at one Parliament St. I thank the Minister for her reply. Many members

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across the House have been contacted by distressed and anxious

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constituents, often hard-working individuals who have a tax credits

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cut unfairly, pushing them, in many cases, into extreme hardship. Whilst

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we on this side certainly welcome that HMRC is finally taking action

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in announcing that the Concentrix contract will not be renewed, it is

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most regrettable that the government has only done this when events have

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been dramatically exposed by the media and indeed My Honourable

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Friend the member for Sheffield Healy and Birkenhead. Whilst

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Concentrix will be carrying out the services far not another eight

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months, there's a risk that without radical amendment to the contract

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itself, service will continue. Most concerning is that the payment model

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creates a conflict of interest as noted by the Social Security

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advisory committee. Can the Minister confirm what arrangement she will

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make to urgently revise the contract to preserve justice for the

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claimants? Furthermore, as you stated, I understand HMRC will

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redeploy 150 staff so that they claimants can get through to

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advisers and resolve their claims. Can the Minister say that the

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government will monitor this going forward, and all the government

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commit to an official investigation into Concentrix's conduct since

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being awarded a contract in 2014, so that we can determine how this

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situation was allowed to arise, and one final point, Mr Speaker. As the

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minister given any consideration to the real prospect of bringing this

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service back in-house? Mr Speaker, it is worth making the comment, I

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think that this is a very complicated system that this

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government, the previous government, indeed inherited, and it is the case

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that long-term, the right answer is to replace tax credits, as is our

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intention, because it is an unnecessarily complex system that we

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will bequeath. But we must make it work whilst it is in operation and

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that is now the focus of our activities. With regard to the

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contract and a decision that HMRC have taken, I want to reassure the

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House that monitoring has been taking place on a regular basis

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throughout the contract, and HMRC have worked closely with Concentrix,

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but it is the case that it is documented in recent weeks that

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performance has not been right, and clearly, that has been something

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that we have noted and which we are now taking action on. With regard to

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the contract going forward, as I think I mentioned in my statement,

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Concentrix will be focusing on resolving expanding claims are not

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opening new ones. In other words the ones that they are already open,

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will be looking to deal with in an orderly and appropriate manner, and

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HMRC is putting in additional resources, focusing on those

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difficult cases where we have heard some high-profile examples in recent

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days, and to make sure that we get those resolved in the quickest

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possible time, to ensure that vulnerable constituents of all of us

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are helped and supported. So that is the key focus. I don't think there

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is any need to go into inquiries etc. We have a contract. It is

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monitored regularly, it is not going to be renewed when it ends in May

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next year, and the focus, I think, for all of us, and for me and for

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HMRC in the coming days and weeks, is in making sure that we get

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through outstanding cases and resolve them, particularly those

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involving the most vulnerable, and we make sure that people have the

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money to which they are correctly entitled.

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I have got cases of women who have had their tax credits stop because

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they have been told they are living with a man they have never heard of,

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they have had their benefits withdrawn. I am not sure that I need

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advice tomorrow morning in one Parliament St when the House is

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sitting. What we need to know is how quickly these cases can be reviewed.

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I quite understand. The drop-in is bearish as a facility as members

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should want to use it, but there is an alternative to the HMRC lines

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already in place. We would encourage anyone to call the HMRC number. We

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are putting significant resource with immediate effect to make sure

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we can resolve that. I am reassured and I will be talking to HMRC

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consistently on this fact, as soon as we can resolve a case and the

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facts of a case, weakening get money into people's accounts in a short

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number of days. -- can get. I am delighted that the macro one

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contract is not to be renewed, that will as some comfort by those

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affected by their activity. -- Concentrix. The minister tells us

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some 300 million has been saved. How much of the so-called savings were

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as a result of false accusations by Concentrix against tax credit

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recipients? If there were somewhere between 120 many thousands of people

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why was this contract not cancelled sooner? The cost of the contract is

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also meant to be ?75 million, how much will the government claw Pack

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to compensate those affected? The ministers tell us that civil

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servants have been drafted in to clean up the mess. How much will

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that cost the tax payer in additional pay and will the

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government be seeking payments from Concentrix to fund that remedial

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action? Will there are one of two of the points that the honourable

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gentleman raises their I am not able to respond to. My priority and that

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of HMRC officials at the moment is to make sure we resolve the

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outstanding cases, especially difficult cases for vulnerable

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constituents. We are not renewing the contract but we do intend to

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continue to bear down on fraud, there is a lot of fraud in the

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system. But we had a great deal of success in recent years and reducing

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that. It has have from 100 million to 400 million in terms of the

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amount of fraud in the system and we need to bear down on that because

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obviously money that is fraudulently obtained is not available to

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taxpayers and it remains a vital matter that we do address that. But

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for the moment, my primary consideration is to resolve the most

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difficult cases. I am a supporter of those trying to get on in life. And

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depend on tax credit. One of the concerns I have is that over the

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next eight months, they will have that fear of being falsely accused

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and prosecuted almost as they go forward. What reassurance can the

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then Minister give that those people will be looked after and will HMRC

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carry on with the contract going forward or will the look for a new

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tender? I have laid down the arrangements are in place. HMRC will

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be supporting Concentrix around the outstanding cases. In particular

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looking at complex cases, supporting back-office functions while

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Concentrix staff look at resolving already open cases. It is important

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to put a bit of perspective on this. There are a lot of claims that have

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been correctly identified as being erroneous or fraudulently which

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Concentrix have assisted the government, and indeed the taxpayer

:20:28.:20:31.

in identifying. And I think it is important to keep this in

:20:32.:20:36.

perspective. But HMRC have made it clear they will not continue the

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contract beyond the spring. Can I thank the Minister and HMRC reacting

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so quickly two issues I have raised in this House. Several questions

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remain. What estimation has been made of the backlog that has to be

:20:52.:20:57.

dealt with by Concentrix and HMRC? How should people contact

:20:58.:21:03.

Concentrix? Should the contact them through the current helpline or

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contact-macro to directly? Why were these not acted on is HMRC were

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monitoring the contract so closely? Will they be bringing the contact

:21:15.:21:21.

back in House next year? Will he -- she commit to a review to the

:21:22.:21:30.

systems that are inappropriate in our organisations? She has been very

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active in these issues. With regard to performance, it is important to

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note, and the figures of performance does support this, that actually it

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is only in recent weeks particular the performance has been not

:21:54.:21:59.

acceptable. It has, it is not a case that has been something that has

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been acute problem for a considerable length of time, but it

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is the proper -- fact that performance has not been acceptable

:22:11.:22:12.

in recent weeks. With regard to who people should contact. They should

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contact the number on the letters that they have received. I am aware

:22:15.:22:19.

of the problems of getting through on the phones in recent weeks. And

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indeed I have tested that for myself, so what we are doing is

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putting that additional to allow Concentrix to concentrate on

:22:29.:22:35.

focusing on existing cases so staff can resolve some of the back office

:22:36.:22:45.

problems. In terms of mandatory considerations, some or are coming

:22:46.:22:49.

in, but we think there are around 2500 in the system at the moment

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left to be dealt with. We do expect more to come in because it is that

:22:53.:22:58.

time of year after people who have not supplied additional information

:22:59.:23:03.

as requested, have seen their tax credits potentially stopped. We can

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with the additional resources, resolve that very quickly. And that

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is my focus. Can my honourable friend clarify for the House, the

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position now is that Concentrix will not deal with any new claims cases.

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Who from HMRC or whoever is going to deal with claims of errors, fraud

:23:24.:23:29.

and other systems, so we send a strong signal to people that this is

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not going to be acceptable but we want to see the genuine claimants

:23:33.:23:41.

compensated for the money they need? I can reassure my honourable friend

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that it has been the case that both Concentrix and HMRC were pursuing

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claims of error and fraud. HMRC will continue to pursue cases of error

:23:52.:23:56.

and fraud. The government has put in additional resource in recent years

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into supporting the general tax avoidance and evasion compliance

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aspects of HMRC's work. May I thank the Minister for her statement and

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drop to the House how different this responses from previous

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governments's response. I do not believe we have would have had to

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be's statement had we not had a leadership election, so I thank her

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for that. Might she thank on her thanks to the colleague for the

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immediate action she took on the report that I submitted on Hermes

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where the revenue had been asked to investigate their unlawful use of

:24:40.:24:42.

self-employment. The two questions that I would like to ask. Worries

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about this contract is that they appear to some people to be cutting

:24:50.:24:53.

benefit and asking questions afterwards. And there is no

:24:54.:25:00.

mechanism by which MPs have got a hotline to try and sort out those

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issues out. Well very much work King -- working to bring the work in

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House, might she acknowledge that this is a contract in place where a

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private company is able to make a decision on benefit money for

:25:26.:25:36.

people? It could be deemed as quite cheeky tasks many questions. Mr

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Speaker, I thank the right macro -- to honourable member around fact

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that it is priority to resolve issues of this nature. I do think it

:25:54.:25:56.

is again be it a rating that through this contract we have secured to

:25:57.:26:02.

?280 million of identified savings in terms of error and fraud and that

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it continues to be considerable fraud and regard to where people are

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living singularly in a household. I do not think it is important to

:26:16.:26:22.

recognise this contract has brought benefits to those area. This

:26:23.:26:29.

contract does have its place but it work appropriately and it must do

:26:30.:26:33.

what it is set out to do and it should work for taxpayers and should

:26:34.:26:38.

work for the vulnerable. I will reflect on as wide a point if I may.

:26:39.:26:41.

I want to give him reassurance on that Gerald Bull point. All members

:26:42.:26:48.

of the House will have received a deluge of harrowing cases of people

:26:49.:26:53.

who have had cause to have interaction with Concentrix. The

:26:54.:26:57.

first of all they were even unsure this company existed, they thought

:26:58.:27:01.

it was a scam letter, of all we see far too often. There has been for

:27:02.:27:07.

delay in post-opening and try to get through on the telephone has been

:27:08.:27:12.

next to impossible. This has been a service level that has an acceptable

:27:13.:27:19.

in the public sector. Can she assured us that her statement shows

:27:20.:27:22.

this government is committed to helping the vulnerable immediately

:27:23.:27:26.

and accurately? I thank my honourable friend for those

:27:27.:27:29.

comments, I hope it does show that. These contracts, right across

:27:30.:27:37.

government we have important contracts with people to provide a

:27:38.:27:41.

server, but they need to be provided to an acceptable standard. --

:27:42.:27:48.

service. HMRC have taken into account operational performance

:27:49.:27:52.

issues. I think the focus for all of us, for ministers, for HMRC and

:27:53.:27:58.

individual members working in their constituency capacities as to make

:27:59.:28:01.

sure our most vulnerable constituents are supported as soon

:28:02.:28:04.

as possible to make sure that money they are entitled to hits their bank

:28:05.:28:07.

accounts and they do not have the stress of wondering where that money

:28:08.:28:14.

is good to come from. All of us as constituency members of Parliament

:28:15.:28:18.

can relay stories of how the service contract has worked and has been

:28:19.:28:23.

deplorable. But on the issue of the jobs that will be lost, some of them

:28:24.:28:30.

in Belfast, can she tell us what contact she has had with the

:28:31.:28:32.

Northern Ireland executive or the HMRC has had with the relevant

:28:33.:28:36.

devolved administrations regions are about the effect on jobs and what

:28:37.:28:41.

will be done to give support to those who will lose jobs? I think it

:28:42.:28:47.

is important to note that the decision has been taken by HMRC not

:28:48.:28:52.

to renew the contract, so to that extent the decision for a private

:28:53.:28:56.

company like Concentrix as to what they do beyond that point is a

:28:57.:29:00.

matter for them. But I am sure that in the normal way, if the right

:29:01.:29:05.

honourable gentleman has concerns that nature, we would be happy to

:29:06.:29:15.

top term. This is not a decision to end the contract here and no, it is

:29:16.:29:18.

a decision not to renew it in the spring. What other steps being taken

:29:19.:29:25.

by the government to protect the vulnerable in this situation. Can my

:29:26.:29:30.

honourable friend assure them a House that the lessons learned in

:29:31.:29:33.

this case will not be applied to the hat contract in May, but across more

:29:34.:29:41.

contracts across government widely? I hope I can give that reassurance

:29:42.:29:45.

that not just in the future but obviously in the past and to date,

:29:46.:29:49.

it has always been the case that when the government contracts with

:29:50.:29:54.

the supplier to provide a service, that it should be provided to the

:29:55.:29:56.

right standard, that contract will be monitored and we make sure that

:29:57.:30:01.

service levels are except 22 members and to their constituents. Despite

:30:02.:30:09.

what the Minister has said earlier, I have constituents who have had

:30:10.:30:15.

their tax credits cut off without receiving any prior notification and

:30:16.:30:27.

has spent up to 70 minutes on the phone tried to get through. Which is

:30:28.:30:30.

a huge drain on the resources. Can she tell us whether the contract

:30:31.:30:32.

included penalties for concentric 's not providing an acceptable service

:30:33.:30:37.

level or answering call is within a set time, if not, who will take the

:30:38.:30:42.

responsibility or negotiating such a flood contract? -- Concentrix.

:30:43.:30:47.

Waiting 70 minutes to have a collards and is not acceptable. I

:30:48.:30:54.

would understand the distress caused. I am going to write to the

:30:55.:31:01.

honourable lady about that, I do not have the detail at hand. I need to

:31:02.:31:06.

assess what we can sleep in terms of commercial content or shouted -- the

:31:07.:31:11.

in terms of commercial confidentiality.

:31:12.:31:13.

The National Audit Office found that the Concentrix contract delivered

:31:14.:31:20.

savings of half ?1 million in 2014-15 compared with the original

:31:21.:31:25.

estimate of ?285 million and was expected to deliver at best half the

:31:26.:31:28.

original savings planned in the contract and as we have heard from

:31:29.:31:32.

constituency post Banks, a large number of errors in the process.

:31:33.:31:36.

What more can the government do to improve the tendering process in

:31:37.:31:41.

future, particularly at HMRC and to improve the managerial capability at

:31:42.:31:44.

HMRC, so that we don't have these mistakes in the future? This is a

:31:45.:31:49.

payment by results contract. As I said in my response to the

:31:50.:31:56.

honourable lady, at the outset, Concentrix will not be paid where

:31:57.:32:01.

they have not acted appropriately and not what the result. Clearly, it

:32:02.:32:05.

is important we get these things right. I take the point that My

:32:06.:32:09.

Honourable Friend has made and I do give him the reassurance that HMRC

:32:10.:32:14.

and government ministers will also raise seek to get the right

:32:15.:32:18.

contracts, but where there are lessons to be learned, we must

:32:19.:32:23.

reflect on them and make sure that they are then reflected in future

:32:24.:32:29.

arrangements. Last week in evidence to the Institute of government, the

:32:30.:32:34.

former Secretary of State, the member for Chingford and Woodford

:32:35.:32:39.

Green admitted that outsourcing to the private sector was not a

:32:40.:32:43.

panacea. Is it not surely with this fiasco around this contract, time

:32:44.:32:48.

for a full review of outsourcing to private companies in the welfare

:32:49.:32:53.

system, actually looking at whether it is appropriate at all or if it is

:32:54.:32:59.

going to continue to be done, what better provision is done by civil

:33:00.:33:03.

servants to oversee these contracts to ensure that these things do not

:33:04.:33:09.

happen again? Again, I would urge members to keep a degree of

:33:10.:33:12.

perspective. There are lots of contracts that deliver. It is worth

:33:13.:33:19.

noting that this contract delivered more than ?280 million of savings to

:33:20.:33:23.

the taxpayer, which represents a sensible return on that investment

:33:24.:33:29.

but service levels must be acceptable to the standard that we

:33:30.:33:33.

have contracted. And there are circumstances in which the use of a

:33:34.:33:36.

private company offers a cost-effective way for government

:33:37.:33:39.

departments to do something which it might not have either the flexible

:33:40.:33:43.

capacity to do or might be for an uncertain period where the

:33:44.:33:45.

flexibility of this nature of contract offers is easier than doing

:33:46.:33:52.

it in-house. I take the points he has made and I will reflect on them

:33:53.:33:55.

but I don't draw the same general conclusion that he has. I very much

:33:56.:34:02.

welcome the statement by the Minister and concur with the point

:34:03.:34:05.

made by the member for the new Forest. The Minister will know that

:34:06.:34:11.

sometimes genuine errors can be made by constituents or by HMRC, and

:34:12.:34:16.

going by my casework or constituency surgeries sometimes that full

:34:17.:34:21.

compassion is not shown by HMRC when a genuine error is made and cannot

:34:22.:34:28.

be done in those difficult circumstances for those most

:34:29.:34:32.

vulnerable and in need? I have the same experience as My Honourable

:34:33.:34:35.

Friend. Only last week in a constituency surgery I sat with the

:34:36.:34:41.

constituent who had a very complex case and was a difficult situation.

:34:42.:34:45.

It is the case that, obviously we can take it up on behalf of

:34:46.:34:50.

constituents, but when constituents deal with HMRC, it is important that

:34:51.:34:54.

they explain the circumstances and HMRC will make every effort to

:34:55.:34:57.

quickly resolve the situation and they are very aware of the need to

:34:58.:35:00.

get people sorted out and get money into their bank accounts as

:35:01.:35:05.

appropriate, and quickly, but it is something that I will reemphasise,

:35:06.:35:10.

it is something I have discussed in recent days and clearly, the

:35:11.:35:13.

interest in this urgent question and the points being made on all sides

:35:14.:35:16.

of the House will be heard where they need to be heard. A significant

:35:17.:35:22.

number of my constituents have been left financially disadvantaged as a

:35:23.:35:26.

result of the antics and the processes at Concentrix. Can the

:35:27.:35:30.

Minister reassure this House at last the priority is to resolve those

:35:31.:35:36.

case is urgently, she should look into finding this company and using

:35:37.:35:42.

those resources to compensate my constituents who have experienced

:35:43.:35:47.

financial distress. I will ask HMRC to advise me on what the nature of

:35:48.:35:51.

on that it is again something that on that it is again something that

:35:52.:36:00.

could be arranged. As a constituency MP who has dealt with the number of

:36:01.:36:03.

cases I am pleased that action will be taken. As a member of the Public

:36:04.:36:07.

Accounts Committee I have sat through reports on the quality of

:36:08.:36:11.

service HMRC provider which is hardly gold standard at times. What

:36:12.:36:15.

reassurance can the Minister provide that we will not see a drop-off in

:36:16.:36:20.

services elsewhere in terms of standards and future arrangements as

:36:21.:36:24.

well with HMRC? I don't believe that will be the case. HMRC has been

:36:25.:36:31.

dealing with cases at the same time as Concentrix throughout this period

:36:32.:36:36.

of the contract. I have been sure that the 150 additional staff

:36:37.:36:39.

deployed with immediate effect are going to be focused on this. I have

:36:40.:36:43.

no reason to believe that any other services. . But his point is well

:36:44.:36:49.

made and will be reemphasise to HMRC. I'm glad to hear that the

:36:50.:36:56.

Concentrix contract is ending. As the Minister mentioned, they will be

:36:57.:37:02.

dealing with ongoing casework. Can she personally intervened to help my

:37:03.:37:06.

constituent who has been plunged into ?1300 worth of debt through the

:37:07.:37:11.

incompetence of Concentrix and they failed to processes annual review

:37:12.:37:15.

review and refused to technology any of my correspondence. Will she take

:37:16.:37:22.

up this case, please? Of course. If any member wishes to write to me I

:37:23.:37:26.

will ask HMRC to look at it as a matter of priority. If she wanted to

:37:27.:37:31.

come, if any other member wants to bring a similar complex case

:37:32.:37:36.

tomorrow to the drop-in, HMRC officials will be available but if

:37:37.:37:39.

she would like to write me of course I will look at it. I first raised

:37:40.:37:46.

this issue last January. It has taken eight months to get to this

:37:47.:37:51.

and that was about a family over the Christmas period who did not have

:37:52.:37:58.

any income. Why does it take the BBC programme two days running to bring

:37:59.:38:03.

ministers to the dispatch box? On Monday a member of my staff was

:38:04.:38:08.

given the runaround between HMRC and Concentrix. On the basis that nobody

:38:09.:38:12.

would take responsibility. My constituents have spent hours on

:38:13.:38:21.

this. I think that involving the private sector in a sensitive issue

:38:22.:38:25.

like this does not work. I'm sorry to hear that the honourable

:38:26.:38:27.

gentleman had that difficult experience. I can't agree with his

:38:28.:38:34.

general point that there is no role for the private sector in this

:38:35.:38:37.

regard. I would refer again to the amount of money saved for the

:38:38.:38:40.

taxpayer. There was a lot of error and fraud in the system. It is

:38:41.:38:45.

important that we bear down on this. Clearly, we don't want money going

:38:46.:38:49.

to people for whom it is not appropriate, and this issue around

:38:50.:38:55.

the nature of people'shouseholds, most of the fraud, much of the fraud

:38:56.:39:00.

does rest in that area. As he highlighted, it is a particularly

:39:01.:39:03.

difficult and sensitive area to investigate. We need to continue to

:39:04.:39:07.

investigate it because of the amount of fraud involved in that area of

:39:08.:39:16.

tax credits is considerable. We can all share the stories of anguish to

:39:17.:39:21.

constituents and frustration for our officers in dealing with this

:39:22.:39:27.

debacle, but we should also remember that the HMRC itself is not an

:39:28.:39:30.

innocent agent in this. It designed this contract. It specified customer

:39:31.:39:40.

hostility and suspicion into the standards of performance and

:39:41.:39:43.

practice in the contract and it was HMRC that were providing the names

:39:44.:39:48.

that were targeted by Concentrix and this is against the backdrop were

:39:49.:39:51.

government has persisted in running down the capacity and character of

:39:52.:39:58.

HMRC. So, will some of those bigger misguided policies be looked at as

:39:59.:40:03.

well as the enjoyment were having today in scapegoating Concentrix

:40:04.:40:08.

themselves? I return to the answer I gave a moment ago. We need to

:40:09.:40:14.

continue to bear down on four unit -- fraud in the system. There is a

:40:15.:40:18.

considerable amount of error and fraud. It would be naive to think

:40:19.:40:25.

that all of this is error. There is fraud in the system. But there is a

:40:26.:40:29.

lot of error which the original design of tax credits makes easier.

:40:30.:40:32.

So it is the case that we need to continue to bear down on fraud, but

:40:33.:40:36.

we need to do it in a way that doesn't make it difficult to the --

:40:37.:40:44.

to assist the most vulnerable. The Minister has mentioned fraud a

:40:45.:40:49.

number of times. There is fraud in the system but I don't see it as an

:40:50.:40:52.

excuse for the errors and the failures that constituents like

:40:53.:40:58.

Sarah Hudson, with three Jobim, struggling to put food on the table.

:40:59.:41:02.

It is no excuse for incompetent contractors. The main point I'd like

:41:03.:41:08.

to make is that I'm glad about the redeployment of HMRC staff to

:41:09.:41:14.

support people. The HMRC office in my constituency and Workington which

:41:15.:41:17.

employs 200 people is due for closure. The nearest regional office

:41:18.:41:20.

is more than two hours Drive away. The phone system is not working and

:41:21.:41:23.

not helping people with their inquiries. We need to review the

:41:24.:41:28.

closure of local offices so that people can keep the support and

:41:29.:41:31.

face-to-face contact that base a much need in situations like this.

:41:32.:41:37.

I'm sorry to hear about the case that she mentions on behalf of her

:41:38.:41:41.

constituent. She raises wider issue about the modernisation project that

:41:42.:41:45.

HMRC is going through, and perhaps it would be appropriate if she wrote

:41:46.:41:51.

to me. It is important, in terms of the modernisation of HMRC as it goes

:41:52.:41:57.

forward, the process that she has described, although it does mean

:41:58.:42:00.

some regional offices are being close. It is an important one,

:42:01.:42:04.

fundamentally, because it is about delivering a better, more modernised

:42:05.:42:08.

service into the future for all of our constituents. I trust that there

:42:09.:42:16.

will be some compensation paid by the company, first of all on whether

:42:17.:42:23.

the contract should have been handled and the way that costs of

:42:24.:42:27.

Bianco, but were other people talking today about how wonderful it

:42:28.:42:33.

would be if this had been brought in House. It wasn't long ago that this

:42:34.:42:38.

House was condemning HMRC for not answering more than half of the

:42:39.:42:42.

telephone calls made by constituents about tax matters. What steps as the

:42:43.:42:47.

minister taken to ensure that new cases will be brought in-house, and

:42:48.:42:50.

that there will not be the same problems with HMRC, as there was

:42:51.:42:59.

with Concentrix? It is obviously documented that at times in the past

:43:00.:43:04.

HMRC have had problems with the phones, but some of the information

:43:05.:43:08.

that has been in the public domain of late has been rather out of date

:43:09.:43:12.

and indeed performance in answering the phones is considerably better

:43:13.:43:16.

and indeed has reached a very good standard in recent weeks. It is

:43:17.:43:19.

important that in all of these things we retain some balance and,

:43:20.:43:26.

with regard to the point around Concentrix, again, worth noting that

:43:27.:43:32.

they have amended around 103,000 claims following checks that they

:43:33.:43:35.

have made. This has been an important exercise but clearly, it

:43:36.:43:41.

needs to be done in the right way. I welcome pennies from the Minister

:43:42.:43:45.

that Concentrix will not get their contract renewed. -- I will the

:43:46.:43:53.

news. But in the meantime, there has been talk about what is

:43:54.:43:58.

unacceptable. Some of the focus on fraud, what we are talking about

:43:59.:44:03.

here today are errors that have been made at which have caused tremendous

:44:04.:44:08.

suffering. We're not talking about occasional exceptions. We are

:44:09.:44:12.

talking about widespread numbers of errors that have been made causing

:44:13.:44:18.

exceptional misery to some families. One of my constituents, a single

:44:19.:44:24.

mother of four, tax credits were in error, and as a result of that,

:44:25.:44:32.

children can no longer access school dinners, the baby, she can't get

:44:33.:44:35.

free milk tokens for, and she's being told, more importantly,

:44:36.:44:45.

that... Will the Minister assure me that she will look into this as a

:44:46.:44:49.

matter of urgency to make sure that this mother can continue to feed her

:44:50.:44:50.

children? I am sorry to hear her constituents

:44:51.:45:02.

has had such a difficult time. I would urge her to use the resource I

:45:03.:45:07.

have referred to take that up. I hope that can be resolved that we as

:45:08.:45:14.

soon as possible. I have emphasised and HMRC are aware of this, speed is

:45:15.:45:21.

of the essence where people have had their tax credits erroneously

:45:22.:45:24.

stopped. She is right, there is an error in the system. This is to

:45:25.:45:29.

complex system and that is why the government is looking to make a

:45:30.:45:35.

major long-term reform to the way we do this, because even the honest

:45:36.:45:40.

taxpayer can easily fall into error in a system that was so complex and

:45:41.:45:46.

its design from the start. As we sit here, families up and down the

:45:47.:45:49.

country have had to rely on charity and food bags to make ends meet due

:45:50.:45:57.

to ridiculous decisions made by Concentrix. Given that so many are

:45:58.:46:04.

living a day to day existence, can the Minister confirm just how

:46:05.:46:09.

quickly people can be elected to receive the money they are rightly

:46:10.:46:19.

entitled? The HMRC, the point to which the facts are resolved, it is

:46:20.:46:24.

important we do that quickly, at the point we have done that and that may

:46:25.:46:29.

be in the course of one phone call, I am assured and this is what I

:46:30.:46:35.

expect to see, in a matter of around four working days, no longer, we get

:46:36.:46:40.

money into people's accounts. This is a matter of days, not weeks. But

:46:41.:46:46.

we need to establish those facts. It is worsening, for the sake of the

:46:47.:46:49.

House having some sense of the perspective on this, -- worth

:46:50.:46:56.

saying. 6% of customers asked for a review of a decision following a

:46:57.:47:04.

cheque. That is a large number of people being checked, but

:47:05.:47:06.

nevertheless it would be wrong to think that this was a huge

:47:07.:47:10.

proportion of the cases. It is important we get those ones right

:47:11.:47:14.

and we look to pay people within days, as soon as we have established

:47:15.:47:19.

the facts of the case. The Minister says that HMRC is supporting

:47:20.:47:23.

Concentrix in performing their contract ending next year. What is

:47:24.:47:29.

the cost to the public purse of that support that is being provided and

:47:30.:47:33.

is that recoverable from Concentrix? It has always been the case that as

:47:34.:47:41.

you would expect managers within HMRC have been working with

:47:42.:47:45.

Concentrix throughout, so I don't anticipate that will be an enormous

:47:46.:47:50.

additional costs because there has always been a relationship between

:47:51.:47:52.

the two because there has been some overlap in the work to be done and I

:47:53.:47:56.

would expect that they continue as we work towards the end of the

:47:57.:48:04.

contract. The Minister is engaged in crisis management, crisis management

:48:05.:48:10.

itself is not good enough. In the opening statement she said that

:48:11.:48:17.

Concentrix are not allowed to fish. They have been fishing. One of my

:48:18.:48:23.

constituents got a letter wanting ?10,000 in back payments.

:48:24.:48:27.

Investigation is needed soon and it needs to look at the contract terms,

:48:28.:48:31.

order process and Concentrix behaviour and needs to look what is

:48:32.:48:41.

the true resource requirements. Unless she announces this, we will

:48:42.:48:44.

be back here in a couple of your's time. Macro to has operational

:48:45.:48:49.

experience to deliver the kind of savings we are looking for in terms

:48:50.:48:56.

of reducing error and fraud. -- two. Practical measures in going forward

:48:57.:49:03.

in simplifying the system, and improving detection of fraud are

:49:04.:49:07.

important parts of making sure we improve performance going for it. It

:49:08.:49:11.

is worth noting again that we have saved hundreds of millions of pounds

:49:12.:49:14.

to the taxpayer by reducing error and fraud but we want to make it

:49:15.:49:18.

harder in the future for people to make errors. As long as I have been

:49:19.:49:26.

one of their MPs, HMRC has treated people in the Wirral with this

:49:27.:49:30.

respect and indignity and this is just the worst in a long series of

:49:31.:49:35.

cases. Can I asked the minister one question, when did she first meet

:49:36.:49:41.

Concentrix to raise our concerns with them for? I have been a

:49:42.:49:45.

minister since mid-July, I have not met Concentrix, I have not been a

:49:46.:49:52.

minister for that long. Clearly colleagues, previous colleagues have

:49:53.:49:57.

done that. But I have been working with HMRC to look at the regular

:49:58.:50:01.

monitoring and given the interest from colleagues across the House in

:50:02.:50:04.

recent weeks, I have been getting daily updates for HMRC in terms of

:50:05.:50:11.

performance. But in the relatively short time, given that we have had

:50:12.:50:16.

summer recess, being in my post, I have not met them. I am sure HMRC

:50:17.:50:20.

will be disappointed to hear what she has dizzy but I think they would

:50:21.:50:25.

want to reflect on her words. To say. One of the issues reported by

:50:26.:50:36.

my constituents is the requirement to send all the documentation by

:50:37.:50:39.

registered post which costs over ?13. This is money that they can ill

:50:40.:50:44.

afford when they're living on the bread line. Will the Secretary of

:50:45.:50:53.

State will look -- look urgently at ways of sending documentation in the

:50:54.:50:57.

remaining ones that Concentrix have the contract? I will ask that

:50:58.:51:02.

question, but I cannot give any assurance if it is possible to alter

:51:03.:51:07.

that in the contract left to run. She highlights an important point

:51:08.:51:12.

about where we go in the future with these sorts of systems. The more

:51:13.:51:16.

that we can make these things Digital and make them really easy

:51:17.:51:20.

for people to get right, the more likely we are to avoid these unhappy

:51:21.:51:29.

situations. The financial Secretary must know I tabled five questions on

:51:30.:51:36.

this issue on Monday. With 1800 people in Belfast employed by

:51:37.:51:44.

Concentrix, with Concentrix redeveloping down to one location in

:51:45.:51:47.

the city of Belfast, could I ask to reflect how appalling that was that

:51:48.:51:52.

members of staff, many of my constituents, found out this news

:51:53.:51:57.

last night from a tweet by the BBC, as by any information from

:51:58.:52:03.

Concentrix and any information from this House. As I have said a number

:52:04.:52:08.

of times, the contract is not being renewed. It has not been terminated.

:52:09.:52:12.

The consideration of whether quite any contract is renewed is something

:52:13.:52:15.

that takes place in the normal course of events. The honourable

:52:16.:52:20.

gentleman does give me an opportunity to place on record my

:52:21.:52:25.

thanks to the many, many Concentrix staff who are doing a job. It is as

:52:26.:52:35.

the same time as we shine a light on where Adam -- form is as

:52:36.:52:40.

unacceptable, there are many people who are doing a good job and

:52:41.:52:44.

providing a good level of service. Many people are succeeding in that

:52:45.:52:51.

regard. I know the Minister says she sees no need for an enquiry but I

:52:52.:52:55.

and I know many colleagues in the chamber today and certainly

:52:56.:52:57.

constituents of us would disagree with that position. My question

:52:58.:53:05.

would be how can we learn lessons to ensure these practices employed by

:53:06.:53:07.

Concentrix don't ever come to light again if we don't look into the

:53:08.:53:12.

practices carried out by some form of investigation or enquiry? I think

:53:13.:53:16.

it is right that in the normal course of events we would always

:53:17.:53:21.

look to, at looking at how we arrange things in the future, to

:53:22.:53:25.

reflect on what we can learn from things that have already happened,

:53:26.:53:29.

and that would be something you would do through a normal process of

:53:30.:53:33.

review and consideration. We will just have to agree to differ with

:53:34.:53:38.

regard to the issue whether an enquiry is needed. I have been

:53:39.:53:44.

contacted by so many distressed moment in my constituency about or

:53:45.:53:48.

how awful Concentrix is. Some advisers have suggested that they

:53:49.:53:56.

were only trying to renew their tax credits to get payday loans to feed

:53:57.:53:59.

their children. Once the claim is processed. There is a grouping

:54:00.:54:08.

formed with over 5000 members. On this group, mothers share the horror

:54:09.:54:14.

stories. I will just give a couple. One will suffice. One it is. The

:54:15.:54:22.

lady may have got the Burnley condition. Does that involve

:54:23.:54:31.

shoehorning. No? OK. One mother hadn't eaten first three days so

:54:32.:54:35.

that she could feed her children. This is sickening and should be

:54:36.:54:44.

stopped. It should have been stopped a long time ago. I am aware of the

:54:45.:54:49.

face group group she mentions and the nature of the cases documented

:54:50.:54:54.

there. To end on when I began, Mr Speaker, that is why we are

:54:55.:54:57.

deploying additional reason so we can deal with the most difficult

:54:58.:55:05.

cases where people are vulnerable in the quickest time possible and that

:55:06.:55:08.

will be my focus and that of HMRC in the coming days. Order. I am most

:55:09.:55:11.

grateful for the financial Secretary and colleagues. Point of order, Mr

:55:12.:55:21.

Gareth Morris. She said she would make an announcement at some point

:55:22.:55:26.

next week. While the reply Lou Schmidt fund is next week and

:55:27.:55:32.

represents a hard deadline, given the scale of taxpayers funding at

:55:33.:55:37.

stake, will fully up to ?1.2 billion, should not this House of

:55:38.:55:41.

Commons representative as we are of the British taxpayers interest be

:55:42.:55:44.

informed first before any briefings to the media or to other countries?

:55:45.:55:54.

It is a matter for ministers. Announcements are made and

:55:55.:55:56.

frequently are during recess periods. But if the government knows

:55:57.:56:01.

what it is that it intends to announce, I would hope that it would

:56:02.:56:07.

be sensitive to the prior claim of members of this House, first to be

:56:08.:56:14.

informed, rather than for the information to be disseminated

:56:15.:56:16.

through the media. Or to some other less deserving source. I hope that

:56:17.:56:26.

deals with the matter for now. I am grateful to the honourable gentleman

:56:27.:56:32.

for raising this issue. These often need to be announced in the House

:56:33.:56:44.

anyway. When it made have been -- to have been made earlier to the House.

:56:45.:56:49.

When it was delivered to the House, I ensured that everybody questioned

:56:50.:56:55.

the relevant ministers sought a considerable allocation of time was

:56:56.:56:57.

required. It is better if the government anticipates these things

:56:58.:57:01.

in the first place rather than waiting on later than necessary. On

:57:02.:57:07.

the presentation of the bill, the Minister of the exchequer. Second

:57:08.:57:18.

reading, what day? Tomorrow. Presentation of Bill, Raymond Tisch

:57:19.:57:26.

day. Health services commissioning equality Bill. Second reading, what

:57:27.:57:38.

day? 2nd of December 20 16. Air quality, diesel emissions. 18th of

:57:39.:57:55.

November 2000 16. Sugar and food and drinks, targets labelling and label

:57:56.:58:05.

information Bill. Friday the 4th of November 20 16. The honourable

:58:06.:58:13.

gentleman will prove to be a busy bee. He is buzzing away now. Her

:58:14.:58:22.

helpfully as he points out. We come to the ten minute rule motion. Ten

:58:23.:58:33.

minute rule motion, Charlie Elphicke. I beg the leave be given

:58:34.:58:39.

to bring in a bill to plumb on the withdrawal of the United Kingdom

:58:40.:58:41.

from membership of the European Union and her connected furnaces.

:58:42.:58:48.

Brexit means Brexit and we will make a success of it. It also means

:58:49.:58:56.

Brexit means Brexit and it means we need to get on with it. The mantle

:58:57.:59:01.

of Article 50 is a matter for the Prime Minister alone. She has the

:59:02.:59:07.

mandate of the masses given to her on June the 23rd and it is right

:59:08.:59:12.

that she invoke it. I hope the sooner she invokes that the better

:59:13.:59:16.

so we have the security, the stability and the certainty we need

:59:17.:59:22.

as we seek to build a post Brexit Britain. I bring this House, I bring

:59:23.:59:27.

this bill to the House today. First to give the House an opportunity to

:59:28.:59:30.

endorse and accept the decision of the British people on June the 23rd.

:59:31.:59:38.

And second, to talk about the red lines that the British people

:59:39.:59:41.

clearly have in terms of what Brexit will look like. And third, a

:59:42.:59:45.

visionary can have for a post Brexit Britain that we will build. The

:59:46.:59:50.

first issue is this issue of where members of Parliament were when it

:59:51.:00:00.

came to the referendum. I'm a self was concerned about the border

:00:01.:00:07.

between border -- myself concerned about the border between Dover and

:00:08.:00:09.

Calais. I am here today to say that is their decision. We must endorse

:00:10.:00:15.

it. This is in particular for the Labour Party to reject we should

:00:16.:00:21.

have a second referendum to drive the British people back into the

:00:22.:00:23.

European Union again. It is not urgent if the party opposite to say

:00:24.:00:28.

we accept and will submit to the will of the British people and will

:00:29.:00:33.

help make Brexit as excess. I see to the SNP as well who don't seem like

:00:34.:00:43.

too -- to like the result of any referendum on these British Isles at

:00:44.:00:55.

all. Including accepting the decision of the Scottish people to

:00:56.:01:03.

remain part of the European union and the United Kingdom. I would say

:01:04.:01:08.

to them, they would be wrong to think that if at first you don't

:01:09.:01:13.

succeed, vote, vote again should be the motto. That would be the wrong

:01:14.:01:18.

approach to take. Turning to the red lines of the British people, it is

:01:19.:01:22.

very clear that the British people are deeply concerned about the level

:01:23.:01:27.

of uncontrolled EU immigration. And they have been told and pledged in

:01:28.:01:32.

manifestos that the number would be brought down of net migration to

:01:33.:01:35.

tens of thousands. Last year, it was 330,000. And they are very

:01:36.:01:41.

concerned, people on Dover tell me on a regular basis, about the

:01:42.:01:48.

pressure this makes on their wages and they have been underlined and

:01:49.:01:53.

proved right. By important research that showed it has wages to be ?450

:01:54.:02:00.

lower for hard-working classes of Britain.

:02:01.:02:12.

There is work by the OECD published in 2014 that underlines that mass

:02:13.:02:21.

migration does not, and has not, benefited the people of Britain or

:02:22.:02:26.

across the world in general. It does not have an economic good and work

:02:27.:02:29.

for the British people in their daily lives. So that red line is

:02:30.:02:36.

clear. We must end uncontrolled EU immigration. And the second point,

:02:37.:02:42.

underlined by Apple recently published by Lord Ashcroft, that

:02:43.:02:47.

people do not want to have billions for Brussels -- underlined by an

:02:48.:02:53.

opinion poll recently published. We cannot have a Brexit deal that

:02:54.:02:56.

involves handing over billions to Brussels. That money should be

:02:57.:03:00.

invested at home in Britain. We need to have a renaissance for the towns

:03:01.:03:03.

and regions of Britain and we should use that money wisely which brings

:03:04.:03:08.

me to the final point I want to make in this bill, and the most important

:03:09.:03:13.

point, what is the kind of post-Brexit Britain that we're going

:03:14.:03:16.

to build? What is this country going to look like? And by constituents

:03:17.:03:20.

say to me, it always seems to be about investing in HS2, or runways

:03:21.:03:28.

at Heathrow, or ?4.7 billion for Crossrail, it always seems to be

:03:29.:03:33.

about benefiting London or the jet elite. What about us in Dover? Why

:03:34.:03:45.

not dual the A2? Every region of this country will tell you about an

:03:46.:03:51.

infrastructure project, and that it always seems to work for the London

:03:52.:03:54.

metropolitan populist rather than regions. We need to have a

:03:55.:03:58.

rebalancing of this country for the 90% that live in their towns and

:03:59.:04:02.

regions of this nation rather than the capital. It is time for a

:04:03.:04:05.

Britain that works for everyone and to have capital expenditure working

:04:06.:04:10.

for everyone as well. London gets ?10,000 up public expenditure per

:04:11.:04:14.

head, the Southeast less than 8000. It is a difference of some 26%. My

:04:15.:04:22.

constituents say that the allegation resources isn't there, getting this

:04:23.:04:26.

money back from Brussels is an opportunity to make it fair. Then

:04:27.:04:30.

this issue of who does Britain work for, and who do the constituents of

:04:31.:04:34.

the towns and regions of this nation, who did it feel that it

:04:35.:04:38.

works for? That too often, it works for people like Philip Green, the

:04:39.:04:42.

privileged few, rather than the hard working class kids of Dover Deal,

:04:43.:04:48.

and Doncaster and Darlington and they think that that needs to

:04:49.:04:51.

change. Big business needs to have a change of culture. We know about how

:04:52.:04:58.

Apple have been gaming the tax system and how when it comes to the

:04:59.:05:01.

tax system in this country there are bad Apple and we know that Amazon

:05:02.:05:05.

have a Luxembourg structure, and we should look closely into their

:05:06.:05:09.

books, and I hope that HMRC will do that. We must make sure that when it

:05:10.:05:13.

comes to Google, the Public Accounts Committee is supported in making

:05:14.:05:16.

sure that Google pays a fair share of tax in this country and when it

:05:17.:05:23.

comes to car rental businesses like Avis, that gestured that we are

:05:24.:05:28.

being taken for a ride when they are imposing a Brexit tax on British

:05:29.:05:32.

people but not paying any corporation tax to Britain, because

:05:33.:05:35.

they have a Luxembourg structure. It is that kind of thing that drives

:05:36.:05:39.

the people of Dover Deal round the bend and we need to put a stop to

:05:40.:05:44.

it. We can do that when we leave the European Union. Very simply, we can

:05:45.:05:49.

do that, because we will not be stuck by anti-discrimination rules

:05:50.:05:52.

that make it hard for us to secure our tax base. We must make sure that

:05:53.:05:56.

Britain's works with people as a whole, rather than for the bloated

:05:57.:06:00.

boardroom bonuses that we have seen too much of recently, and too much

:06:01.:06:04.

in years. The ground-breaking research that the member for Croydon

:06:05.:06:09.

South showed is that pay in the boardroom is 150 times that for

:06:10.:06:13.

chief executives, than it is for employees of FTSE 100 companies.

:06:14.:06:16.

That is not right, and yet that has doubled in the last 12 years.

:06:17.:06:23.

Companies like BP say, we are not accountable to you, we will do what

:06:24.:06:27.

we like. That kind of culture needs to change. We must have a country

:06:28.:06:31.

that works for everyone, not just the privileged few. It is really

:06:32.:06:35.

important, then, that we make sure that when we have investment, we

:06:36.:06:43.

have more further regions, regions like Bristol, Birmingham and

:06:44.:06:46.

Manchester that we have railways that work for everyone in the

:06:47.:06:49.

regions as well with bigger investment and that we have roads

:06:50.:06:53.

further regions as well. So, in closing, I simply say this, Brexit

:06:54.:06:57.

means Brexit. We are going to make a success of it, but it is an

:06:58.:07:01.

opportunity to change how we run Britain and the change of a national

:07:02.:07:04.

way of life, to change with the country works for, and to make sure

:07:05.:07:08.

that it works for the truly everyone, rather than just the

:07:09.:07:11.

privileged few, as it has for too long. That is a kind of change we

:07:12.:07:15.

can make. It was the towns and regions of this country take this

:07:16.:07:25.

country out of the European Union, and it was the towns and regions of

:07:26.:07:27.

this country that should be supported in leading the charge to

:07:28.:07:30.

have a future that we can build as we head out into the single market

:07:31.:07:33.

of the world. The question is that the honourable member has lead to

:07:34.:07:38.

bring in the bill, Stewart Hosie. To decline the honourable member about

:07:39.:07:43.

to bring in his bill. He said that we in Scotland, the SNP in

:07:44.:07:47.

particular should "Respect the decision, the outcome of the

:07:48.:07:52.

referendum". Madam Deputy Speaker, I very much respect the outcome of

:07:53.:07:56.

those nations who voted to leave the EU. I would simply say to my friend

:07:57.:08:00.

from Dover that perhaps he and his colleagues should respect the wishes

:08:01.:08:05.

of those nations who voted to remain in the EU. It is always sweet, I

:08:06.:08:11.

think, to be chided by the honourable member for Dover. He

:08:12.:08:17.

railed against the Jetset elite. He talked about the imbalance in

:08:18.:08:21.

boardroom pay. We don't need to leave the EU and destroy

:08:22.:08:25.

opportunities to tackle imbalance in boardroom pay. He talked about the

:08:26.:08:32.

imbalance in public spending, and he was right to do so. Other parts of

:08:33.:08:38.

the country, the East Berlin, the north-west of England, get even less

:08:39.:08:41.

than the south-east gets, such is the imbalance. We don't need to

:08:42.:08:47.

leave the EU, and we can job opportunities and export

:08:48.:08:51.

opportunities, in order to rebalance public spending throughout the

:08:52.:08:55.

English regions. If only we had an English Parliament to deal with

:08:56.:08:58.

these things, things would be so much better. The honourable

:08:59.:09:04.

gentleman spoke about corporate tax, and how little is paid by some of

:09:05.:09:10.

the Goliath s of the global corporate world. We don't to leave

:09:11.:09:17.

the EU and we can opportunity further in order to deliver fairness

:09:18.:09:22.

and corporate taxation. In essence, the honourable gentleman made a

:09:23.:09:27.

pitch to leave now, because he said Brexit means Brexit and we will make

:09:28.:09:32.

a success of it. I think I am quoting accurately. The problem,

:09:33.:09:38.

Madam Deputy Speaker, and why no one can support this, is when the Prime

:09:39.:09:47.

Minister, the leader of government, the high heid yin of the Tory Party

:09:48.:09:51.

is asked, if Brexit means Brexit and it means will we stay in the single

:09:52.:09:54.

market, she doesn't know. When she was asked the most simple question,

:09:55.:10:02.

will the passport thing in place for financial services be maintained,

:10:03.:10:05.

she said, I refer you to the answer I gave last week, which is that I

:10:06.:10:09.

don't actually know. On the basis that Brexit means Brexit is more --

:10:10.:10:13.

is no more than a meaningless campaigning expression and none of

:10:14.:10:21.

the attributes or benefits described by the honourable gentleman in terms

:10:22.:10:26.

of Brexit, tackling corporate pay, tackling corporate taxation,

:10:27.:10:29.

tackling the imbalance in regional public expenditure in England, will

:10:30.:10:33.

in any way, shape or form be addressed, let alone improved, by

:10:34.:10:38.

Brexit, and I feel, Madam Deputy Speaker, that we're going to have

:10:39.:10:44.

two call against his valiant attempts to drag the whole of the UK

:10:45.:10:50.

including those parts that voted to stay in out of the EU, therefore

:10:51.:10:54.

there is even a plan. The question is that the honourable member have

:10:55.:11:04.

leave to bring in the bill. As many as another opinion say aye, contrary

:11:05.:11:05.

know. Division, division. -- As many as are of that opinion

:11:06.:11:34.

say aye, contrary no division, division.

:11:35.:11:49.

The question is that the honourable member have leave to bring in the

:11:50.:11:54.

bill. As many as are of that opinion say aye, contrary no. Tellers for

:11:55.:12:00.

the Ayes eyes Craig McKinlay, tellers for the Noes, Jeff Smith.

:12:01.:12:07.

The ayes, 50. Thenos, 17 The nos have it. IBEC to note that the draft

:12:08.:22:31.

wealthier and work order be approved. These will ensure that the

:22:32.:22:38.

welfare reforms ensured by the welfare and reform work or that a

:22:39.:22:45.

work order will be delivered in Northern Ireland. This is an

:22:46.:22:49.

important part of delivering the fresh start agreement and enables

:22:50.:22:52.

the Northern island executive to provide for supplementary welfare

:22:53.:22:56.

payments from within their own budget. Before the fresh start

:22:57.:22:59.

agreement, the impasse on agreeing the intimidation of welfare reform

:23:00.:23:02.

and that the Northern Ireland executive have been operating on and

:23:03.:23:07.

on workable budget. This credit significant political instability

:23:08.:23:10.

and risked a collapse in the devolution settlement. This order

:23:11.:23:13.

today brings changes that will help ensure the budget of the Northern

:23:14.:23:16.

Ireland executive is placed on a stable footing. Madam Deputy

:23:17.:23:20.

Speaker, we want to work with the Northern Ireland executive to

:23:21.:23:24.

support eight Northern Ireland where politics works and a Northern

:23:25.:23:27.

Ireland with a stronger economy and a stronger and secure society. It is

:23:28.:23:31.

in light of these goals, that the Government agreed to legislate on

:23:32.:23:34.

behalf of the executive to enable the welfare reform changes in both

:23:35.:23:40.

the 2012 and the welfare reform and work out of 2016. Changes such as

:23:41.:23:44.

the introduction of universal credit, personal independence

:23:45.:23:48.

payment, and the benefit. It has formed an integral part of the fresh

:23:49.:23:52.

start agreement in November last year. The welfare reform Northern

:23:53.:23:55.

Ireland order passed in December last year has enabled the making of

:23:56.:24:00.

over 30 sets of regulations, replicating in Northern Ireland the

:24:01.:24:05.

welfare reforms from the 2012 act. The welfare reform and work order

:24:06.:24:08.

before the house today is the next step in that process. It has been

:24:09.:24:12.

drafted with the full consent and collaboration of the Northern

:24:13.:24:22.

Ireland executive to bring Social Security in Northern Ireland back to

:24:23.:24:24.

a position of parity, thereby helping to rebalance and

:24:25.:24:26.

strengthened the finances of the executive. Madam Deputy Speaker,

:24:27.:24:28.

across the UK, are welfare reforms are focused on supporting people to

:24:29.:24:31.

find and keep work, a focus on employment, fairness and

:24:32.:24:34.

affordability, while supporting the vulnerable. Over the past six years,

:24:35.:24:38.

we have stuck to our economic plan, delivered welfare reform and seemed

:24:39.:24:42.

great progress with climate up at 2.7 million. Broadening life chances

:24:43.:24:48.

is a central part of this Government's plans. In Northern

:24:49.:24:52.

Ireland, raising of tax thresholds will take 110,000 of the lowest paid

:24:53.:24:57.

people out of income tax altogether and 700,000 people will benefit from

:24:58.:25:01.

reduced taxes. 100,000 people in Northern Ireland are predicted to

:25:02.:25:04.

benefit from the national living wage by 2020. The Government wants

:25:05.:25:13.

to support people hand-in-hand with the welfare programme to encourage

:25:14.:25:17.

people into work. We have also invested in Northern Ireland. The

:25:18.:25:20.

Stormont health and fresh start agreement included packages to

:25:21.:25:25.

support investment and reform. This includes ?350 million of additional

:25:26.:25:28.

capital borrowing explicitly for economic development projects. By

:25:29.:25:32.

working together, the Government and the executive have achieved

:25:33.:25:37.

significant successes, including bringing ?69 in additional finance

:25:38.:25:41.

to Northern Ireland businesses, providing additional borrowing for a

:25:42.:25:45.

shared education projects and increasing green investment by ?70

:25:46.:25:50.

million. In Northern Ireland, there are 55,000 more people in employment

:25:51.:25:55.

since 2010. But there is much more still to be done. The most recent

:25:56.:25:59.

Northern Ireland unemployment rate of 5.6% is above the overall UK

:26:00.:26:05.

average of 4.9%. The percentage of unemployed people who have been out

:26:06.:26:09.

of work for more than a year is 47.8%, markedly higher than the UK

:26:10.:26:15.

average of 27%. 22% of working age households in Northern Ireland are

:26:16.:26:20.

workless, can to 15% in the UK as a whole. The welfare reform and work

:26:21.:26:26.

act is built on the 2012 reforms, this order provides these

:26:27.:26:29.

legislative framework to repeat some of its most important aspects.

:26:30.:26:32.

Changes such as improving fairness in the welfare system by changing

:26:33.:26:36.

the level of the benefit. This order will bring the level of the benefit

:26:37.:26:41.

in Northern Ireland alongside that of Great Britain, ensuring parity.

:26:42.:26:44.

Changes such as providing new funding for additional support to

:26:45.:26:48.

help US eight and universal credit claimants with Alcan efficient and

:26:49.:26:53.

disabilities into work as well as removing the EAS a work-related

:26:54.:26:56.

activity components of the right support and the right incentives are

:26:57.:27:00.

in place for those who are able to take steps back into work. Changes

:27:01.:27:04.

such as correcting the unsustainable rise in benefit levels compared to

:27:05.:27:09.

earnings by freezing most working age benefits. Importantly, these

:27:10.:27:12.

changes will help ensure the budget of the Northern Ireland indicative

:27:13.:27:15.

is placed on a stable footing. It was agreed in the fresh start

:27:16.:27:18.

agreement that the executive to could supplement benefits from

:27:19.:27:20.

within their own budget. The agreement allocated up to 585

:27:21.:27:27.

million pounds of the executive's block grant over four years to

:27:28.:27:30.

provide for supplementary welfare payments in Northern Ireland, which

:27:31.:27:33.

would be reviewed in three years. Under the 2015 order, the assembly

:27:34.:27:40.

has already passed regulations for supplementary welfare payments

:27:41.:27:43.

related to the 2012 order. The provision of this order will give

:27:44.:27:46.

the assembly the ability to design and pass further such regulation

:27:47.:27:49.

including supplementary payments to those affected by the removal of the

:27:50.:27:53.

spare room subsidy. These time-limited payments follow the

:27:54.:27:59.

recommendations of the Everson report, which flowed from a

:28:00.:28:02.

commitment in the fresh start agreement. This order is about

:28:03.:28:05.

delivering the fresh start agreement and returning Northern Ireland to a

:28:06.:28:09.

position of legislative parity and financial stability and Madam Deputy

:28:10.:28:16.

Speaker, I commend it to the house. The question is and is on the order

:28:17.:28:22.

paper. Thank you, Madam Deputy Speaker. Can I thank the member for

:28:23.:28:26.

bringing this bill to the house? It is a shame it could not have been

:28:27.:28:33.

resolved in Northern Ireland. In an attempt to break a budgetary

:28:34.:28:36.

deadlock and avoid the potential collapse of the Stormont

:28:37.:28:42.

institutions, I and many members are glad to see this deal reached and

:28:43.:28:49.

credit to all of those involved. I have personally been involved in

:28:50.:28:52.

Northern Ireland affairs for almost 30 years, within the trade union

:28:53.:28:55.

movement, as a member of the Northern Ireland affairs committee

:28:56.:29:01.

and as a juror of the British Irish Parliamentary Association. In the

:29:02.:29:04.

union work I was involved in any 1990s, we worked hard to deal with

:29:05.:29:07.

the peace process. We coined a phrase that we were a nonpartisan

:29:08.:29:12.

agent for change. It is that phrase that has guided my work inside and

:29:13.:29:18.

outside of this house. With that attitude in mind, I want to address

:29:19.:29:22.

the house. My party takes great pride in the role we played in

:29:23.:29:26.

bringing about in Northern Ireland. We have worked with good people on

:29:27.:29:29.

the ground and from around the world, from the Good Friday

:29:30.:29:32.

agreement to the fresh start agreement and much in between. We

:29:33.:29:35.

have always tried to work in the best interests of the people of

:29:36.:29:39.

Northern Ireland. What is paramount here today is the ongoing peace and

:29:40.:29:43.

stability in Northern Ireland and we in the Labour Party will work with

:29:44.:29:48.

the Government and all interested parties in this house and in

:29:49.:29:51.

Northern Ireland in maintaining this, and I'm sure all members will

:29:52.:29:56.

agree with that. As part of the fresh start agreement, we included

:29:57.:29:59.

legislative consent for the Northern Ireland assembly and now Parliament

:30:00.:30:04.

to create legislation on its behalf and I respect the authority of these

:30:05.:30:07.

heavily to do that and I am sad that they have had to do it. Amongst all

:30:08.:30:14.

of the measures, the welfare reform act of 2012 and 2016, it is quite

:30:15.:30:21.

clear to me that the Government's welfare reform programme has

:30:22.:30:24.

devastated the lives of far too many vulnerable people across the whole

:30:25.:30:27.

of Great Britain, plunging them into financial distress. We heard for the

:30:28.:30:31.

last hour of the discussions around the tax credit fiasco. These are

:30:32.:30:36.

real people, suffering as a result of the work that this Government has

:30:37.:30:43.

brought in. I and many of my members across this house have seen these

:30:44.:30:44.

cuts day-to-day. We will never, in this party, stop

:30:45.:31:01.

showing our opposition to the Tory austerity agenda, something we have

:31:02.:31:03.

constantly railed against over recent years. We stood in opposition

:31:04.:31:12.

against cuts to tax credits, a benefit cut that doesn't rise with

:31:13.:31:16.

inflation, cuts to cancel tax credits, cuts to crisis loans and

:31:17.:31:23.

never say to as the that 42% deemed to be fit for work were actually

:31:24.:31:28.

cleared on site on appeal. What a damning indictment on the party

:31:29.:31:36.

opposite. Biden Deputy Speaker, welfare reform was intended by this

:31:37.:31:39.

Government to impact very, very hard on the most vulnerable people in the

:31:40.:31:43.

UK and forced them into work even when they are not well equipped to

:31:44.:31:48.

do so. The desire to inflict in the people of Northern Ireland the same

:31:49.:31:51.

disastrous policy that has lacked the lives of so many constituents

:31:52.:31:56.

right across Great Britain is a desperate tactic by a government

:31:57.:31:59.

more concerned with ideology than compassion. Using austerity as a

:32:00.:32:08.

weapon of policy was and still is a crude instrument. The role of

:32:09.:32:16.

posterity in the note one errant -- long-term economic plan, path, the

:32:17.:32:22.

language they used in seeing we will make work pay rental for those

:32:23.:32:27.

forced to work while struggling with illness, injury or disease. It

:32:28.:32:32.

should be shown as the truth, as government wants to make it

:32:33.:32:34.

impossible for anyone to survive on benefits. That is hugely unfair to

:32:35.:32:39.

those struggling day to day through no fault of their own. There may be

:32:40.:32:43.

some who say these changes should apply to Northern Ireland because

:32:44.:32:46.

they do across the rest of Great Britain. But two wrongs do not make

:32:47.:32:54.

a right. The party opposite clearly believes in the equalisation of

:32:55.:32:57.

misery. Madame Deputy Speaker, this party believes in the alleviation of

:32:58.:33:03.

misery. And we would get back to power, we will not be attacking the

:33:04.:33:07.

city, the young, the elderly and disabled, we will not be calling

:33:08.:33:10.

them scroungers or skivers. We will not declare on anyone whose curtains

:33:11.:33:16.

are not open by a specific time any day and we will not be making the

:33:17.:33:20.

poor pay for the failings of the rich and those who dabbled in the

:33:21.:33:24.

money markets. It is interesting, as the Minister said, that within the

:33:25.:33:28.

fresh start agreement, there are measures to mitigate against the

:33:29.:33:34.

ongoing austerity regime. But does that not sure that these measures

:33:35.:33:38.

should not be being brought in in the first place? It is an acceptance

:33:39.:33:42.

of the problems that they're going to pile on to people that do not

:33:43.:33:46.

deserve them. Another issue we have advised is that these cuts will take

:33:47.:33:50.

?750 million out of the Northern Ireland economy, and that lost their

:33:51.:33:56.

work age adults is 38% higher than what the UK average would be, at

:33:57.:34:01.

?650 per year. In Northern Ireland, the recent announcement of job

:34:02.:34:09.

losses, the job losses at Ballina upwards of 850, or the Caterpillar

:34:10.:34:13.

factory in Newtownabbey and others. Those men and women losing their

:34:14.:34:17.

jobs would find less support than ever and this will do nothing but

:34:18.:34:22.

compounded their difficulties as they try to find their way to the

:34:23.:34:26.

world of unemployment. Northern Ireland, as the Minister just

:34:27.:34:29.

mentioned, has some of the highest levels of long-term unemployment in

:34:30.:34:33.

the United Kingdom. Almost one in ten adults of working age are in

:34:34.:34:37.

receipt of disability living allowance. Almost twice the national

:34:38.:34:42.

average. They are hit much more than other parts of the major kingdom.

:34:43.:34:49.

Belfast in particular is the city that will be damaged most by these

:34:50.:34:52.

reforms. Poverty is an all too real everyday reality for many in

:34:53.:34:55.

Northern Ireland. These reforms will serve no other purpose than to

:34:56.:34:59.

compound his difficulties. These cuts had the vulnerable, the

:35:00.:35:03.

disabled, families and children. That is something that this party

:35:04.:35:07.

will not be complicit in. We have to accept, despite the huge opposition

:35:08.:35:13.

to these so-called reforms, they have been enforced on the people of

:35:14.:35:16.

Great Britain but that does not make it any more palatable or give any

:35:17.:35:19.

more reason to also forced the changes on the people of Northern

:35:20.:35:22.

Ireland and I would say we have to accept the very real circumstances

:35:23.:35:27.

in history, and the current difficulties people in Northern

:35:28.:35:31.

Ireland first. According to figures from Northern Ireland statistics and

:35:32.:35:36.

research agency, since 1998, more people have taken their own life in

:35:37.:35:41.

Northern Ireland than died throughout the Troubles. Research

:35:42.:35:44.

shows that during the recession those figures increased. The suicide

:35:45.:35:49.

rate is 70% higher in Northern Ireland than the UK average. Forcing

:35:50.:35:54.

the vulnerable in society further into despair will do nothing to

:35:55.:35:59.

defeat this problem. We support any work aimed at maintaining the

:36:00.:36:02.

long-term stability of the institutions of Northern Ireland.

:36:03.:36:08.

But we also remember the days of direct rule as a testament of how

:36:09.:36:12.

important it is to make sure that these institutions did not just

:36:13.:36:15.

carry on but flourished and improve. On that basis, we will not block

:36:16.:36:20.

this today, we will not oppose this today, but in no way should this be

:36:21.:36:24.

taken that we condone what is being done by this Government to the

:36:25.:36:28.

people of Northern Ireland. Thank you, Madam Deputy Speaker. Could I

:36:29.:36:36.

thank the honourable member, my honourable friend, for outlining the

:36:37.:36:40.

position in relation to welfare reform and about the fact that it

:36:41.:36:45.

can be so pernicious in bringing about bad impacts on people who are

:36:46.:36:51.

already in receipt of low income? I welcome the fact that the Minister

:36:52.:36:57.

is here, the Minister in the Treasury, the honourable member for

:36:58.:37:01.

East Hampshire, who has outlined the position in relation to this

:37:02.:37:05.

supplementary legislation. We have always been very clear about our

:37:06.:37:10.

position on this, and our position is on the record. Both in this

:37:11.:37:14.

chamber and in the Northern Ireland assembly. Legislation dealing with

:37:15.:37:16.

welfare reform should have been dealt with in the assembly, as

:37:17.:37:23.

originally envisaged. Westminster's interference into our devolved

:37:24.:37:25.

welfare arrangements was inappropriate. As were the

:37:26.:37:31.

subsequent fines. And I do recall, as a former minister for social

:37:32.:37:35.

development in Northern Ireland for some three years, bringing forward,

:37:36.:37:39.

shall we say, karaoke legislation in relation to welfare issues in terms

:37:40.:37:47.

of all of the regulations, why should this have been different this

:37:48.:37:52.

time? The DUP and Sinn Fein voted through the legislative consent

:37:53.:37:57.

motion in the assembly to hand our welfare powers over to Westminster.

:37:58.:38:02.

Indeed, far from their original promises that no claimant would be

:38:03.:38:09.

worse off, Sinn Fein handed our welfare powers over to here to carry

:38:10.:38:16.

out its dirty work when they do not even take their seats in this

:38:17.:38:21.

chamber. The whole essence of devolution as to improve the lives

:38:22.:38:25.

of people in Northern Ireland and devolution, we feel, is damaged if

:38:26.:38:29.

the two largest parties in the assembly, and the Northern Ireland

:38:30.:38:32.

Executive, pick and choose which powers they have and when they have

:38:33.:38:37.

them. People in Northern Ireland must be able to have that confidence

:38:38.:38:41.

that the political institutions upon which we agreed back in the

:38:42.:38:50.

referendum, in May 1998, that they have to believe that the people and

:38:51.:38:56.

the politicians are serious about the powers that they have and that

:38:57.:38:59.

they will fiercely defend any attempts to reduce those powers.

:39:00.:39:05.

This should have been a matter for the devolved assembly, which should

:39:06.:39:08.

have resisted the Treasury's interference is and taxes on our

:39:09.:39:13.

devolved budget, and instead the DUP and Sinn Fein were delighted to have

:39:14.:39:18.

the power is taken off their hands for some 30 months. We made numerous

:39:19.:39:25.

attempts to build consensus on welfare reform as far back as 2010.

:39:26.:39:31.

-- for some 13 months. In the assembly, and in this House, when

:39:32.:39:34.

the original Welfare Reform Bill was going through the House, through my

:39:35.:39:38.

honourable friend the member of foil, and even before it came to the

:39:39.:39:44.

assembly. We, as a party, were always realistic about the

:39:45.:39:47.

implications of welfare reform and made the case for mitigation, which

:39:48.:39:53.

was sustainable and which would be included in the devolved budget. And

:39:54.:40:00.

I can well recall a meeting that we had, with the Minister at that

:40:01.:40:03.

stage, in the Department for Work and Pensions, the Minister, who sits

:40:04.:40:11.

in the other Place, Lord Freud, and at that stage, we outline specific

:40:12.:40:18.

measures that would to mitigate the impact of welfare reform in Northern

:40:19.:40:22.

Ireland, and it is surprising, maybe not so surprising, that those very

:40:23.:40:26.

areas were eventually to come about as mitigation measures. We divided

:40:27.:40:32.

on the bill, last year, and the order when it came to the size in

:40:33.:40:39.

2015. And there is another matter that I would welcome clarification

:40:40.:40:42.

on from the Minister, regarding clause nine of the Finance Bill,

:40:43.:40:48.

which is directly related to this statutory instrument, and I hope the

:40:49.:40:51.

Minister will be able to clarify the situation for me. My honourable

:40:52.:40:57.

friend, the Member for Foyle, raised the matter of new clothes name in

:40:58.:41:01.

the Finance Bill last week, and it provides for the Treasury to ensure,

:41:02.:41:07.

and open quotations, that no liability to income tax allowance on

:41:08.:41:12.

welfare payments of a specified description". But it also makes

:41:13.:41:19.

provision for the Treasury to make regulations to impose a charge to

:41:20.:41:28.

income tax under part ten on payments of a specified description.

:41:29.:41:32.

We have been at the forefront of securing mitigating powers for the

:41:33.:41:35.

assembly to enable it to make supplementary payments, so could the

:41:36.:41:40.

Minister, the honourable member for East Hampshire, confirmed today that

:41:41.:41:47.

it does not give the Treasury the green light to interfere in

:41:48.:41:50.

decisions by the executive and the assembly around supplementary

:41:51.:41:55.

payments by dictating that these payments could be subject to a tax

:41:56.:42:00.

claw-back? These top welfare payments will be made, as the

:42:01.:42:05.

Minister knows, from the executive's on devolved budget and will not come

:42:06.:42:10.

under annually managed expenditure, which is the usual route for payment

:42:11.:42:18.

of benefits throughout Northern Ireland. Minister Ellison last week

:42:19.:42:23.

confirmed that it would not, in response to my honourable friend,

:42:24.:42:26.

the Member for foil, could the honourable member for East

:42:27.:42:31.

Hampshire, the Minister at the dispatch box today, confirm...

:42:32.:42:37.

Reconfirmed this position? As stated, we as a party have worked to

:42:38.:42:52.

secure mitigation and we need supplementary payments for

:42:53.:42:54.

mitigation measures and it is for this reason today that we will not

:42:55.:42:58.

push the House to evade decision on this matter, which I am sure some

:42:59.:43:04.

people will be pleased about! But notwithstanding that it is important

:43:05.:43:10.

to remember that welfare reform, and particularly welfare reform and work

:43:11.:43:17.

Bill, upon which this regulation is based, will introduce fairly

:43:18.:43:23.

pernicious measures into Northern Ireland, and will impact on those,

:43:24.:43:28.

in terms of low income, who are reliant on benefit. And I fear that

:43:29.:43:33.

it could push people further into poverty. So it is incumbent, we

:43:34.:43:41.

feel, on the government to ensure that people are protected, that

:43:42.:43:46.

there is some form of vision. And I respect the fact that the mitigation

:43:47.:43:50.

measures will ensure that, but that they look... That the government

:43:51.:43:55.

looks at other measures to ensure that people can live in a decent

:43:56.:44:02.

sort of life. And, in fact, early today, the honourable member for

:44:03.:44:06.

East Belfast initiated a debate on social funeral payments. And we

:44:07.:44:11.

participated in that debate because there is a feeling that those

:44:12.:44:14.

general payments have been capped for several years and there has been

:44:15.:44:20.

no corresponding increase when the cost of such measures have exceeded

:44:21.:44:29.

beyond, shall we say, the income bounds of many people. So, in that

:44:30.:44:32.

respect, we did not hear from the Minister responding this morning --

:44:33.:44:42.

we get -- about the government's measures, or Treasury measures,

:44:43.:44:47.

about increasing such measures. So it is important, when we discuss

:44:48.:44:50.

about welfare matters in relation to Northern Ireland, that the special

:44:51.:44:56.

circumstances of many people, particularly in urban areas, who

:44:57.:45:00.

find themselves unemployed, maybe through no cause of their own, who

:45:01.:45:05.

are in receipt of benefits, do have that financial cushion and

:45:06.:45:11.

protection in order to live a life without any detriment. Thank you,

:45:12.:45:13.

Madam Deputy Speaker. First of all, the fact that this

:45:14.:45:23.

legislation is before the house today is an indication of the very

:45:24.:45:28.

radical steps which had to be taken to rescue the Northern Ireland

:45:29.:45:35.

assembly from financial and political collapse. And let's make

:45:36.:45:40.

no doubt about it, that was the situation which faced the Northern

:45:41.:45:47.

Ireland assembly because of the attitude which had been adopted by

:45:48.:45:56.

those who decided that, despite all their protestations, that

:45:57.:45:59.

legislation for matters which were devolved in Northern Ireland should

:46:00.:46:02.

be dealt with by the Northern Ireland assembly, took a totally

:46:03.:46:07.

irresponsible view, and blocked the ability for decisions to be made,

:46:08.:46:12.

hence plunging the assembly into a financial crisis. It was less than a

:46:13.:46:20.

year ago, Madam Deputy Speaker, that the Northern Ireland assembly were

:46:21.:46:24.

faced with a situation where the welfare reform legislation which had

:46:25.:46:33.

gone through the House of Commons here and which was a matter which

:46:34.:46:37.

had been devolved to Northern Ireland, but it was always assumed

:46:38.:46:45.

that there would be a reflection of the legislation which was passed

:46:46.:46:49.

here and the legislation which was passed in Northern Ireland, because

:46:50.:46:52.

of course the bill was being paid for through the payments which came

:46:53.:47:03.

to the Northern Ireland assembly. In other words, it was money which was

:47:04.:47:08.

paid on demand, so if unemployment went up, then we did not have

:47:09.:47:13.

defined it from the block grant. It was found simply from the Exchequer.

:47:14.:47:18.

If there were a change in a number of claimants and the area and

:47:19.:47:22.

happened to be, then the money was automatically made available. And of

:47:23.:47:28.

course, and I understand that whilst there may have been opposition to

:47:29.:47:31.

some of the measures which were undertaken in the welfare reform and

:47:32.:47:36.

indeed my party voted against a number of them, but once it went to

:47:37.:47:41.

the House of Commons, the stark choice for the people and for the

:47:42.:47:43.

assembly in Northern Ireland was either you deviate and you pay for

:47:44.:47:50.

the deviation or else you comply and ensure the payments continue to the

:47:51.:47:59.

Northern Ireland expenditure block. And that was the stark reality.

:48:00.:48:06.

There were some who, because of their sonority position and the SDLP

:48:07.:48:10.

of course led the charge in this, because of their minority position

:48:11.:48:15.

in the Northern Ireland assembly, they wanted to assure that the

:48:16.:48:20.

budget was not put into jeopardy but at the same time they could wash

:48:21.:48:27.

their hands and say the consequences of welfare reform are nothing to do

:48:28.:48:31.

with us because we voted against them. It was all those other parties

:48:32.:48:39.

who voted it through. And of course, that was the position that

:48:40.:48:44.

unfortunately we had because of the kind of political structures which

:48:45.:48:49.

are faced in Northern Ireland. The result is... I will give way. Thank

:48:50.:48:55.

you. I am very grateful to my honourable friend. The honourable

:48:56.:48:58.

lady suggested there were attempts to reach consensus between the

:48:59.:49:03.

parties in Northern Ireland. Family member recall any proposal that was

:49:04.:49:08.

able build consensus and also overcome the significant hurdle of

:49:09.:49:15.

either deviating or following? This was the problem indeed. The member

:49:16.:49:23.

perhaps did not have an opportunity to explain it. We were not delighted

:49:24.:49:27.

that the powers were taken away from us, but because of the use of the

:49:28.:49:35.

provisional concern by the SDLP and others, the ability to bring the

:49:36.:49:39.

legislation forward was blocked and we then faced the situation where we

:49:40.:49:45.

could not bring forward our own bespoke Northern Ireland legislation

:49:46.:49:50.

because the situation had been blocked. I will give way in a

:49:51.:49:54.

moment. Let us, because it is important. Rather than being

:49:55.:50:00.

delighted that Westminster to response ability, our party, the

:50:01.:50:07.

DUP, worked frantically to try and find ways of ensuring that the worst

:50:08.:50:14.

aspect of welfare reform, the ones that we believe are most damaging

:50:15.:50:18.

and could not because of some structural reasons be introduced in

:50:19.:50:22.

Northern Ireland, that they were dealt with and were dealt with by

:50:23.:50:28.

taking money from other priorities and then using that money to

:50:29.:50:30.

alleviate some of the difficulties and that was blocked, stopped dead

:50:31.:50:39.

in its tracks by the use of the addition of concern by the SDLP, so

:50:40.:50:43.

rather than being delighted that Westminster had to take over the

:50:44.:50:47.

responsibility, we worked our socks off to try to get a bespoke

:50:48.:50:51.

arrangement for Northern Ireland which could be agreed by all of the

:50:52.:50:54.

parties in Northern Ireland and would therefore have some kind of

:50:55.:51:00.

democratic authority. And it was impossible to do that because of the

:51:01.:51:06.

action of the SDLP, who protest and that they wanted the legislation

:51:07.:51:11.

dealt with in Northern Ireland, but did their hardest to make sure it

:51:12.:51:14.

could not be dealt with there and had to be dealt with the year. I

:51:15.:51:20.

thank the MLA forgiving way, just to refresh his memory for fear he and

:51:21.:51:25.

his colleagues may have forgotten that, my colleagues in the Northern

:51:26.:51:30.

Ireland Assembly proposed and all party committee as far back as

:51:31.:51:40.

February, as far back as March and April 2011, to address this

:51:41.:51:43.

particular issue, to achieve all-party consensus, whereby we

:51:44.:51:51.

could go forward as a United team to end the Treasury year in London and

:51:52.:51:55.

to achieve the best possible deal for the people of Northern Ireland.

:51:56.:52:01.

Madam Deputy Speaker, I happen to be the finance minister in Northern

:52:02.:52:04.

Ireland at the time and I can remember those discussions and there

:52:05.:52:07.

was a whole list of demands, which was that you do not introduce any of

:52:08.:52:13.

the welfare reform proposals and that we just go ahead as usual. Now,

:52:14.:52:20.

the question of course was this. Who was going to pay for it? There was a

:52:21.:52:28.

naive belief that somehow or other, if all of the parties in Northern

:52:29.:52:34.

Ireland came to ministers here in London and brought along the great

:52:35.:52:38.

and the good from Northern Ireland on the coat-tails and pleaded eight

:52:39.:52:43.

special case that somehow or other we would be exempt from the

:52:44.:52:48.

arrangements and the welfare changes that were being made in all other

:52:49.:52:53.

parts of the United Kingdom. That was a cunning plan. And I am afraid

:52:54.:53:03.

that even those who were sympathetic to the SDLP's point of view new that

:53:04.:53:13.

there was nothing cunning about it. Indeed, Baldrick could not have

:53:14.:53:18.

devised a more stupid plan, should he have done so. We tried to find

:53:19.:53:25.

ways of changing this. The only suggestion was we are opposed to the

:53:26.:53:29.

changes and therefore we don't want them for Northern Ireland. The more

:53:30.:53:34.

realistic position and a position which is now reflected actually in

:53:35.:53:40.

the legislation that we have today was let's look at what resources are

:53:41.:53:46.

available. Let's look at where the most damaging aspects of the

:53:47.:53:52.

legislation are going to be. And could we find the ability within our

:53:53.:53:57.

own resources to try and mitigate against some of those? And that is

:53:58.:54:04.

what has been done. Over the term of this assembly, the Northern Ireland

:54:05.:54:08.

assembly will from its own resources and that means making some other

:54:09.:54:12.

things in lesser priority, will seek to protect the most vulnerable by

:54:13.:54:18.

mitigation measures, whether it is with the spare room subsidy, not

:54:19.:54:23.

being enacted in Northern Ireland or people being compensated for it or

:54:24.:54:27.

the cost of work allowance and people being compensated for that

:54:28.:54:30.

and a range of other things, will find half ?1 billion over the

:54:31.:54:36.

lifetime of the current assembly to alleviate some of the impacts of the

:54:37.:54:42.

welfare reform changes, and of course those are reflected in some

:54:43.:54:48.

of the legislation that is being put before the house today. In my view,

:54:49.:54:54.

it is a great pity that there was not the majority to actually have

:54:55.:55:04.

those changes made through legislation which was passed and

:55:05.:55:07.

debated in the Northern Ireland assembly and the fact that under the

:55:08.:55:14.

agreement, which was made around this time or just later, this time

:55:15.:55:22.

last year at the Fresh Start talks, it was agreed that rather than go

:55:23.:55:27.

through the process of trying to force is through the assembly when

:55:28.:55:30.

the blocking mechanism we knew would be employed again by the SDLP and

:55:31.:55:35.

some of their allies on this, that it would have to be done here in the

:55:36.:55:40.

House of Commons. And that's where we are today. But let me does

:55:41.:55:43.

emphasise a number of points. First of all, there are changes and there

:55:44.:55:50.

are welfare changes which we supported here, because we believe

:55:51.:55:54.

that welfare did need reform. Secondly, we do believe that any

:55:55.:55:58.

welfare system ought not to be designed in a way to dissuade people

:55:59.:56:04.

from wanting to look for work. That is important. And therefore they

:56:05.:56:11.

were some of the changes that we did support. Even when the debates were

:56:12.:56:16.

here in the House of Commons will stop thirdly, there were things that

:56:17.:56:19.

we did not support but once they got through the House of Commons and we

:56:20.:56:22.

knew we could not afford them in Northern Ireland, we accepted that

:56:23.:56:26.

they should be part of the legislation. Fourthly, there were

:56:27.:56:30.

things that we believed we could change and we could find money to

:56:31.:56:34.

change, and have this book legislation for Northern Ireland and

:56:35.:56:39.

those were reflected in the proposal that we have before us. And the last

:56:40.:56:44.

point is, of course, that this will all be devolved back to Northern

:56:45.:56:47.

Ireland at the end of this year and I trust that we will have learned

:56:48.:56:52.

from the debacle which brought the assembly into disrepute, brought

:56:53.:56:58.

politics into disrepute, and in future we will learn that sometimes

:56:59.:57:02.

there are hard choices to be made and at least what we should do is be

:57:03.:57:06.

prepared to face up to those hard choices and find ways of dealing

:57:07.:57:13.

with the consequences of legislation which come from here. I will give

:57:14.:57:18.

way. But remember not honestly except Eddie Howe is that really the

:57:19.:57:21.

holder Barkley was really about him and his party not wanting to trip

:57:22.:57:24.

through the lobbies with Sinn Fein in a love in with Sinn Fein to

:57:25.:57:30.

inflict poverty on the people of Northern Ireland? This is the

:57:31.:57:37.

amazing thing. I don't know... I know there are all these attempts to

:57:38.:57:42.

rewrite history. It was a DUP minister who brought the legislation

:57:43.:57:46.

to the assembly and was prepared to walk through the lobbies and vote

:57:47.:57:52.

for it, and because there was a petition of concern introduced by

:57:53.:57:58.

the SDLP, which even a majority of members in the assembly had voted

:57:59.:58:03.

for the legislation, it would still not have become law, and once that

:58:04.:58:07.

addition of concern was triggered and the legislation was turned down,

:58:08.:58:12.

we were in a position where we couldn't have any Welfare Reform

:58:13.:58:16.

Bill. That is the truth of the matter. Not that we ran away. We

:58:17.:58:21.

faced up to it. I can remember doing interview after interview. Even

:58:22.:58:24.

faced flak from people who said you're going to hurt individuals

:58:25.:58:27.

because a part of this legislation and we argued that at least we have

:58:28.:58:30.

done something to mitigate against it. We have got the possible deal

:58:31.:58:39.

and can I do say? -- can I just say? We did get changes and we did get

:58:40.:58:44.

allowance is made by the DWP. I want to give credit to ministers in the

:58:45.:58:50.

DWP. When we were negotiating with welfare reform, they accepted that

:58:51.:58:53.

Northern Ireland could make changes, albeit that we had to accept the

:58:54.:58:58.

financial consequences of those changes, but folks ability was

:58:59.:59:02.

demonstrated by the Department for Work and Pensions. It was rejected

:59:03.:59:05.

by those who wanted to simply be able to say we are purer than

:59:06.:59:14.

everyone else on this issue and we have stood on our principles

:59:15.:59:17.

regardless of the consequences of that. We have got the legislation we

:59:18.:59:24.

have here today. I believe that those who are most vulnerable in

:59:25.:59:28.

Northern Ireland have been safeguarded by the changes which

:59:29.:59:30.

have been made by the resources which have been devoted by the

:59:31.:59:35.

Northern Ireland assembly and that has been a painful choice, because

:59:36.:59:38.

of course it means that there is less money to spend on some other

:59:39.:59:43.

things, and I think that since the member had plenty of opportunity

:59:44.:59:47.

during the debate, I have given three or four interventions already,

:59:48.:59:51.

I know that she is struggling with the case that she has and with the

:59:52.:59:55.

embarrassment of the way in which the SDLP have handled this issue,

:59:56.:00:05.

but I say this. That we have now got the piece of legislation and today I

:00:06.:00:10.

recommended it to the house. I believe it is the best deal we could

:00:11.:00:14.

have got. Unfortunately, I believe it would have been far better had it

:00:15.:00:17.

gone through the assembly but because of the assembly structures

:00:18.:00:20.

and the ability for Menorah Narathiwat parties to obstruct

:00:21.:00:24.

legislation through a position of concern, this is the only way by

:00:25.:00:29.

which we can ensure that the assembly finances were protected and

:00:30.:00:32.

indeed the political process in Northern Ireland was able to

:00:33.:00:33.

continue. Do a few of the points that are

:00:34.:00:48.

raised later, a very short speech. Firstly, on the detail of the

:00:49.:00:53.

legislation, I wanted to make it clear that the Ulster Unionist

:00:54.:00:56.

Party, for example, support the benefit cap, because it is important

:00:57.:01:04.

that we keep people in work, they are better in work than totally

:01:05.:01:06.

relying on benefits. We do support a raft of these issues are rendered.

:01:07.:01:11.

We are still concerned that the split camp levels between London of

:01:12.:01:19.

?23,000 and the rest of the UK of ?20,000 represents the most

:01:20.:01:21.

significant nonconformity of the UK's Social Security system and will

:01:22.:01:25.

need to be watched entirely closely, and obviously but as with the

:01:26.:01:31.

reserved government here at the moment. So clearly that is ready

:01:32.:01:34.

watching brief must be, but I am sure the assembly and executive will

:01:35.:01:38.

also be making representation here as well. It had originally been

:01:39.:01:45.

planned we introduce universal credit from 2017 and Northern

:01:46.:01:48.

Ireland but this has now been moved because the development work on the

:01:49.:01:53.

changes to universal credit ICT system has been delayed. The

:01:54.:01:59.

deadline still remains June 2018. As such, the local department for, to

:02:00.:02:02.

use in Northern Ireland has now found itself with the unenviable

:02:03.:02:06.

task of trying to implement one of the biggest shake-ups in a

:02:07.:02:13.

generation over less than a 12 month period. But anyway, I am sure they

:02:14.:02:18.

will manage that with the help of others. We still do not support the

:02:19.:02:21.

abolition of the work-related activity component for a new

:02:22.:02:28.

claimants from April 20 17. However, that debate has been held and the

:02:29.:02:31.

government have not taken it on board. So we must progress but what

:02:32.:02:37.

we have. We must now move on to identify all the additional support

:02:38.:02:40.

and help that claimants do to help them return to work. On the more

:02:41.:02:46.

principal issue, Madam Deputy Speaker, there is a huge frustration

:02:47.:02:55.

that this is number one, that it had to come back here to be implemented,

:02:56.:02:59.

but secondly that it is taken so long, at a huge cost to other

:03:00.:03:03.

departments, departments like the health service and education

:03:04.:03:06.

service, where there have been delays after delays. And a lot of it

:03:07.:03:10.

has been just grandstanding. I fully accept the point that some people

:03:11.:03:15.

just did not want to vote for this in the Northern Ireland Assembly and

:03:16.:03:19.

executive. That has been talked about. Sinn Fein being the biggest

:03:20.:03:25.

proponent of it, assisted by some extent by the SDLP. But this could

:03:26.:03:30.

have been resolved many, many months, in fact years, ago. On the

:03:31.:03:34.

delays have been at a huge cost to the people of Northern Ireland. The

:03:35.:03:38.

ordinary people who needed that health care and education. I support

:03:39.:03:45.

the continuance of this. There are some changes that I would have liked

:03:46.:03:49.

to have seen that did not happen, that we are asked who I am

:03:50.:03:52.

supporting the progression of it. But clearly we cannot get into this

:03:53.:03:58.

mess that we have been in for the last couple of years. Otherwise, the

:03:59.:04:01.

Northern Ireland Executive and assembly will be back to a very,

:04:02.:04:05.

very difficult position and once again at stalemate. It is a pleasure

:04:06.:04:14.

to follow the honourable gentleman. I wanted to support what my

:04:15.:04:21.

honourable friend has said very personally just as to why we are

:04:22.:04:26.

here today debating this particular statutory instrument. It is

:04:27.:04:31.

important that it is emphasised that this is not a situation that we

:04:32.:04:41.

wanted to see. It should be noted, that in Scotland, of course, with

:04:42.:04:45.

the Scottish parliament, with the extensive powers that it has does

:04:46.:04:51.

not have responsibility for welfare. This is an area where Northern

:04:52.:04:54.

Ireland took responsibility, those who negotiated the agreement decided

:04:55.:05:03.

it would be a good idea to devolve welfare to Northern Ireland, with a

:05:04.:05:10.

massive cost that comes with that, but it comes to direct payments, not

:05:11.:05:14.

out of the Northern Ireland block. So the understanding, the agreement,

:05:15.:05:19.

was, and I am a former minister of social development, back when

:05:20.:05:24.

devolution began in 1999, the understanding was parity. Because if

:05:25.:05:27.

we deviate their Northern Ireland as to pay for that out of the block

:05:28.:05:33.

grant. So areas like hospital spending, education, environment,

:05:34.:05:35.

housing all is to suffer cuts in order to pay for any deviation. Now,

:05:36.:05:44.

this comes to the crux of the arguments that took place in the

:05:45.:05:46.

Northern Ireland Assembly in recent times. Were people in certain

:05:47.:05:53.

parties, notably the SDLP, Sinn Fein and others, who wanted to say let's

:05:54.:06:00.

deviate, let's do our own thing, we are not accepting these welfare

:06:01.:06:04.

cuts, and their proposal to try to then get something for Northern

:06:05.:06:08.

Ireland was let to set up a committee, go and knock on the door

:06:09.:06:10.

of the Treasury and demand that Northern Ireland receive hundreds of

:06:11.:06:15.

millions of pounds extra, which was never going to happen. The reality

:06:16.:06:20.

is that had this measure not taken place, the fresh start negotiations

:06:21.:06:25.

which took place primarily between the DUP and Sinn Fein, not had a

:06:26.:06:29.

successful outcome then we would have had still direct rule by now

:06:30.:06:34.

from this place. That is the reality of it. And what we would have added

:06:35.:06:40.

Northern Ireland would have been welfare changes which were exactly

:06:41.:06:42.

the same as have taken place in England and Wales. There would have

:06:43.:06:46.

been none the mitigations. There would have been none of the

:06:47.:06:49.

change... I will admit. There will be none of the changes which we

:06:50.:06:53.

implemented and wanted to see implemented. So, the consequences of

:06:54.:06:58.

the approach of the members of the SDLP and others who opposed a

:06:59.:07:05.

sensible compromise was to have Phil, untrammelled welfare changes

:07:06.:07:11.

of the sort that they thought, or say, that they oppose. I thank the

:07:12.:07:15.

Member for getting way. I am wondering if you can enlighten us,

:07:16.:07:18.

because I have not got to the bottom of it, why Sinn Fein has done such a

:07:19.:07:23.

somersault on all of this? They total are posted for years. All of a

:07:24.:07:28.

sudden, they seemed to come to their senses and accept the principle of

:07:29.:07:32.

it. I am just wondering if he can shed any light. It is for Sinn Fein

:07:33.:07:35.

to explain their own positions, not for me to speak for them. Especially

:07:36.:07:40.

when they do not come to this House. They are often seen about the

:07:41.:07:47.

corridors, certain members, here to collect their allowances, political

:07:48.:07:50.

representation money, constituency allowances, that is all they did.

:07:51.:07:53.

They do not take part in any other Parliamentary processes. So I will

:07:54.:07:56.

leave it to them. But what I would say is this, that reality had to

:07:57.:08:01.

dawn on people in Northern Ireland that we were facing into the

:08:02.:08:06.

collapse of the political institutions. It is a biblically

:08:07.:08:09.

local council in England or Wales or anywhere else. "Here's Your

:08:10.:08:12.

financial settlement, here is what you have got to work with them." And

:08:13.:08:18.

the leading party and unable to say, sorry, we are not going to be able

:08:19.:08:22.

to accept that, we are going to set budgets were beyond that. We are

:08:23.:08:25.

going to just ignore the financial realities. We're not going to make

:08:26.:08:28.

any compromises which will safeguard the most vulnerable. The honourable

:08:29.:08:32.

lady had plenty of time to put her arguments. The fact that she was not

:08:33.:08:36.

able to bridge any convincing arguments to the House is her

:08:37.:08:40.

responsibility. I will set out very clearly, the fact of the matter is

:08:41.:08:45.

that financial responsibility, serious parties of government,

:08:46.:08:49.

parties that are serious about running countries and being in

:08:50.:08:54.

government, have to take difficult decisions within the financial

:08:55.:08:58.

parameters that they are set. Especially a devolved government.

:08:59.:09:02.

And if you just simply say we are not going to do that, keep we demand

:09:03.:09:07.

you give us more, have actually it leads to collapse. Let's remember

:09:08.:09:11.

that the people of Northern Ireland... Giveaway! The lady has

:09:12.:09:15.

had a opportunity to speak and I am not giving way. The reality is that

:09:16.:09:19.

the people of Northern Ireland have had their say. There was an election

:09:20.:09:24.

in May in which they delivered their verdict. On the whole social

:09:25.:09:29.

security Tobacco, in which they delivered their verdict in terms of

:09:30.:09:34.

how the DUP and other parties outperformed, and the SDLP and

:09:35.:09:38.

certain other parties had their worst result ever. In assembly

:09:39.:09:45.

elections. And the DUP was returned with one of its best result ever,

:09:46.:09:49.

back at the head of government in Northern Ireland. The people of

:09:50.:09:53.

Northern Ireland so very clearly what was going on. They recognised

:09:54.:09:59.

the parties, the politicians have to face up to their responsibilities.

:10:00.:10:01.

If they are not serious about that, they will be rejected at the polls.

:10:02.:10:08.

I also welcome the legislation and I wish the Minister in the Department

:10:09.:10:11.

for Work and Pensions, I know he has moved from the Department of

:10:12.:10:14.

Treasury, I wish him well in his work and also hope that we can come

:10:15.:10:20.

to a part where we do not need this legislation coming to the floor of

:10:21.:10:23.

the House of commons and we can get back to dealing with that in the

:10:24.:10:29.

Northern Ireland Assembly. Thank you very much, Madam Deputy Speaker. Let

:10:30.:10:34.

me conclude briefly by emphasising that this order fulfil the vital

:10:35.:10:38.

commitment made as part of the fresh start agreement. Today, we have had

:10:39.:10:43.

a robust debate on some of the historical aspect of how we got to

:10:44.:10:47.

this point. In the interests of time, I think it best I do not

:10:48.:10:51.

reflect further on that. Suffice to say, the two largest parties in the

:10:52.:10:54.

assembly signed up to the fresh start agreement, of which this

:10:55.:10:58.

legislation was a crucial part. Moreover, the assembly passed a

:10:59.:11:02.

legislative consent motion supporting the legislation to be

:11:03.:11:06.

done here in Westminster. I've read honourable member for Belfast North

:11:07.:11:14.

said, Northern Ireland has long kept parity on social security as set out

:11:15.:11:19.

in section 87 of the Northern Ireland act 1998, and restoring that

:11:20.:11:23.

parity is a crucial part of keeping the executive's finance and stable.

:11:24.:11:27.

What is in the legislation on the welfare supplementary payment will

:11:28.:11:34.

be put forward in all its detail by the executive and the assembly. In

:11:35.:11:40.

response to the specific question that the honourable lady from side

:11:41.:11:44.

to most about taxation, supplementary payments to nontaxable

:11:45.:11:49.

benefit will be nontaxable and supplementary payments to taxable

:11:50.:11:53.

benefits will be taxable. So the tax treatment will be the same as any

:11:54.:11:57.

current system. So, Madam Deputy Speaker, this order is a crucial

:11:58.:12:01.

part of delivering the start agreement. It will help build a

:12:02.:12:04.

politically and financially stable Northern Ireland and I commented to

:12:05.:12:09.

the House. The question is as on the order

:12:10.:12:10.

paper. As many as are of that opinion

:12:11.:12:11.

say "aye". Motion on the pensions act. Minister

:12:12.:12:27.

to move. Thank you, Madam Deputy Speaker. I beg is that the draft

:12:28.:12:33.

pensions act 2014 consequential amendments order 2016, which was

:12:34.:12:37.

laid before the size on the 4th of July, be approved. This order

:12:38.:12:44.

implements a small number of further minor consequential amendments in

:12:45.:12:47.

connection with the introduction of the new State Pension. It does two

:12:48.:12:53.

things. Firstly, it ensures that existing administrative arrangements

:12:54.:12:58.

which are designed to facilitate the annual operating exercise will

:12:59.:13:01.

continue to operate as they do now. And secondly giving appeal rights to

:13:02.:13:06.

decisions about national insurance credits that count for new State

:13:07.:13:13.

Pension purposes. So, if I deal with the amendments to do with up-rating

:13:14.:13:18.

first, Madam Deputy Speaker. Article two amends the Social Security

:13:19.:13:23.

Administration act 1992. The deals with alterations in the payable

:13:24.:13:28.

amount of certain income related benefits due to up-rating. That

:13:29.:13:30.

would be income support, income -based jobseeker's allowance, income

:13:31.:13:37.

related deployment and support allowance, universal credit and

:13:38.:13:44.

pension credit. These provisions allow an existing award of these

:13:45.:13:47.

benefits to be altered automatically to take account of the upgrading of

:13:48.:13:51.

another benefit in payment to the claimant or their partner or the

:13:52.:13:56.

need for a further decision by a decision maker. They can also enable

:13:57.:13:59.

the decision maker to take account of the new rates from the up-rating

:14:00.:14:03.

date when he or she is determining a new award that begins before the

:14:04.:14:07.

up-rating order is come into force, rather than having to revisit the

:14:08.:14:12.

award to apply the new rates at a later date. Article two retains

:14:13.:14:16.

long-standing administrative easements which support the annual

:14:17.:14:21.

operating exercise. So it is simply a case, Madam Deputy Speaker,

:14:22.:14:25.

delivering business as usual in a case where a person or their

:14:26.:14:28.

partner's benefiting covers the new State Pension. These amendments will

:14:29.:14:35.

therefore apply for the first time in April 2017, which, of course, is

:14:36.:14:38.

the first operating exercise for the new State Pension. Then the

:14:39.:14:44.

amendments to do with appeal rights for national insurance credits.

:14:45.:14:51.

Turning to article three, this amends schedule three to the

:14:52.:14:55.

security act 1998, which lists decisions which carry the right to

:14:56.:14:59.

appeal. The schedule already includes decisions on credits

:15:00.:15:05.

awarded under the all 1975 credit regulations, and also needs to

:15:06.:15:07.

include those provided for under part eight of the new State Pension

:15:08.:15:14.

regulations 2015. The policy intention is that decisions made in

:15:15.:15:16.

relation to these credits should have the right to appeal. This

:15:17.:15:22.

should have been an active with effect from the 6th of April 2016.

:15:23.:15:27.

And I regret to say, Madam Deputy Speaker, that it was overlooked and,

:15:28.:15:31.

as the law stands, they do not. This amendment makes good the mission and

:15:32.:15:35.

will come into force on the day after the order is made. Of course,

:15:36.:15:39.

this does mean that there is a period when decisions will be made,

:15:40.:15:42.

which it was intended should carry the right of appeal but which cannot

:15:43.:15:48.

a lot be appealed. These decisions are made by HMRC officials on the

:15:49.:15:53.

half of State for work and work and pensions and therefore my officials

:15:54.:15:58.

have been working very closely with HMRC to find a solution. That

:15:59.:16:01.

solution, Madam Deputy Speaker, involves a workaround. Once the

:16:02.:16:06.

order has come into force, any decisions that are made under the

:16:07.:16:09.

provisions in part eight of the State Pension regulation 2015 will

:16:10.:16:10.

be appealable. Birdie will be revisited in any

:16:11.:16:27.

decisions made prior. There will be no change in outcome from the

:16:28.:16:31.

original decision, hadn't been a peelable, and a fresh decision that

:16:32.:16:34.

is successfully appealed. A successful appellant will have

:16:35.:16:38.

credits awarded to them. Importantly, I can reassure the

:16:39.:16:42.

house that today no one has in practice been affected. This may

:16:43.:16:47.

seem unlikely at first glance, but there are a number of reasons for

:16:48.:16:51.

this. First, the omission can only affect certain decisions made since

:16:52.:16:55.

the 6th of April this year. Secondly, it only affects credit

:16:56.:17:00.

which a person has to apply for. The practical impact of this gap in the

:17:01.:17:03.

law relates only to decisions about credit, where a person has applied

:17:04.:17:09.

for since the 6th of April 2000 16. These include new credits which

:17:10.:17:13.

cover past periods in which a person was accompanying their Armed Forces

:17:14.:17:18.

spouse or civil partner on an overseas posting. Ordinarily,

:17:19.:17:22.

credits awarded for the tax year 2016 and 2017 will be taken into

:17:23.:17:25.

account only in the assessment of new state pension awards, which will

:17:26.:17:30.

be made after the six of April 2000 and 17. However, these new credits

:17:31.:17:32.

could affect state pension awards made since the 6th of April 2000 16.

:17:33.:17:39.

A further mitigation is that before a person can lodge an appeal, they

:17:40.:17:45.

have to ask for the decision to be reconsidered by a decision maker.

:17:46.:17:48.

That is the mandatory reconsideration. This enables the

:17:49.:17:55.

decision to be reconsidered and the facts taken into account in making

:17:56.:18:00.

it. Upon reflection, it is considered that the decision should

:18:01.:18:04.

be change, it can be changed without the claimant having to go through an

:18:05.:18:10.

appeal process. HRMC data from the last tax year tells us that there

:18:11.:18:16.

are fewer than ten cases where a decision under those 1975

:18:17.:18:19.

regulations was disputed and ended progressing to an appeal. And

:18:20.:18:25.

finally, we know that out of 324 applications for the new Armed

:18:26.:18:27.

Forces partner credits which have been refused, that is up to the 5th

:18:28.:18:31.

of September, 201 of these refusals were because of the tax year being

:18:32.:18:36.

applied for was already a qualifying year for other reasons, so the

:18:37.:18:39.

applicant wouldn't need the credit in order to establish their new

:18:40.:18:44.

state pension entitlement. It is an unfortunate situation, but I do hope

:18:45.:18:49.

I have reassured the house that even indicate where it did materialise,

:18:50.:18:52.

we have measures in place to ensure that whilst justice will be delayed,

:18:53.:18:57.

it may be denied. We are confident that no individual be disadvantaged

:18:58.:19:00.

by the oversight. Madam Deputy Speaker, I am sure you will be

:19:01.:19:07.

delighted that I can confirm that this is compatible with the European

:19:08.:19:12.

Convention of Human Rights and I commend the order to the house. The

:19:13.:19:20.

question is as on the order paper. I thank the Minister very warmly for

:19:21.:19:24.

the introduction of the order and if I could also take the opportunity to

:19:25.:19:28.

welcome him to his place? I know it is different and new and it is nice

:19:29.:19:32.

to see him there. And while I do recognise that this is principally

:19:33.:19:37.

tidying up existing legislation, and as such I will not be opposed in the

:19:38.:19:42.

order, I would like to make some comments in relation to both article

:19:43.:19:47.

two and three. Alongside the decision not to conduct an impact

:19:48.:19:53.

assessment. So relation to article two of the order, this enables the

:19:54.:19:58.

income related benefits awarded to recipients to be adjusted to account

:19:59.:20:02.

for additional income being received through an upgrading of the new

:20:03.:20:06.

state pension without requiring the Secretary of State oversight, as the

:20:07.:20:13.

gentleman has explained. This arrangement means that the old state

:20:14.:20:16.

pension is now carried forward into the new one, which is relatively

:20:17.:20:20.

uncontroversial. However, I would like to push the Minister on the

:20:21.:20:25.

specific changes in relation to entitlements for couples. The

:20:26.:20:28.

explanatory memorandum states that currently where one member of a

:20:29.:20:32.

couple has reached a qualifying age for pension credit, while the other

:20:33.:20:36.

has not, the couple can choose to claim either pension credit or the

:20:37.:20:42.

relevant working age benefit. The explanatory memorandum points out

:20:43.:20:45.

that most Jews to go for pension credit as should they choose to

:20:46.:20:50.

access the working age benefit, they will be subject to conditions which

:20:51.:20:55.

do not apply to pension credit. From 2018, it is planned to remove the

:20:56.:21:00.

option to claim pension credit, replacing it with universal credit

:21:01.:21:04.

for the next stage cobbles and making new claims. So can I what the

:21:05.:21:09.

proposed transitional arrangements are to cover these changes? Would

:21:10.:21:15.

someone covered by transitional protections who loses their

:21:16.:21:18.

entitlement to pension credit for a short period then be expected to

:21:19.:21:24.

roll into universal credit? How does the Government planted Unigate these

:21:25.:21:30.

changes, given the importance of the differences in the amount awarded of

:21:31.:21:34.

pension credit when comparing with other working age entitlements as

:21:35.:21:39.

well as the strict conditions on universal credit I am sure that the

:21:40.:21:44.

Minister will agree with me on the importance of ensuring that all

:21:45.:21:50.

those affected are well informed. Turning to Article three, this

:21:51.:21:53.

provides for a right of appeal against a decision as to whether a

:21:54.:21:58.

person is to be credited with earnings or contributions for the

:21:59.:22:01.

purposes of entitlement to the state pension. In relation to the old

:22:02.:22:04.

state pension for people who reached state pension age before the 6th of

:22:05.:22:10.

April 2016, there was already a right to appeal decisions as to

:22:11.:22:13.

whether the individual was eligible for a credits and this order, as the

:22:14.:22:19.

Minister has explained, this would apply to the new state pension. The

:22:20.:22:23.

expanded to memorandum states that this should have been taking place

:22:24.:22:30.

since 2016 was unfortunately overlooked and yes this omission is

:22:31.:22:34.

disappointing, not least for those that have been affected and while

:22:35.:22:39.

the Minister has taken some pains to explain that this hasn't affected

:22:40.:22:44.

anybody and there are measures in place to ensure that no one will

:22:45.:22:47.

lose out in relation to that, I would be grateful if you could write

:22:48.:22:51.

to me and clarify how many people have been denied a claim since the

:22:52.:22:59.

6th of April and who this might have affected, so women are for example

:23:00.:23:06.

or people from low incomes. And again, if you could confirm in

:23:07.:23:09.

writing to me with all those that have made applications for credits

:23:10.:23:16.

and were declined how this will be being resolved, I would be very

:23:17.:23:21.

grateful. I would also like to briefly touch on the related issue

:23:22.:23:24.

of take-up of national insurance credits. These cover circumstances

:23:25.:23:30.

in which people are not working and in some cases require an application

:23:31.:23:35.

to be made. In 2013, the Government acknowledged there was a low level

:23:36.:23:39.

of awareness and understanding of some national insurance credits such

:23:40.:23:42.

as carer's credit. It is said that the low take-up rates suggest that

:23:43.:23:46.

these credits work on and I quote, not achieving their stated aim of

:23:47.:23:49.

protecting the state pension position that individuals who take

:23:50.:23:53.

time out of paid employment due to caring responsibilities, and of

:23:54.:23:58.

course in many cases these are women. As the Minister will know,

:23:59.:24:01.

the Government undertook to review this system and developed a customer

:24:02.:24:07.

focused medication strategy and worked with outside agencies to

:24:08.:24:11.

encourage take-up. It said state pension statements, which

:24:12.:24:17.

individuals have to request would be the vehicle providing individuals

:24:18.:24:19.

with personalised information about their entitlement. In the debate on

:24:20.:24:22.

this order in the other place last week, the Minister of State for work

:24:23.:24:27.

reform said there were around 400,000 eligible people for carer's

:24:28.:24:35.

credit and in August, there are only 10,900 recipients, so according to

:24:36.:24:42.

my maps, it is about one in 40. And this is the very low proportion.

:24:43.:24:48.

Does the Government have plans to review its approach and look again

:24:49.:24:51.

at some of the recommendations by the work and pensions Select

:24:52.:24:55.

Committee report on allegations of the new state pension? Finally, I

:24:56.:25:00.

would like to push the Minister on the decision not to undertake an

:25:01.:25:05.

impact assessment when preparing the order. The Government argued that

:25:06.:25:09.

this order has no impact upon several organisations or the private

:25:10.:25:13.

sector. Is this not a really narrow interpretation of when you apply in

:25:14.:25:18.

impact assessment? I would be very concerned if this was the start of a

:25:19.:25:27.

precedent. And again, I would ask the Minister to look into that. I

:25:28.:25:33.

would like the Minister to reassure this side of the house that this is

:25:34.:25:38.

not setting a dangerous precedent. Again, we do know that impact

:25:39.:25:42.

assessment from this Government have tended to be rather inadequate.

:25:43.:25:49.

Thank you, Madam Deputy Speaker. Thank you very much, Madam Deputy

:25:50.:25:52.

Speaker, and let me welcome the Minister to his place. It is a

:25:53.:25:56.

pleasure to see him here and let me say again that those of us on our

:25:57.:25:59.

bench as you look forward to working with him to the benefit of

:26:00.:26:03.

pensioners. We on these benches welcome these measures in so far as

:26:04.:26:08.

this enables the award of certain income related benefits to be

:26:09.:26:11.

adjusted automatically when the new state pension is operated. Can I ask

:26:12.:26:16.

the Minister in bringing forward this measure where the consideration

:26:17.:26:20.

was given to the results of the EU referendum and the uncertainty that

:26:21.:26:24.

arises for the 400,000 UK pensioners living in EU countries? The house

:26:25.:26:30.

will be aware that long-standing rules enable the coordination of

:26:31.:26:33.

Social Security entitlements for people living within the EU. One

:26:34.:26:38.

result is that the UK state pension has risen in line. Elsewhere, the UK

:26:39.:26:50.

state pension is only operated if there is a reciprocal Social

:26:51.:26:53.

Security agreement requiring this. The Government could have taken the

:26:54.:26:55.

opportunity to deal with these measures to address the concerns of

:26:56.:27:02.

the 400,000 UK pensioners living in the EU. Can I ask the Minister why

:27:03.:27:08.

has this not been done? Does the Minister agree with me that those UK

:27:09.:27:13.

citizens who are residing in EU countries, who are entitled to a UK

:27:14.:27:16.

pension and annual increments as would be the case if they were

:27:17.:27:20.

residing in the UK, should have those rights protected with the

:27:21.:27:23.

Brexit vote? Can the Minister give an assurance today that this will

:27:24.:27:29.

happen? The Minister, when doing a Parliamentary answer on the issue on

:27:30.:27:33.

the 8th of July said, it will be for the next Prime Minister to determine

:27:34.:27:36.

along with the cabinet exactly the right approach to take in

:27:37.:27:39.

negotiating these provisions going forward. By the Government's guiding

:27:40.:27:43.

principle will be in ensuring the best possible outcome for the

:27:44.:27:48.

British people. Madam Deputy Speaker, given that the Prime

:27:49.:27:51.

Minister has had time to settle in, there has been ample opportunity to

:27:52.:27:55.

address this question. Can we have an answer today and remove this

:27:56.:28:01.

uncertainty for UK pensioners? Madam Deputy Speaker, prior to our entry

:28:02.:28:05.

into the UK, the UK had bilateral arrangements with a number of

:28:06.:28:10.

European countries. What will be the situation, where this was previously

:28:11.:28:13.

the case? Do they remain in force and can he reassure pensioners in

:28:14.:28:19.

those countries? Of course, what the measures in front of us today also

:28:20.:28:24.

failed to address the issue of the half a million UK pensioners living

:28:25.:28:30.

in territories where there is no annual operating. Why is the

:28:31.:28:34.

Government not bringing forward today plans to restore annual

:28:35.:28:39.

operating to all British pensioners, based on entitlement, regardless of

:28:40.:28:46.

domicile? Madam Debaty Speaker, it is morally unjust and truly unfair

:28:47.:28:51.

for the Government to strip the pensioners of their rights to equal

:28:52.:28:56.

state pension payments. There are a host of reasons why a pensioner may

:28:57.:29:00.

choose to move abroad in later life. Such as wanting to because of the

:29:01.:29:05.

family or friends. Or to enjoy a different lifestyle. It is simply

:29:06.:29:09.

wrong to punish them for making this choice. Pensioners who have paid the

:29:10.:29:15.

required national insurance conditions during their working

:29:16.:29:19.

lives, in expectation of a decent basic pension in retirement, will

:29:20.:29:22.

find themselves living on incomes that fall in real terms year on

:29:23.:29:28.

year. Payments of national insurance contributions in order to qualify

:29:29.:29:33.

for a state pension is mandatory. All recipients of the British state

:29:34.:29:36.

pensions have made these contributions, and the historically

:29:37.:29:42.

level of the pension has varied according to the level of contrition

:29:43.:29:46.

is made, it is clearly unfair to differentiate payments levels by any

:29:47.:29:50.

other criteria. Pensioners will now face ending their days in poverty

:29:51.:29:55.

because they choose to live in the wrong country. In most cases,

:29:56.:29:58.

without any knowledge of the invocations of the choice for their

:29:59.:30:03.

pension. Others are forced back into the UK, away from the family they

:30:04.:30:07.

love, just to secure an income they can retire on. All should receive

:30:08.:30:13.

their full and operated pension according to this contribution,

:30:14.:30:15.

regardless of where they choose to reside. The form would bring the UK

:30:16.:30:20.

in line with international norms, as most other developed countries do

:30:21.:30:23.

now pay their state pension equivalent in this way. We are the

:30:24.:30:28.

only all EEC the member who does not do so. Most pensioners have no idea

:30:29.:30:33.

that their pension would be frozen when they chose to emigrate. The

:30:34.:30:40.

frozen pension policy also acts as a disincentive to immigration, as the

:30:41.:30:46.

integration of people currently living in the UK who would like to

:30:47.:30:49.

emigrate and who are aware of the frozen pension policy know that they

:30:50.:30:52.

would not be able to afford to live on a state pension at its current

:30:53.:30:56.

level in the older years, by which time inflation will have decreased

:30:57.:31:00.

its value and decide not to move accordingly.

:31:01.:31:08.

There is a treatment of British pensioners and no consensus over how

:31:09.:31:15.

they are treated overseas. If you live in the US Virgin Islands, you

:31:16.:31:19.

get a feel UK State Pension, if you live in the British Virgin Islands,

:31:20.:31:23.

you do not. Overseas pensioners are entitled to fairness. The State

:31:24.:31:27.

Pension is, after all, a right, not a privilege. It is not a benefit, it

:31:28.:31:39.

is an entitlement to a pension based on paying National Insurance

:31:40.:31:41.

contributions. Madam Deputy Speaker, given the measures before us today,

:31:42.:31:44.

our provisions which support the annual exercise to upgrade payments,

:31:45.:31:50.

then I asked the Minister to clarify the government's positions on the

:31:51.:31:53.

triple lock? There have been suggestions that it may not survive.

:31:54.:31:59.

We on these benches to the support the continuation of the triple lock.

:32:00.:32:03.

It is the right thing to do to protect the interests of pensioners.

:32:04.:32:08.

While the Minister join me in the championing the triple lock and

:32:09.:32:12.

commit the government to continuing with that? Whilst we talk about

:32:13.:32:16.

pensioners' rates, equity and fairness, perhaps the Minister would

:32:17.:32:21.

like to tell us why, when we are discussing the State Pension, there

:32:22.:32:24.

is no mention of the Waspy woman and no solution to the injustice of many

:32:25.:32:27.

faith in this secondary legislation package? It is not right that women

:32:28.:32:33.

born after 1953 are having to wait so much longer than those born in

:32:34.:32:38.

previous years to collect their state pension. The government is

:32:39.:32:41.

going to have to bring forward mitigation to deal with these

:32:42.:32:45.

injustices and needs to do so quickly. Wired and omissions in this

:32:46.:32:49.

package to deal with this issue? Thank you very much. -- why are

:32:50.:32:58.

there no measures in this package? I am very grateful for the two

:32:59.:33:01.

honourable members for their contributions to this debate on this

:33:02.:33:05.

instrument today, but also for their kind words, which they appreciate. I

:33:06.:33:09.

am sure this'll be the first of many occasions which we take part such

:33:10.:33:13.

debates. If I may, very briefly, deal with the points the honourable

:33:14.:33:16.

gentleman from Ross, Skye and Lochaber made. I could take a long

:33:17.:33:23.

time to do it but affected just the very briefly that he is very aware,

:33:24.:33:27.

he has spoken many times on the frozen pensions issue, which I am

:33:28.:33:31.

aware of. But the policy on this issue is unchanged. It has been in

:33:32.:33:35.

place for almost 70 years, with all sorts of governments, and there is

:33:36.:33:40.

no plans to change it. The government complies with that legal

:33:41.:33:42.

obligations where there is reciprocal agreements with different

:33:43.:33:45.

countries, but there is no plans whatsoever, and I would not like to

:33:46.:33:51.

mislead him by saying that there are, there are no plans to change

:33:52.:33:54.

that. As far as the triple lock is concerned, he knows that the

:33:55.:33:57.

government, I would very happily send them a copy of the Conservative

:33:58.:34:01.

party manifesto if he is interested, I am sure it is still available from

:34:02.:34:07.

all good book shops! In fact, probably some bad book shops as

:34:08.:34:11.

well. But the government is committed to retaining a triple lock

:34:12.:34:14.

throughout this parliament and has said it several times in the past. I

:34:15.:34:21.

am happy to repeat it for him. That is not to ignore the honourable

:34:22.:34:25.

lady, but I will now return to the statutory instrument which she very

:34:26.:34:29.

kindly commented on. The transitional arrangements which she

:34:30.:34:37.

mentioned, to do for example with ending his choice for mixed age

:34:38.:34:43.

couples, really, the choice is ending because it is not

:34:44.:35:18.

couples, really, the choice is have been denied the right of appeal

:35:19.:35:20.

to date as result of this mission. I will check and if necessary respond

:35:21.:35:25.

to her in writing, but, to my knowledge, we do not all that

:35:26.:35:28.

information because administrative data is not originally collected by

:35:29.:35:35.

HMRC on volumes of all clinically administered credit, but I am happy

:35:36.:35:38.

to get back to her on that particular point. Very briefly,

:35:39.:35:46.

Madam Deputy Speaker, because I have had many honourable and Right

:35:47.:35:48.

Honourable members have had a lot of patience honours, but she asked, I

:35:49.:35:53.

would just like to tell her that the credit affected include applications

:35:54.:35:57.

in this case predominantly for spices and civil partners of members

:35:58.:36:02.

of the Armed Forces, as she said, but I must also say in respect of

:36:03.:36:06.

partners and recipients of child benefit, where entitlement to the

:36:07.:36:11.

credit is transferred to the applicant, for people providing care

:36:12.:36:15.

for a child under the age of 12, grandparents' credit, for being a

:36:16.:36:19.

foster parent and four persons approaching pensionable age. Welcome

:36:20.:36:25.

Madam Deputy Speaker, very briefly, I have explained as the beginning

:36:26.:36:30.

was the order covers, these consequential amendments. We have

:36:31.:36:33.

been through them both in really quite some detail. And I would like

:36:34.:36:40.

to say we have acknowledged the one that it was a gap in the law. The

:36:41.:36:44.

first time I have ever dealt with a gap in the law but there was a clear

:36:45.:36:48.

gap in the law and at least we have good mechanisms in place to make

:36:49.:36:51.

sure that nobody is disadvantaged and, fortunately, we have not yet

:36:52.:36:54.

needed to employ these because nobody has sought to appeal. I hope

:36:55.:37:00.

have provided the qualification the honourable member is required. I am

:37:01.:37:03.

very happy to speak to them separately on the occasion, should

:37:04.:37:10.

you require further clarification. I commend those order to the House.

:37:11.:37:15.

The question is as on the order paper.

:37:16.:37:16.

As many as are of that opinion say "aye".

:37:17.:37:18.

Motion number four on local government. I remember those that

:37:19.:37:34.

the Speaker has certified that this relates specifically to England at

:37:35.:37:39.

were devolved confidence, it is subject to double majority. All

:37:40.:37:43.

members of the House are able to vote in the division. Understanding

:37:44.:37:46.

order 83 Q, the motion will be agreed only if, of those voting,

:37:47.:37:52.

both the majority of all members and members representing constituencies

:37:53.:37:54.

in England vote in support of the motion. At the end, the tellers will

:37:55.:37:59.

report the results first for all members and secondly for those

:38:00.:38:02.

representing constituencies in England. Minister to move formally.

:38:03.:38:06.

The question as on the order paper. As many as are of that opinion

:38:07.:38:08.

say "aye". As many as are of that opinion

:38:09.:38:10.

say "aye". Tellers for the ayes mac. Sorry

:38:11.:39:52.

about that. Thank you. 290, ayes. Three noes. 271

:39:53.:52:06.

representing England and three noes. It is a double majority sold 290

:52:07.:52:14.

four aye, no 43. 271 from England. We now come to the opposition day in

:52:15.:52:46.

the name of the Leader of the Opposition. Mr J Deputy Speaker, I

:52:47.:52:56.

am glad to open this debate on the NHS sustainability and

:52:57.:52:59.

transformation plans. As the whole house knows, the NHS has a special

:53:00.:53:05.

place in the affections of our constituents. No other public

:53:06.:53:09.

service engages with ours all when we are at our most vulnerable.

:53:10.:53:16.

Birth, death, and illness. And the public, and obviously staff, are

:53:17.:53:23.

increasingly aware that the NHS is under severe financial pressure. And

:53:24.:53:27.

that I will return to. So it is in this context, the context of

:53:28.:53:37.

financial pressure and concern about the availability of services, that

:53:38.:53:39.

the sustainability and transformation plans are arousing

:53:40.:53:46.

concern. They sound like something anodyne and managerial, and there is

:53:47.:53:53.

undoubtedly a case for bringing health and social care stakeholders

:53:54.:53:56.

together to improve planning and coordination. But the concern is

:53:57.:54:02.

that in the outing the sustainability and transformation

:54:03.:54:07.

plans will be used to force cuts," but is, and actually make it harder

:54:08.:54:12.

for patients to access face to face consultants and above all that they

:54:13.:54:17.

opened the door to more privatisation. And I have to say

:54:18.:54:24.

that it tells the public how little the Secretary of State cares about

:54:25.:54:29.

their concerns that he is not in the chamber to either listen or respond

:54:30.:54:35.

to this debate. We know that recently he has missed all seven

:54:36.:54:41.

meetings of the NHS board, so the public is entitled to say, how much

:54:42.:54:46.

does he care about their very real concerns? I thank forgiving way. She

:54:47.:54:53.

mentioned the word cuts just now, but actually this Government is

:54:54.:54:55.

putting more money into the National Health Service, an extra ?10 billion

:54:56.:55:02.

a year and if the party opposite had no intention of making that sort of

:55:03.:55:06.

financial commitment to the NHS, as we saw in its failure to do so

:55:07.:55:11.

before the last election. The NHS was never a better funded than under

:55:12.:55:18.

the last Labour Government. And the public notice. This is why they

:55:19.:55:25.

trust us the NHS. I need to make progress. Order, order. As the

:55:26.:55:36.

honourable lady has just given weight, we do not need the cheering

:55:37.:55:43.

to go with it. I just want to check with my honourable friend, the last

:55:44.:55:49.

time I read Simon Stephens said that the SDP was designed to make up the

:55:50.:55:54.

?22 billion shortfall that the Government isn't prepared to

:55:55.:55:59.

Britain. Is that not the case? It is indeed the case that the

:56:00.:56:01.

sustainability and transformation plans, rather than just being an

:56:02.:56:06.

anodyne managerial exercise are indeed designed to make up the

:56:07.:56:18.

dissing ?22 billion. Alarming aspects of the sustainability plan

:56:19.:56:23.

has been their secrecy. England has been divided into 44 regional

:56:24.:56:27.

footprints and it is worth noting, they are called footprints to

:56:28.:56:32.

distract from the fact they are ad hoc regional structures, the exact

:56:33.:56:35.

same regional structures that the Tory health bill was supposed to

:56:36.:56:40.

sweep away. But because they are ad hoc and because they are

:56:41.:56:46.

non-statutory, they are also wholly unaccountable and in the world of

:56:47.:56:51.

the S T P, the public has no right to know. I am grateful to my

:56:52.:57:00.

honourable friend forgiving way. We have a leak of the one firm as

:57:01.:57:03.

desired and gesture, which says that there is an appetite for hospital

:57:04.:57:06.

reconfiguration as the existing setup is currently unaffordable.

:57:07.:57:11.

Given that it also says that there is almost a ?1 billion to be

:57:12.:57:16.

expected by 2021 and that the public have not yet been consulted, does

:57:17.:57:20.

she agree with me that when the public are consulted, there is going

:57:21.:57:25.

to be an absolute outcry? I believe this is a reason for the secrecy

:57:26.:57:32.

does far. The Government knows if the public understood what SDP

:57:33.:57:36.

meant, there would be an outcry. So in fact, initially... I am very

:57:37.:57:42.

grateful to the honourable lady for giving way. Would she agree with me

:57:43.:57:47.

that unless the local community are fully engaged in the process of

:57:48.:57:51.

considering how the health and care system needs to change in their

:57:52.:57:55.

area, then it is destined to failure? The process simply will not

:57:56.:58:02.

work. I am grateful. For nearly the whole time I have been in

:58:03.:58:06.

Parliament, there have been attempts to reconfigure hospitals, close A,

:58:07.:58:15.

make these changes. In London, what we have found is that where the

:58:16.:58:19.

local community doesn't take ownership of these plans, it is

:58:20.:58:24.

impossible to take them forward, and the secrecy actually runs counter to

:58:25.:58:33.

making the real reorganisations that we may have to make. So initially,

:58:34.:58:46.

the STP where not publishing their plans. No minutes of the board

:58:47.:58:50.

meetings existed. We are bound to ask, if these plans are really in

:58:51.:58:55.

the interests of patients and the public, White has everyone been so

:58:56.:59:01.

anxious that patients and the public know as little as possible? In some

:59:02.:59:10.

cases, even local GPs have not been fully involved in decision-making.

:59:11.:59:17.

Honourable members may not take it seriously, but I assured them that

:59:18.:59:20.

their constituents will. GP leaders... Order, order. Can I just

:59:21.:59:28.

suggest, it is up to the Honourable Lady whether she wishes to give way

:59:29.:59:31.

or not. Shouting and screaming will not help but the debate because

:59:32.:59:35.

members also want a year on both sides, so please, I am a charming

:59:36.:59:38.

that when the Honourable Lady wants to give way, she will do. Screaming

:59:39.:59:40.

will not help. GP leaders have said that plans to

:59:41.:59:57.

transform general practice and transform what other secondary

:59:58.:00:00.

killer into general practice are already vast and lead a only at this

:00:01.:00:04.

late stage have they been shared with GB providing representatives.

:00:05.:00:10.

The Freedom of Information requests are also uncovered the substantial

:00:11.:00:13.

goal of the private sector in formulating these plans. GE

:00:14.:00:18.

Fenimore, for example, is advising across the South and I have no doubt

:00:19.:00:21.

the work is underway for them to get larger slices of the action of the

:00:22.:00:26.

future. In the name of transparency, does she agree that all these

:00:27.:00:30.

motions should be publishing -- boards should be publishing who is

:00:31.:00:34.

on them and declare their interests? I entirely agree. All of these FTPs

:00:35.:00:40.

should be publishing who is on them, what their financial interests are

:00:41.:00:44.

and also how far advanced they are in the planning. However, thanks to

:00:45.:00:54.

the work of organisations like Open Democracy, 38 Degrees and also,

:00:55.:01:00.

frankly, leaks, the picture of what these FTPs will mean is becoming

:01:01.:01:05.

clearer. We know from the information we have been able to

:01:06.:01:10.

glean that the reality of a sustainability and transformation

:01:11.:01:16.

plans is in fact quite concerning. For instance, in the Black Country

:01:17.:01:20.

there are plans for major changes to front line services in the Midlands

:01:21.:01:24.

Metropolitan Hospital, including the closure of the hospital's A The

:01:25.:01:29.

plans also propose to close one of the two Leicester General Hospital

:01:30.:01:33.

's as part of a planned merger, and we know that by 2021 the Health and

:01:34.:01:39.

Social Care Act system in the Black Country is projected to be 476.6

:01:40.:01:45.

million short of the funds it needs to balance its books. And members

:01:46.:01:51.

opposite me shout now, but they are going to need an answer for their

:01:52.:01:57.

constituents when the reality of some of these proposed closures

:01:58.:02:02.

becomes apparent. In Leicester, Leicestershire and Rutland there are

:02:03.:02:06.

apparently plans to reduce the number of hospitals in the area from

:02:07.:02:12.

three to two and by 2021 the Health and Social Care Act system in the

:02:13.:02:16.

area will be 700 million short of the money it needs to balance its

:02:17.:02:19.

books. And in Southwark and North East Essex the uprating plan refers

:02:20.:02:26.

to the reconfiguration of acute services that are local hospital,

:02:27.:02:30.

Colchester Hospital University trust, and the whole house knows

:02:31.:02:36.

that historically reconfiguration in the NHS has meant cuts, and there

:02:37.:02:40.

are also plans to close GP practices. While the honourable lady

:02:41.:02:49.

give way?! And the context to these plans, of which I have given an

:02:50.:02:55.

idea, is the current NHS financial crisis. Most recently we have heard

:02:56.:02:59.

from NHS providers about this financial crisis and they represent

:03:00.:03:05.

the NHS acute, ambulance community and mental health services, and what

:03:06.:03:09.

NHS providers say is that despite the best efforts of hard-working

:03:10.:03:16.

staff, including, I might say, junior doctors, hospital Accident

:03:17.:03:20.

and Emergency performance is the worst it has ever been. Waiting

:03:21.:03:25.

lists for operations, 3.9 million, I've high as they have been since

:03:26.:03:30.

December 2007 and we ended the last financial year with trusts reported

:03:31.:03:35.

the largest deficit in the history of the NHS. 2.45 billion. I have to

:03:36.:03:45.

make a little progress. So, many STPs will be facing a large

:03:46.:03:50.

financial deficit. And I say to members opposite who do not seem to

:03:51.:03:56.

take this debate seriously, when... SHOUTING

:03:57.:04:02.

When their constituents come to them asking about these cuts and

:04:03.:04:08.

closures, they will have to take it seriously then. So, many STPs will

:04:09.:04:16.

be faced with a large financial deficit, which is subject to control

:04:17.:04:21.

total staters cuts. In the case of north-west London, which does not

:04:22.:04:24.

have the largest projected deficit by any means, spending on acute care

:04:25.:04:30.

is predicted to fall in nominal terms over a six-year period,

:04:31.:04:34.

despite a population which is both increasing and ageing and cost

:04:35.:04:38.

pressures such as the sharply rising cost of drugs. STPs have made an

:04:39.:04:45.

assessment of their own deficits by 2021, researchers have just caused

:04:46.:04:54.

that approximately 29 of those 44 STPs have projected substantial

:04:55.:04:57.

deficits. I have to make some progress. Point of order. It is a

:04:58.:05:07.

requirement of the member of the size to know the difference between

:05:08.:05:11.

a debate and a monologue. Then it is for me to make that decision. I am

:05:12.:05:14.

quite happy for the shadow of Secretary of State to decide whether

:05:15.:05:18.

she wishes to give way or not. It is the opposition debate and she is

:05:19.:05:25.

leading that debate. Let's not have any more points of order because I

:05:26.:05:28.

am very worried about the numbers of last and I want to try to get

:05:29.:05:32.

everybody in. Diane Abbott. So, when the STPs talk about efficiency, they

:05:33.:05:37.

actually meant cuts. And increasingly at the heart of these

:05:38.:05:44.

are asset sales of land, buildings to cover deficits. No wonder the

:05:45.:05:49.

leader of Hammersmith and Fulham Council has said that his local STP,

:05:50.:05:57.

this is about closing hospitals and getting capital receipts. He goes

:05:58.:06:01.

on, it is a cynical rehab of earlier plans. It is about the breaking up

:06:02.:06:08.

and the selling off of the NHS. And the King 's fund has said, I have to

:06:09.:06:11.

make progress. The King 's fund has said there are some concerns that

:06:12.:06:16.

NHS leaders have focused their efforts on plans for are considering

:06:17.:06:22.

hospital services, despite the evidence that major acute

:06:23.:06:24.

reconfigurations actually rarely save money and sometimes failed to

:06:25.:06:31.

improve the quality of care. The BMA has said the same thing. And the

:06:32.:06:38.

King's fund has said the cuts under the FTPs are eye-watering, and the

:06:39.:06:43.

Health Select Committee, I am anxious to complete my remarks so

:06:44.:06:46.

you can get a chance intervene to stop and the Health Select

:06:47.:06:51.

Committee's recent reports about the impact of the 2015 spending Review

:06:52.:06:56.

stated at present the sustainability transformation fund is being used

:06:57.:07:02.

widely to suspend, in the form of logging provider deficits, rather

:07:03.:07:05.

than transforming the system at scale and pace. As the financial...

:07:06.:07:11.

If the financial situation of trust is not resolved, or worse

:07:12.:07:17.

deteriorates further, it is likely that the overwhelming majority of

:07:18.:07:22.

the FTP -- the STP fund will be continued to be used to great

:07:23.:07:26.

short-term problems, rather than support long-term solutions. Will

:07:27.:07:36.

she give way? The other... The other aspect of the STPs, in order to cut

:07:37.:07:44.

expenditure, is a combination of factors, including the use of new

:07:45.:07:49.

technology, apps, scared, patients taking more responsibility for their

:07:50.:07:52.

own health, new pathways for elderly care, increased reliance on

:07:53.:07:57.

volunteers and the downgrading of treatment by skills, responsibility

:07:58.:08:01.

and pay bands. It seems to be that these proposals, whilst having fun

:08:02.:08:04.

at merit in themselves, is delusional to imagine that they will

:08:05.:08:10.

deal with the financial black hole and the NHS. There is no evidence

:08:11.:08:16.

that in the patient population as a whole increased use of apps, skate

:08:17.:08:20.

and telemedicine can produce the efficiency is required whilst

:08:21.:08:26.

expecting units, Department and hospitals are being closed. And I

:08:27.:08:32.

would remind the House, many of them on a weekly basis speak to their

:08:33.:08:35.

constituents by surgery, the truth is that when you are speaking to

:08:36.:08:38.

people face-to-face, it is often towards the end of a conversation

:08:39.:08:42.

that they come out with what really concerns them. And my concern about

:08:43.:08:48.

the increased use of video calls is that many patients will not get that

:08:49.:08:53.

familiarity and comfortable nice to actually say at the end of the

:08:54.:08:57.

session what it is they are concerned about. Will she give way?

:08:58.:09:05.

Clearly, the plans took a great deal into preventative medicine. This

:09:06.:09:08.

would indeed have the effect of lowering demand for acute NHS care,

:09:09.:09:12.

but would also require a very substantial investment in public

:09:13.:09:16.

health programmes and this Government is just not funded. The

:09:17.:09:20.

elderly, the poor, patients for whom English is not their first language,

:09:21.:09:25.

are the least likely to use these apps and this telemedicine and

:09:26.:09:31.

Skype. -- and video calls. It is inappropriate to expect elderly

:09:32.:09:37.

patients, the biggest users of acute care, to use online video calls for

:09:38.:09:41.

any sensitive matter. And new pathways for the elderly as an idea

:09:42.:09:45.

is sufficiently vague to raise alarm bells, given the projected rise in

:09:46.:09:50.

demand for geriatric services and the continuing cuts in social care

:09:51.:09:53.

funding. SHOUTING

:09:54.:10:00.

I am very grateful to my honourable friend.

:10:01.:10:02.

She is making a very important point, because she has already

:10:03.:10:06.

touched on the financial problems in the NHS, but aligned doubles at the

:10:07.:10:10.

financial problems in adult social care. We are not going to get that

:10:11.:10:17.

truly integrated Health and Social Care Act that we all desire with

:10:18.:10:20.

these STPs been swept under the doors without people knowing

:10:21.:10:24.

precisely what it means to public services in their areas. My

:10:25.:10:30.

honourable friend makes a very important point. The danger is that

:10:31.:10:36.

in a blizzard of apps and Skype, patients will find it harder to

:10:37.:10:40.

access one-to-one care, particularly the elderly, and those that can

:10:41.:10:43.

afford it will find themselves forced into the private sector. And

:10:44.:10:48.

now, a word about the increasing private sector involvement in the

:10:49.:10:56.

NHS. It is the NHS England director of STPs, Michael McDonald, who has

:10:57.:11:03.

said they the private sector and third sector organisations an

:11:04.:11:08.

enormous amount of opportunity. We know that Price Waterhouse Coopers

:11:09.:11:11.

has been very heavily involved in the formulation of a large number of

:11:12.:11:19.

these plans and, as was referenced earlier, other companies have been

:11:20.:11:23.

heavily involved in the formulation of plant on the South West and

:11:24.:11:27.

possibly wait. The strong suspicion is that the combination of cuts,

:11:28.:11:30.

reorganisation of service on a geographical basis and the growth of

:11:31.:11:35.

hospital chains will all facilitate the greater privatisation of the

:11:36.:11:40.

NHS. SHOUTING

:11:41.:11:44.

In drawing to a close... GROANING

:11:45.:11:52.

It is absolutely right that Health and Social Care Act stakeholders

:11:53.:11:54.

should come together to plan for the future. It is absolutely wrong that

:11:55.:11:59.

social transformation plans should be hatched in secret and

:12:00.:12:08.

increasingly clear that social transformation plans may be a

:12:09.:12:11.

stalking horse for more privatisation. Members opposite may

:12:12.:12:16.

not take this issue seriously... SHOUTING

:12:17.:12:24.

Members opposite may not take this issue seriously, but, and members

:12:25.:12:32.

opposite response may be too shot, but I stress to this has the

:12:33.:12:37.

consequences of these STPs will be very material for all our

:12:38.:12:45.

constituents. And very material also for those that work in the NHS. So,

:12:46.:12:53.

I take this issue seriously. This is why we have called this debate, and

:12:54.:12:57.

I await with interest what ministers have to say. The question is as of

:12:58.:13:10.

the order paper. Thank you very much indeed, Mr Deputy Speaker. It is a

:13:11.:13:14.

pleasure to be here today. I would like to start by welcoming the

:13:15.:13:18.

honourable lady to her post. I think this is the first time she has

:13:19.:13:24.

spoken from the dispatched box in opening a debate in her present

:13:25.:13:27.

position and I am pleased also to be doing so for the first time for our

:13:28.:13:31.

site. I think she was appointed to her post about three weeks before

:13:32.:13:37.

me, so we are both on a steep learning curve, I think it would be

:13:38.:13:40.

courteously. I am very pleased that she has chosen as a object for today

:13:41.:13:44.

was my debate to discuss the sustainability and transformation

:13:45.:13:47.

plans, because it gives me the opportunity to correct some of the

:13:48.:13:52.

misconceptions that she has just revealed, and, more importantly, to

:13:53.:13:56.

inform the whole house of the status of these plans within the NHS. And I

:13:57.:14:01.

would like to start by reminding the House of the origins of these plans.

:14:02.:14:07.

The NHS's on plans for the future, set out in the five-year forward

:14:08.:14:12.

view, and endorsed by this Government, but not, as it happens,

:14:13.:14:16.

endorsed by the party opposite, recognised three great challenges

:14:17.:14:20.

facing the NHS. Health and well-being, care and quality and

:14:21.:14:26.

finance and efficiency. Will he give way? I am most grateful to him for

:14:27.:14:30.

giving way. Can I add my congratulations in saying how

:14:31.:14:33.

delighted I am to see him at the dispatch box, doing such a crucial

:14:34.:14:38.

pre-. While he is on his steep learning curve, and the Hereford

:14:39.:14:41.

Hospital and understand the difficulties that rural patients

:14:42.:14:46.

face and they would he can do to help us? I am delighted to be able

:14:47.:14:50.

to accept that invitation on behalf of my neighbour and friend. Not

:14:51.:14:53.

least because many of my constituents looked to Hereford

:14:54.:14:57.

Hospital for their acute care, and it is one of the hospital trusts in

:14:58.:15:01.

special measures, which is my specific responsibility, for I would

:15:02.:15:04.

forward to seeing him there, perhaps even during the coming recess. I

:15:05.:15:11.

will. When I am very grateful and wish the Minister all the best for

:15:12.:15:17.

his new role. With the share my concern at the fact that around the

:15:18.:15:20.

country there is evidence that in many areas mental health is

:15:21.:15:25.

peripheral to this STP process? And will he ensure that every STP plan

:15:26.:15:29.

will not be accepted unless mental health is absolutely central to what

:15:30.:15:32.

they are doing? I am grateful for that intervention,

:15:33.:15:36.

not least for the honourable member who has taken such a personal

:15:37.:15:39.

interest in the subject and I can confirm that mental health is one of

:15:40.:15:42.

the issues which will be addressed by each of the plans that are going

:15:43.:15:54.

to be taken forward. I hope that reassurance will see its way

:15:55.:15:56.

through. I am going to make a little bit of progress. The issues facing

:15:57.:16:01.

Hackney are not the same as those based in Ludlow and a single

:16:02.:16:06.

national plan would not be effective or appropriate. Indeed, the Labour

:16:07.:16:12.

Party recognises in the general election manifesto, which most

:16:13.:16:15.

people on that side of the House stood on, it said to reshape

:16:16.:16:19.

services over the next ten years, the NHS will need the freedom to

:16:20.:16:23.

collaborate, integrate and merge across organisational divides.

:16:24.:16:32.

Could the minister let me know what percentage of acute trusts are in

:16:33.:16:42.

deficit and what proportion of CCGs are in special measures? Many trusts

:16:43.:16:52.

in the last financial year were in deficit and those deficits were

:16:53.:16:54.

funded by the Department of Health. Looking forward, we are using the

:16:55.:16:59.

financial discipline of control totals not to instigate cuts but to

:17:00.:17:06.

hold the accountable managers to account for delivering within the

:17:07.:17:12.

financial envelope. This is what responsible government and

:17:13.:17:16.

administration does. We give money to public services and expect them

:17:17.:17:21.

to live within their means. This year, the NHS has received one of

:17:22.:17:24.

the largest cash settlements it is ever had. Over three times more than

:17:25.:17:26.

the rate of inflation. Can I ask my honourable friend to

:17:27.:17:45.

look very closely at STP footprints? For those of us who represent ball

:17:46.:17:51.

errors, our experience is aligning our areas with more urban centres

:17:52.:17:56.

can very often mean a constituents get a raw deal. Since my footprint

:17:57.:18:01.

includes urban areas in Bath in Swindon, I am concerned that the

:18:02.:18:06.

same thing may happen again. If I manage to get there, I will come

:18:07.:18:11.

onto the Prince and how it was that 44 areas were identified. It is

:18:12.:18:18.

clearly the case that in rural areas in Wiltshire and Shropshire, we look

:18:19.:18:23.

to urban areas to provide acute care for all of our local residents. It

:18:24.:18:30.

is appropriate that the print areas are sufficient to encompass both the

:18:31.:18:33.

acute and full range of primary sectors. Can he tell the House what

:18:34.:18:46.

is happening in relation to bed blocking and what the government is

:18:47.:18:52.

doing to deal with the impact on the community? He races a critical

:18:53.:18:57.

point. One of the real challenges facing the NHS is how to make

:18:58.:19:02.

discharge out of the acute setting right the way through the patient

:19:03.:19:09.

flow more effective. That is precisely why we are looking at

:19:10.:19:13.

bringing the local authorities into the footprints for these STPs so the

:19:14.:19:19.

entire patient pathway can be taken into account. I will give way to the

:19:20.:19:24.

honourable member for Colchester, who has been the most persistent...

:19:25.:19:35.

Chelmsford in Essex, sorry. I am very grateful to my honourable

:19:36.:19:41.

friend. So that there can be no misunderstanding, because the Shadow

:19:42.:19:45.

Secretary of State does not seem to have fully grasped the brief, will

:19:46.:19:50.

my honourable friend, with his superior knowledge, explain

:19:51.:19:56.

categorically to the House about transparency in the health service,

:19:57.:20:04.

not only regarding STPs, but other reconfigurations that always

:20:05.:20:09.

automatically has to be a public consultation with local communities

:20:10.:20:19.

before any decisions are made? My honourable friend does have a great

:20:20.:20:23.

deal of experience in this area, having served in the Department for

:20:24.:20:31.

many years. He pre-empts the remarks I am proposing to make about

:20:32.:20:39.

precisely how these STPs are subject to full and appropriate public

:20:40.:20:43.

consultation. I will now proceed with my remarks, as I have been

:20:44.:20:52.

quite generous already. As part of NHS England's annual planning round

:20:53.:20:58.

in 2015, NHS England published planning guidance in December last

:20:59.:21:03.

year, nine months ago, which called for clinical commissioning groups to

:21:04.:21:07.

come together with their providers across entire health economies to

:21:08.:21:11.

develop a collective strategy for addressing the challenges in their

:21:12.:21:17.

area. These are the sustainability and transformation plans. There are

:21:18.:21:20.

44 of these areas and the areas were agreed in March, six months ago,

:21:21.:21:26.

covering the whole of England, bringing together multiple

:21:27.:21:29.

commissioners and providers in a unique exercise in collaboration.

:21:30.:21:33.

These geographies have been determined not by central diktats

:21:34.:21:40.

but by what commissioners have felt made the most sense locally. Each

:21:41.:21:46.

area has also identified a strong senior leader who has agreed to

:21:47.:21:50.

chair and lead the STP process but half of their peers. These are well

:21:51.:21:55.

respected credible figures in their local health economies and we in NHS

:21:56.:21:59.

England are committed to supporting them, to bring people together to

:22:00.:22:04.

agree a shed plan for how best to improve and sustain health services

:22:05.:22:10.

for their local populations. Local authorities are also fully engaged

:22:11.:22:14.

in the development of these plans. In some cases, local authorities

:22:15.:22:23.

that a senior council leader is leading the STP, and this is

:22:24.:22:26.

happening in Birmingham, for example. In Merseyside and Cheshire,

:22:27.:22:36.

it is clear from the leaked document that they are looking by 2021 to

:22:37.:22:43.

save ?1 billion. In that context, does he not believe that proposals

:22:44.:22:49.

to merge hospitals and cut services in Liverpool will lead to an

:22:50.:22:55.

absolute outcry when the secret proposals that have been leaked

:22:56.:23:01.

finally get consulted upon? I think the honourable lady is leaping far

:23:02.:23:06.

too far ahead. There are no proposals at this point. I will come

:23:07.:23:13.

on to explain the state of STPs shortly. There are a number of draft

:23:14.:23:20.

ideas to try to improve the services delivered to patients. Looking to

:23:21.:23:23.

the future and the efficiencies that need to be provided, as part of the

:23:24.:23:30.

five-year forward view, the NHS leadership asks the government to

:23:31.:23:35.

fund ?1 billion of additional cash into the NHS. We provided 10

:23:36.:23:41.

billion. The Labour Party refused to provide anything like it. And in

:23:42.:23:46.

return, the NHS agreed to look for ?22 billion of efficiencies up to

:23:47.:23:51.

2020. We have assisted them to the efforts of Lord Carter, who we are

:23:52.:23:58.

asked to undertake a review. He has identified ten work streams where

:23:59.:24:01.

there are clear of efficiencies that can be found, many of which have

:24:02.:24:08.

been identified by members opposite. The Shadow spokesman herself has

:24:09.:24:12.

referred in the past the areas where there is waste in the NHS and the

:24:13.:24:19.

recent comments in the newspapers this week from the former chair the

:24:20.:24:22.

Public Accounts Committee referred to some spending practice in the NHS

:24:23.:24:27.

is absurd. It is trying to put some of these things right there have

:24:28.:24:31.

been swept under the carpet for too long. I would like to turn to the

:24:32.:24:35.

timetable on progress so far. Each area was asked to work together for

:24:36.:24:39.

the first six months to draw up their initial thinking into a first

:24:40.:24:45.

draft plan. It was published internally up to the NHS England by

:24:46.:24:50.

the end of June. These were individually reviewed by senior

:24:51.:24:56.

leaders from NHS England during July and August. Each area is now in the

:24:57.:25:01.

process of developing their STP with a view to submitting a work Duplan

:25:02.:25:06.

the NHS England in October. The plans as one would expect will vary

:25:07.:25:12.

in-depth proposals but all I expected to demonstrate a shared

:25:13.:25:15.

understanding of where an error is in relation to the three challenges

:25:16.:25:18.

set out in the five-year forward view and where they need to be by

:25:19.:25:26.

2020 -- 21. The last time I had the opportunity to give way, he was very

:25:27.:25:33.

generous. Part of the concern in my constituency about the north-west

:25:34.:25:36.

London STP relates to the fact that Harrow receives less per patient

:25:37.:25:42.

than any other part of London. We have sought for some months a

:25:43.:25:47.

meeting with a minister and I want to discuss that very issue. But the

:25:48.:25:52.

minister himself be prepared to receive a delegation from our

:25:53.:25:54.

clinical commissioning group to discuss this issue? I am grateful to

:25:55.:26:04.

him for his kind words about my willingness to take interventions

:26:05.:26:10.

from both sides of the House. Funding allocations across the NHS

:26:11.:26:15.

are a legacy of the allocation formulas set in place by the

:26:16.:26:19.

government of which he was a member during the last Labour government.

:26:20.:26:23.

There are people all across the country, not least in rural areas

:26:24.:26:26.

like Shropshire, who cannot understand why it is that the

:26:27.:26:31.

funding per capita in some parts of the country are much less generous

:26:32.:26:36.

than others. This is something I am taking an interest in. I would be

:26:37.:26:39.

willing to sit down with him and colleagues to understand what the

:26:40.:26:43.

particular circumstances are in north-west London. We will have to

:26:44.:26:47.

do that after the coming recess. I will go back to the progress made

:26:48.:26:53.

with these plans. In addition to what I have just said, they are all

:26:54.:26:57.

expected to present a strategy for their area and identified the top

:26:58.:27:01.

3-5 priorities required to deliver it. The most advanced plans, we are

:27:02.:27:07.

also expecting areas to sit at how they will deliver national

:27:08.:27:12.

priorities. They will include mental health and diabetes. Some will build

:27:13.:27:19.

on the early work which has been developing better coordinated models

:27:20.:27:25.

over the past year or so. These plans for the NHS is a unique

:27:26.:27:28.

opportunity to think strategically. For the first time, the NHS is

:27:29.:27:34.

planning across multiple organisations. Commissioners and

:27:35.:27:37.

providers with local authorities to address the health needs of Mary and

:27:38.:27:42.

the people it serves. Also for the first time, the NHS is producing

:27:43.:27:47.

multi-year plans, showing clearly how local services will develop over

:27:48.:27:51.

the next five years to deliver real improvements in patient care and

:27:52.:27:56.

better efficiency to ensure continued sustainability of the NHS

:27:57.:28:01.

to cope with rising demand from our ageing population. This is leading

:28:02.:28:07.

some STPs to face up to tough choices. Choices that may have been

:28:08.:28:12.

postponed because they were always too hard or relied on individual

:28:13.:28:17.

organisations operating on their own to shoulder the responsibility

:28:18.:28:21.

rather than share it across the geography or whole health care

:28:22.:28:28.

economy. Does he recognise the concerns in constituencies like

:28:29.:28:32.

mine, a border constituency with Wales, which suffers from pressures

:28:33.:28:38.

due to numerous closures of hospitals in Wales by the Welsh

:28:39.:28:42.

Labour government and the pressures that places on the Cheshire and

:28:43.:28:52.

Merseyside? I share a border with Wales like she does so I am acutely

:28:53.:28:57.

aware that patients in Wales have to wait longer, get less good access to

:28:58.:29:02.

treatment in Wales and England, and many of them are looking to English

:29:03.:29:06.

hospitals to provide the service that is not available in Wales in

:29:07.:29:11.

part because of a conscious political decision for less funding

:29:12.:29:14.

to go to the health service in Wales by the worst government. I met a

:29:15.:29:24.

young surgeon last week. She was caring. She was so dedicated that it

:29:25.:29:28.

made me proud that she worked for the NHS but I was not proud to hear

:29:29.:29:34.

about the facility she has to work in following the cancellation of a

:29:35.:29:40.

hospital project in 2010. They can have as many plans as they like but

:29:41.:29:43.

if you do not have the infrastructure, he cannot deliver

:29:44.:29:49.

the care that some of our communities require. There is

:29:50.:29:53.

undoubted pressure on infrastructure is there is an technology, and as

:29:54.:29:58.

technology improves and becomes available to the NHS, it provides

:29:59.:30:02.

opportunity for much more care to be undertaken closer to the patient,

:30:03.:30:08.

increasingly in or near their home. That will have consequences for the

:30:09.:30:15.

infrastructure we have. Some of that will lead the reconfiguration of

:30:16.:30:21.

existing hospital services. There is a programme of relegation against

:30:22.:30:25.

our hospitals and cannot get everywhere at the same time. I

:30:26.:30:28.

apologise to the honourable gentleman for not leaving a shiny

:30:29.:30:33.

new hospital like you would like but there is a building programme which

:30:34.:30:34.

will continue in the future. As you are aware, we have particular

:30:35.:30:46.

issues in Cumbria which has led to as having the success regime, we are

:30:47.:30:51.

about to go to consultation on that in key areas like maternity, AMD. My

:30:52.:30:59.

constituencies are concerned about how this is going to fit in with the

:31:00.:31:05.

success regime. Would it not be a challenge and confusing? This will

:31:06.:31:13.

become subsumed within the STP but the attractions, the advantages for

:31:14.:31:19.

those areas in the success regime are that it means that the areas

:31:20.:31:25.

have been working together for longer than the pure STP areas and

:31:26.:31:31.

will have benefit with the maturity of their plan. I'm not going to take

:31:32.:31:34.

any more interventions because I have to wind up shortly. The

:31:35.:31:43.

honourable lady has raised in her remarks are some concerns I'd like

:31:44.:31:48.

to address before I wind up. She has said that the STPs will result in

:31:49.:31:55.

significant cuts and changes to front line services. For all her

:31:56.:31:59.

protestations, these plans are not about cuts. They are about local

:32:00.:32:04.

areas including provision is and providers coming together to improve

:32:05.:32:09.

services in the medium and long-term. Some areas are taking

:32:10.:32:13.

difficult decisions to tackle long-term problems but this will be

:32:14.:32:19.

subject to rigorous and national security. I can categorically assure

:32:20.:32:25.

the lady that no changes will occur without consultation and in the

:32:26.:32:33.

normal process of reconfiguration. She has accused the process of

:32:34.:32:38.

lacking transparency and time. Planning within the NHS is not new.

:32:39.:32:43.

There is an annual planning round which culminates in December each

:32:44.:32:53.

year. Since then, local STP leads have been engaging locally as they

:32:54.:32:57.

deemed appropriate. There has been no secret. For the first time in

:32:58.:33:03.

years, different NHS bodies with local authorities have been working

:33:04.:33:06.

collaboratively to develop these plans. The 44 local areas are

:33:07.:33:12.

submitting plans to NHS England for consideration in October. The NHS

:33:13.:33:16.

will scrutinise these plans and make recommendations over which to take

:33:17.:33:21.

forward and prioritise for formal consultation which will follow.

:33:22.:33:26.

Implementation will take place once the feedback has been assessed so

:33:27.:33:30.

that from early next year, this implementation will begin with the

:33:31.:33:38.

time is dependent on each individual area's specific proposal. The

:33:39.:33:41.

honourable lady has claimed that it does not allow for sufficient

:33:42.:33:47.

parliamentary engagement. The proposals remain at draft stage but

:33:48.:33:51.

the local authorities are responsible for in gauge went with

:33:52.:33:54.

local stakeholders when they are ready and proposed changes will be

:33:55.:33:59.

subject to local consultation. Many have engaged with the groups of

:34:00.:34:03.

clinicians and other stakeholders in their areas already in providing

:34:04.:34:09.

draft plans. Local areas will be launching public consultation

:34:10.:34:12.

shortly once updated plans have been scrutinised by NHS England and we

:34:13.:34:17.

would welcome public involvement and from members of Parliament and I

:34:18.:34:20.

have no doubt there will be opportunities in coming months to

:34:21.:34:24.

continue these discussants in this house and in the Department because

:34:25.:34:29.

I will be willing to talk to members of Parliament who are concerned

:34:30.:34:34.

about activities in their area. The honourable lady has called on the

:34:35.:34:38.

government to publish the plans. These plans are being planned by

:34:39.:34:42.

local areas within the NHS and they will be subject to further

:34:43.:34:47.

consultation in due course. She has raised concerns about the use of

:34:48.:34:51.

private sectors advisers in developing STPs. I'd like to point

:34:52.:34:57.

out very gently to her if I made, the irony that 38 degrees who she

:34:58.:35:06.

relied upon for much of her advice in this debate rely on a

:35:07.:35:10.

private-sector advisory group themselves, whose report I happen to

:35:11.:35:17.

have. A recognised private sector adviser within the NHS. It is a bit

:35:18.:35:23.

rich to come to the house arguing against the use of the private

:35:24.:35:35.

sector when she does so herself. I'm sorry that it is such an acrimonious

:35:36.:35:40.

debate today because I welcome the principle of the sustainability of

:35:41.:35:47.

the transformation plans. These are key opportunity to reverse the

:35:48.:35:51.

fragmentation and reintegrate the NHS but you actually have to get it

:35:52.:35:57.

right so to turn this into just a game of moving the deck chairs on

:35:58.:36:01.

the Titanic would be really an opportunity that we would regret in

:36:02.:36:07.

a few years' time. This is a place -based approach and that is similar

:36:08.:36:12.

to what we have in Scotland so I absolutely welcome it but the places

:36:13.:36:16.

have to be right. They need to cover the whole population and the

:36:17.:36:20.

geography as to make sense. That is in the relationships of the

:36:21.:36:25.

organisations that are there but you have to think of things like public

:36:26.:36:30.

transport. There is no point plonking a community in an STP that

:36:31.:36:34.

they are completely unconnected to. How these places are designed is

:36:35.:36:39.

really important. The partners that are in them. All of this should be

:36:40.:36:45.

about integration and reintegration from acute care, primary care and

:36:46.:36:50.

local authority. So that we have single pathways and wraparound

:36:51.:36:54.

patient centred care. I will give way. I have some sympathy with what

:36:55.:37:01.

she is saying but does she agree with me that integration is not

:37:02.:37:07.

going to happen in any one part of those partnerships are severely

:37:08.:37:12.

underfunded. She mentions local authorities. Many of the pressures

:37:13.:37:15.

in the NHS today are solely as the root cause of the severe

:37:16.:37:21.

underfunding of adult social care. Don't we make sure that these

:37:22.:37:28.

finances are in place for STP is to work. I totally agree. That is what

:37:29.:37:34.

I was coming on to. It is not just funding. It is the whole model. The

:37:35.:37:44.

tariff model rewards hospitals for doing minor things and punishes them

:37:45.:37:48.

for doing more complex things. Just working harder and doing more makes

:37:49.:37:55.

the deficit grow. The problem we have is that we have all sorts of

:37:56.:37:59.

perverse incentives in the system that mean organisations will still

:38:00.:38:04.

be looking out for their budget and their survival instead of working

:38:05.:38:09.

together. What has happened in Scotland, we got rid of hospital

:38:10.:38:14.

trusts, Primary Care Trusts, since 20 14th we've had integrated joint

:38:15.:38:19.

wards but they were handed joint funding that came from health and

:38:20.:38:22.

local authority which meant the whole business of your purse or my

:38:23.:38:30.

purse disappeared. Then you can look what is the best way to make the

:38:31.:38:36.

pathways smooth. Getting a shared vision of what it is you are trying

:38:37.:38:42.

to get is crucial. It means stakeholders, both those who work in

:38:43.:38:47.

the NHS and those who use it, need to believe in where you are trying

:38:48.:38:54.

to get to. Public conversations and involvement, not consulting on

:38:55.:38:57.

something that is already signed off but actually involving their ideas

:38:58.:39:01.

in what they would like it to be would make it much stronger. I think

:39:02.:39:05.

there are deep-seated changes that need to be made to the system as

:39:06.:39:10.

opposed to only talking about the money for the deficits. It's clear,

:39:11.:39:17.

already on the health committee we've been talking about it for

:39:18.:39:23.

ages, the phrase sustainability has been short hand for paying off the

:39:24.:39:31.

deficit. The 2.1 billion for transformation, 1.8 billion is in

:39:32.:39:37.

earmarked for deficit. At least 300 million to change an entire system.

:39:38.:39:42.

I know we talk about money a lot in the here and it is important but we

:39:43.:39:46.

have far vigour sustainability issues than the 2.5 billion deficit

:39:47.:39:54.

in the NHS. We have an ageing population. They are carrying more

:39:55.:39:59.

and more chronic illnesses. That means more demand, more complexity

:40:00.:40:04.

and more convocations. That is one of the things that is actually

:40:05.:40:08.

pushing the NHS to fall over. On the other side of that, we have a

:40:09.:40:13.

shortage in our workforce. We don't have enough nurses or doctors,

:40:14.:40:20.

including specialists, consultants, A and general practitioners.

:40:21.:40:27.

Although the advice has been very much that finances were third and

:40:28.:40:32.

prevention and quality of care was meant to come one and two in

:40:33.:40:37.

delivering the five-year forward, finances seems to be trumping

:40:38.:40:41.

everything else. It's absolutely correct that health is no longer

:40:42.:40:47.

buildings, there are lots of methods of health that are bringing care

:40:48.:40:51.

closer to patients and some things that are taking patients further

:40:52.:40:55.

away from their home. We have hyper acute stroke units, urgent cardiac

:40:56.:41:01.

units, where they get an angiogram and angioplasty that prevent heart

:41:02.:41:06.

failure in future, but you can't start there. You can't shut

:41:07.:41:11.

hospitals and units to free up money to do better things. You have to

:41:12.:41:15.

actually go for the transformation and do the better things first. To

:41:16.:41:20.

design the service around the pathways we need. That wraparound

:41:21.:41:25.

care for patients. Then work backwards. If more health and

:41:26.:41:30.

treatment is coming closer to the patient, then we will see, I don't

:41:31.:41:34.

go to the hospital very often and I want that hospital to have

:41:35.:41:37.

everything it needs when I need it. Then you can look at the estate and

:41:38.:41:44.

see, do we have the right units and in the right place? What concerns me

:41:45.:41:48.

is this seems to be the other way around. We are starting with

:41:49.:41:52.

hospitals which often is a very expensive thing to do and hoping it

:41:53.:42:00.

will deliver everything else. Thank you for giving way. I thank the

:42:01.:42:08.

honourable lady. Out of the original sum of money allocated for this

:42:09.:42:16.

transformation process the vast majority seems to be going to prop

:42:17.:42:21.

up acute trusts and very little is available for transformation. As I

:42:22.:42:28.

said, it only leaves 300 million. You cannot transform a system on the

:42:29.:42:34.

scale that is being considered on ?300 million. The guidance talks

:42:35.:42:40.

about prevention, tackling health inequalities, focusing on health and

:42:41.:42:45.

well-being and by that I mean physical and mental well-being. We

:42:46.:42:50.

need to be strengthening public health. Something else that has been

:42:51.:42:55.

cut. We need to look at the quality of health and care right across in

:42:56.:42:59.

social care. We must fund social care because it can make a

:43:00.:43:02.

difference to things like delayed discharges. We are not even three

:43:03.:43:08.

years down the integration in Scotland, only to a half years, and

:43:09.:43:13.

yet delayed discharges has dropped 9% and, yet, the last time the

:43:14.:43:20.

Secretary of State was in select committee, it has gone up 32%.

:43:21.:43:25.

Literally just moving things around and allowing one part of the system

:43:26.:43:29.

to fail will mean that the entire system will fail. I always listen

:43:30.:43:36.

with care to what the honourable lady has to say and agree with a

:43:37.:43:39.

great deal of it. Would she agree that part of the problem with

:43:40.:43:45.

delayed discharges is a retrenchment of community hospitals and their

:43:46.:43:50.

beds which have provided step up, step-down care into needed beds and

:43:51.:43:54.

they are unfortunately available which means inevitably hospital

:43:55.:43:57.

discharges are delayed with all that distress it causes? I totally agree.

:43:58.:44:06.

It is care in the home for those who can go to that. Convalescence for

:44:07.:44:11.

those who require it. In my health board, we have rebuilt the three

:44:12.:44:17.

cottage hospitals. They are now modern state-of-the-art small units

:44:18.:44:22.

that means our population have less to travel. Older people will not

:44:23.:44:26.

need to come to hospital. We are still in that transition. They are

:44:27.:44:30.

not doing everything they have potential for but certainly in

:44:31.:44:34.

Scotland, indeed, we are and were all population, but there is more

:44:35.:44:38.

recognition that you need intermediate care between people

:44:39.:44:41.

being at home and looked after by their GP and ending up in a very

:44:42.:44:49.

expensive acute unit. It is not just finance. People do not want to be in

:44:50.:44:55.

hospital. These levels of care are crucial. It's important that this

:44:56.:45:01.

grows out of the ST Petes. I see that this is a crucial opportunity

:45:02.:45:09.

that can't be missed. There is a startling fact about underfunding of

:45:10.:45:11.

social care that ministers can't get away from. We've heard today of a

:45:12.:45:19.

case of a care worker suing the contract they work for, only paid ?3

:45:20.:45:27.

27 per hour, how can somebody be discharged from hospital adequately

:45:28.:45:31.

when that is the domiciliary care waiting for them? It was interesting

:45:32.:45:35.

to hear the former care Minister say that we have not got the cost of

:45:36.:45:41.

adult social care sorted out. I totally agree. I'm not sure if the

:45:42.:45:45.

honourable lady took part in the carers debate that we had not long

:45:46.:45:50.

ago. I made the point that unless we develop social care as a profession,

:45:51.:45:55.

then all others face a fairly miserable time in old age. Nursing

:45:56.:46:02.

is a profession that is recognised and valued. Caring for our ill and

:46:03.:46:06.

elderly population should also be. To give them time to do their job

:46:07.:46:11.

and to pay them and give them a career development structure that

:46:12.:46:14.

means we bring the best people up and running teams.

:46:15.:46:19.

I was disappointed at the aggression on both sides. I know it is always a

:46:20.:46:27.

good tennis match for point-scoring but the development of the STPs is

:46:28.:46:33.

literally an opportunity where there would be things everyone in this

:46:34.:46:38.

House would agree with but if this is just a figleaf to pretend that

:46:39.:46:42.

something is being done, the NHS will suffer and we will be the

:46:43.:46:46.

generation of politicians who move the deck chairs on the Titanic.

:46:47.:46:54.

Pleasure to follow my colleague on the health committee. I absolutely

:46:55.:46:59.

agree that we should see this as an opportunity to move away from the

:47:00.:47:04.

fragmented system where people are moving the commission and provide

:47:05.:47:09.

care in isolated silence the one that looks across the whole of the

:47:10.:47:14.

system, across geographical areas, where we can move to a system where

:47:15.:47:19.

we have a truly integrated approach between health and social care. But

:47:20.:47:25.

to do that, we need to see local authorities involved in STPs as well

:47:26.:47:29.

as the health system. We need to also involve local people. The

:47:30.:47:35.

lesson we learned from every major reorganisation has been there if you

:47:36.:47:39.

take local people with you on the journey, they are much more likely

:47:40.:47:47.

to be successful. We should not see genuine local consultation and

:47:48.:47:49.

engagement as an inconvenience but something that actually improves the

:47:50.:47:53.

eventual plans. I think it is a real shame that this debate has devolved

:47:54.:48:01.

into secret NHS plans and now NHS England has the that and say, how

:48:02.:48:06.

could they have been better at engaging local communities and those

:48:07.:48:10.

who represent them? It is a great shame that members across this House

:48:11.:48:14.

were not able to see the draft plans until they were leaked to the press.

:48:15.:48:19.

That is not the right way forward for any genuine engagement. Would

:48:20.:48:27.

she not agree with me that if staff, nurses, doctors, physios,

:48:28.:48:30.

pharmacists, had been involved from the start of the process, that would

:48:31.:48:40.

have helped staff morale in the NHS? I absolutely agree with my

:48:41.:48:47.

honourable friend. It is about local communities and their

:48:48.:48:49.

representatives. Public meetings are important but so are involving

:48:50.:48:54.

public bodies like health watch, making sure underrepresented groups

:48:55.:48:58.

are involved. The honourable gentleman opposite talked about the

:48:59.:49:02.

need to involve mental health services in these plans. It is very

:49:03.:49:06.

important we make sure the underrepresented groups are

:49:07.:49:09.

involved, including those who use mental health services. The

:49:10.:49:16.

honourable lady, with the lifetime of experience in the NHS, is

:49:17.:49:21.

absolutely right about the importance of consultation. Dishy

:49:22.:49:26.

therefore understand the concern expressed by both the staff at the

:49:27.:49:32.

Dove sexual health centre in one of the poorest constituencies in

:49:33.:49:37.

England and the 2000 patients, that none of them have been consulted,

:49:38.:49:41.

neither have any of the stakeholders, over a proposal to

:49:42.:49:47.

close a vital facility? I thank the honourable gentleman for his

:49:48.:49:52.

intervention. The plans you produce at the end of the day will be better

:49:53.:49:56.

if you involve those who are both using services, those who are

:49:57.:49:59.

providing them as well as those commissioning them as you go along

:50:00.:50:06.

rather than presenting a freight company because then it becomes a

:50:07.:50:10.

more binary choice rather than one where people can make suggestions to

:50:11.:50:18.

improve plans in development. I know that Scotland is a lot easier to get

:50:19.:50:24.

round in population or the size and transport is not that easy, but one

:50:25.:50:29.

of the mechanisms the Scottish Government use is what they call a

:50:30.:50:33.

national conversation, and that is literally that the ministerial team

:50:34.:50:38.

go walkabout and have meetings to hear directly before anything goes

:50:39.:50:43.

on paper. I would like if I made to make progress. If we get too caught

:50:44.:50:51.

up in the process of consultation, we will miss some very serious

:50:52.:50:56.

underlying hurdles that are in the way of STPs achieving their aims.

:50:57.:51:03.

Chief among those is the issue of finance. The NHS is in its seventh

:51:04.:51:09.

year now of a historic level of austerity, the average increase of

:51:10.:51:15.

1.1% uplift in funding to the NHS over the last six years is an

:51:16.:51:19.

extraordinary challenge when we look at that and the context of

:51:20.:51:22.

increasing demand. It is a good thing that we are living longer but

:51:23.:51:27.

we are living longer with more complex conditions, more expensive

:51:28.:51:31.

treatments available, to tackle those. We need to be clear that

:51:32.:51:35.

because of that, divide is opening up, even though the settlement for

:51:36.:51:41.

health has been generous in relation to other government departments. It

:51:42.:51:47.

means that a significant gap is opening up in health but even worse

:51:48.:51:55.

in social care. We know from figures that 400,000 fewer people are in

:51:56.:51:59.

receipt of social care packages in 2015-16 than they were in 2009-10.

:52:00.:52:08.

Not only fewer people are receiving social care packages, but the

:52:09.:52:12.

packages they are receiving less. Very much of what we see around the

:52:13.:52:18.

STPs is about transferring care into the community. We need to be

:52:19.:52:23.

absolutely clear that we need to make sure that the funding is there

:52:24.:52:28.

to provide the social care packages but also that we have the workforce

:52:29.:52:36.

to deliver them. In the area I represent, the proposals are too

:52:37.:52:41.

close two community hospitals used by my constituents. I know as a

:52:42.:52:47.

former rollable GP just how important these facilities at a

:52:48.:52:51.

local people. These are the places that are not only special to people

:52:52.:52:56.

for the step down, step up care that the honourable lady opposite

:52:57.:52:59.

referred to. These are places that people like to be at the end of

:53:00.:53:04.

their lives, providing personal care to people and allowing people,

:53:05.:53:09.

particularly in rural areas who are doubly disadvantaged by not being

:53:10.:53:14.

able to travel to a larger centres, the opportunity to be treated closer

:53:15.:53:27.

to home. In my constituency, a hospital has been adopted by the

:53:28.:53:31.

local community and is continuing to provide that step up, step down care

:53:32.:53:36.

without being part of the NHS. I wonder whether she would be

:53:37.:53:41.

interested in meeting some of the trustees of the hospital? It may

:53:42.:53:46.

provide some hope for the future as a way that communities can come

:53:47.:53:49.

together and support their local assets. I have been to visit on many

:53:50.:53:57.

occasions community hospitals to hear from community hospitals around

:53:58.:54:01.

the country and I will continue to do so. I would like to commend the

:54:02.:54:08.

very valuable role they play. Would she agree with me the community

:54:09.:54:13.

hospitals can also keep the bean counters happy since, if you get the

:54:14.:54:18.

case measure right, it can treat people in Community Hospital beds

:54:19.:54:21.

much more affordably than in an acute unit which is extraordinary

:54:22.:54:27.

costly? You will also give patients what they would like, which is care

:54:28.:54:33.

close to their homes, as my constituents will attest, where we

:54:34.:54:37.

still have Community Hospital beds and I know my honourable friend

:54:38.:54:42.

would say the same. I thank my honourable friend. Across this

:54:43.:54:47.

House, we are all aware of the value of community hospitals to our

:54:48.:54:50.

constituents to take that back a step further, I would say that the

:54:51.:54:55.

best bet for any patient is their own bed, provided they can be given

:54:56.:54:59.

the right package of care close to home. We know that there are many

:55:00.:55:04.

people, even within Community Hospital beds, that do not need to

:55:05.:55:09.

be there. They are there because they want the right social care

:55:10.:55:15.

package to enable them to be a home. What we should do is be realistic.

:55:16.:55:21.

Of the financial challenge they also face and the cost of providing those

:55:22.:55:26.

services. This is a huge challenge for them. In my area alone, the STP

:55:27.:55:34.

is facing a ?572 million shortfall by 2021 if they do not take any

:55:35.:55:40.

action. I can understand why they will look at the relative cost of

:55:41.:55:46.

providing care to people both in acute hospitals, community hospitals

:55:47.:55:51.

and at home and make an argument that sounds very reasonable about

:55:52.:55:56.

how you could care much better for a larger number of people if that

:55:57.:56:00.

setting was at home. But go back to the point that my friend, the member

:56:01.:56:06.

for Central Ayrshire made. You need to have access to the transformation

:56:07.:56:12.

part of the fund to put those services in place. Very often, to

:56:13.:56:16.

build the infrastructure that we need, or example, when I look at

:56:17.:56:21.

Dartmouth, I look at the possibility of providing more care closer to

:56:22.:56:27.

home within a community hub. But that will take having upfront funds

:56:28.:56:36.

to build and develop a new centre back and actually allow people to

:56:37.:56:40.

develop the work force and provide more services closer to home. The

:56:41.:56:46.

trouble is what we often see is the closure of a much loved facility

:56:47.:56:50.

without the new service in place and that is what I would like to see as

:56:51.:56:59.

plans progress, a genuine focus on the opportunities we can have to

:57:00.:57:04.

provide more care closer to home. I do fear that we will miss that

:57:05.:57:09.

opportunity because, as we have already heard, ?1.8 billion of the

:57:10.:57:18.

?2.1 billion fund is going towards the sustainability bit and only ?300

:57:19.:57:28.

million is left nationally to put in place all these plans. We also know

:57:29.:57:34.

that part of the way the government has managed to fulfil its promise to

:57:35.:57:39.

NHS England in terms of the funding they asked for has been to take

:57:40.:57:44.

funding out of capital budgets because these are essentially flat

:57:45.:57:52.

cash, but also to take money out of health education England budgets and

:57:53.:57:56.

public budgets. It does concern me that many of the principles behind

:57:57.:58:01.

the sustainability and transformation plans are put at risk

:58:02.:58:06.

by other parts of the system. We have already heard the point about

:58:07.:58:12.

prevention. It is central to the achievements of the sustainability

:58:13.:58:16.

and transformation plans, the prevention peas, the public health

:58:17.:58:21.

peace. It is a great shame the Public health budgets have been

:58:22.:58:25.

squeezed in order for them to achieve those aims. I know there are

:58:26.:58:28.

many members wishing to speak so I will move on and make asks of the

:58:29.:58:36.

minister in moving forward. There is more that the government can do. We

:58:37.:58:41.

were very disappointed on the health committee that none of the witnesses

:58:42.:58:50.

that came for us from NHS England, NHS improvement or the Department of

:58:51.:58:59.

Health were able to set out the impact of cuts to social care on

:59:00.:59:06.

health care. We really do need to do much better quantifying the cost of

:59:07.:59:11.

the NHS because of cuts to the NHS budget. I think that the minister

:59:12.:59:17.

needs to take the long view of prevention and help the service by

:59:18.:59:21.

implementing policies that could help local authorities to make

:59:22.:59:25.

changes. For example, I would suggest making a hell of a material

:59:26.:59:30.

consideration in planning and licensing. We need a much greater

:59:31.:59:39.

focus on workforce because the sustainability and transformation

:59:40.:59:42.

plans cannot achieve their aims if there is not the workforce in place

:59:43.:59:47.

to achieve it. Finally, I would ask the Minister if you would kindly

:59:48.:59:52.

visit my area to look at the proposals within the sustainability

:59:53.:59:57.

and transformation plans in South Devon, to look at the opportunities

:59:58.:00:05.

and how we could achieve them. Some people will not get in.

:00:06.:00:18.

I am grateful for the opportunity to speak in this debate today.

:00:19.:00:23.

Sustainability and transformation plans, should the public be

:00:24.:00:28.

concerned, and are they good, bad or a mixture of both? As we have heard,

:00:29.:00:35.

STPs have been drawn up in 44 areas in England by a range of people

:00:36.:00:39.

involved in the running of the NHS and local government. As far as I

:00:40.:00:44.

can work out, they have come about because NHS England could see that

:00:45.:00:49.

in the chaos following the last government's health and social care

:00:50.:00:53.

packed, there was no obvious body responsible for thinking about how

:00:54.:00:55.

best to NHS staff at local and governmental

:00:56.:01:10.

levels were charged with discussing the best way to meet those needs and

:01:11.:01:18.

developing ideas as to how those needs might be better met within

:01:19.:01:21.

available resources. So far, so good. There are three big problems.

:01:22.:01:30.

First, the current financial pressures on the NHS means these

:01:31.:01:34.

plans are likely to be all about sustainability and not

:01:35.:01:41.

transformation. Second, this is a standardised process is to define

:01:42.:01:46.

and drive change running the risk of good proposals being lumped in with

:01:47.:01:55.

bad ones and some plans simply focusing on the achievable as

:01:56.:01:59.

opposed to the necessary and most desirable. Third, these plans are

:02:00.:02:07.

being developed when there is huge public cynicism about the motives of

:02:08.:02:11.

a Tory government when it comes to change in the NHS. If you want to

:02:12.:02:16.

deliver change, the debate with the public needs to start in the right

:02:17.:02:21.

place, not behind closed doors, not using jargon that no one

:02:22.:02:26.

understands. It needs to be focused on patients and their families and

:02:27.:02:32.

not accountants and spreadsheets. I think most people understand that

:02:33.:02:38.

the NHS can't be preserved in aspic. They understand that compared to the

:02:39.:02:43.

1950s we now use the NHS in a very different way. At the moment, they

:02:44.:02:48.

simply see an NHS under enormous pressure. They are waiting longer

:02:49.:02:53.

for an ambulance to see a GP, to be treated in a A, people are on the

:02:54.:03:05.

streets in protest. When MPs and their nature leaders talk about

:03:06.:03:13.

transformation they are dubious. For sustainability, they read cuts and

:03:14.:03:18.

in some cases they will be right. Cutting staff, closing services,

:03:19.:03:22.

restricting access to treatment. No matter how good the plan, no matter

:03:23.:03:27.

how thorough the analysis or innovative dissolution, you cannot

:03:28.:03:31.

escape the basic problem of inadequate funding for both the NHS

:03:32.:03:39.

and social care. I will give way. Certainly, in my constituency we are

:03:40.:03:46.

very concerned because Bristol is in surplus but we will be going in with

:03:47.:03:52.

North Somerset which has a cumulative deficits. To us, it means

:03:53.:03:58.

cuts. That's the story we hear from all over the country. This is not

:03:59.:04:04.

profligate overspending on the part of NHS bosses or local government

:04:05.:04:09.

leaders. It is chronic underfunding on the part of government. There was

:04:10.:04:25.

much fun -- fanfare alongside the last budget but it is a flat-lining

:04:26.:04:30.

budget to deal with soaring demand. The reality is that in the last ten

:04:31.:04:36.

years, the number of people living beyond 80 has increased by half a

:04:37.:04:41.

million. The NHS and social care is buckling under the strain. While we

:04:42.:04:46.

should never give up on trying to organise the NHS in the most

:04:47.:04:50.

efficient and effective way possible, we have a choice as a

:04:51.:04:55.

country. Do we want to cut services to match the funding available? Do

:04:56.:05:01.

we want to pay more to ensure our grandparents and mums and dads get

:05:02.:05:04.

the sort of care that we would want for them. If the NHS is to provide

:05:05.:05:10.

decent care for older people, not only do we have to fund social care

:05:11.:05:14.

adequately but we also need to find better ways of organising services

:05:15.:05:18.

to keep people out of hospital for as long as possible. That leads me

:05:19.:05:25.

to the second problem. STPs are being used as a catchall process to

:05:26.:05:30.

bring about change in the NHS but many run the risk of focusing on the

:05:31.:05:37.

wrong things. They are being used to do different things in different

:05:38.:05:41.

places and while some may lead to better outcomes, the danger is that

:05:42.:05:46.

there will be blanket opposition to everything. Some proposals will be

:05:47.:05:53.

controversial. The closure or downgrading of an A department

:05:54.:05:59.

will never be easy. But these plans may end up with a lot of focus on

:06:00.:06:03.

something that isn't the burning issue. In my local area, the

:06:04.:06:12.

Southeast London STP proposes to orthopaedic care centres. The sites

:06:13.:06:18.

I've never been agreed. On the face of it, there is nothing wrong with

:06:19.:06:29.

the proposal. Create centres of excellence so that all operations

:06:30.:06:34.

are done in one place. But when newspapers talk about secret plans

:06:35.:06:44.

to close A they will smell a rat when one might not exist. I'm aware

:06:45.:06:51.

that many people want to speak and I wish to conclude my remarks. They

:06:52.:06:57.

say, what happens if Lewisham is on the site of the new centre? If it is

:06:58.:07:02.

shifted elsewhere and Busby. Does just that the emergency department?

:07:03.:07:08.

Is orthopaedic care and the burning issue in south-east London? What

:07:09.:07:13.

about the queues of ambulances? What about the homeless man who pitches

:07:14.:07:18.

up in A because he has nowhere to sleep and there is nowhere for him

:07:19.:07:22.

in the community. Where does the money come from to redesign the NHS

:07:23.:07:27.

buildings that such a care centre would entail? With ?1 billion taken

:07:28.:07:32.

out of the capital budget and switched to revenue last year, it

:07:33.:07:36.

seems fanciful to think that there will be money lying around to do

:07:37.:07:41.

these sorts of projects. The NHS is on its knees. Everyone knows that

:07:42.:07:47.

hospitals ended up being ?2.5 billion in deficit last year. We

:07:48.:07:53.

have seen the reports of the A closing overnight because they don't

:07:54.:08:01.

have the staff. We know that GPs are run ragged, ambulance staff are

:08:02.:08:05.

stressed out and nurses are demoralised. Without even mentioning

:08:06.:08:10.

junior doctors. If you don't fund the NHS adequately, if you don't

:08:11.:08:14.

staff it properly, don't be surprised when the public don't

:08:15.:08:19.

trust your so-called improvement plans. There is a deep public

:08:20.:08:23.

cynicism when it comes to anything that this government wants to do the

:08:24.:08:30.

NHS. People believe government ministers are trying to privatise

:08:31.:08:34.

it, they believe services are contracted out to the private sector

:08:35.:08:38.

to save money and not improve quality and in many cases they will

:08:39.:08:44.

be right. The problem isn't STPs as such but the context in which they

:08:45.:08:48.

are being developed. Inadequate funding, an inability to make the

:08:49.:08:53.

case for change, a workforce crisis which is leading to overnight

:08:54.:08:58.

closure of services. As a result of all of these, a deep public mistrust

:08:59.:09:11.

of government's intentions. May I congratulate my old whip to his

:09:12.:09:15.

elevation to be Minister of State at health. I hope he brings with him

:09:16.:09:19.

all the skills he learned at the Department of defence where he met

:09:20.:09:25.

many tough challenges. There are many ahead. At a time when there is

:09:26.:09:31.

upheaval in every department in Westminster, I suggest this is a

:09:32.:09:36.

good time to look afresh at where this department is going and I'd

:09:37.:09:40.

like to suggest some initiatives. This debate divides neatly into

:09:41.:09:45.

sustainability and transformation. I'd like to suggest that to have a

:09:46.:09:53.

sustainable health service is about reducing demand, we have to look at

:09:54.:09:58.

reducing demand on the service, if we're going to have a transformation

:09:59.:10:02.

it has to include increasing supply and looking for new types of

:10:03.:10:10.

treatments that are available. Mr Deputy Speaker, I am proud to have

:10:11.:10:17.

represented the middle of England, Leicestershire, for many years and,

:10:18.:10:22.

in particular, the whole of Hinckley Borough Council and share the

:10:23.:10:26.

initiatives they have taken since the health and social care act came

:10:27.:10:32.

in to being and suggest what we need to do beyond the kind of initiatives

:10:33.:10:37.

that this very successful Conservative controlled council have

:10:38.:10:42.

taken. They have taken three major initiatives in my constituency.

:10:43.:10:47.

Getting people to be more active, of all ages. Including young people

:10:48.:10:54.

putting an activity days for soccer tops, aged 2-4. Bike ability courses

:10:55.:11:01.

for six-year olds. BMX, track works, skipping, making smoothies, all

:11:02.:11:07.

kinds of activities. They were also built a new leisure centre which has

:11:08.:11:11.

been a huge success in that the numbers attending swimming in the

:11:12.:11:16.

borough have gone up at an exponential rate. They have produced

:11:17.:11:23.

excellent facilities. It's sad to relate that in my constituency 7%

:11:24.:11:32.

have diabetes, 68% are recorded as having excess weight, 20% would be

:11:33.:11:39.

obese. Obesity in children is increasing. My point is that however

:11:40.:11:43.

good local people are, we have to take other steps. The chair of the

:11:44.:11:51.

select committee knows what I am going to say. We have to look at

:11:52.:11:57.

obesity. The sugar tax is very important but not enough. We are

:11:58.:12:01.

going to have two deal with diet, food consumption and its very

:12:02.:12:07.

welcome that we have a sugar tax now but the template for moving ahead is

:12:08.:12:12.

the 100 year campaign to stop people smoking. To stop cigarettes

:12:13.:12:18.

dominating our lives. It began in 1868 when the railway bill was

:12:19.:12:23.

passed that mandated smoke-free carriages to prevent injury to

:12:24.:12:27.

nonsmokers and culminated in England going smoke-free in 2007. Mr Deputy

:12:28.:12:35.

Speaker, an transformation of local services we need to have more

:12:36.:12:41.

services. Some of the services are not properly coordinated. I was on

:12:42.:12:45.

the Osteopaths bill and chiropractors bill in 93 and 94.

:12:46.:12:50.

Both regulated by an act of Parliament. But the Osteopaths,

:12:51.:12:55.

chiropractors and orthopaedic surgeons do not talk. It's

:12:56.:12:59.

ridiculous. Too many people having operations that could be dealt with

:13:00.:13:07.

by chiropractors and spare parts. -- Osteopaths. Harry Clayton says that

:13:08.:13:15.

of 63,000 practitioners covering 25 occupations, far too little are

:13:16.:13:20.

being used in the health service. I think that's very sad. Mr Speaker, I

:13:21.:13:26.

have to finish on that for the benefit of the chair, homoeopathy

:13:27.:13:29.

has officially been recognised by the Swiss government to coexist with

:13:30.:13:39.

conventional medicine following a referendum in Scotland where two

:13:40.:13:43.

thirds of the population decided they wanted homoeopathy and

:13:44.:13:46.

acupuncture, traditional Chinese medicine, herbal medicine and

:13:47.:13:50.

holistic medicine as part of their health service and their insurance

:13:51.:14:01.

company s now agree. I think the Labour Party were right to choose

:14:02.:14:05.

the topic for the opposition they debate and wish the minister well in

:14:06.:14:12.

confronting the financial difficulties in confronting these

:14:13.:14:23.

difficulties. There was a call for ?22 billion of efficiency savings to

:14:24.:14:28.

be found by 2020. That was on top of the 20 billion to be found between

:14:29.:14:36.

2010 and 2015. I just don't think this should or can be done. The

:14:37.:14:41.

total deficit in all national health Service trusts reached 2.4

:14:42.:14:47.

5,000,000,020 15-16. Almost three times greater than in 2015. Monitor

:14:48.:15:01.

estimates that even with all realistic efficiency savings being

:15:02.:15:04.

made a deficit of 1.5 billion would remain in this year's financial

:15:05.:15:12.

year. It is simply not possible to deal with this situation through

:15:13.:15:15.

efficiency savings. The government knows this and it is stuck. Hence

:15:16.:15:21.

the sustainability and transformation plans covering the

:15:22.:15:27.

next five years. Organised along 44 areas that don't have any coherence

:15:28.:15:32.

to existing boundaries in the north-east, Northumberland, Tyne

:15:33.:15:39.

Wear footprint covers five commissioning groups, six local

:15:40.:15:41.

authorities and seven foundation trusts. Newcastle, the city I

:15:42.:15:48.

represent, enjoys well-run and efficient health services, it is a

:15:49.:15:52.

testament to staff at all levels in the National health services. Our

:15:53.:15:57.

services are well regarded across the local area. But the

:15:58.:16:03.

sustainability and transformation plans raise at least three serious

:16:04.:16:04.

questions. If NHS England think that over half

:16:05.:16:16.

of clinical commissioning groups are underperforming, why are they asking

:16:17.:16:19.

them to draw up the key documents that will transform the structure of

:16:20.:16:24.

the NHS? Given that many clinical commissioning groups will have to

:16:25.:16:29.

merge, where is the motivation to create plans? And it seemed that the

:16:30.:16:35.

footprints will have no formal structure, who is accountable for

:16:36.:16:41.

the long-term consequences of the sustainability and transformation

:16:42.:16:45.

plans? These plans or the approach that has been adopted bears a

:16:46.:16:53.

striking resemblance to the previous top-down unwonted revision of the

:16:54.:16:57.

NHS which we were promised would not happen when the government came to

:16:58.:17:02.

power in 2010. So the government are doing almost a difficult thing to

:17:03.:17:09.

do, which is to break their promises twice. This is not the first threat

:17:10.:17:14.

the north-east has faced on the redistribution of money, downgrading

:17:15.:17:22.

in the distribution formula the social deprivation component in

:17:23.:17:29.

placing far more emphasis on the age-related part of the formula,

:17:30.:17:36.

which affects the elderly rather than the people who are ill. When in

:17:37.:17:43.

government, Labour promised to increase help spending to match the

:17:44.:17:49.

European average of 8.5% of GDP. We kept his promise but successive

:17:50.:17:57.

governments have failed to release funds to the health service and that

:17:58.:18:05.

is why health spending will fall to 6.6% by 2021. That will leave us

:18:06.:18:13.

lagging behind the average spend of 9.1% and compatible countries like

:18:14.:18:21.

Germany, who spend 11% of GDP. The government should be honest about

:18:22.:18:24.

the challenges the NHS faces and the response needed to meet those

:18:25.:18:30.

challenges. The sustainability and transformation plans are a

:18:31.:18:33.

fundamentally bureaucratic response to the funding in the NHS. As such,

:18:34.:18:39.

it completely misunderstands what the NHS really needs is not more

:18:40.:18:51.

meetings but more money. A change in life is frequently a source of

:18:52.:18:56.

anxiety or downright scary. When you are young, you change schools. When

:18:57.:19:03.

you get married, it is scary. But there is nothing scarier than change

:19:04.:19:10.

in the way in which health services are provided. Perhaps it is not

:19:11.:19:15.

surprising that the NHS is found in managing change one of the most

:19:16.:19:21.

difficult things to accomplish. It is often an frequently, as the

:19:22.:19:27.

honourable lady mentioned, there are substantial challenges, overwhelming

:19:28.:19:31.

challenges, that we face in society, from people growing older with more

:19:32.:19:36.

complex needs and more expensive equipment and supplies required to

:19:37.:19:40.

assist ever increasing standards of expectation for health care in our

:19:41.:19:45.

country. The NHS is presented with two options for change. One is

:19:46.:19:50.

radical. We will meet those challenges and a fine future that

:19:51.:19:55.

offers great outcomes for all. That sounds a bit too scary. On the other

:19:56.:19:59.

side, the incremental approach which will move things along a little

:20:00.:20:05.

minute but will not deal with the fundamentals but will enable us to

:20:06.:20:09.

feel we retain the same institutions and structures with which we are

:20:10.:20:13.

familiar. As someone who was born and grown up in Bedford, I am very

:20:14.:20:19.

familiar with each of the buildings and institutions in my community,

:20:20.:20:22.

and to see those changes are very scary thing. When we look at change,

:20:23.:20:29.

we have to recognise this position of anxiety. It is important that all

:20:30.:20:34.

Members of Parliament do not play on those anxieties. It is not effective

:20:35.:20:39.

opposition to create scare stories ahead of an outcome. That is not in

:20:40.:20:45.

the public interest. To raise concerns, yes, as the honourable

:20:46.:20:53.

lady mentioned. Racial concerns but in a way that looks to the

:20:54.:20:57.

sensitivities of local situations, and that is really what I would like

:20:58.:21:06.

to focus my remarks on. I actually welcomed the approach of the STP,

:21:07.:21:12.

first of all because of the integration of care with health,

:21:13.:21:16.

secondly because it is providing for the first time local authorities

:21:17.:21:20.

with a voice in the decision-making about local care choices. For the

:21:21.:21:25.

first time, the NHS will not get its own way if this process lives up to

:21:26.:21:31.

what it says will be actually local decision-making. I think that will

:21:32.:21:33.

be very helpful in getting local support. I can see in my own

:21:34.:21:40.

locality the community approach, which is now cross-party. We are all

:21:41.:21:50.

united in our approach that says we want local care in the NHS and STP

:21:51.:21:55.

is a way of having that. Would it not therefore, particularly if there

:21:56.:22:02.

is a cross-party work across the local authority, be more effective

:22:03.:22:06.

to have local consultation early on about what can be gained in exchange

:22:07.:22:13.

for what might be felt to be lost? That question gets to the point I'm

:22:14.:22:18.

getting too. I am sceptical about what consultation means. I was

:22:19.:22:27.

trying to measure it in terms of MPs for Corby. It proceeded Louise

:22:28.:22:33.

Mensch becoming MP, it went through or other period of Andy Salford

:22:34.:22:39.

being MP, and now it is taking up the current MP. That has had

:22:40.:22:46.

consultation and participation and all the features of the NHS saying

:22:47.:22:51.

they want to listen to people, consult them, listen to them, no. It

:22:52.:22:55.

went through and ticked all the boxes and was a complete another

:22:56.:23:00.

disgrace in terms of its local accountability. I do not have this

:23:01.:23:05.

reaction to say I do not trust Pauline Philip, the lead of our STP,

:23:06.:23:10.

the chief executive, but I need to know everything. What I need to know

:23:11.:23:14.

is that our local authorities are having their voices heard. I feel

:23:15.:23:23.

relatively comfortable that that process, because it involves local

:23:24.:23:27.

authorities as well as the NHS, will lead the options that are more

:23:28.:23:31.

acceptable to the population. I would say to her another members

:23:32.:23:35.

that the outcomes we should expect from these processes around the

:23:36.:23:39.

country will be highly varied. Some will be correct and acceptable and

:23:40.:23:45.

go forward. Others will be controversial, downright wrong. We

:23:46.:23:50.

should not curse this whole process across the country because it

:23:51.:23:52.

achieves a difference in outcomes in different parts of the country. We

:23:53.:23:56.

should be prepared to look at each on its own merits and judge them

:23:57.:24:03.

accordingly. Is there not a real challenge to reconcile the reticence

:24:04.:24:08.

to change and adapt would be clear imperative that new technologies and

:24:09.:24:12.

ways of doing things can bring in terms of offering that step change

:24:13.:24:17.

that is often resisted? Consultation will not necessarily deal with that.

:24:18.:24:22.

I come back to the central part of what is different about STP. That is

:24:23.:24:28.

the fact it is involving local authorities with things like mental

:24:29.:24:31.

health issues, care in the community. That voice will be heard

:24:32.:24:38.

more clearly also, these people are representing our local people. That

:24:39.:24:42.

voice will make a substantial difference. Two final points. In

:24:43.:24:50.

Bedford, as CCG is on the legal direction, or that affect local

:24:51.:24:56.

decision-making as a result? Secondly, as CCG set up a joint

:24:57.:24:59.

committee to review acute services, is he in a position to assure me

:25:00.:25:04.

that that joint CCG will not take any part whatsoever in the decision

:25:05.:25:09.

processes when the STP result is made? Like many others in this

:25:10.:25:16.

House, I have received hundreds of e-mails from concerned constituents

:25:17.:25:20.

about the sustainability and transformation plans, what this

:25:21.:25:24.

means for the NHS nationally, regionally and locally. To put some

:25:25.:25:29.

local context, my constituency covers two health trusts. They are

:25:30.:25:43.

under four CCGs. We are in the council Borough of Kirklees which

:25:44.:25:49.

serves a population of over 430,000. A hospital is in the advanced stages

:25:50.:25:53.

of reconfiguration or downgrade as many people see it. The Dewsbury

:25:54.:25:58.

Hospital with this week loses maternity unit. There will be

:25:59.:26:06.

changes in acute surgery, gynaecology and paediatrics. The

:26:07.:26:09.

accident and emergency centre will be reduced as well. On the other

:26:10.:26:17.

side of my constituency SARS Huddersfield Royal Infirmary. They

:26:18.:26:21.

have just completed a so-called consultation for the reconfiguration

:26:22.:26:28.

of services. Their proposers are accepted, Huddersfield Royal

:26:29.:26:32.

Infirmary will also have its accident and emergency department

:26:33.:26:38.

downgraded. My constituents will be left without a full accident and

:26:39.:26:43.

emergency provision, over 430,000 people who will have to travel

:26:44.:26:47.

outside of the borough to access vital emergency health care.

:26:48.:26:52.

Kirklees is a vast geographical area that spawns many towns and rural and

:26:53.:26:57.

semirural areas and many people rely on public transport as a means of

:26:58.:27:06.

travel. It brings about huge health issues and inequalities. These cuts

:27:07.:27:11.

to services are not improving life chances of enhancing health care

:27:12.:27:14.

provision. They are part of a cost-cutting exercise that could

:27:15.:27:17.

result in lives being put at risk. Just this afternoon, it is reported

:27:18.:27:24.

that a senior representative has commented that NHS England is

:27:25.:27:28.

putting money before quality. We now learn that the government has set up

:27:29.:27:35.

STPs to look at health services on a larger open. Some would soon suggest

:27:36.:27:38.

this is a to shutting the stable door after hold-ups has bolted. How

:27:39.:27:43.

could this work when we are so far down the line already there have

:27:44.:27:47.

been developed and implemented completely and isolation of each

:27:48.:27:52.

other with no regard for the wider population or the geographical

:27:53.:27:57.

boundaries the cover? Unless the STPs had been put in place to

:27:58.:28:01.

implement further cuts to our already overstretched NHS services.

:28:02.:28:06.

We on these benches sadly acknowledge that our NHS is in

:28:07.:28:11.

crisis. We are genuinely fearful for the future of health provision in

:28:12.:28:14.

our country and these fears are shared by many health experts. One

:28:15.:28:20.

of the key aims of STPs is to achieve financial balance by 2020.

:28:21.:28:25.

They have concerns this will be the priority for STPs rather than

:28:26.:28:29.

developing their best models for patients. Our assessment of draft

:28:30.:28:34.

plans shows that in the absence of eye watering efficiency, there will

:28:35.:28:37.

be a financial gap leading to hundreds of millions of pounds by

:28:38.:28:45.

2021, and even by cost efficient measures, it would still not be

:28:46.:28:48.

possible to achieve the financial balance expected by national

:28:49.:28:53.

regulators. Their assessment has seen that struggling to achieve his

:28:54.:29:01.

goals was like attempting to do synchronised swimming against a

:29:02.:29:05.

tide. When will the government admit that their efficiency plans are not

:29:06.:29:09.

working? And the only way to fully address these needs is to stop the

:29:10.:29:16.

cuts and pledge more money and adequately fund our NHS? Constituent

:29:17.:29:24.

contacted me this week. I said to heard the words that many of us have

:29:25.:29:28.

used many times over the years. At least it is in the right place,

:29:29.:29:32.

Hospital, getting the best care. While I know first-hand how hard

:29:33.:29:38.

those in our health service are working and how much our staff do in

:29:39.:29:42.

hospitals, how much confidence do we have in those words now in a time of

:29:43.:29:48.

diminishing budgets and cuts the budgets? Our health services

:29:49.:29:52.

adequate to provide the best care for our loved ones? The NHS will

:29:53.:30:00.

last as long as there are people fighting for it. I along with my

:30:01.:30:04.

colleagues on this side of the House will continue to fight tooth and

:30:05.:30:07.

nail to ensure that this government does not succeed in destroying the

:30:08.:30:09.

health service we hold so dear. plans raise at least three serious

:30:10.:30:11.

questions. It's a great honour to be able to

:30:12.:30:30.

speak in this debate. I would like to pick up on the remarks of the

:30:31.:30:36.

Honourable member for Newcastle upon Tyne East who spoke about Labour's

:30:37.:30:43.

commitment to meet OECD spending in 2001 on the NHS and I think it's

:30:44.:30:47.

perfectly acceptable in a discussion of this kind to point out that in

:30:48.:30:55.

2001 we had a balanced budget. The then Labour government had succeeded

:30:56.:31:01.

in running a balanced budget for four years, Moreau less. We had at

:31:02.:31:05.

the time, we thought, the money to meet that commitment. As a member of

:31:06.:31:10.

that government, he will remember over the next nine years we ran

:31:11.:31:14.

consecutive deficits and as a consequence of policy, I think

:31:15.:31:21.

misguided, in many instances, we had a deficit of 160 billion, I think it

:31:22.:31:27.

was when the coalition government took its place at the Treasury bench

:31:28.:31:32.

in 2010. It was inevitable given the circumstances that there was going

:31:33.:31:36.

to be a constraint on finance and that's something that we have to

:31:37.:31:42.

speak about. I very much enjoyed the Honourable member for Central Asia's

:31:43.:31:48.

contribution and she said, if I remember correctly, we talk about

:31:49.:31:52.

finance but it should be the third consideration. I wish it was as easy

:31:53.:31:58.

as that. I wish we could relegate finance to a subordinate role but I

:31:59.:32:04.

don't think that is fair on the country. I don't think it is fair on

:32:05.:32:08.

our constituents. The Honourable member for Newcastle on Tyne East,

:32:09.:32:26.

talked about, obviously, the budget constraints and the fact we were not

:32:27.:32:33.

spending enough money. I think this opportunity with the SDP is a

:32:34.:32:36.

serious engagement with what all members recognise is an ongoing

:32:37.:32:42.

problem, growing population, an ageing population, inevitably,

:32:43.:32:50.

issues of finance, issues of resources will become increasingly

:32:51.:32:56.

important and I'm very pleased to hear that local consultation will be

:32:57.:33:03.

at the centre of this draft proposal because that is essential, that is

:33:04.:33:12.

what our constituents want. In Ashford Hospital, right in the

:33:13.:33:18.

centre of Spelthorne, many of the facilities have been downgraded.

:33:19.:33:21.

It's been a difficult time. We've always tried, the borough council,

:33:22.:33:26.

me as a member of Parliament, we've always tried to explain to residents

:33:27.:33:31.

what was driving the decision. Why we were making the kinds of changes

:33:32.:33:36.

that we sought to make. Broadly, they were very understanding. When

:33:37.:33:40.

you explain to people and you can carry them with you, I think people

:33:41.:33:44.

across the country are very sensible and they take a very measured view

:33:45.:33:51.

of the services. They realise that the NHS of Nye Bevan in 1948 has had

:33:52.:33:58.

to evolve. People are much more open to evolution and change than many

:33:59.:34:01.

Honourable members of this house. My last point, a slightly -1, I've been

:34:02.:34:13.

to many of these debates, on the economy, on welfare and all I hear

:34:14.:34:17.

from the opposing benches is the same mantra, stop the cuts. More

:34:18.:34:24.

money. For every single problem that we face as a country, this seems to

:34:25.:34:29.

be their sole solution. The one answer. They always say that to a

:34:30.:34:37.

man with a hammer, every problem is a nail. They seem to say stop the

:34:38.:34:44.

cuts, more money is the answer to everything. I think it's entirely on

:34:45.:34:54.

constructive. It's very disappointing to hear no

:34:55.:34:58.

constructive ideas, no reform, no appetite for fresh thinking,

:34:59.:35:01.

absolutely nothing in the way of intellectual engagement with the

:35:02.:35:05.

real problems we face as a nation. It's very disappointing to take part

:35:06.:35:10.

in another debate and have the same mantra, stop the cuts, more money. I

:35:11.:35:17.

wanted to start by saying I very much agree with the point made by

:35:18.:35:22.

the Honourable member for Central Ayrshire. This ought to present a

:35:23.:35:30.

real opportunity. It has brought people together, discussions have

:35:31.:35:33.

started across organisations that in the past haven't talked to each

:35:34.:35:38.

other nearly enough both across the health and social care divide and

:35:39.:35:41.

bringing in people from outside the health service and social care

:35:42.:35:46.

system. I fear that the opportunity will be fatally undermined for three

:35:47.:35:51.

central reasons. First of all, the point I made in my challenge to the

:35:52.:35:56.

Minister, mental health. Unless every -esque TP addresses -- every

:35:57.:36:06.

STP addresses the burden of mental health is central to its plan it

:36:07.:36:10.

will fail. No doubt about that. I noticed the Minister and attempt at

:36:11.:36:19.

a reassurance to me but it did not succeed because it seems that it is

:36:20.:36:24.

not going to be a requirement that every plan sensually address this

:36:25.:36:28.

problem. If it is not done, it will absolutely fail. We are dealing

:36:29.:36:32.

often with some of the people who are failed most by the system who

:36:33.:36:37.

use A departments more than any other people. Yet, my fear is that

:36:38.:36:43.

this will be a massive missed opportunity in that regard. I will

:36:44.:36:49.

give way very quickly. I wanted to make the point again. I will say it

:36:50.:36:56.

very clearly. If an STP does not come forward with very clear plans

:36:57.:37:00.

as to how mental health and dementia plans are going to move ahead very

:37:01.:37:05.

quickly, they will not go ahead. I'm grateful for the Minister for that

:37:06.:37:09.

and I hope the message goes out across the country. Andy bell today

:37:10.:37:16.

has raced concerns about the process across many parts of the country.

:37:17.:37:21.

The second question that causes real concern is the financial backdrop

:37:22.:37:25.

and the ability to deliver on the plans given the finances are

:37:26.:37:28.

available. We have already heard that the bulk of the money available

:37:29.:37:33.

is going into clear link deficits in providers rather than the

:37:34.:37:40.

transformation that is so necessary. As the Honourable member for

:37:41.:37:44.

Spelthorne made clear to spend money more efficiently and effectively in

:37:45.:37:48.

delivering care for our communities. When you hear the commentary of the

:37:49.:37:55.

chief executive of the King 's fund, a well respected commentator, he

:37:56.:37:59.

says that their assessment of the draft plans shows that in the

:38:00.:38:05.

absence of eye watering efficiency improvements, there will be a

:38:06.:38:07.

financial gap running into hundreds of millions of pounds into 2021 in

:38:08.:38:13.

most footprints. Not across the country. This is completely

:38:14.:38:19.

unachievable. He questions the deliverability of plans which

:38:20.:38:21.

include the closure of cottage hospitals in many areas. The very

:38:22.:38:29.

things that can keep people out of acute hospitals, we are in many

:38:30.:38:34.

cases planning to close down. It makes no sense at all. The way in

:38:35.:38:40.

which regulation operates in the NHS is that we regulate organisations

:38:41.:38:44.

and not systems. So, within an STP from -- footprint, the organisation

:38:45.:38:54.

has two concentrate on survival rather than looking at the full care

:38:55.:39:02.

system for that area. It is an essential floor. I note that there

:39:03.:39:09.

will be a consultation process but let me tell the government that if

:39:10.:39:14.

they really think that a formal consultation process after full

:39:15.:39:18.

draft plans have been produced in a secret process will in any way

:39:19.:39:23.

conference the public that they are being properly involved, it will

:39:24.:39:28.

fail. It is inevitable that it will fail. People are so suspicious of

:39:29.:39:34.

consultation processes. They do not believe they are properly engaged

:39:35.:39:38.

with. The only way to address these really difficult challenges, the

:39:39.:39:42.

Honourable member for Spelthorne made a good point, people are

:39:43.:39:47.

prepared to go on a journey and prepared to listen to potentially

:39:48.:39:52.

radical changes, potentially to use money more effectively, but the only

:39:53.:39:56.

way they will do that is if they are involved from the start, involved in

:39:57.:40:00.

shaping the proposals rather than responding to something that has

:40:01.:40:08.

been fixed behind closed doors. The Honourable member for Bedfordshire

:40:09.:40:11.

knows full well how the public reacts when presented with what

:40:12.:40:15.

looks like a fait accompli. Around the country, we're slimming down

:40:16.:40:23.

acute hospitals, merging hospitals, and they have not been involved in

:40:24.:40:27.

those plans and they will be rejected. We in no doubt. The

:40:28.:40:33.

government is essentially facing a political disaster if it ploughs on

:40:34.:40:39.

in that way. Open up. Involved the nonexecutive directors who have been

:40:40.:40:43.

told they cannot be part of the discussions, even. This is

:40:44.:40:46.

ridiculous. If we are to take people with us, we have to take them on the

:40:47.:40:52.

journey and engage with them and... I give way very briefly. I am giving

:40:53.:40:58.

a very clear signal that I should not. I take the point Mr Deputy

:40:59.:41:05.

Speaker. I'm sorry for my Elderson. I will conclude by saying that this

:41:06.:41:11.

is the right approach but it will be undermined because of a rushed

:41:12.:41:17.

process that doesn't involve the public and doesn't take people on a

:41:18.:41:20.

journey and because there is not enough money to deliver the

:41:21.:41:31.

transformation required. I value our wonderful NHS having volunteered

:41:32.:41:35.

again this summer in my local Community Hospital and I would like

:41:36.:41:38.

to put on record my admiration for all the wonderful staff who provide

:41:39.:41:42.

great care free at the point of delivery in our communities. Every

:41:43.:41:51.

day our NHS is performing 4400 more operations and seeing 2500 more

:41:52.:41:57.

people in A within four hours than it did in 2010. NHS spending in

:41:58.:42:03.

England is going up by ?10 billion in real terms by 2020-21. Of which 6

:42:04.:42:11.

billion will be delivered by the end of 2016-17. Despite this, though,

:42:12.:42:18.

many communities are seeing big challenges and it was good to hear

:42:19.:42:27.

the calm, rational and considered comments from people in this debate.

:42:28.:42:37.

I just want to speak briefly about my local proposed reconfiguration.

:42:38.:42:41.

My local clinical commissioning group is planning to downgrade A

:42:42.:42:47.

at Huddersfield Royal Infirmary in my constituency. A huge community

:42:48.:42:54.

campaign is supported by the local community, local MPs of all parties,

:42:55.:43:00.

local councillors and local GPs. If this downgrade happens, Huddersfield

:43:01.:43:03.

will be the biggest town in England without a full ana. Patients needing

:43:04.:43:17.

A in a growing university town would have to travel to Wakefield

:43:18.:43:21.

along the notorious Al and bypass. The member for Tatton was taking

:43:22.:43:27.

questions and I asked about the reconfiguration and he said the

:43:28.:43:29.

decision must be based on clear evidence that it will develop better

:43:30.:43:36.

outcomes for patients. He said decisions by local solutions must

:43:37.:43:44.

meet four keep tests. Firstly, they must demonstrate public and patient

:43:45.:43:51.

engagement. The results of the survey said 80% of people in

:43:52.:43:56.

Huddersfield thought it would make care worse. The commissioners on the

:43:57.:44:03.

CCG are proposing this change but the Kirklees local medical Council

:44:04.:44:08.

that represents 200 local GPs have said local resources should be

:44:09.:44:12.

developed instead and this controversial plan should be

:44:13.:44:16.

dropped. Thirdly, based on clinical evidence. I'm pleased to say the

:44:17.:44:23.

recent Sea QC report gave both Halifax and Huddersfield's A

:44:24.:44:33.

departments of good ratings and the centralised department at Halifax

:44:34.:44:40.

required improvement. It's clear that patients want the millions of

:44:41.:44:44.

pounds that would be spent on a new planned care hospital in

:44:45.:44:50.

Huddersfield instead used to improve and safeguard existence local A

:44:51.:44:55.

services. I'm really not interested in the partisan politics of this.

:44:56.:45:01.

And standing up to focus on fighting to save my local A unit. Patients

:45:02.:45:07.

should come first. I have one question for the minister. I'm

:45:08.:45:12.

hearing that the STP plans for West Yorkshire will be released on 21st

:45:13.:45:17.

October, the day after my CCG makes its decision. How will this impact

:45:18.:45:22.

on the future of a full A at Huddersfield Royal Infirmary?

:45:23.:45:30.

Thank you Mr Deputy Speaker. I have serious concerns about the lack of

:45:31.:45:37.

transparency in this whole process. The old pros should have been more

:45:38.:45:41.

transparent. It appears to me that the only aim of the plans is to

:45:42.:45:48.

secure funding rather than examine or improve services. In the black

:45:49.:45:53.

burn and the surrounding area hospitals are under huge pressure,

:45:54.:46:00.

as I'm sure Mr Deputy Speaker is fully aware with the closure of the

:46:01.:46:05.

accident and emergency at Chorley Hospital. Couple that with the huge

:46:06.:46:11.

burden facing local authorities and there's a real challenge of the

:46:12.:46:18.

Pennine Lancashire Health Authority having to find ?238 million in the

:46:19.:46:23.

next five years. With the best will in the world, from local authorities

:46:24.:46:29.

and NHS trusts and communities, and about kind of pressure I feel the

:46:30.:46:34.

change won't be for the better. Let's not forget the savage budget

:46:35.:46:42.

cuts that face local authorities. Blackburn has already cut ?100

:46:43.:46:46.

million on its budget and again faces another 40 million by 20 20.

:46:47.:46:52.

Mr Speaker, I am not opposed to a system approach in theory, for

:46:53.:46:58.

hospital trust fund local authorities to group together. In

:46:59.:47:02.

fact, as council leader for Blackburn Council for many years

:47:03.:47:07.

that was one of our main aims. To improve services. However, it's not

:47:08.:47:12.

clear, that in practice you effectively handed the task for

:47:13.:47:15.

improvement with vanishing resources. The exemption of adult

:47:16.:47:24.

social care from STP is has caused concern for local authorities up and

:47:25.:47:28.

down the country. To submit a plan and be told to leave out that

:47:29.:47:37.

doesn't quit the role fit in with the budget is not helpful. It

:47:38.:47:42.

doesn't produce a more efficient, better service.

:47:43.:47:45.

The funding gap in adult social care is a real and true crisis facing

:47:46.:47:49.

local authority with no remedy to fix it coming forward at the moment.

:47:50.:47:54.

Many pressure groups, experts and even the Chief Executive of the NHS,

:47:55.:48:00.

Simon Stephens, have publicly advised the Government to make extra

:48:01.:48:04.

funding available for social care. Yet, so far, the Government have

:48:05.:48:10.

been silent. They haven't made any commitment to make funds available

:48:11.:48:15.

in 2017. To support adult social care. I'd like to give them an

:48:16.:48:19.

opportunity today, and would happily give way to public ministers at this

:48:20.:48:24.

stage if they are prepared to clarify this point. Willard the

:48:25.:48:29.

Government make available additional funds to ease the burden on adult

:48:30.:48:34.

social care, which will lead to a better better services. I seek

:48:35.:48:44.

clarity on whether additional funds would be made available, because if

:48:45.:48:51.

funding isn't available the STP will fail, and failed miserably. If we

:48:52.:48:55.

really want a transparent process, and improved services, I suggest we

:48:56.:49:01.

move forward people like myself and other colleagues are at least made

:49:02.:49:08.

aware of what are in the plans. We need assurances that the resources

:49:09.:49:13.

will be able to stabilise local authorities in any services before

:49:14.:49:20.

we move on to transformation. Thank you, Mr Deputy Speaker. May I

:49:21.:49:25.

take this opportunity to welcome the new ministerial team to their

:49:26.:49:30.

places, but also to welcome the shadow secretary of state. But can I

:49:31.:49:34.

request a more constructive debate in future on health care. And not to

:49:35.:49:41.

talk about cuts, when she knows perfectly well... She knows

:49:42.:49:45.

perfectly well that this government is putting an extra 10 billion a

:49:46.:49:50.

year into the NHS by 2020, that is not a cut. That is 10 billion extra

:49:51.:50:03.

of taxpayer's money. So please could you not mislead people by talking

:50:04.:50:05.

about cuts. And as also she won those, who party did not commit to

:50:06.:50:08.

spending anything like that... I don't think an honourable member

:50:09.:50:11.

would try to mislead another, it's not a word we would use.

:50:12.:50:17.

I did not mean to use that word. Perhaps you could clarify, when she

:50:18.:50:21.

referred to the 22 billion shortfall that was set out in the analysis

:50:22.:50:26.

whether who party is now planning to make up that, and if so, where will

:50:27.:50:31.

they find the money from? That was not clear in her comments. I moved

:50:32.:50:36.

on because ice is really believe we need a far more constructive debate

:50:37.:50:47.

about the real challenge the NHS faces and how to improve the care it

:50:48.:50:49.

provides row constituents. The NHS is under pressure. No one here is

:50:50.:50:52.

denying that. I know as well as anyone. My grandmother spent five of

:50:53.:50:58.

the last six months of her life in hospital, has the system been better

:50:59.:51:01.

she would not have been there. We know people are living longer with

:51:02.:51:07.

multiple conditions. Around 70% of NHS spending goes on long term

:51:08.:51:12.

conditions. Treatments are fast a wider and more expensive than they

:51:13.:51:16.

were in the past. Patients expect far more of the NHS. The NHS should

:51:17.:51:21.

not constantly be criticised as is often the case, it is seriously

:51:22.:51:26.

rising to the challenge, from forming thousands of operations and

:51:27.:51:30.

patients are seen every day. The response from its staff and

:51:31.:51:34.

incidents like that, there are tens of thousands more doctors and nurses

:51:35.:51:39.

working in the NHS. Skilled staff don't come overnight. Training takes

:51:40.:51:44.

years. There is a lot being done to address the pressures on the

:51:45.:51:48.

workforce and none of this should be overlooked.

:51:49.:51:52.

Though it is also costly. Can I ask us to focus on talking about how the

:51:53.:51:56.

NHS rises to the challenges it faces as well as making sure that it does

:51:57.:52:02.

so in a financially sustainable way. To do that we don't have a blank

:52:03.:52:09.

sheet of paper. There was a five-year forward being published in

:52:10.:52:15.

2014. I have asked questions about what was happening to drive forward

:52:16.:52:19.

the view at the pace and scale that was needed. The STP is a vital part

:52:20.:52:24.

of the process. These STP plans across the country are about putting

:52:25.:52:29.

that five-year review into practice. They are doing so in a really

:52:30.:52:34.

important way, looking at the place, the whole population, bringing

:52:35.:52:37.

together diversity organisations across the NHS. Organisations that

:52:38.:52:45.

are often, really in the same room. Organisations that have come

:52:46.:52:48.

together but have literally not spoken. This is really, really

:52:49.:52:52.

important. It is putting public health at the core of the future

:52:53.:52:59.

plans for the NHS. And looking not just a treatment, but how the

:53:00.:53:04.

population can be healthier. How we can reduce health inequalities. The

:53:05.:53:07.

final thing I'll say is can I urge all colleagues to do as I am going

:53:08.:53:13.

to do, and make sure that the STP in your area rises to the challenges

:53:14.:53:16.

and delivers the care that we all want for operations in future.

:53:17.:53:20.

Thank you, Mr Deputy Speaker. In a recent report to my local health and

:53:21.:53:28.

well-being board in relation to the sustainability transformation plans

:53:29.:53:31.

the state of that was a growing concern that one of the most

:53:32.:53:35.

powerful ways to achieve changes through services working together

:53:36.:53:37.

across entire communities and pathways of care. To find ways to

:53:38.:53:43.

close the gaps between where we are now, and where we need to be in the

:53:44.:53:48.

future. I think this was the hope of many people who written to me on

:53:49.:53:52.

this matter. And I really do appreciate the time they've taken to

:53:53.:53:56.

share their concerns, but I can them little comfort. In my area the

:53:57.:54:04.

footprint is an area in Cheshire and Merseyside not in the Liverpool city

:54:05.:54:09.

region. That was determined unilaterally by the Government

:54:10.:54:13.

structures and it's regrettable. So the process got off to the wrong

:54:14.:54:18.

start. A contact from local political leaders suggesting that

:54:19.:54:24.

were dismissed. That act was compound did, and has compounded the

:54:25.:54:28.

problem. The very people the NHS should be consulting are those

:54:29.:54:33.

people, leaders of councils, local community is, local councils who are

:54:34.:54:37.

democratically elected representatives in those areas. It

:54:38.:54:40.

is all the more disappointing given that there is a council leader whose

:54:41.:54:45.

responsibility for health and social care, the health and social care

:54:46.:54:49.

brief across the city region, but it's more than disappointing. It's

:54:50.:54:53.

bizarre. Especially when local governments are supposed to be a

:54:54.:54:59.

significant partner of the NHS. The Government has pushed integration

:55:00.:55:02.

nor end but it seems more in theory than in practice. You can hardly

:55:03.:55:07.

find a press release without mention it, but many are in the same

:55:08.:55:14.

situation as mine. People are being excluded. There is no doubt about

:55:15.:55:18.

that. And I've laid emphasis on this particular issue because it goes to

:55:19.:55:22.

the heart of the willingness of the NHS to step out of its self-imposed,

:55:23.:55:28.

Bruichladdich mindset it seems to be in. Worryingly, there appears to be

:55:29.:55:33.

a novelist pathological inability to realise it.

:55:34.:55:40.

think, you are on the 20th century, not the 20th century. The reality

:55:41.:55:56.

is, the Democratic lack of accountability in the NHS, certainly

:55:57.:56:00.

on a local level leads to an inability to recognise that in

:56:01.:56:04.

setting the terms of engagement you must do so before decisions are

:56:05.:56:12.

made, and not after. As far as I'm concerned, Mr Speaker, the

:56:13.:56:15.

Government are telling us that all is well. That you've poured loads of

:56:16.:56:20.

money into the NHS. It is just a question of better use of it, but

:56:21.:56:26.

the German spent 40% more per head on GDP run we do, and 25% more

:56:27.:56:31.

across the European Union. But people take that with a big pinch of

:56:32.:56:37.

salt. They are seeing waiting lists grow longer, access to a GP is

:56:38.:56:42.

becoming difficult, waiting times in A growing by the day and ongoing

:56:43.:56:46.

industrial disputes with junior doctors. GP led commissioning

:56:47.:56:51.

services are starting the process of rationing and so it goes on. We need

:56:52.:56:59.

an NHS which has the consent of our community. We need an NHS that links

:57:00.:57:05.

in with the community and are deprived via the plans will turn out

:57:06.:57:09.

to be neither sustainable or transformational. It sends the

:57:10.:57:13.

message that the NHS is not safe in Tory hands. Mr Speaker, I just want

:57:14.:57:21.

to declare an interest as a registered nurse before I speak, but

:57:22.:57:26.

I welcome this debate this afternoon. STP is only really

:57:27.:57:31.

important issue. They have huge potential of transforming care at a

:57:32.:57:36.

local level bringing in social care, bringing in third sector

:57:37.:57:39.

organisations. The RE huge opportunity and not one we want to

:57:40.:57:45.

get wrong. However, because many of these 44 STP 's have not shared or

:57:46.:57:50.

consulted on the plans there is suspicion rightly or wrongly that

:57:51.:57:54.

these STP 's are an excuse to bring in cuts or to breach financial

:57:55.:57:59.

deficits. I welcome the Minister's thoughts on this and his signal that

:58:00.:58:05.

consultation win happen. But it isn't happening at the moment and

:58:06.:58:09.

this is part of the problem. It enables those who want to perpetrate

:58:10.:58:13.

this myth and fear that this is all about cuts to allow them some

:58:14.:58:19.

breathing space. In my area, for example, we fall into the Sussex and

:58:20.:58:25.

East Surrey STP. They have not published their STP. They make great

:58:26.:58:29.

claims to be working with GPs, and health watch, but no one I know, and

:58:30.:58:34.

certainly no local MPs have been involved in any discussions about

:58:35.:58:38.

the process. I'm very disappointed that some of our key committee

:58:39.:58:44.

groups, such as a senior forums, families for autism and many other

:58:45.:58:48.

groups have not been consulted on this STP. It is right that STPs

:58:49.:58:53.

should submit their plans to NHS England to make sure it's a

:58:54.:58:57.

coordinated approach across the country, but it is vital that there

:58:58.:59:01.

is time in the process for consultation and I'm worried that

:59:02.:59:05.

there is only a short space of time after October for this to happen.

:59:06.:59:09.

However, what I will say to the doom mongers trying to instil fear into

:59:10.:59:16.

my constituency is that if current investment is anything to go on I am

:59:17.:59:20.

optimistic about what an STP will plug.

:59:21.:59:27.

My constituency does not have a hospital, but we are seeing huge

:59:28.:59:33.

investment by this government. ?480 million on a redevelopment of the

:59:34.:59:38.

Royal Sussex County Hospital, ?58 million promised to go to Eastbourne

:59:39.:59:42.

District General Hospital and a new multi-million pound is radiotherapy

:59:43.:59:48.

seeds in Eastbourne. A new dialysis unit in deliberately so that

:59:49.:59:52.

patients don't have to travel to Brighton for three times a week

:59:53.:59:56.

dialysis. Working in Eastbourne to develop a new state of the art GP

:59:57.:00:02.

practice surgery in Eastbourne. A new cancer centre in Sussex. I could

:00:03.:00:08.

go on. Huge investment, new services, vital treatment for local

:00:09.:00:11.

patients. But with all this investment, white are people so

:00:12.:00:17.

worried about cuts? Despite an increase of ?10 billion a year in

:00:18.:00:24.

funding the NHS does have to deliver ?22 billion of savings. My

:00:25.:00:27.

constituents know there's an increasing demand for services, 6% a

:00:28.:00:32.

year. They know more treatments are available that are costly and they

:00:33.:00:35.

know that there are more conditions that can be treated.

:00:36.:00:39.

There are concerns that we have not tackled wastage in the NHS such as

:00:40.:00:44.

that of the Chief Executive of the troubled mental health trust who was

:00:45.:00:53.

offered as a new job instead of being investigated for the many

:00:54.:00:55.

hundreds of deaths that happened in her previous role.

:00:56.:01:00.

I thank her for giving way. In order to be efficient and effective the

:01:01.:01:08.

NHS must stop the creation of these jobs that are not helpful with

:01:09.:01:13.

patients being heard in this process but executives ahead in terms of

:01:14.:01:19.

giving new projects and new offices. Absolutely. Madam Deputy Speaker, I

:01:20.:01:29.

hope I'm in a position to assist some of the members who may feel

:01:30.:01:33.

they have in the dark are confused by reporters in their SDP 's.

:01:34.:01:50.

--STPs. Like most NHS documents it is written that style of language

:01:51.:01:53.

that makes it difficult for the ordinary public to understand. For

:01:54.:01:58.

Northwest London this is not a process that has mushroomed

:01:59.:02:03.

overnight as has been the case generally that has been developed

:02:04.:02:13.

over four years. We have fired shipping a healthier future since

:02:14.:02:17.

the middle of 2012. That is simply morphed into this. What did shipping

:02:18.:02:33.

a healthier future mean? --Shaping? It meant to hospitals will be

:02:34.:02:41.

downsized and for accident and emergency is would lose that

:02:42.:02:44.

effective services. What is clear would be the transformation into

:02:45.:02:54.

SDPs an initial anguish was unless we implement these cuts then we will

:02:55.:02:59.

go bankrupt. That language is not good and very well with a 2 million

:03:00.:03:05.

people affected in west London minors. The language changed and was

:03:06.:03:09.

all about care. I'm pleased that the honesty is back in the system and

:03:10.:03:15.

sister very much about money. My own hospital trust is a very important

:03:16.:03:23.

and prestigious trust called Cammack Imperial is over ?50 million in

:03:24.:03:30.

deficit this year alone. And the CCG is a flat-lining in funding. The

:03:31.:03:36.

only possible justification for major cuts in acute care is because

:03:37.:03:41.

social care greater care in primary care will be increased. How that is

:03:42.:03:46.

possible with budgets and best standing still I really don't know.

:03:47.:03:50.

The other interesting factor is the delays over those times. We had this

:03:51.:03:56.

proposal the middle of 2012 and a slight revision and 70,013 and then

:03:57.:04:00.

silence and I have lost count of the number of times I've been promised

:04:01.:04:05.

that a full business case will be published. I act as an unofficial

:04:06.:04:12.

shop steward for the 11th Labour MPs in the region. We were told it would

:04:13.:04:17.

be next Tuesday the role coming in from the recess today but it has has

:04:18.:04:23.

been put off until at least after the New Year. Moreover, the plan has

:04:24.:04:29.

now been becomes so open Realty and difficult to achieve this split --

:04:30.:04:37.

and has been split into. It has become unwieldy. We do not know when

:04:38.:04:45.

the proposals will be published but it has only been taken outside of

:04:46.:04:49.

the process. It is beyond the five-year horizon and nothing will

:04:50.:04:55.

happen until 2022. I'm delighted that the demolition ball is not

:04:56.:04:59.

going into Charing Cross that period of time but in the meantime the

:05:00.:05:02.

uncertainty and the lack of support for the hospital this morning. I see

:05:03.:05:13.

these are about cuts in acute services before the compensatory

:05:14.:05:16.

services and for that reason members should be extremely concerned about

:05:17.:05:22.

them and extremely worried about them and I'm happy to share my pain

:05:23.:05:25.

and knowledge of the subject of members wish to hear that. Can I

:05:26.:05:30.

just say that the person after the next speaker will be down to three

:05:31.:05:35.

minutes. This is to get everybody in. But two things I think we need

:05:36.:05:48.

to kneel before we go any further. I listened to the Fidel Castro like

:05:49.:05:51.

monologue of this shadow Secretary of State. He refused to take an

:05:52.:06:00.

intervention -- she refused to take an intervention. When you consider

:06:01.:06:11.

that my party has been in government the longest giving the existence of

:06:12.:06:16.

the National Health Service, frankly have this Conservative Party wanted

:06:17.:06:21.

to privatise a national health service we would have done it by now

:06:22.:06:24.

and I think that is a very clear point that we want to make. We are

:06:25.:06:30.

all, on the side of the House, as on that side, champions of the NHS and

:06:31.:06:34.

determinedly and doggedly trying to ensure that our constituents get the

:06:35.:06:38.

very best of health care. I'm slightly incredulous as well by

:06:39.:06:48.

wanting to have a penny that the front bench, the opposition front

:06:49.:06:56.

bench, advocated this afternoon. They want to see greater

:06:57.:07:00.

transparency but as soon as it is a powerful idea, they say everybody's

:07:01.:07:06.

going to die and rackets is coming back. It is regrettable that rather

:07:07.:07:11.

like a snail those who are trying to think about changes we tracked

:07:12.:07:16.

further into the shell. An idea for the minister, and I hope Madam

:07:17.:07:19.

Deputy Speaker this will not be ruled out of order, is that everyone

:07:20.:07:23.

to improve sustainability in health care and health service should be

:07:24.:07:33.

taken advantage nursing to be free Brexit world and having in

:07:34.:07:38.

procurement health service and the procurement of British made digest

:07:39.:07:44.

foods and milk. That would certainly add to sustainability. The problem

:07:45.:07:56.

to my constituency regarding the Westminster hospital which is

:07:57.:08:03.

causing enormous concern amongst my constituents and it is a popular and

:08:04.:08:09.

useful committee hospital. I family support and champion the provision

:08:10.:08:16.

and continuation of our community hospitals which provide a very

:08:17.:08:20.

useful spoken in health care framework providing the transition

:08:21.:08:24.

from acute sector with is often pressure and beds right through to

:08:25.:08:26.

hopefully patients returning to their home. I have asked the

:08:27.:08:33.

department to think about this, often consultation is used as a word

:08:34.:08:38.

when a means information. Very often scenarios are not put forward in the

:08:39.:08:41.

public are not stupid. They need to north the news -- need to know they

:08:42.:08:48.

choose this option what happens here in the features that option what

:08:49.:08:55.

happens there. -- if they choose that option what happens there. I'm

:08:56.:09:03.

keeping an open mind about the plans for health care across North Dorset.

:09:04.:09:07.

We cannot just close the door to innovative thinking. And the need to

:09:08.:09:15.

meet modern clinical demands. Patient care must go first and that

:09:16.:09:21.

cannot be offence in order to avoid change and challenge in service

:09:22.:09:25.

provision. But I do hope that anchored in the Dorset plan for

:09:26.:09:29.

health care that is a very clear role and a very clear place for

:09:30.:09:38.

committee hospitals. The so-called transformation process has been

:09:39.:09:43.

going on in fits and starts. It has been going on in Staffordshire since

:09:44.:09:52.

2014 and by 2000 20 and 2021 the deficit and social care has been put

:09:53.:10:03.

out in the draft SDP. The menu being cooked out behind-the-scenes is

:10:04.:10:05.

already being picked out in practice. -- dished out. It is being

:10:06.:10:20.

driven by cost cutting. Even if short-term it increases the pressure

:10:21.:10:26.

on pavements and our local Royal Stoke University hospital when the

:10:27.:10:31.

trolleys queueing up in corridors at accident and emergency. Before the

:10:32.:10:37.

summer the closure of Ward four at a local hospital took away a safe

:10:38.:10:41.

place of discharge for patients with mental health problems and the

:10:42.:10:46.

viability of drug and alcohol and other services as well as respite in

:10:47.:10:51.

rehab facilities are threatened. Last month we learned the both wards

:10:52.:10:54.

at Cheadle Community Hospital would be closed further affecting

:10:55.:10:58.

discharges while social services struggle to Corp. Children's ward at

:10:59.:11:12.

Stafford was closed and Swinton will be freezing closures in spring. The

:11:13.:11:19.

press is an will continue to multiply. While the north and west

:11:20.:11:25.

looks to Stoke, the South and West looks to Birmingham and the East

:11:26.:11:34.

Derby. What is on the cards now is a countywide merger of everything and

:11:35.:11:39.

that monolith with no centre of a Navy is being called and accountable

:11:40.:11:47.

care organisation. But care has been anything but accountable and

:11:48.:11:52.

transformation so far. Not least the paper 's senior executives are

:11:53.:11:59.

raking off this process. This salary of ?160,000 a year for the four-day

:12:00.:12:06.

week and her deputy is 172,000 for five days. The late financier is on

:12:07.:12:13.

244,000 a year. Added to other people and 131,000 at the

:12:14.:12:19.

Staffordshire and the annual bill for the five drunken state and

:12:20.:12:31.

?46,000. -- 846 thousand pounds for the five of them. I have two

:12:32.:12:43.

hospitals which serve my constituency in the counties of

:12:44.:12:47.

Chester and later in hospital which is actually in my constituency. I

:12:48.:12:51.

know that there are going to be pressures on the hospital and the

:12:52.:12:56.

CCG are indicating that they may well cut funding to that hospital

:12:57.:13:03.

and that is despite an increase in funding to the four local CCG 's in

:13:04.:13:10.

my constituency. I had was some surprise the speech from the shadow

:13:11.:13:14.

Secretary of State because the big pressures that are coming in

:13:15.:13:18.

Cheshire at the cause of the slash and burn tactics adopted by Labour

:13:19.:13:25.

in Wales when it comes to health. It is doing as I say, not as I do. If

:13:26.:13:29.

you look at what the Labour Party have done in Wales over the border

:13:30.:13:34.

that is impacting on health services and Cheshire they have cut the

:13:35.:13:38.

budget in health and it is not even kept pace with inflation. They have

:13:39.:13:44.

downgraded a huge number of hospitals and they have closed

:13:45.:13:48.

almost all the community hospitals and all of this and indeed maternity

:13:49.:13:54.

services they were suggesting that some patients would need to drive

:13:55.:13:58.

for over two hours to access maternity wards. One of those

:13:59.:14:04.

hospitals would have been the Countess of Chester which would have

:14:05.:14:07.

served a huge rural hinterland and is not in Wales. I take no lessons

:14:08.:14:13.

from the party opposite when it comes to transformation plans when

:14:14.:14:21.

you see what Labour actually does and is doing means cuts in Wales and

:14:22.:14:28.

downgrading the services and worse access to care than currently is a

:14:29.:14:32.

position in England. In relation to the opportunities that come out of

:14:33.:14:37.

this transformation programme, I very much agree with what was said

:14:38.:14:41.

by the member of Parliament for Central Ayrshire. There are huge

:14:42.:14:48.

local opportunities. There are the opportunities to put in tailor-made

:14:49.:14:53.

plans that will suit local populations and particularly in

:14:54.:14:57.

Cheshire where we have large rural populations the opportunity to

:14:58.:15:01.

deliver services more in the primary care setting is a very real

:15:02.:15:07.

opportunity and one that should be welcomed.

:15:08.:15:17.

I welcome the fact that there are changes in the budget which will go

:15:18.:15:23.

to local authorities to help with the social care budget. To that

:15:24.:15:30.

extent the involvement of the local authorities, Cheshire West and

:15:31.:15:34.

Cheshire East in the transformation plans, and particularly the

:15:35.:15:37.

integration of social care in relation to health services provides

:15:38.:15:43.

a very real opportunity that I hope the plans, the STP in Cheshire will

:15:44.:15:51.

cease. Thank you, before I commence I need to register an interest. My

:15:52.:15:57.

husband is a nonexecutive member of the board Chelsea NHS Trust. I have

:15:58.:16:03.

had a large mailbag about today's debate. I want to be that way. We

:16:04.:16:14.

provide good, appropriate services, accessible, timely and free at the

:16:15.:16:17.

point of entry. We want to address the deficit and improve services.

:16:18.:16:23.

Those who were given the NHS care deeply about its future, and they

:16:24.:16:29.

want to be able to do their best for their patience. Like my honourable

:16:30.:16:35.

friend for Hammersmith, my constituency is, the people in my

:16:36.:16:38.

construes the deeply concerned about the future of charring Cross

:16:39.:16:42.

Hospital. A large General Hospital with a busy A The hospital's

:16:43.:16:50.

future has been uncertain for at least five years since the north

:16:51.:16:54.

west London NHS first proposed closing the A there and in four

:16:55.:16:59.

other hospitals. People are worried about travel times from Chiswick to

:17:00.:17:03.

the nearest AMD. About the inevitable downgrading of other

:17:04.:17:10.

services on that site. Has the capacity of neighbouring hospitals

:17:11.:17:15.

to do with that pressure. In the context of the STP, it is happening

:17:16.:17:20.

at a time when we have ?1 billion funding gap in north-west London,

:17:21.:17:26.

500 beds are proposed to close. A 40% cut proposed in face-to-face

:17:27.:17:30.

consultations, and this is against the background of rising population,

:17:31.:17:35.

increased health needs and in the context of our services, currently,

:17:36.:17:42.

missing many targets. And social care cuts are, again, very crucial

:17:43.:17:47.

to this house how can STP 's have any credibility of the NHS cannot

:17:48.:17:56.

plan nationally? If they are funded and controlled in a different way

:17:57.:18:02.

and being cuts and cut and cut, the Northwest London STP proposes

:18:03.:18:06.

cutting beds that we clearly all want treatment. We want it less

:18:07.:18:09.

dependent on spending nights in hospital beds and a reduction on

:18:10.:18:15.

acute beds is inevitable. With changes in modern health provision,

:18:16.:18:20.

but 500 beds is a staggering number in west London where the population

:18:21.:18:25.

is rising and ageing. IM and by responding to members opposite about

:18:26.:18:31.

the funding gap in the NHS. The NHS wouldn't have a funding crisis of

:18:32.:18:34.

this country match the health funding per head of similar

:18:35.:18:38.

countries. The Kings fund shows the UK public purse spends a smaller

:18:39.:18:46.

proportion than the original, Japan and the Netherlands. If those

:18:47.:18:49.

countries can follow their health in this way, so can the UK.

:18:50.:18:56.

Firstly I'd like to place on record my thanks to the gym and does work

:18:57.:19:00.

of the NHS staff up and down the country, particularly in my

:19:01.:19:08.

constituency. -- thanks to the NHS staff up and down the country. They

:19:09.:19:13.

do a great job over the last five or six years when our particular health

:19:14.:19:17.

economy has been in the national spotlight.

:19:18.:19:21.

Of course, we have had our own sustainability and transformation

:19:22.:19:25.

plan, really, since 2012 will be just Russian administration of the

:19:26.:19:30.

NHS Foundation Trust. It was an extremely difficult time, really

:19:31.:19:33.

challenging. I want to draw out two points of that. The first was made

:19:34.:19:41.

by the member for North Norfolk, the vital importance of consultation at

:19:42.:19:45.

every level. Don't leave people in the dark. There is nothing like as a

:19:46.:19:49.

jewellers like less than finding leaked reports, things that they are

:19:50.:19:54.

supposed to know about -- nothing my constituents like less. They will no

:19:55.:20:01.

doubt be plans that arise anger and hostility but it is better to do it

:20:02.:20:05.

in public and deal with it properly. The second point is stick to what

:20:06.:20:10.

you agree. What they came out with in Staffordshire was not what we

:20:11.:20:15.

wanted. It was far short of what we wanted, although it was better than

:20:16.:20:19.

the minimum first proposed, largely as a result of a local campaign.

:20:20.:20:26.

But, we have just had the temporary closure of our children's emergency

:20:27.:20:31.

centre which was specifically committed to, in the administrator

:20:32.:20:36.

's proposals, only opens a year and two months ago. It must be brought

:20:37.:20:42.

back immediately, or as soon as possible. Which means in the next

:20:43.:20:47.

few weeks. This was a commitment, it has been closed temporarily on

:20:48.:20:51.

safety grounds. Commitments must be met. The final point I want to make

:20:52.:20:56.

is, following on from what others have said, we spend too little of

:20:57.:21:01.

our GDP on health. The Economist this

:21:02.:21:14.

week has had an article which made it quite clear. Even the Economist

:21:15.:21:18.

is saying we need to spend a higher proportion of GDP. That means

:21:19.:21:20.

raising the money, and it means raising it to higher rates of

:21:21.:21:22.

national insurance in the long term. My honourable friend and I wrote an

:21:23.:21:25.

article about this recommending hypothecated tax and I think that is

:21:26.:21:30.

an important way forward. I believe the STP system offers a good

:21:31.:21:34.

opportunity to go forward and make necessary changes around health and

:21:35.:21:39.

social care, but STPs which don't look beyond 2020, at the percentage

:21:40.:21:43.

is spent on health and social care will not succeed. Thank you. The

:21:44.:21:50.

Nuffield trust has said that the sustainability and transformation

:21:51.:21:53.

plans could lead to fundamental changes in the shape of care

:21:54.:21:58.

services, but as we've heard in this debate despite the significance of

:21:59.:22:02.

the brand is being little opportunity for patients, the

:22:03.:22:05.

public, and adjust for Parliament to scrutinise them. The BBC has

:22:06.:22:12.

received draft plans which propose changes to AMD and GP care. The

:22:13.:22:16.

Nuffield trust which examined them also received the same popular

:22:17.:22:21.

changes and are questioning the role of community cottage hospitals.

:22:22.:22:24.

Members opposite have been referring to that today. These are members

:22:25.:22:28.

that many people are concerned about the lack of consultation. In Greater

:22:29.:22:33.

Manchester we have the devolution document, taking charge, which was

:22:34.:22:37.

published last year it's been used as the basis for the STP in Greater

:22:38.:22:43.

Manchester. It outlines the need for integrated health and social care,

:22:44.:22:45.

cancer, mental health and other services. Our partnership believes

:22:46.:22:50.

that made significant efforts to reach out to local people with the

:22:51.:22:54.

taking charge document. But when I looked at it the the number it

:22:55.:22:59.

reached its quite a small proportion of the two wins a half million

:23:00.:23:05.

population of Greater Manchester. Information booklets, 200 metres,

:23:06.:23:10.

600 people completed a survey. We have 2.5 million people living in

:23:11.:23:14.

Greater Manchester. The document doesn't include detailed plans of

:23:15.:23:17.

what would be changed cuts that will be made. It outlines savings

:23:18.:23:26.

totalling ?1.5 billion from things like prevention, reform of the NHS

:23:27.:23:31.

Trust, productivity services and joint working, but no details of how

:23:32.:23:36.

it's going to be done. The board is now finding a number of gaps that

:23:37.:23:39.

need addressing in the delivery of the nine must use in the five-year

:23:40.:23:45.

forward view. It's my view that decisions about how to deliver those

:23:46.:23:49.

mass tattoos, must have a significant impact on local

:23:50.:23:57.

services. -- must dos. I'm concerned that the Government is passing the

:23:58.:24:01.

buck to local authorities and NHS trusts leaving them to make plans

:24:02.:24:06.

without sustainable funding. In Greater Manchester, the Minister

:24:07.:24:09.

will probably know that there revised down the size of the gap to

:24:10.:24:15.

1.7 billion, that's still a very significant financial challenge for

:24:16.:24:20.

the area. There are plans to centralise radiology, what will it

:24:21.:24:25.

mean? Will services" smack these are the sort of decisions that local

:24:26.:24:28.

people are entitled to know about before FTPs are signed. -- these are

:24:29.:24:35.

the sort of decisions that people are entitled to know about before

:24:36.:24:45.

STPs are signed off. Thank you. I follow on from some very hard work

:24:46.:24:53.

from committed campaigners on health issues, particularly my honourable

:24:54.:24:56.

friend from Staffordshire who has championed the NHS. I want to thank

:24:57.:25:01.

all those NHS staff across the entry that work incredibly hard, day in,

:25:02.:25:05.

day out, and don't get the thanks they deserve. Now, compared with

:25:06.:25:11.

some members in this house I've actually had an incredibly good

:25:12.:25:15.

range of consultation exercises with my commissioning group information

:25:16.:25:20.

to the STPs. They having gauged with MPs, not just in Bath and North East

:25:21.:25:25.

Somerset where our hospital is, but across Wiltshire and Swindon two. If

:25:26.:25:31.

the ministerial team are looking at Best practice examples, then I would

:25:32.:25:35.

be more than happy to host them in Bath and North East Somerset, and

:25:36.:25:40.

the STP group to show them the work they are doing to engage their early

:25:41.:25:44.

across the entire patch. I have incredibly pleased to be speaking on

:25:45.:25:48.

today's debate because in Berkeley have a range of very difficult niche

:25:49.:25:53.

concerns in relation to health. Not just the population, but we have not

:25:54.:26:00.

just the one in five children who live in poverty but the high as

:26:01.:26:04.

levels of alcohol and substance misuse in the south-west. That gets

:26:05.:26:10.

glossed over. I think STPs will be Friday Freeman to tackle those

:26:11.:26:12.

issues which haven't necessarily been tackled before. -- provides the

:26:13.:26:23.

framework to tackle. I am the think that actually those people that need

:26:24.:26:28.

more should get more, and unfortunately, the NHS hasn't been

:26:29.:26:32.

able to provide that finding it absolutely needs to reform going

:26:33.:26:37.

forward. There has been a huge amount of misconception and a lot of

:26:38.:26:42.

scaremongering. Unfortunately this is harming what is quite likely to

:26:43.:26:46.

be an incredibly positive policy which is being acquired for a number

:26:47.:26:52.

of years. In Bath we want to work with Swindon and Wiltshire through

:26:53.:26:56.

the new transformation and sustainability plans and work with

:26:57.:26:59.

our neighbours in other areas as well. I would like to find out from

:27:00.:27:04.

the minister if this is going to be a constantly evolving project.

:27:05.:27:08.

Because as devolution and that a brand the UK sometimes these plans

:27:09.:27:11.

will need to be changed in order to make sure they fit with the new

:27:12.:27:15.

footprints as devolution comes into force. In these debates it is

:27:16.:27:23.

important to stand up what the commissioning group has been asking

:27:24.:27:28.

for. I would be failing if I didn't say that this year finances are OK.

:27:29.:27:33.

Next year but it did finances are expect to be difficult. Without

:27:34.:27:36.

funding to match some of those plans I think everyone in this house has

:27:37.:27:40.

agreed that we need to make sure the funding does match the requirements

:27:41.:27:47.

of those local communities. To understand the significance of the

:27:48.:27:51.

Government's creation of the sustainability transformation plans

:27:52.:27:54.

we need to be aware of what's gone before to consider the extent of the

:27:55.:27:58.

financial crisis. In 2012 we have and social care act was passed

:27:59.:28:03.

paving the way the privatisation and removing the duty of the Secretary

:28:04.:28:06.

of State to provide an secure a comprehensive health service in

:28:07.:28:10.

England. I believe these STPs are a key part of the Government's plan to

:28:11.:28:14.

drive through privatisation. I will give way. Will she agree with me

:28:15.:28:22.

that the concern in our part of the world is that the word

:28:23.:28:26.

sustainability is all about financial scalability and not about

:28:27.:28:31.

sustainability and services? I think the honourable member has hit the

:28:32.:28:36.

nail on the head there. A report on Monday's Liverpool Echo reports an

:28:37.:28:43.

anticipated ?1 billion deficit by 2012. It talks of a need to reduce

:28:44.:28:47.

demand, and reduce costs. All very nice ambitions but the idea of

:28:48.:28:52.

trying to reduce demand just to plug a funding gap is the wrong way to

:28:53.:28:55.

deal with planning a sensible has service. The STP also says that

:28:56.:29:01.

there is an appetite for hostel reconsideration, and appetite with

:29:02.:29:05.

whom? The existing setup is unaffordable. That wrap the hospital

:29:06.:29:09.

reconfiguration. There was a problem with commas in

:29:10.:29:18.

the document, so who knows what they mean. There will be cuts to staff,

:29:19.:29:22.

and cuts to hospitals. I will indeed give way. Thank you, could this

:29:23.:29:32.

perhaps be a way in which this is done by stealth. Clearly, there is

:29:33.:29:38.

an increase in demand but this demand is being spread rather than

:29:39.:29:43.

being targeted at localities. My honourable friend is absolutely

:29:44.:29:47.

right. It goes on to say that the shape and size of hospital beds will

:29:48.:29:52.

need to be considered, there is a real threat to the number of beds we

:29:53.:29:56.

have available. I am concerned would be often in my constituency.

:29:57.:30:01.

One of the radical poses as the major of four major hospitals in the

:30:02.:30:04.

area. Let's be clear, the STPs are

:30:05.:30:08.

vehicles for cuts. They are being devised in sequence hence the need

:30:09.:30:11.

for a local newspaper to leak details and they are being delivered

:30:12.:30:16.

at arms length just as the 2012 health and social care act allows

:30:17.:30:20.

him to. He can shrug his shoulders and say it's nothing to do with me.

:30:21.:30:25.

This is not good enough. The Government must publish the STPs

:30:26.:30:32.

involved. It must provide time and resources for meaningful

:30:33.:30:34.

concentration with care workers, the public and representatives and it's

:30:35.:30:38.

much provide the funding the NHS needs all these STPs will approve

:30:39.:30:42.

the final piece in the privatisation jigsaw. We will see our hospital

:30:43.:30:47.

sold up, the break-up of services and patients having to find their

:30:48.:30:50.

way around a fragmented and dwindling system and our

:30:51.:30:54.

hard-working staff would receive a jobs moving to private providers and

:30:55.:30:57.

their patrons and conditions being undermined.

:30:58.:31:05.

The public knows what the government is up to never had such a big

:31:06.:31:13.

mailbag on this issue. I believe it is time a further government to hold

:31:14.:31:18.

up its hands and the bidders had been rumbled and end the

:31:19.:31:22.

privatisation of the National Health Service. We have all become used to

:31:23.:31:31.

the disdain of the party opposite for our National Health Service. Now

:31:32.:31:35.

we have the reduction of sustainability and transformation

:31:36.:31:42.

plans, cigarette brands that seek to bring unjustifiable reforms to

:31:43.:31:45.

cash-strapped hospitals. Instead of being given the funds they need the

:31:46.:31:55.

ask to make efficiencies. -- secret plans. The audacity to make

:31:56.:32:01.

hospitals pay the price for this by threatening them with closure of

:32:02.:32:07.

reduction of acute services is the final act of treachery in a plan to

:32:08.:32:12.

totally decimate an NHS. So Shields is part of an alien time and we are.

:32:13.:32:21.

-- part of a Nadir in time and we are. --An area in Tyne and Wear.

:32:22.:32:36.

Make no mistake that the plans there are about cuts and nothing to do

:32:37.:32:40.

with transforming our NHS for the better. The NHS has been set an

:32:41.:32:46.

impossible task I this government and the endgame is to see the NHS

:32:47.:32:50.

and private hands. The government has said that the national STP

:32:51.:32:59.

submissions for NHS England are for local use and there are no plans to

:33:00.:33:03.

publish them which once again puts the onus on our local hospitals so

:33:04.:33:06.

the government does not have to deal with the flak. I would rather not

:33:07.:33:11.

give way because a lot of people waiting to speak. I was born in

:33:12.:33:16.

South Tyneside hospital and I am the local MP for the area and I have not

:33:17.:33:21.

seen a single plan, not even the governors in my own hospital have

:33:22.:33:26.

let alone the people of South Shields police services these could

:33:27.:33:35.

devastate. I believe the timetable believes this autumn -- begin this

:33:36.:33:44.

autumn. I am extremely alarmed at the lack of accountability and

:33:45.:33:47.

transparency with which these plans are being pushed through. The simply

:33:48.:33:52.

no time at the consultation and I would like to make a plea to all NHS

:33:53.:33:56.

leaders to not be complicit and to stand up for the hospitals and

:33:57.:34:00.

communities that they sell. The government have no mandate for a

:34:01.:34:04.

radical reconfiguration of an NHS which could involve the closure of

:34:05.:34:09.

accident and emergency and acute services up and down the country.

:34:10.:34:13.

Last week the Prime Minister called an NHS leaders to order them to stop

:34:14.:34:16.

any hospital managers are closures that risk causing local protest.

:34:17.:34:22.

Madam Speaker that is already a protest in my constituency. Before

:34:23.:34:32.

entering the Commons award for 33 years in the NHS and Sark on a

:34:33.:34:36.

day-to-day basis the service provides from GPs to work on leading

:34:37.:34:43.

research and development. I feel that with 80% of hospitals on debt

:34:44.:34:50.

and an ageing population and waiting times lengthening for cancer

:34:51.:34:54.

treatment and underfunding for social care and staff shortages at

:34:55.:34:58.

local hospitals and a future where collaboration with the European

:34:59.:35:01.

Union is unclear we should know at this time she'll commitment to our

:35:02.:35:05.

NHS this time of need and give at the funding it deserves to succeed

:35:06.:35:11.

for all patients. At the NHS sustainability and transformation

:35:12.:35:14.

plans did not clearly addresses issues. The STPs have been shrouded

:35:15.:35:24.

in secrecy and runner-up behind closed doors. There has been no

:35:25.:35:28.

public consultation on the staggering lack of evidence to show

:35:29.:35:32.

that it will deliver the reductions and improvements that the government

:35:33.:35:37.

promises. It will be untried and untested and will come at an

:35:38.:35:42.

unimaginable cost to patients. If it is found not to be the right path to

:35:43.:35:46.

pursue. As an MP in Greater Manchester they introduction of

:35:47.:35:58.

Metro mayor made bold promises, including a health. She mentioned

:35:59.:36:05.

local government and wonder she's aware in North West London, both the

:36:06.:36:11.

London Borough of Ealing and Hackney and Fulham have not signed up to the

:36:12.:36:17.

STP because it threatens the closure was Ealing and Charing Cross

:36:18.:36:22.

hospitals. The secret stuff is anywhere including local government.

:36:23.:36:28.

I thank for that intervention. I think intervention highlights the

:36:29.:36:33.

issues with the secrecy surrounding the STPs anti-attempts of local

:36:34.:36:39.

authorities and the bold regions to do what this was to be doing and in

:36:40.:36:43.

Greater Manchester deal with the bolt health issues. -- devolved

:36:44.:36:52.

regions and devolved health issues. This was at the front of the citizen

:36:53.:36:59.

devolution act. STPs Would need to consult with metro mayors but they

:37:00.:37:08.

jeopardise the economy of their powers. The British medical Journal

:37:09.:37:15.

said it might risk they metro mayors pose is becoming a rallying point to

:37:16.:37:25.

service reconfiguration. If the STPs to be effective councillors and

:37:26.:37:28.

committees must be the very heart of the planning process and health and

:37:29.:37:32.

well-being boys will be an integral part of the process. They're the

:37:33.:37:36.

only place where local political, clinical and professional readers

:37:37.:37:40.

come together and they will be pivotal in driving change. But they

:37:41.:37:43.

also seem to have been put on the waiting list for consultation. --

:37:44.:37:49.

leaders. As with the disastrous health and social care act overseen

:37:50.:37:54.

by the former panellist and no former MP for Whitney these

:37:55.:37:58.

proposals are taking us on a journey to another calamitous reorganisation

:37:59.:38:03.

of the NHS. It is now a necessity that the government abandons this

:38:04.:38:08.

timetable and scheduling of such a major rescheduling package. Maybe

:38:09.:38:12.

like the former pollster now is the time to step down and take stock. I

:38:13.:38:16.

am calling on the government and the Secretary of State for Health to go

:38:17.:38:19.

back and be considered not only the time frame but also the proposals in

:38:20.:38:24.

general and have a full and frank public consultation line for

:38:25.:38:28.

transparency and debate at the local and national level to take place.

:38:29.:38:37.

This is been a high-quality debate and I would like to start by

:38:38.:38:41.

welcoming the honourable member for Ludlow to his new role. He will

:38:42.:38:47.

forgive me for not knowing how many trusts precisely ended last year in

:38:48.:38:52.

deficit. It is 80% last year and that is a context in which these

:38:53.:38:56.

plans are being discussed. This means that the public will rightly

:38:57.:39:00.

be cynical about proposals, particularly if they are presented

:39:01.:39:04.

for the final time. The minister underplayed the development when he

:39:05.:39:08.

said they were simply ideas. If that is all they are let us see them now.

:39:09.:39:25.

There have been MPs for several areas. I'm sorry I will not be able

:39:26.:39:34.

to make reference to more of the contributions made by members

:39:35.:39:38.

because of the time pressure. Let's get down to brass tacks of what this

:39:39.:39:43.

is really about. It is another reorganisation of the NHS only this

:39:44.:39:47.

time it is being done behind closed doors. It is not just a

:39:48.:39:51.

reorganisation, it is also an admission as a free do. Already know

:39:52.:39:55.

that they got the last round wrong. We do not need to be persuaded on

:39:56.:39:59.

the side of the House of that is of benefit to having a more localised

:40:00.:40:09.

strategic NHS because we supported the government 's decision to scrap

:40:10.:40:13.

strategic health authorities. But unlike them the is no for STPs and

:40:14.:40:24.

no scrutiny. -- most strategic basis. -- no strategic basis. This

:40:25.:40:34.

is happening without the involvement of patients and clinicians and

:40:35.:40:43.

carers and physicians and staff. It means it involving them from day one

:40:44.:40:46.

and the bigger the change the better it is to start early without

:40:47.:40:53.

consultation. In my own area it states that the Cheshire and

:40:54.:40:58.

Merseyside hospitals will be reconfigured and consolidated with

:40:59.:41:03.

less sites with less hospitals and less doctors and no wonder that the

:41:04.:41:07.

government don't want a doc about it. Many have talked about the

:41:08.:41:12.

importance of consultation and we know that attempts to make local

:41:13.:41:18.

health services without engaging the public and establish local

:41:19.:41:20.

supporters in early stage will fail. That is not only my view, this is

:41:21.:41:25.

what the Secretary of State himself said. The success of STPs wool

:41:26.:41:32.

depend on having an open process that involves local currency

:41:33.:41:36.

partners and carers and physicians and patients and local government

:41:37.:41:39.

and this is just not happened so far. Not only are the public locked

:41:40.:41:45.

out of this process they cannot even find out what is happening. I have

:41:46.:41:51.

submitted a request for copies of the plan submitted in June for 44

:41:52.:42:01.

STPs and not one has been submitted. Many have simply refused to reply

:42:02.:42:04.

using the exemption that they are intended for future publication. We

:42:05.:42:14.

have STPs seen one thing as the saying something is about the plant

:42:15.:42:18.

will be published. The wonder people are concerned about what is with

:42:19.:42:22.

them. Plans were about fundamental changes to local health services

:42:23.:42:25.

have been sitting on the desk of the Secretary of State since June but it

:42:26.:42:29.

will not release them. Surely in the interest of transparency we should

:42:30.:42:32.

be publicly made available now. There's nothing wrong in principle

:42:33.:42:38.

with the idea of of local partners working to transform local health

:42:39.:42:40.

services but that is everything wrong in doing so without

:42:41.:42:43.

transparency and public involvement and clear lines of accountability. I

:42:44.:42:47.

welcome the member of Warrington South to the front bench. I will ask

:42:48.:42:57.

when he was he will now commit to dropping the secrecy and listen to

:42:58.:43:05.

the concerns of patients. I would also ask him to clarify his will the

:43:06.:43:08.

plans because when responding to a point made earlier he said plans

:43:09.:43:14.

will not go ahead if they don't involve mental health but another

:43:15.:43:18.

answer at the responses matter for local health services. So which is?

:43:19.:43:22.

Who will get the final say? Will be the government of the local STPs? --

:43:23.:43:34.

or the local STPs? Council leaders and officers are queueing up to

:43:35.:43:38.

express concerns and we had from in Wembley for a brutal about this. --

:43:39.:43:44.

we had from the Honourable member for brittle. --Bootle. The

:43:45.:43:54.

Conservative leader of Warwickshire County Council said that local

:43:55.:43:57.

government was being left out called are not consulted. Kenny tell me why

:43:58.:44:05.

council additions party are finding themselves this process? Members

:44:06.:44:10.

made the point that much of the money put aside for transformation

:44:11.:44:12.

has been spent in deficit is so let us not pretend what STPs can

:44:13.:44:28.

achieve. It should not be overestimated. Nigel Edwards says I

:44:29.:44:35.

have been visiting lot of STPs a nobody have spoken to is confident

:44:36.:44:39.

they can reduce the financial gap. Given the warnings we already had

:44:40.:44:42.

other governments with the health service on the chance they face

:44:43.:44:46.

architect continued to insist on a possible targets and unrealistic

:44:47.:44:49.

timetables? And sewer of continued to insist on a possible targets and

:44:50.:44:52.

unrealistic timetables? And Sue the response will and again that the

:44:53.:44:55.

government is investing ?10 million more in the NHS but we know that is

:44:56.:44:58.

an illusion. They're the living less than half the mass was in town

:44:59.:45:02.

chronically underfunding social care and while the NHS has had its

:45:03.:45:06.

biggest deficit in history under the stewardship of this government the

:45:07.:45:08.

Secretary of State has tried to convince is that not only will the

:45:09.:45:13.

maintain services at the current level but they will somehow do more.

:45:14.:45:18.

He is in denial. Virtually every day summit warning is that the NHS is on

:45:19.:45:25.

the brink of collapse. The Executive of NHS said the NHS was slowly

:45:26.:45:34.

deteriorating. It could experience pockets of meltdown. Not one NHS

:45:35.:45:44.

manager believes that the NHS could deliver services are currently does.

:45:45.:45:47.

And these are financially sustainable. Let's end the Charente

:45:48.:45:53.

and openness debate and get to the truth. About the damage caused to

:45:54.:45:59.

their chests by this government. I commend this motion to the House. --

:46:00.:46:02.

damage caused to the NHS. In these six minutes I've got

:46:03.:46:14.

available to me it's not possible to answer the 40 or so speeches we've

:46:15.:46:20.

heard today. I will pick out two contributions for special mention.

:46:21.:46:23.

The Shadow Secretary of State, as far as I can see, genuinely believes

:46:24.:46:29.

that an organisation that provides care to 45 million people, as a

:46:30.:46:34.

budget of ?100 billion, should not do planning. That really appears to

:46:35.:46:39.

be the view. I also mention the member for a show who made an

:46:40.:46:45.

excellent speech, and she used, in that speech, he word of opportunity

:46:46.:46:48.

around these STPs, that is what they are. She also used a phrase which is

:46:49.:46:55.

very useful, health care systems are about more than buildings. And I

:46:56.:47:00.

think it's very important that as we go forward with this process we

:47:01.:47:05.

think about that and what it means. The health service, Madam Deputy

:47:06.:47:08.

Speaker, is not something that is static. Technology is changing,

:47:09.:47:14.

drugs are changing, expectations are changing. Tomography is changing. It

:47:15.:47:21.

is right that we try and make it evolve, Dodge Rockwood demographics

:47:22.:47:26.

are changing. The NHS is a planning mechanism to put into place a

:47:27.:47:35.

five-year food that was in the -- a five-year review. It needs to be

:47:36.:47:41.

care driven, and it is. And it has to be properly funded and locally

:47:42.:47:46.

driven. Three things. I'm not going to take interventions because I now

:47:47.:47:51.

have five minutes left. In terms of funding, we have put in an extra 10

:47:52.:47:57.

billion. That is real money. Have they had that money in Wales some of

:47:58.:48:03.

the points raised in this debate would have been quite different.

:48:04.:48:07.

This year the increase in health funding is 4%. In real terms. That's

:48:08.:48:13.

the times the rate of inflation. The real point isn't to do with that. It

:48:14.:48:18.

isn't do with money. However much money this side of the house put in,

:48:19.:48:22.

and however much that harassment say they put in, however much we put in

:48:23.:48:29.

it doesn't take away the need for the health service to be managed

:48:30.:48:33.

effectively and properly so it can approve and innovate. There is a

:48:34.:48:40.

price to these STPs. At the end of it we will have a health service

:48:41.:48:44.

that is more orientated towards primary care. Towards community care

:48:45.:48:48.

where people live which provides better access to GPs, which

:48:49.:48:52.

emphasises prevention more than ad hoc response. Which probably

:48:53.:48:58.

addresses long-term conditions like diabetes. Which does begin to

:48:59.:49:03.

address more quickly the commitments that have been made on mental health

:49:04.:49:10.

and dementia. I say it again. If STPs come back without addressing

:49:11.:49:14.

these things they will not go forward. All of these things, and

:49:15.:49:18.

perhaps the most important one of all of that is the unacceptable gap

:49:19.:49:21.

that exists between health care and social care. That could be breached.

:49:22.:49:27.

That is at the centre of all of this. No, I won't give way. She can

:49:28.:49:36.

come and see me. We will together on the PAC. But it is true to say that

:49:37.:49:42.

if we achieve all of those things they will be lower hospital

:49:43.:49:47.

admissions, there will be more humane and timely discharges. That

:49:48.:49:51.

may save money. But it's not being driven by that process of saving

:49:52.:49:56.

money. It's being driven by the care needs, because it's the right thing

:49:57.:50:02.

to do. I want to talk very quickly about the SDP process itself. We've

:50:03.:50:08.

been told it's a secret process, a Trojan horse for privatisation. But

:50:09.:50:14.

we're not going to consult, well, Madam Deputy Speaker, first of all

:50:15.:50:18.

let's talk about consultation. I fought the member for Suffolk made

:50:19.:50:23.

some good points on the change programmes. The difficulties of

:50:24.:50:26.

change programmes that are not properly consulted with, but we need

:50:27.:50:31.

something to consult on that is reasonably agreed and reasonably

:50:32.:50:35.

stable. If we don't we set expectations running that can't be

:50:36.:50:40.

achieved. In both directions, positive and negative. When the SDP

:50:41.:50:44.

's comeback in October having been signed off they will be consulted

:50:45.:50:50.

on. -- STPs. This document will be in the House of Commons library by

:50:51.:50:54.

the end of this week and describes in detail how members will be

:50:55.:50:58.

consulted with and what we will do. The points made by the member for

:50:59.:51:04.

Chelmsford, no consultation, no engagement takes away the statuary

:51:05.:51:08.

commitments, and the need for configurations to be properly looked

:51:09.:51:16.

at and for nothing to go forward that isn't locally agreed. We were

:51:17.:51:21.

told these plans are secret. They will associate bread that they were

:51:22.:51:24.

announced in December 2015 in the NHS planning guidelines. -- they

:51:25.:51:32.

were so secret. They will associate groups that the websites of the

:51:33.:51:36.

companies that were keeping its egrets, the organisations that were

:51:37.:51:40.

keeping it secret provided information. If we do something in

:51:41.:51:45.

secret in future, it will be better than this. It really well! I want to

:51:46.:51:53.

finish by making this point. The SDP process is complex. It -- the FTP

:51:54.:52:04.

complex. Some plans, they are not adequate will not be preceded within

:52:05.:52:09.

the same way as others. What I say to members in this house is, we need

:52:10.:52:17.

you to engage with... Older! Led to the question now be part As many as

:52:18.:52:20.

are of the opinion, say 'aye'. To the contrary, 'no'. I think ayes.

:52:21.:52:29.

Eyes-macro. The question is as on the order

:52:30.:53:44.

paper, As many as are of the opinion, say 'aye'. To the contrary,

:53:45.:53:46.

'no'.. If all this. -- law the doors.

:53:47.:00:54.

--Lock the doors. Order. The ayes two 195 the noes to

:00:55.:06:42.

the left 200 and 80. The ayes to the right 195, noes the to the left 200

:06:43.:07:02.

native. The -- 200 native. -- 280. The noes habit. -- have it. The

:07:03.:07:17.

rushes everybody was to join in this debate. Can I begin please by

:07:18.:07:24.

beginning a very warm welcome to my friend who was sitting here. And

:07:25.:07:34.

what better may I say than the Honourable member who represents

:07:35.:07:37.

Blackpool to deal and respond to this debate about the extension of

:07:38.:07:40.

the tram system through my constituency. I want to make a very

:07:41.:07:48.

clear that this is not a debate about the rights and wrongs are

:07:49.:07:54.

trams and funding. This is very clear in my mind about for the short

:07:55.:07:58.

debate is about. It is about looking what has happened as those tram

:07:59.:08:03.

works have taken over two years to be completed. And looking at what

:08:04.:08:10.

has and deadly been a nightmare for both my residents and my business

:08:11.:08:22.

community. Definitely. And learning the lessons from them so we no

:08:23.:08:27.

longer repeat what has been a whole the unfortunate unacceptable

:08:28.:08:32.

terrible from what has been two years in eight months. I want to

:08:33.:08:36.

make it very clear the planet lived in Nottingham for about 25 years

:08:37.:08:41.

until I was elected in 2010 I use the tram. Personally I think it is a

:08:42.:08:47.

very pleasant and more modern form of public transport so want to make

:08:48.:08:50.

it very clear that I am not against trams. But am against the

:08:51.:08:54.

experiences of so many of my constituents. It costs ?570 million.

:08:55.:09:01.

Unfortunately it was eight months late. And it has been as I say sorry

:09:02.:09:11.

tale. A photograph speaks a million words and so I'm asking people to do

:09:12.:09:17.

my website and follow some of the photographs and tweeting out because

:09:18.:09:23.

those photographs really do show the night may for my constituents. We

:09:24.:09:29.

have to learn the lessons. We are soft to be aware this is often the

:09:30.:09:32.

case that when we do these huge pieces of infrastructure there are

:09:33.:09:37.

many who feel they have suffered incredible pain that actually have

:09:38.:09:41.

an game very much for themselves. So want to start with what I think is a

:09:42.:09:45.

very big problem we have in our society. I think we are also aware

:09:46.:09:51.

that post-referendum this huge swathe in our society that feels

:09:52.:09:55.

they have no voice and they have been disconnected. They feel in

:09:56.:09:58.

short that they are powerless. I'm afraid to say that a large number of

:09:59.:10:04.

my constituents in this particular area feel quite that. And I'm going

:10:05.:10:10.

to put forward and congratulate our Facebook page called the net

:10:11.:10:17.

transport extension group. He will forgive me if I will say he is that

:10:18.:10:24.

ordinary person. He is still but he is actually a rather remarkable

:10:25.:10:29.

person. He set up this Facebook page with real frustration in the face of

:10:30.:10:34.

the tram works. It is no errors that since somewhere in about the 1990s

:10:35.:10:39.

understandably people feel very strongly favour the trams and they

:10:40.:10:43.

want better transport but what we don't like is when people get

:10:44.:10:48.

together and use aliases and do things online and off-line in their

:10:49.:10:52.

campaigning which actually create an atmosphere where people feel that I

:10:53.:10:57.

do not agree with that but I feel I have no voice and I'm not going to

:10:58.:11:02.

get involved in this. When I got a public meeting howled down. People

:11:03.:11:05.

feel as I say powerless and that is what has happened in the run-up to

:11:06.:11:12.

the public inquiry about 2007. I really would urge my honourable

:11:13.:11:15.

friend to look at public enquiries in particular and I am writing with

:11:16.:11:24.

high feel we can make sure that the voices only people generally have.

:11:25.:11:26.

I'm very concerned about some of these online questionnaires. And the

:11:27.:11:31.

fact that people can organising campaign groups can actually abuse

:11:32.:11:40.

social media. When it comes to public enquiries that is no genuine

:11:41.:11:45.

equality. And so what we were left with was this barrage of local

:11:46.:11:52.

authority and the City Council and the borough council and the county

:11:53.:11:55.

council and the people who want to build the tram and they have the

:11:56.:12:01.

ability and resources to employ experts and so sometimes Queens

:12:02.:12:11.

Counsel and they can organise but if you're just about a citizen to be

:12:12.:12:16.

truthful, you often rely on your borough council when dealing with

:12:17.:12:22.

people but nothing like as well prepared with although resources are

:12:23.:12:26.

others have. This is what has come out of this explain to my

:12:27.:12:32.

constituency. Ordinary people living in the streets there were about to

:12:33.:12:38.

be turned up felt they had no voice and had no say. -- dug up. The group

:12:39.:12:54.

now has 1050 members. It is not always pretty and the language is

:12:55.:12:59.

often very fruity and I vigorously dissociate myself some of the

:13:00.:13:03.

Commons. This is a place where real and genuine or do people come to

:13:04.:13:08.

protest as they saw the committee being dug up and felt completely

:13:09.:13:13.

disenfranchised and so the lies being turned over. Out of this has

:13:14.:13:17.

come much good and 20s been formed. There have been a few romances are

:13:18.:13:23.

lots of ventures and continuing desire to hold people to account. --

:13:24.:13:34.

friendships have been informed. Ordinary people fill the hole voice

:13:35.:13:37.

and the voices heard a minute to make sure that we plan properly for

:13:38.:13:41.

these huge pieces of infrastructure and is willing to some of the work

:13:42.:13:45.

that the government has embarked on an quite properly so, such as HS2, I

:13:46.:13:53.

am a great fan of it. I stood on platform supporting it. I believe it

:13:54.:13:59.

is supported by the majority people my constituency but those sort of

:14:00.:14:04.

projects, I believe my right honourable friend also has a project

:14:05.:14:07.

of his own constituency so he knows that these pieces of infrastructure

:14:08.:14:12.

must be done properly so let's learn from all these various experiences.

:14:13.:14:16.

If we look a proper planning we have to make it very clear what are the

:14:17.:14:19.

benefits that we seek to achieve. It is obvious that if you extend the

:14:20.:14:25.

tram system in Nottingham into a place like Toton and the other line

:14:26.:14:37.

going to Clifton the ultimate benefit is to provide good public

:14:38.:14:40.

transport for all those people live on the line but also to knitters --

:14:41.:14:47.

to commuters with park-and-ride and getting people into the city and

:14:48.:14:52.

reduce traffic jams all those things. I have no difficulty with

:14:53.:14:58.

people catching the tram to go to the QVC of the Central college

:14:59.:15:02.

Nottingham University. These are all good things but when you then have a

:15:03.:15:07.

business case often attached these projects we asked spiritually with

:15:08.:15:11.

more care to make sure that some of the big claims that are made are in

:15:12.:15:16.

fact accurate. So the 2011 business said there will be 10,000 jobs

:15:17.:15:21.

created with the extension of the Gnostic tram system. There will be

:15:22.:15:29.

regeneration. Regeneration of Beeston. -- regeneration. -- the

:15:30.:15:36.

Nottingham tram system. I think there may be some hollow

:15:37.:15:50.

laughter from people who are now sitting there in a great time in my

:15:51.:15:57.

constituency with lots of great shops, independent shops. Who are

:15:58.:16:00.

yet to see this regeneration and this transformation. This is a town

:16:01.:16:06.

that was, in effect, strangled by the works. They were meant to last

:16:07.:16:13.

for two years but went on for an extra eight months. We have a shiny

:16:14.:16:18.

new tram, and Heidi Road where my office sits looks good, but is

:16:19.:16:24.

bereft of shoppers. The town centre needs urgent and radical

:16:25.:16:28.

improvement. You would have thought that they were digging at the time,

:16:29.:16:34.

but basically it wasn't. That was a really big, and serious failure. If

:16:35.:16:39.

you are doing these huge pieces of infrastructure then you must do the

:16:40.:16:44.

whole picture so that when the infrastructure is completed in these

:16:45.:16:48.

urban, suburban areas you have what you want, you got the place sorted

:16:49.:16:53.

out. You have a place that can now recover from what has been an

:16:54.:16:57.

extraordinary appearance for people and a damaging experience. I've been

:16:58.:17:04.

talking about business, but for residents, and I minded of course of

:17:05.:17:11.

the residents on lower road and Fletcher Road, two cul-de-sacs that

:17:12.:17:15.

funding major infrastructure, power tools literally by their French

:17:16.:17:20.

door. Not just worry few weeks, month after month, indeed, it became

:17:21.:17:26.

year after year. They had to live through all of that. As I say, I

:17:27.:17:30.

think the photographs really do say it all. Now we've got problems so it

:17:31.:17:36.

goes on. Everything has been dug up and started again. In the planning,

:17:37.:17:44.

I would suggest it is important that little tiny things that seem minor

:17:45.:17:49.

bugs are hugely important, these small details, the stuff of life

:17:50.:17:53.

that really make a difference to the quality of people's life. It makes a

:17:54.:17:57.

difference to whether people feeling gauged with something or totally

:17:58.:18:02.

alienated. Apparently Sky News used to look at my newsletter when I was

:18:03.:18:09.

raging on against these works and the real inconvenience and upset it

:18:10.:18:13.

was causing to my constituents. It seems such a small point, but it was

:18:14.:18:18.

incredibly important to those individuals that they couldn't get

:18:19.:18:21.

the fencing that had been promised so they could scream the trains.

:18:22.:18:26.

These were people who enjoyed a green Vista over a piece of green

:18:27.:18:33.

open space, the tram comes along and they have the disruption. Then they

:18:34.:18:37.

can't get the right height of friends. It sounds so small, but if

:18:38.:18:42.

you live on one of those streets, it meant an awful lot to you. They had

:18:43.:18:49.

to fight like tigers to get that. I pay tribute to the City Council and

:18:50.:18:54.

I understand, essentially, what was happening. In fact, the tram

:18:55.:18:59.

benefits the citizens of Nottingham. It goes through my constituency. It

:19:00.:19:04.

does benefit those people who choose to use it, but the pain it has

:19:05.:19:08.

caused has been extraordinary. And so there a democratic gap between

:19:09.:19:15.

accountability. Because the people of the towns who suffered all of

:19:16.:19:20.

this, but the accountable authority wasn't their local council. It was

:19:21.:19:24.

the City Council. With great respect John Collins who leaves the City

:19:25.:19:31.

Council, and I like, not the same party, but I like him. He would try

:19:32.:19:37.

and help, and I know it sounds harsh, but it was never really in

:19:38.:19:41.

their interests to sort it out because they weren't going to take

:19:42.:19:45.

the hit at the ballot box when elections came about. We need to

:19:46.:19:50.

make sure there is a better way of doing things so there is genuine

:19:51.:19:53.

accountability when things don't go right. Construction, it was a

:19:54.:20:01.

nightmare. We need good, responsible, efficient construction.

:20:02.:20:05.

And we need proper communications people. One of the things that drove

:20:06.:20:10.

wonderful community champions, were one of the good things that came out

:20:11.:20:16.

of this. They stepped up and devoted their lives to representing

:20:17.:20:19.

constituents because there was this terrible lack of communication.

:20:20.:20:24.

People were literally being told, oh, by the way, in two days' time

:20:25.:20:28.

you are moving out of your home. For a week, also. Cars were going to

:20:29.:20:35.

work through the night. Carol Wall stepped forward as well, and I have

:20:36.:20:40.

to mention a man who lived on lower road all his life but ignored, when

:20:41.:20:44.

you talked about the state of what was under the road, his local

:20:45.:20:49.

knowledge was ignored. When we look at construction, obviously, it's got

:20:50.:20:54.

to be done on time. But we've got to make sure the works are done in a

:20:55.:20:58.

reasonably civilised way so that people's lives aren't as blighted as

:20:59.:21:03.

the word when this huge piece of infrastructure was literally being

:21:04.:21:13.

carried out on the road. There is a photograph I have of somebody on

:21:14.:21:15.

high road. It's their front room which is almost on the pavement.

:21:16.:21:18.

There is a man with a drill leaning against her front window. That was

:21:19.:21:23.

the reality of life for people through the tramways. They must be a

:21:24.:21:28.

better way of doing it. So that we could take much more care about the

:21:29.:21:32.

lives of people who are living in these major infrastructures. So, as

:21:33.:21:39.

I say, working times. I accept you got to crack a lot of eggs when

:21:40.:21:42.

you're making these sorts of projects. I mean, they can be hugely

:21:43.:21:49.

beneficial. But there must be better ways of organising things so that we

:21:50.:21:54.

reduce the dust, the noise, even rats. It was, as I say, for them a

:21:55.:21:59.

terrible experience. For many of them is when they will not forget.

:22:00.:22:05.

Look at Heidi Road by way of example, this is where my

:22:06.:22:10.

constituency office is. We were told it would be closed in one direction

:22:11.:22:14.

for six months, and in another for six months. In the event the entire

:22:15.:22:20.

road was closed for a year. I brought my right honourable friend,

:22:21.:22:24.

the member for Derbyshire Dales, and I don't think he could believe me.

:22:25.:22:29.

And another honourable friend came down and I don't think the former

:22:30.:22:32.

Chancellor could actually believe the scale of the works and this

:22:33.:22:37.

incredible impact, adverse impact it was having an business and the lives

:22:38.:22:43.

of ordinary people. I think when it comes to construction, there has to

:22:44.:22:46.

be better organisation. I think when we promised people by way of example

:22:47.:22:50.

that they will be good communication we make sure that we deliver.

:22:51.:22:56.

Literally, putting out a leaflet the night before some huge disruption

:22:57.:23:05.

takes takes place is not acceptable. Then compensation. Part of the

:23:06.:23:09.

public enquiry talked about how businesses would be compensated,

:23:10.:23:14.

plans were put in place, in the event, by way of example, the area

:23:15.:23:17.

of the businesses that could claim was far too restrictive. And then,

:23:18.:23:23.

of course, as the whole of highly road was closed down and businesses

:23:24.:23:27.

were on the brink of going under it took a campaign to achieve it but we

:23:28.:23:32.

did it. We had a petition. We went to the city, we went to the county

:23:33.:23:36.

council and we got extra funds for an emergency hardship fund. I pay

:23:37.:23:44.

credit to the officials at the council who did everything they

:23:45.:23:49.

could to speed that up. But it took an awful lot of aggravation from

:23:50.:23:52.

their member of Parliament to achieve it. It shouldn't take that.

:23:53.:23:57.

It shouldn't need me to have two fire off e-mails, go to the press,

:23:58.:24:02.

so on and so forth to make sure businesses weren't properly

:24:03.:24:06.

compensated, probably taken care of, and indeed, it could be argued that

:24:07.:24:09.

that compensation continues as they try to make good the damage that's

:24:10.:24:15.

been caused to the town. For two years, basically, as they say, it

:24:16.:24:20.

was in a stranglehold of these construction works. And we all know

:24:21.:24:26.

how we shop. We are creatures of habit. So a large number of people

:24:27.:24:31.

have simply gone elsewhere. They've found new shopping habits. I don't

:24:32.:24:36.

mean any disrespect to Derbyshire, it's a very nice place, but people

:24:37.:24:40.

have gone off to Long Eaton to go shopping. They've formed new

:24:41.:24:44.

shopping habits and now we have two drugs, well, not like them,

:24:45.:24:48.

encourage them back to their shopping habits in Beeston. But that

:24:49.:24:55.

takes a lot of effort. It needs proper planning. You need to do that

:24:56.:24:59.

before the event, not twice but like mirrors unfolding. But for

:25:00.:25:08.

residents... -- not while the nightmare is unfolding. There was no

:25:09.:25:13.

compensation at all. No conversation for the dust, noise, pile drivers,

:25:14.:25:18.

day after day, month after month. Walking on board with your shopping,

:25:19.:25:23.

your car parked further down the road in the dark. Slipping, no

:25:24.:25:29.

street lights, and so it goes on. No compensation for that loss of

:25:30.:25:33.

amenity and for that destruction of the quality of life. I would urge

:25:34.:25:37.

the Minister to look at that when we go into big pieces of infrastructure

:25:38.:25:43.

project to make sure that we don't just dismissed residents and think,

:25:44.:25:47.

oh, they'll put up with it. Cracking a few eggs to create a glorious

:25:48.:25:55.

omelette. We'll see it was all worth it. I have to tell the house, that

:25:56.:26:00.

for many of my constituents, they do not believe that it has been worth

:26:01.:26:05.

it. Not worth it by any means at all. It goes on. It's such a small

:26:06.:26:11.

thing, but I out of this debate someone could go and put the

:26:12.:26:12.

flower bed in that was promised, cut the grass that was promised. And

:26:13.:26:19.

make the entrance to that cul-de-sac that has been ripped up look good.

:26:20.:26:25.

To give the residents just something back after everything that they have

:26:26.:26:30.

been through. So that is what I would say, Madam Deputy Speaker, I

:26:31.:26:35.

don't want to sound overly negative. I do put huge caution, there are

:26:36.:26:41.

those, some of them not always covered themselves with much glory

:26:42.:26:44.

in the way they have campaigned in the past in favour of further

:26:45.:26:48.

extension of the tram. Who will now seek to persuade the City Council to

:26:49.:26:54.

extend up into Kimberley and Eastleigh. I don't represent those

:26:55.:27:00.

constituencies, but I do represent Kimberley. The good people of

:27:01.:27:04.

Kimberley have looked at what has happened in Beeston, and they share,

:27:05.:27:09.

I think and believe, my concern is that they will find that the works

:27:10.:27:14.

will not be worth it. And I certainly won't support any

:27:15.:27:17.

extension of the tram works to anywhere else, actually, until such

:27:18.:27:22.

time as we've learnt the lessons. Of course I will. Thank you for giving

:27:23.:27:29.

way. She quite rightly asks the Minister to look at the lessons that

:27:30.:27:34.

can be learned from this important infrastructure project which created

:27:35.:27:39.

real hardship for many of my constituents, president and

:27:40.:27:41.

businesses, but does she agree with me that Nottingham city are to be

:27:42.:27:46.

congratulated on creating a world-class public transport system,

:27:47.:27:50.

such that the campaign for better transport have recognised it as the

:27:51.:27:54.

least car dependent city. It's actually reducing congestion and not

:27:55.:27:58.

just for those who use the tramp of those who drive from the city's

:27:59.:28:03.

roads, cutting carbon emissions and improving air quality.

:28:04.:28:10.

What I would say to the honourable lady is that Nottingham is not alone

:28:11.:28:15.

in having a tram system. Many other great cities have tram systems and,

:28:16.:28:19.

indeed, many of the lessons to be learned will apply to them. There is

:28:20.:28:25.

nothing new in it. I like the tram, but my goodness we will have more

:28:26.:28:29.

debates in this place about the cost of trans-and by way of example about

:28:30.:28:34.

the fact they have two connect other pieces of transport. It is

:28:35.:28:38.

absolutely critical. It is a crying shame that cyclists have found that

:28:39.:28:41.

the tram tracks are dangerous, I don't know if there is a debate

:28:42.:28:49.

about that. But you've got to connect up transport. You can't

:28:50.:28:53.

actually use your bicycle in parts of my constituency because of the

:28:54.:28:57.

narrowness of the route. That is a know nothing that has come out of

:28:58.:29:01.

this. It is critical that we get the roots right. So that we don't have a

:29:02.:29:07.

situation whereby a tram track, as in my constituency is winding its

:29:08.:29:11.

way around when actually they was no doubt a better route that would have

:29:12.:29:17.

delivered people far better along that transport system, produced the

:29:18.:29:22.

aunt of disruption. But Madam Deputy Speaker, as I say, there are lessons

:29:23.:29:26.

to be learned and I look forward to my honourable friend coming to

:29:27.:29:30.

Beeston, seeing the tramp system speaking to my brilliant

:29:31.:29:33.

constituents and I know he'll take up these lessons. -- the tram

:29:34.:29:41.

system. Thank you, Madam Deputy Speaker. It

:29:42.:29:46.

is a pleasure to listen to the speech of my right honourable friend

:29:47.:29:51.

on this topic. She speaks with her customary vim and vigour. I think

:29:52.:29:55.

it's fair to say that she and I share a great deal of experience in

:29:56.:29:59.

terms of these traumas in our constituencies, and how they are not

:30:00.:30:03.

always plain sailing. Particularly when they cross the boundaries of

:30:04.:30:07.

authorities it can cause a problem. I recognise a lot in what she has

:30:08.:30:12.

said of my own seven years as a member of Parliament. Of course the

:30:13.:30:16.

Government is supportive of light rail in the right place. It is

:30:17.:30:22.

convenient, reliable and popular. It has a considerable scope for

:30:23.:30:26.

innovation, also. Particularly where it offers an alternative to

:30:27.:30:29.

expensive real solutions and potential transport problems. More

:30:30.:30:35.

people are talking about light rail than at any time since records began

:30:36.:30:40.

in 1983. There has been an increase in the last year alone.

:30:41.:30:49.

Improvements in discrediting transporters as people can rely on

:30:50.:30:52.

butter and creating jobs and opportunity. -- but are creating

:30:53.:31:10.

jobs and opportunity. Overall journalist satisfaction increased by

:31:11.:31:25.

92% and 90% in itself. -- journey. -- 90% Nottingham itself. -- 98% in

:31:26.:31:40.

Nottingham itself. It is worth approximately 10.7 billion

:31:41.:31:43.

supporting around 300,000 locally -based jobs. Nottingham is a

:31:44.:31:47.

regional capital and an important industrial and commercial centre and

:31:48.:31:50.

it is vital that as a transport system that is reliable and can

:31:51.:31:54.

support customers and shoppers and commuters and visitors. It is a key

:31:55.:32:01.

element in the greater Nottingham transport strategy and since phase

:32:02.:32:05.

one opened with 10 million passengers a year taking 3 million

:32:06.:32:10.

car journeys offer local roads and improving accessibility for local

:32:11.:32:14.

communities. Phase two is now been open for just over a year and is

:32:15.:32:18.

already clear that it is boosting the local economy and improving

:32:19.:32:24.

local employment levels of the supply chain than the local area.

:32:25.:32:28.

There are an immense amount of positive is that I could list at

:32:29.:32:31.

great length and time available but I also recognise the voice points of

:32:32.:32:39.

my friend that it is not all plain sailing. Two main roads were closed

:32:40.:32:49.

for two six months for safety reasons had an immense impact on

:32:50.:32:52.

local communities and affected trade and business. I saw this in

:32:53.:33:01.

Blackpool and in Fleetwood. Many of the visitors their were affected.

:33:02.:33:08.

Many businesses are to shut down. Plus it is inevitable that something

:33:09.:33:14.

of this nature will cause disruption to third parties including local

:33:15.:33:18.

businesses that needs to be properly and effectively managed and planned

:33:19.:33:21.

incorporation with the local community. I know efforts were made

:33:22.:33:30.

were made to minimise impact but always more can be done in another

:33:31.:33:34.

promoters undertook a number of additional measures to help deal

:33:35.:33:37.

with the problems encountered along the way including a discretionary

:33:38.:33:42.

financial package for small businesses and logistical support

:33:43.:33:45.

traders and businesses during particularly intrusive works. She

:33:46.:33:48.

herself had a significant hand in the development of much of that and

:33:49.:33:52.

it needs to be put in place much earlier, I think, in these schemes

:33:53.:34:02.

for the visitors and businesses to greater percentage over Polk

:34:03.:34:04.

underwear. I know there was particular concern of equivocation

:34:05.:34:09.

between stakeholders and local people and agree that location of

:34:10.:34:11.

businesses and residents be undertaken. Not just originally but

:34:12.:34:18.

also throughout construction a timely fashion since nobody is

:34:19.:34:22.

taking. I am almost convinced that is more that can be done in these

:34:23.:34:26.

situations and in particular uncertainty of the timescale and the

:34:27.:34:33.

timeliness of work can harm small businesses but also harm the

:34:34.:34:36.

decision people make about how they choose to spend their lives and with

:34:37.:34:40.

a chisel of villages to do with the properties. With this in mind I

:34:41.:34:43.

wholeheartedly agree with my honourable friend that it is vital

:34:44.:34:48.

lessons I learned in the construction of all major road

:34:49.:34:51.

groups and projects. I understand that this in particular case report

:34:52.:34:57.

will be published shortly that will have to focus on issues such as

:34:58.:35:01.

project programming and planning and how diverse this could be managed

:35:02.:35:09.

and extensive disruption to third parties and implementation of

:35:10.:35:13.

property management measures. The department I will want to study the

:35:14.:35:16.

outcomes and conclusions of that report into what further steps are

:35:17.:35:20.

required but I agree we need to apply these lessons to future

:35:21.:35:24.

infrastructure projects to do all we can to minimise these negative

:35:25.:35:27.

impacts and will look to work with UK Tram to disseminate these

:35:28.:35:35.

findings. I would be delighted to come to Beeston. I look forward to

:35:36.:35:41.

meeting her constituents and take note of her points on safety

:35:42.:35:47.

reversing it in Blackpool there can be all too inviting motorcycle pass

:35:48.:35:50.

the tram when it is not a cycle path at all. -- all too inviting to cycle

:35:51.:36:04.

past. I commend the honourable lady for raising important points but

:36:05.:36:11.

from the Nottingham East point of view my constituents really use the

:36:12.:36:15.

tram and love it and would quite like it to extent the side of the

:36:16.:36:21.

city. I very much note the comment is the honourable gentleman makes a

:36:22.:36:25.

whole pub and try to make clear that are immense positive values and

:36:26.:36:30.

benefits from light rail in Nottingham and the country as a

:36:31.:36:33.

holder that should not minimise the impact it has on those who live

:36:34.:36:36.

immediately adjacent to the tracks themselves. In my own constituency

:36:37.:36:42.

the tram track has been there for 100 years. When we are planning new

:36:43.:36:52.

tram routes it may come as moreover surprise to people. It will laws be

:36:53.:37:02.

a case of horses for courses. Would he agree with me that we might

:37:03.:37:06.

actually have a very interesting debate in this place about the

:37:07.:37:12.

safety of tram tracks and bicycles? There are many examples in Sheffield

:37:13.:37:17.

and in Edinburgh, not just Nottingham, are people who have

:37:18.:37:21.

suffered as a result of their wheels getting stuck in tram tracks. Would

:37:22.:37:27.

you share my concern that a large part of the scheme in Nottingham,

:37:28.:37:35.

including in my constituency tram tracks and cycle routes are

:37:36.:37:45.

co-terminus. Whenever you have a co-terminus where roads and trams

:37:46.:37:49.

occupy the same space can be very difficult, particularly for visitors

:37:50.:37:54.

who are not familiar with the road available and Blackpool being a

:37:55.:38:00.

tourist town people do not realise that what is tram track is tram

:38:01.:38:04.

track. I will be delighted to have that debate at point. I understated

:38:05.:38:10.

that as the Messiah can take part in it. I noted my honourable friend 's

:38:11.:38:15.

point about the public inquiry system and the finger are very

:38:16.:38:22.

important. These protesters have to take part in the very beginning. --

:38:23.:38:31.

I understand that as the Minister I am frustrated that I cannot take

:38:32.:38:35.

part. It is important that enquiries are overseen by an independent

:38:36.:38:41.

inspector. This includes consideration of the route alignment

:38:42.:38:45.

of other alternative roads can be considered and then dissipated

:38:46.:38:48.

transport regeneration and environmental and social economic

:38:49.:38:55.

benefits. As she knows just such a public inquiry was held for

:38:56.:38:58.

Nottingham transit fees two and commented the views of all parties.

:38:59.:39:02.

I generally hear the point she making about ensuring a balanced

:39:03.:39:08.

approach to these and that everybody who has an interest actually gets a

:39:09.:39:12.

fair chance to have their say and those contributions are considered

:39:13.:39:15.

in the round rather than just a matter of he who shouts loudest.

:39:16.:39:18.

Look forward to hearing your views when she does write to me and we

:39:19.:39:23.

will look at them very closely. I also note why this is important in

:39:24.:39:33.

terms of HS2 potentially coming to Toton. An older Secretary of State

:39:34.:39:39.

is still to make a decision but that is no alternative being considered.

:39:40.:39:44.

-- I know the Secretary of State is still to make a decision. We have to

:39:45.:39:49.

learn from what we have done the first time round. We have to ensure

:39:50.:39:54.

those mystics are not made again. In conclusion Madam Deputy Speaker we

:39:55.:39:58.

will continue to work with the light rail and tram sector to help bring

:39:59.:40:02.

down costs but the decision over which schemes to develop will

:40:03.:40:07.

continue to rest with local areas. It is vital that lessons are learned

:40:08.:40:11.

about minimising disruption on all sorts of infrastructure projects

:40:12.:40:16.

allowing more committees of the country a say in how light rail or

:40:17.:40:19.

indeed other solutions are developed to benefit their communities. The

:40:20.:40:28.

light your minister is not unacquainted with trams and light

:40:29.:40:32.

rail will have an important role to play that has to happen when

:40:33.:40:35.

treatment is not just to communities. That has to be my

:40:36.:40:43.

watchword as we use forward. Working with the communities who will be

:40:44.:40:51.

effected not against them. The question is that this House node to

:40:52.:40:52.

adjourn. The ayes habit. Ayes Order, order. That is the end

:40:53.:41:17.

of the day in the House of Commons. We will now be going over live to

:41:18.:41:22.

the House of lords. You can watch coverage after the daily later

:41:23.:41:30.

tonight. -- after the Daily Politics tonight. The way it operates has

:41:31.:41:37.

been Jiddah knows has

:41:38.:41:38.

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