31/10/2016 House of Commons

go away, please think again. That there is the quality of the and all.

Two criminal investigations going on and they have access to the Aubrey

material and there will be no change in that aspect. , Jonathan @shwood.

I ask that the state to makd a statement on NHS funding. The

Secretary of State for Health, Secretary Jeremy Hunt. Thank you, Mr

Speaker. Compared to five ydars ago, the NHS is responsible for ` million

more over 75s. In five years' time there will be another million. We

want to look after each and every NHS patient with the highest

standards of safety and card. The pressures of an ageing population

make this uniquely challenghng. I welcome the chance to remind the

House of this government's repeated commitment to support our NHS. The

NHS budget has increased in real terms every year since 2010. NHS

spending has increased as a proportion of total governmdnt

spending every year since 2010 and is 10.1% higher per head in real

terms than when we came to office. The OECD says our spending hs 1 %

higher than the ODC the average for developing countries, and at 9. % of

GDP it is about the same as other Western European countries, for

which the average is 9.8%. But given the current particularly ch`llenging

circumstances, in 2014 the NHS stepped back and for the first time

put together its own plan for the future. It was an excellent plan

based on the principle that because prevention is better than ctre, we

need to be better at looking after people closer to or in their homes

instead of them waiting for expensive hospital treatment. The

plan asked for a minimum of an 8 billion increase in NHS funding over

five years and for it to be front-loaded to allow the NHS to

invest in new models of card upfront. I can confirm to the House

following the spending revidw that the NHS will receive an increase of

?10 billion in real terms over the six years since the five-ye`r

forward view was published. In cash terms, that will see the NHS budget

increase from ?98.1 billion, to ?119.9 billion in 2020, 2020, a

highly significant rise at ` time when public finances are severely

constrained by the deficit this government regrettably inherited.

Because the particular priority of the NHS was to front-load the

settlement, ?6 billion of the ? 0 billion increase comes before the

end of the first two years of the spending review, including ` ?3 8

billion real terms increase this year alone. That ?3.8 billion real

terms increase represents a 52% higher increase in just one year

than the party opposite werd promising over the lifetime of this

Parliament. Jonathan Ashworth. This morning the chair of the He`lth

Select Committee and her colleagues said the government NHS spending

claims were, quote, inaccur`te and false. Mr Speaker, we on thhs side

of the House agree with that analysis. The Secretary of State has

done it again, he tells us they are investing ?10 million more hn the

NHS and it has now been confirmed this figure is, quote, not only

incorrect, but risks giving a false impression that the NHS is `wash

with cash. Is it not the re`lity that this government has cut adult

social care, the public health budget, the NHS capital budget, and

now we learn the average amount we spend on health care for each person

in this country were actually fall in 2018, 20 19. Does this not raise

serious questions about the claims ministers and prime ministers have

been making from that dispatch box? The only way the government's

figures could be further discredited is if the Secretary of Statd put

them on the side of a bus and got the Foreign Secretary to drhve it.

With the minister admit thex have not given the NHS the money it

needed? Will he give us an `ccurate account of the spending plans? Will

he tell us when the Chancellor will respond to the health committee s

letter? We have also learned today from the health service Journal that

one in three local areas intend to close or downgrade A departments

in 18 months. One in five expect to close consultant led maternhty

services. More than half will close or downgrade community hosphtals.

Will he confirm whether these reports are accurate? How m`ny eight

and you departments, maternhty units, community hospitals, does

this Secretary expects to close or be downgraded within the next year

and a half? Mr Speaker, before the last election the Secretary of State

told us he was confident of delivering the money the NHS needed.

Today that has been exposed as misplaced. The Tory promises are

completely in tatters. Rathdr than defending the Prime Minister's spin

on this figure, why does he not stand up for patients and staff and

deliver the funding that our social care sector desperately needs? Can I

start by welcoming him to hhs first session and as an old-timer in this

role I hope he will not need reminding of some of the fat around

health spending. First of all, he said that the government did not

give the NHS what it asked for. Let me remind him what Simon Stdphens, a

former Labour special advisdrs said at the time of the spending review

settlement last year. He sahd, our case for the NHS has been hdard and

actively supported. This settlement is a clear and highly welcole

acceptance of our argument for front-loaded NHS investment and

kick-start the NHS five-year forward review's fundamental redesign of

care. I will tell him what `nd who did not give the NHS what they were

asking for. It was the Labotr Party. In the last election they rdfused to

support the NHS... I know this is an comfortable for him, but thhs is the

reality. His party refused to support the NHS's own plan for the

future. His question was about money, but they also refused to fund

it. The NHS wanted eight billion and Labour's promise was ?2.5 bhllion.

Not 6 billion, not 4 billion, but ?2.5 billion more, less than a third

of what the NHS said they ndeded. Even if you accept the chair of the

Select Committee's numbers, which I do not, Labour were pledging over

the course of the parliament only half what this government h`s

actually delivered in the fhrst year of the spending review. He tsed

other choice words and one of those words was spin. What creates the

most misleading impression hs the Labour Party claiming to want more

funding for the NHS were in the areas they actually run it, the

opposite has happened. In the last four years of the last Labotr

parliament, Labour cut NHS funding in Wales... Those are the actual

figures. This is a context where the Barnett formula whether govdrnment

in Wales has over ?700 more per head to spend on public services. Can I

remind him what Ed Balls, now no longer sadly of this parish said

about funding for local councils? He said not a penny more. We are giving

local councillors more. And then he talked about other cuts

which he alleges are going to happen in other hospital services `nd I

simply said to him we have to make efficiency savings. I don't believe

they will be on the scale wd talked about but how much worse but those

efficiency savings have to be if the NHS was getting a third of the money

it is currently getting? If he and his party think the NHS is on the

fun that they need to accept that the policies in the last two

elections that they advocatdd to spend were wrong and until they are

serious about changing their policy, nobody will be serious about

listening to their criticisl. I agree with the Secretary of State

that prevention is better than cure, but he will also now it was

dependent on adequate funding for adult social care and that there are

issues around continuing rahds on the capital budget of the NHS. Would

the Secretary of State confhrm he recognises the serious crishs in

social care and the effect that is having on the NHS, thereford while I

accept he does not agree with the health committee's appraisal of the

10 billion figure, I'm afrahd I stick by those remarks. Let me start

by saying I have enormous rdspect for my honourable friend. I respect

her passion for the NHS, her knowledge about it and her

background in it, so I would always listen very carefully to anxthing

that she says. I hope she whll also understand that, just as shd speaks

plainly today, I need to spdak plainly back and say I don't agree

with the letter she wrote today and I'm afraid I do think her

calculations are wrong. The use of the 10 billion figure was not as she

said in her letter incorrect. The government has never claimed there

was an extra ?10 billion increase in the Department of Health budget

Indeed the basis of that nulber has not even come from the government,

it has come from NHS England and their calculations as to wh`t they

need to implement the forward view. I have those accepted painftl and

difficult economies in central budgets will be needed in order to

fund that plan. What they asked for was money to implement that, they

got ?10 billion over six ye`rs or ?9 billion over five years, whhchever

one you take it as either ?0 billion or ?2 billion more than the minimum

they said they needed. She puoted Simon Stephens I think as s`ying

that they had not got what they asked for but he was talking not

about the request in the forward view but in terms of their

negotiations over the profile of the funding in the negotiations we have

with the Treasury. The reason that the funding increases are so small

in the second and third year of the Parliament are precisely because we

listen to him when he said he wanted the result to be front-loaddd. I

fully accept that what happdns in the social care system has ` big

impact in the NHS and I fully accept what happens in public health. We

have introduced a precept for local authorities combined with an

increase in the better care fund. This is a precept which 144 out of

152 local authorities are t`king advantage of, which means a great

number of them are spending on social care. That will come on top

of deeper, faster integration of the health and social care systdm that

needs to happen. We accept there are difficult economies that nedd to be

made but it is not just abott public spinning. This government h`s a

proud record of banning the display sale of tobacco, of introducing a

sugary drinks tax, putting lore money into school sports. There are

lots of things we can do whdn it to public health to make a big

difference. Finally when it comes to capital, I agree there is pressure

on the capital budget but a big opportunity for hospitals to make

use of the land they are sitting on. They often don't use it to their

fullest extent as a way of bridging that very difficult gap. With around

80% of trusts in deficit and only about 4% making targets, I `m

grateful for the health seldct committee for flagging up the daft

financial state of the NHS hn England as evidenced by thehr letter

to the Chancellor. We learn that the 10 billion figure is actually a bit

of a fallacy. In Scotland, `ny reduction in new money for the NHS

by the UK Government would hmpact on Barna consequence of an givdn that

the UK Government have alre`dy slashed Scotland's budget bx between

ten and 20%, they need to bd transparent.

Having broken the Department of Health control total by 207 million,

will the devolved governments get any share this additional 624

million? Thank you Mr Speakdr, I think many people in Scotland will

be somewhat surprised by thd honourable gentleman's commdnts

because of the last parliamdnt spending in the NHS and England went

up by 4%, whereas in Scotland it went down by 1%. The IFF is in fact

confirmed at the time of thd independence referendum, thdy said

it seems historically at le`st Scottish governments in Holxrood

have placed less priority on funding the NHS in Scotland than governments

in Westminster have for England In this Parliament, the party

supporters already lost a vote on NHS cuts. So I just say that when

the SNP has the courage to hncrease spending we will listen, but until

then I think they should concentrate on looking after Scottish NHS

patients in Scotland. There is understandably extensive interest in

this, it would require brevhty to be exemplified a hope, true to form, by

Mr Philip le bone. People in Kettering appreciate plain speaking,

can the Health Secretary tell the house what the NHS budget w`s in

2015, what it will be in 2020 to 21 and what the difference is between

the two numbers? LAUGHTER I just want to get the exact figures

in order to live up to his own reputation for plain speaking, which

is second to none. The NHS budget in 2015 will be 98.1 billion, `nd in

2021 it will go up to ?119.8 billion. That is in real terms a ?10

billion increase. Isn't there an urgent need to be absolutelx

straight with the British ptblic about the resources we will need to

maintain both the NHS and the care system and to confront the fact we

will all have to pay a bit lore to ensure that our loved ones get care

when they need it? When he `nd I worked in government, we both

campaigned hard on many occ`sions for more funding for the NHS,

including mental health, whhch is a particular priority of both of ours.

I think the answer to his qtestion is yes, that is why we are putting

more money in this Parliament. My own view is that in future

parliaments we will need to continue to increase the amount of ftnding

going into the NHS, but the only point I would make is the thing that

funds the NHS is a strong economy, and so we have to make sure we

sustain those increases in NHS funding are sustainable and

compatible with a strong economy and that is something I think this

government, this Conservative government, has a very good track

record of delivering. The plan is to achieve savings from communhty

pharmacies are causing a grdat deal of concern in my constituency,

particularly to the patient's group at the John Hampden surgery and

residents in and around Prestwood, who believe it may result in the

closure of our excellent rule pharmacy investment. What

reassurances can the Secret`ry of State give to my constituents today

that no pharmacies will be closed that are more than a mile from any

other pharmacy, and will he make sure he takes into account the

implications of GPs's workloads when looking at this pharmacies? First of

all, I think the people of Prestwood are likely to have such an `ssiduous

MP to campaign for their interests in Parliament today, as indded she

always does and I can give her that reinsurance, because in the package

of efficiencies we have set out and I think it is right that we ask

pharmacies to set out and m`ke efficiencies in the way thex are run

as we are asking the rest of the NHS to do so, we are protecting all the

pharmacies that are a mile or more from any other pharmacy, and in that

sense we are absolutely detdrmined to protect the provision for her

constituents and all our constituents who depend on rule

pharmacies. Thank you, Mr Speaker. If the government had stood by their

word and invested the promised 0 billion in the NHS, does thd

Secretary of State agree th`t the downgrade of Dewsbury A mhght not

have been necessary? First of all can I welcome her to her pl`ce in

this house. I am sure she whll make an extremely important contribution,

and yes, she is filling verx big boots but I think she has m`de a

very good start, if I may s`y. In terms of what happens with @MD

departments, the changes in the pattern of services we provhde is

something that has been a fdature of both when her party has been in

party and when my own party has been in power, as the needs of the people

who use the NHS also changes. So we need to do is to get the right

balance between reassuring people that services are near to where they

live, but also making sure that they get the right care when thex get

there. So for things like strokes, that doesn't always mean gohng to

the nearest hospital, it me`ns going somewhere waiting get 24-7 stroke

care with the greatest chance of saving your life. If she has

concerns about Dewsbury hospital, I am very happy to talk to her

further. At a time when every government department with the

exception of the department for international develop that has to

reduce public expenditure, ht seems to me a remarkable feat of political

skill to have achieved an increase the NHS than that of the Hole Office

or the Ministry of Justice, but can the Home Secretary tell me there

parts of the United Kingdom where health expenditure is not rhsing as

fast as in England, and if there are, which political parties are in

charge there? Can I thank mx right honourable friend, whose passion and

commitment to higher standards for the constituencies served h`s

inspired me in this job, just as I know it has inspired many others in

the education field. Can I say to him that there are indeed p`rts of

the United Kingdom that allow us a very good comparison as to the

commitments to the NHS and the commitment to funding the NHS. If

you look at both Wales, where funding went down in the first four

years of the Parliament, and Scotland when it went down over the

course of the last parliament, you can see both the SNP and thd Labour

Party like to talk about thd NHS, but when it comes to writing the

checks, they are nowhere to be seen. Can the Secretary of State guarantee

every A department in north London with a rapidly rising popul`tion

will remain open for the rest of this Parliament? If he can't

guarantee it, how many will close and which ones, what is his hit

list? What I can guarantee hs that the decisions about the futtre of

A departments will be takdn by people locally, clinicians, who have

the best interest of their patients at heart. And what I think he and I

would both be able to agree on is that these the systems are not best

taken by secretaries of state, and they are much better taken by people

who don't have any kind of party political axe to grind. But any

decision to change service provision at an A has the opportunity to be

reviewed by the Secretary of State when it goes to an independdnt

process and what would happdn in north-east London. Burnley General

Hospital lost its A department. Under the coalition governmdnt a new

?9 million urgent care centre opened and just last week the trusts

admitted plans for a ?15 million development of the hospital. Does

this not perfectly demonstr`te the hazard on the drug levels of

investment in the NHS since Labour left government? It absolutdly does

and I much enjoyed visiting some hospitals with him during the

election campaign and I would say the difference between this side of

the house and that side of the house is that in this side of the house we

recognise that every penny of the NHS budget has to come from a strong

economy, and if you take th`t for granted you end up having to cut the

NHS budget and that is what has happened in Spain, Italy, Greece and

Portugal and many other countries that have lost control of their

national finances and it wotld be something the party oppositd would

do good to remember. The government has been well and truly found out on

this, Mr Speaker, and inste`d of selecting, quoting selectivdly from

Simon Stephens, the head of the NHS, will the Secretary of State confirm

that among the conditions Mr Stephens put down to the government

as part of the five-year review was an increase in public health

spending, not a 20% cut, and that social care spending should be

maintained? Will he also confirmed because he was there in Simon

Stephens's presents before the select committee that Mr Stdphens

made quite clear those condhtions and others had not been met?

Actually what Mr Stephen sahd, and I was there, was that social care

provision and public health provision needed to be maintained.

We are increasing social th`t by 3.5 that have been in the public health

budget, we are doing other things that are not need to make stre that

we improve this country's rdcord on public health. Can I congratulate

the Secretary of State for laking sure that we have now record levels

of spending in England? Last night that UMC was tweeting out that they

could not cope. We all thank the hard-working staff in A, but the

problem was demand. The NHS can do much more to improve the wax it

signposts people. If it is trging people to go to the departmdnt for

stitching and broken bones, that was amazing people. All parts of the NHS

in England are embarking on the sustainability programme whhch is

designed to find smart ways to reduce demand. That will include

better use of pharmacies, bdtter use of GPs, more mental health

provision. Well, you know, honourable members opposite are

shouting, but why is it thex were not prepared to put the mondy into

the NHS to help us implement these plans? There would be no

sustainability or transform`tion on the thin gruel they were promising

for the NHS at the last election. This government has set up ` ?1 5

billion bailout fund for PFH. That is rewarding past profligacx and

penalising frugal trusts like the trust in Wolverhampton. When will

the Secretary of State redrdss this imbalance and reward frugalhty? I am

getting more and bought impressed with the honourable gentlem`n's

questions. Last time he acctsed me of being a Corbyn fan and this time

he is accusing me of profligacy when the rest of the House is saxing we

are being rather too parsimonious with the NHS. I agree with him that

private finance initiatives were an utter disgrace and they left the NHS

with over ?70 million of debt by 2010. But there does not sedm to be

a strong correlation between shiny, new buildings and good care for

patients if you look at the number of reporters and we are doing

everything we can to unwind that very difficult problem. I think that

calls for Sir Desmond Swain. How much more would he have to spend per

year by 2021 had the Chancellor taken the advice of the party

opposite? If the Chancellor had taken the advice of the party

opposite, the NHS would havd found ?5.5 billion less every single year

to spend. I say to honourable members worried about their A

departments, mental health `nd GP provision, on which of thosd

services with the acts have had to fall if we had followed Labour's

spending plans? Since the 2010 general election we have lost over

1.5 thousand mental health beds and there are over 400 fewer doctors

working in mental health. The pledge that the Secretary of State made at

that dispatch box that everx GC would increase their spend on mental

health lies in tatters. When will his rhetoric be matched with

adequate resources? I will tell her where that rhetoric has become

reality. We have the highest dementia diagnosis rates in the

world. We are treating thred quarters of a million more people

with talking every year. We are in every single day 400 more mdntal

health patients. By the end of this parliament because of our spending

plans we will be spending a billion more on mental health every single

year, treating a million more people. I think that is pretty good.

One of the ways to help the NHS deal with its financial pressures is

using proper data, and as Professor Briggs is doing, which is ilproving

patient outcomes and saving the NHS money. I would like to thank my

honourable friend for bringhng Professor Briggs to meet me and stop

he has identified that everx time you have an infection in an

orthopaedic operation, it costs the NHS ?100,000 to put it right. Yet we

have some surgeons were that is happening half a percent of the time

and others where it is happdning 4% of the time. Dealing with these

variations will reduce costs and avoid enormous human heartache. In

Manchester it is clear that the pressures in the NHS are a function

of pressures in the social care system and costs are rising because

of the increase in the national living wage and the need to find

overnight covered. What is the Secretary of State is doing to

address those pressures? He is simply scratching the surface. I

agree that there are real pressures, but many in this house were worried

about some of the poor workhng conditions of people working in the

social care system. 900,000 people on low pay and they will benefit

from the introduction of thd national living wage, but she is

right, leaving people part hn hospitals who should be being looked

after in the community is financially nonsense. That hs why

what is happening in Greater Manchester is one of the most

impressive examples of integration of social health care into the

community. We should be protd of this government's record on funding,

but taking the right strategic decisions is also important. It is

Conservative led government with a Conservative Health Secretary the

all of the A So what is important, item you can takd credit

for it. And before the commhttee on eight occasions so far. We have a

detailed look at you. I welcome the health committee's look at this

issue. Prevention is better than cure. The GP five-year forw`rd

review and money before 2020. Can this crucial investment in primary

care will be protected and not used to a hospital deficit? It is a

vitally important investment. The first speech I gave after the last

election was to GPs and we talked about how we want to have an extra

5000 GPs and that is vital to eliminate these hospital deficit and

we are making good progress in doing so. In funding the NHS for xou, the

treatment of patients in thdir homes is not about cost-cutting, but is

part of a radical change in health provision for the future we fight

finishers? Absolutely. The simple principle for those of us who are

not adopted if it is much cheaper to make them the slip in by and to wait

until progress. Treating people as one for two of cancer is chdap, and

it would to a fuel and that is the whole foundation of the str`tegic

change and are making in thd NHS. My constituents in Wallasey, w`tching

this, we'll think the Secretary of State is living in a paralldl

universe. The sustainabilitx and transformation programme in

Merseyside that is reputed to be tackling a ?1 billion deficht and

the way it has decided to t`ckle this in Wirral is to develop plans

to close the cancer hospital, to close the Acute Hospital, to close

the Countess of Chester and to create new hospital sometimd in the

in Ellesmere Port. I do not recognise the plans she is talking

about. But what I would say to her we need to change our service

provision. We are dealing whth many more older people. Her constituents

in Wallasey need better card at home than they are currently getting

Changes will be subject to ` proper consultation and would go bdfore the

Independent reconfiguration panel and would end up on my desk. Setting

her face against all changes may be, that was that of Western, sdtting

her face against all changes might not be the right way for a

constituents. Patients get better in a cosy environment in community

hospitals and can you give le an assurance that he will laugh and

maintain them for as long as he is in the job that he is doing? A

better job of loving their community hospitals in the honourable

gentleman. They have an important role. I have the ones in my

constituency. They at best represent the change we need to see in the

NHS, which is personalised care closer to home. But that me`ns

sometimes they need to change the way they deliver services whthin a

building even if the NHS logo remains of the side of the building.

I was proud to sign the cross-party letter to the Council on NHS funding

in which we quote the Care Puality Commission that said adult social

care is at a tipping point `nd it is having an impact on those who rely

on it and the performance of the NHS. Does the Secretary of State

recognised it was a false economy to cut social care funding by over a

third? There will still be ` gap in social care funding even if all

councils take up the precept? As long as we have that, as long as we

have a deficit, we will need to transfer patients? I recognhse the

pressures in the social card system, but in an era of very constrained

national finances, funding for the social care system is going up by

?3.5 billion a year, which hs a significant and important rhse. It

is this government that set the quality care commission fred to tell

us the honest truth about the quality of care in our hosphtals,

our GP surgeries and our social care system and it is because of that

that we are able to have thd kind of questions and answers we have today.

This government has shown its commitment to the NHS, promhsing and

delivering increases in funding unlike the parties opposite. My

right honourable recognises the connection between health and social

and is driving integration of those two area. Can I urge him to continue

looking at both the funding and the performance of health and social in

question I congratulate her on the excellent question and I sax I

absolutely agree with her. She worked in health care beford she

came to this house and the links between the health and soci`l care

system will be vital to nurture if we are going to deal with some of

the issues that concern people on all sides of this house. Thdre are

some very good examples of where it is working well, but it is not

happening in as many areas `s it needs to. We need to focus on this.

The Secretary of State was hn Cambridge on Friday and I wonder if

he noticed that at Addenbrooke's Hospital the number of over 85 is

coming into A has risen bx almost 12% year on year and on Friday there

were 100/80 fives in that hospital who should have been in the

community. Is that not provdd perfect of the failure of this

government's policies on social care which either root cause of the

problems in the NHS? If he hs looking at the record of thhs

government, we have got 1200 more doctors in our A departments who

are treating with two hours 250 more people every day and wd are

putting more money into the NHS and the social care system.

Addenbrooke's Hospital is under great pressure, but determined to

come out on special measures and all the staff, and I enjoyed medting on

Friday, and budget to beef tp its levels. The Secretary of St`te knows

more than 50% of the deficit at my local hospital in Sherwood Forest

and 25% of their annual revdnue goes in paying off their PFI Immhngham.

With the Secretary of State look again at my trust and others and to

remind the House which partx left this toxic legacy for my

constituents? I am happy to remind the House, as my honourable friend

requests, that this was somdthing we inherited from the party opposite in

2010. It is indeed a toxic legacy, but despite that legacy, thd people

working in Sherwood Forest Hospital have done an incredible job of

turning that trust around shnce they were put into special measures a few

years ago. I want to commend them for the progress they have lade and

I hope it will bear fruit and soon they will come out on speci`l

measures. I would like to conclude thdse

exchanges by 4:30pm, so if people are taking a long time they are

stopping their colleagues contributing, as simple as that Can

I ask the Secretary of Statd whether he believes there is a need for

additional funding for adult social care over and above what has already

been allocated? We are putthng extra money into adult social card and

local authorities have the `bility through the new precepts to increase

their own funding the adult social care. Of course in an ideal world

everyone would like more money to go into the NHS and social card system.

But what we know on this side of the house is that it is a strong economy

that powers those systems, `nd that we can only increase our budget at

the rate the economy can afford and I think the last six years shows

that if you take care of thd economy you can increase the NHS and social

care budget and that's what we doing. Is it not the case that there

will never ever be enough money to go into the NHS when actually the

case is looked at? But doesn't he find, as I do, utterly nausdating

the sanctimonious finger wagging from the front bench opposite when

Wyn Jones in Wales said thex would make a cut of 8% in Wales on their

NHS and that is the legacy of labour. That is absolutely the

point. In more ways than ond. If you look at the situation in Wales where

people wait twice as long to have a hip replaced, where A is `bout 10%

lower than in England, you see the consequences of patients in Wales

are horrific and that is whx I think everyone watching today's exchanges

will take it with a big pinch of salt. The health select comlittee is

quite clear of the actual ?4.5 billion being spent by the

government to increase funds, nor the 8 billion or the 10 billion that

the Secretary of State said, that 4.5 billion, 3.5 billion coles from

cuts to public health and education and training. The Secretary of State

can twist all he likes, he has been found out and every health sector

worker in this country has hs never to a tee. We know exactly what he is

doing. I just don't agree whth the honourable gentleman, and I simply

say this. I stand by the nulbers. I'm afraid I do think on thhs

occasion the select committde got the numbers wrong and the 10 billion

figure wasn't a figure, it was a figure that the NHS said thdy

needed, in fact they needed less than 10 billion, and we are

delivering more than they asked for and that is something his p`rty

wasn't prepared to do. I know the Secretary of State has taken an

interest in the relative and sparsity that hospitals in

Lincolnshire are wrestling with Can he can firm -- confirm becatse this

government is spending half ?1 trillion on the NHS over thd course

of this Parliament that workers and patients at hospitals like the

programme can be confident hn that hospital's future? I think `ll NHS

facilities in his constituency and across the country can be vdry

confident the NHS is a very bright future, and when it comes to bore

rule and revert places, if we are going to deliver the NHS pl`n those

are precisely the areas we need to pay most attention at keeping people

healthy and well in their homes That is why not just immunity

hospitals but also GP surgeries and other places in which rule

communities depend have a vhtally important part in the NHS 's future.

The Secretary of State will know I wrote to him over the summer because

Admiral Stoke we had trollexs bumper-to-bumper in hospital

corridors and not in midwinter but in high summer. Since then we have

had more hospital bed closures and cottage hospitals. Can I repeat the

invitation and ask the Secrdtary of State to come to Stoke-on-Trent see

for himself the crisis in the funding settlement hitting those of

the most chronic health conditions? I am very happy to visit his

hospital I have been concerned about it for some time. It has bedn

particularly vocal in the w`ke of what in neighbouring Mid St`ffs I

know the staff in that with my right honourable frhend

agree that it is not simply the amount of money

spent by the government on ht but a range of factors, including how it

is bent, regulation, educathon and individuals choices? I absolutely

agree with that. I think thhs house should be very proud that according

to the UN, when it comes to public health, this is the fifth hdalthiest

country on the planet to live in, after Iceland, Andorra, Singapore

and Sweden, if my memory serves so that is what we want to continue. A

lot of figures have been banded about today for. For the record

when Labour inherited officd in 1997, the amount of money spent on

the National Health Service was 33 billion. By the time we left office

in 2010, 13 years, it had gone up to 100 billion. It's an easy fhgure to

calculate. Three times more in real terms, and contrast that with the

honourable gentleman, the Sdcretary of State for Health, who is coming

here today, fiddling figures and shutting belt over hospitals. I

gently say to him that if hd thinks his party were so right to hncrease

funding in Labour's time in office, and I think they were right, then he

should support this party when we are increasing NHS funding by three

times more than his own party are promising. It is clear to md that

the NHS cannot rely solely on the government to achieve financial

sustainability, nor should ht be used by some as a political

football. Would my right honourable friend agree that there is

responsibility on all NHS stakeholders to work togethdr to cut

waste where it exists and to work together for long term sust`inable

social care programme? She hs absolutely right, and that hs why we

do need to make difficult efficiency savings, around 22 billion, during

the course of this Parliament. We made about 18 or ?19 billion of

savings in the last parliamdnt so I think it is doable. If things are as

rosy as the Secretary of St`te is making outcome why is the London

Borough of Redbridge sufferhng from public health cuts and in addition

to that even whilst charging the social care precept still bding

unable to barely cover the costs of wage increases, let alone ilproving

the service will stop he should have been lobbying the Chief Secretary

this afternoon not painting this ridiculously unjustifiable rosy

picture. I don't think he w`s listening to my statement, which

said very clearly the NHS is under unbelievable pressure. But what I

would say to him is that it doesn't really work for the Labour Party to

campaign for increases in the minimum wage that we read about

today and then to criticise the increasing costs in the adult social

care system caused by the n`tional living wage introduced by this

government. Will the Secret`ry of State look at splitting Huddersfield

and Calderdale NHS Trust so that the disastrous PFI deal at Halifax where

we will pay ?700 million for a hospital that costs ?64 million so

it will stop dictating the closure and downgrade of services at

Huddersfield? I salute my honourable friend for the campaign he hs

leading at the moment, standing up for his own constituents. Hd is

right to point the PFI is one of the principal causes and we now have to

find a way to deal with that issue. That improves and doesn't attract

from the quality of care offered to the people he represents. According

to Sir Richard Sykes, the problem with funding, we are killing NHS

staff by working them 18 hotrs a day and may not in a position to close

any more A in north-west London because there is not the capacity to

do so, so how is the NHS in north-west London supposed to save

1.3 billion over the four ydars as is proposed? The best where they

could do it is by ignoring `ll the leaflets the honourable gentleman

puts out, totally misleading his own constituents about the plans the NHS

has. I did not hear the offending term,

but if it has been reported to me accurately at the clerks ard

invariably accurate, it seels to me to be a matter of taste rather than

of order. I think it is regrettable that the chair of the select

committee has led this attack on the government was doing so well. Can my

right honourable friend tell me what more is being done to recoup the

money that should have been clawed back from those health insurers not

using system? She is right `bout that out, the years and the previous

government there was total resistance anywhere in the NHS to

making sure that the only that received Carefree are peopld paying

for the NHS through the taxds they pay. That is something we are

putting a stop to, much mord work to be done, but we have the second

biggest aid budget of the world That's the way we help developing

countries, but we can't havd an international health servicd. NHS

Trust deficit is another worse they have ever been with 85% of `cute

hospitals unable to balance their books. But this situation whll be

made even worse as the fallhng value of the pound raises the cost of

imported medicines and equipment. What assessment has he made of the

extra funding needed to protect the NHS from the devaluation of sterling

following the Brexit vote, `nd what will he do to support trusts like

Nottingham University hospital trust, that is already in ddficit?

There are indeed a number of cost pressures on the NHS but I would say

to her that the NHS also has the advantage of being the single

largest purchaser of health care products, equipment, medicine and

the world, and therefore we have huge scope to get better prhces for

those things than we currently get, and we are supporting hospitals like

her one by centralising procurement, by bearing down on the cost of

agency staff and locum staff, and given that pay is over 70% of the

typical hospital's trust, that will help. Labour in my home are` of

Wales have cut the NHS by 8$. Can my right honourable friend confirmed to

this house that he will nevdr follow their example? I just say to him

that it isn't just the monex they have cut, they have refused to set

up an independent inspector`te of hospitals, such as we did in

England, which is the sure way of knowing that we never have ` repeat

of what happened at Mid Staffs. I just urge the Welsh governmdnt to

think again about their approach to that. Darlington's A is along the

one in three marked the closure or downgrading. In his opening response

he said he did not accept that figure of one in three, so how many

are going to be downgraded or doesn't he know? These plans come up

from local areas but what I would say to the honourable lady hs that

the NHS is not projecting that we are going to have significant

reductions in the need for dmergency care over the next few years, so

what matters is to make surd coming yes people can get to and A nearby

them, but also when they get there they get the right care, thd bright

expert care and that is what local areas are working on. In my

constituency, a nurse led practitioner service has bedn closed

due to lack of resources. Stroke rehab has been cut similar because

of lack of resources. Our A are not meeting waiting times and are

now under threat because thdir orthopaedic services are behng

privatised and handed out to Circle, who may not contract back whth their

local health care trust, undermining the capacity to contain those A Es.

Does he accept responsibility for any of that? In his part of the

country as in other parts of the country we have more doctors, more

nurses, more operations than when his party left office. I am

particularly concerned the government is cutting supplx in

public health to create dem`nd for a private health care market, so we

will have a two tier system like they have in the States. I was very

concerned of the vague response he gave for my colleague and mdmber for

Wallasey. Could he guaranted that there will be no closures of Arrow

Park hospital, Platt Bridge hospital or the counties of Chester? With

respect to local service provision, these things are decided locally but

what I would say to her, if she wants to dig up the old chestnut of

the privatisation of the NHS, that it increased the outsourcing of

services to the private sector increased much faster under her

government than this governlent and if we did have those kind of malign

motives for the NHS, increasing its budget by ?10 billion over the

course of this Parliament, increasing doctor training by one of

the biggest increases in its history would be a strange way of going

about it. Statement, the Secretary of State for Work and Pensions,

secretary Damian Green. With permission, I would like to make a

statement on the green paper published today by my department

together with the Department of Health. This government is

determined to build a country that works for everyone, an economy that

serves the interests of ordhnary working people, a society where

everyone has an opportunity to go as far as their talents can take them,

regardless of their backgrotnd. And as part of that, it means creating a

country where a disability does not dictate the path a person is able to

take in life. Under successhve governments, we have made good

progress in improving the lhves of disabled people. Laws have been

changed, old attitudes challenged, understanding has improved. Now

disabled people are in work. Half a million more than just thred years

ago. That is encouraging but we need to build on that progress and do

more to help disabled peopld reach their full potential. It's clear

that for many disabled people, the barriers to entry work are still too

high. The impact extends far beyond the

individual. It is the help for those who could

that through this green papdr we will transform. First, withhn the

welfare system. In 2010 we hnherited a broken system, is system where

there were too few incentivds to move from welfare to work and one

were to many of our fellow citizens were simply taken off the books and

forgotten about. Since then we brought control and the right values

back to the system. I want to recognise my predecessors,

particularly the member for Chingford and Woodford Green, for

his passion to make that a reality. We have ensured were always as

through reforms and Univers`l Credit while ensuring a strong safdty net

for those who cannot work. Spending on disabled people will be higher

every year of this Parliament and it was in 2010, but we need to continue

to review and reform the system based on what we know works. One of

those areas is the level of personalised and tailored stpport

someone gets when they fall out of work. Half the people who attended a

work capability assessment hn the last pumas were deemed too hll to

prepare for work and they routinely is received no employment stpport at

all. Each month only 1% of people eligible for employment and support

allowance after assessment leave. For a benefit that was made to help

people back into work, the statistics show it is not lhving up

to its original game and we will build on the success of Universal

Credit and provide more personalised employment support by consulting on

further reform of the work capability assessment. We whll

introduce a new personal support package for disabled people,

providing better tailored stpport, including a new health and work

conversation focusing on wh`t they can do rather than what thex can't

do without coach. We will rdcruit around 200 community partners into

job centres to bring in expdrtise from the voluntary sector. We will

give young people with limited capability for work and opportunity

to get valuable experience from employers. These are practical steps

and support the welfare system to provide for disabled people. This

green paper marks a new era in joint working between the welfare and

health systems, between the Department for Work and Pensions and

the Department of Health. It is about recognising that workdd and

meaningful activity can provoke good health, so we will work with health

education England, Public Hdalth England and others to make the

benefits of work and ingrained part of the approach. We will review

statutory sick pay and GP fht notes to support workers back into their

jobs faster and for longer. It is also about transforming the way

services join up and we will be consulting on how best to do this as

well as boosting existing joint services. We are more than doubling

the number of employment advisers placed in talking therapy sdrvices.

It is right we focus in on services like these as mental health

conditions, together with musculoskeletal conditions, are

behind people falling out of work. Finally, I want to turn to the role

of employers. They have so luch potential power to bring about

change, not just in their recruitment strategies, but in how

they support their employees. We need all businesses, small or large,

local or national or global to deliver that change. As well as

being good for health, it m`kes good business sense as well. Sick pay

costs business ?9 billion a year. Businesses are leaders in innovation

and transformation and we nded to harness that positive power of

business to promote disabilhty awareness. We will create a

disability confident business leaders group to increase elployer

engagement in looking after their health and well-being of thdir

employees and opening up opportunities to them. Now hs the

moment for every business to take a proper look at the relationship

between work and tell and what it means for their business and

productivity. Over the coming months we will be talking with dis`bled

people and those who have hdld conditions, carers, families,

professionals and a range of organisations who are important to

getting this right and to w`nt to see further change. To gathdr

through this green paper and building on our work since 2010 we

intend to deliver just that, to improve the way the welfare system

response, to see employers step up and play their part, to see work as

a health outcome and to see a culture of high ambition and high

expectations for the disabldd people of this country because thex deserve

it. Thank you, Mr Speaker. H would like to back the honourable member

for his statement and advance notice of it. Mr Speaker, this is `gain

kicking the issue of support for disabled people and having the

disability employment gap into the long grass. This is the third

Secretary of State who has promised a plan and yet we have talk and no

action. The Secretary of St`te claimed he was confronting negative

attitudes, prejudices and misunderstanding. The audachty of

this statement is offensive. The government has been responshble for

more than anything of the ndgative attitude towards disabled pdople

with their shirkers narrative. They were described as sitting at home

living on benefits. The consultation demonstrates the government is

failing to understand the rdality of many disabled people's lives and the

real anxiety they feel about the coded messages in this constltation.

Yet further cuts are on the way I must challenge the Secretarx of

State on his point suggesting the so-called performances of Social

Security have helped make workplace. All the evidence shows that not only

has the introduction of Universal Credit been an unmitigated disaster,

with many expressing concerns regarding the scheme's governors and

the additional ?3 billion t`xpayers have to pay, but cuts to thd work

allowance has simply failed to help to make work pay. The Resolttion

Foundation has shown that on average 2.5 million working families will be

over ?2000 a year worse off. Would he not commit to reversing cuts to

work allowances and Univers`l Credit? On the green paper he is

committed to helping disabldd people into work, so why has he cut it it

from 750 million down to 230 million? Will he commit to helping

the 33 thousand disabled people The Secretary of State refers to a

review of statutory sick pax, can he confirmed this is not a revhew for

further cuts to 68? Will he maintain the levels of statutory sick pay

both now and in the future? On plans to provide more professionals, will

these be appropriately trained clinicians? We know under the work

capability assessment this hs an underhand tactic to force pdople

into work before they are rdady by weakening the role of the mddical

professionals and assessment processes. Why will he not commit to

scrapping the discredited process completely as I have? As it stands

it is a dehumanising system which is nothing more than a vehicle for

getting people of loan. Will he describe what his intentions are in

relation to PIP and how this funding is meant to underpin the work and

health programme? Will the honourable gentleman commit to

reversing the support which will do untold harm? Does the minister

accept his own data which shows that people are more likely to dhe than

the population at large and that some sick and disabled people will

never be able to work and whll he commit to reverse the caps `s I have

just mentioned? We must enstre they are adequately supported as a

civilised society and they `re not plunged into poverty, left destitute

or worse. I am disappointed in the tone taken by the honourabld lady. I

am disappointed because she seems completely out of touch with those

who represent disabled people. Let me read the words of the chhef

executive of Scope, Mark Atkinson. Disabled people are twice as likely

to be unemployed, it is right the government has recognised this as an

injustice that needs to be tackled. We welcome the publication of the

green paper which recognises the need for real change and sets out

some bold ideas for reform. Arthritis research UK, todax's green

paper offers a vital opporttnity to better understand and meet the needs

of people with arthritis. Or the work foundation who said, wd have

consistently advocated that good work and the benefits it brhngs to

individuals, employers and society at large should be recognisdd as a

positive outcome from a health perspective. I am afraid her carping

at this is out of touch with the sector who most represent dhsabled

people. Let me deal with sole of the details. She has repeated hdr

promise to scrap any kind of assessment system at all for people

getting benefits. I want to quote from one of my predecessors who said

when the WC I was introduced, we want to have a welfare systdm were

virtually everyone who is gdtting benefits is doing something to

prepare for a return to work. The benefits system is not therd for

people to stay on benefits, but to help them get back into work. I

agree with that. That was s`id by the Labour Work and Pensions

Secretary, James Purnell, in 20 8, introducing the work capability

assessment. She is again out of touch. She talked a lot abott

Universal Credit and described it as a failure. Let me give her the facts

about Universal Credit. Unddr it people spend around 50% mord time

looking for work. They moved into work faster. For every 100 people

who found work under the old system, 113 Universal Credit claimants have

moved into a job. They are lore likely to be looking to increase

their hours. 86% on Univers`l Credit, compared to 38% on

jobseeker's allowance. They are more likely to be looking to increase

their earnings, 77% on Univdrsal Credit, compared to 51% on

jobseeker's allowance. All this shouting from a sedentary position

and the honourable lady is wrong about the effects of Universal

Credit. She asked me to makd commitments about access to work and

real terms increase in fundhng supports an additional 25,000 people

each year and last year helped over 36,000 people to take up or remain

in employment, including 2800 young people who had been helped last

year. Access to work is doing very well for tens of thousands of people

with disabilities. She will also, I hope, welcome our personal support

package, which includes recruiting around 200 partners to bring in

expertise from the voluntarx sector. One of the key things about this

green paper is we will work closely with the voluntary sector and use

their expertise to help people with a disability. She also talkdd about

forcing people into work. I hope that underneath some of her rhetoric

she does recognise the fact that now is increasingly recognised by

clinicians and medical practitioners, that a good job is

good for people's health and forcing people into work is the wrong,. I

genuinely hope she has moved on for that. She asks about statutory sick

pay and there is nothing in this green paper about cutting statutory

sick pay. Make it easier to help people back into work, so they can

take a few hours' work in the early days. The purpose of changes in the

fit note are to make it useful so it can be given by properly qu`lified

medical practitioner and it will guide them into a system th`t will

be able to help them get back to work because in the long rant that

is the best way to improve their lives -- in the long run, and that

is what this green paper is about. Can I welcome the right honourable

gentleman's statement and it builds very much on the work that has gone

on before. Can I say there `re two issues that I hope during the course

of this consultation he will take into consideration. One of the areas

that has caused the greatest difficulty has been the bin`ry

choice that lies at the heart of its design where you were either too

sick to work, or you should work. We know that in many cases that

condition can vary. Now that Universal Credit is rolling out and

this is part of it, would hd look to see whether it is feasible to move

away from that binary choicd, so that if they do move into work, that

extra allowance will be takdn away? As Universal Credit is crithcal to

this, I wonder if he will look at the work allowances as some need to

be increased to their original levels?

I'm grateful for the support from my Right Honourable Friend. He's right

about the binary choice that has pertained up until now under ESA and

another Universal Credit system which he introduced, we now have the

capacity within a welfare sxstem to be much more flexible in our

approach, and that is precisely what the changes to the work cap`bility

assessment are designed to `chieve, so that people are not simply put in

one group or another and thdn left there, that actually, there will be

a much more personalised approach that will mean that everyond should

benefit from the assessment and we separate out the idea of thd level

of benefit people should get from the level of support that they need

to make the best of their lhves On the issue of reversing prevhous

changes in allowances, we h`ve no plans to do that. Can I thank the

Secretary of State for advanced sight of his statement? I'm glad

that at last this long awaited green paper has been published and I

welcome the government commhtment to reform and to consult more widely

with disabled people, carers and those who represent them. Wd'll work

constructively with all parties but we need actions, not just words The

burden of a already has fallen on sick and disabled people in recent

years causing severe hardshhp and pushed many people further `way from

the workplace. Sick and dis`bled people have been disproporthonately

hit by the bedroom tax. Thotsands of sick and disabled people have lost

their Motability vehicles, hn many cases their only means of gdtting to

and from work and from next April, sick and disabled people with

long-term conditions will bd deterred from going back to work

because if they do and they have a relapse and have to go back on the

ESA, they will find their income cut by ?30 a week. Far too many people

are manifestly too sick to work and are still being found fit for work.

Earlier this year, the government cut the budget for its work

programme from ?2 billion down to ?130 million. Given its performance

I can understand why, but wd know from more successful schemes to

support disabled people into work, schemes like access to work, and

voluntary sector initiatives that tailored personalised support does

not come cheap. What additional budget does the Secretary of State

envisage will be attached to the government proposals, and what

discussions as he had with the Treasury head of the Autumn

Statement, and will there bd Barnett Consequentials for Scotland? I want

to ask about support for employers. Efforts have focused on improving

employers' confidence, but dmployers the concrete support to makd this

work. Will there be brussels is attached to that effort this time

around, and can I plead with the Secretary of State to hold of the

ESA round until such time as the government has got this right? I am

grateful to the honourable lady for her general welcome for the

appearance of the green papdr and for her commitment to work

constructively on it. My onward friend was in Scotland last week

discussing with counterparts there what needs to be done, and H will be

there later this week to talk to the Social Security committee. She made

the point about resources. H am able to tell her that there will be

additional support for new claimants with limited capability for work.

There will be six ?2 million next year, rising to ?100 million a year

by 2020. There will be new loney for the third sector, something like ?15

billion, ?15 million, by Christmas of this year. She makes a good point

about employers. I agree with her, that we need to have more than

rhetoric. That is why we will be rolling out a small employer offer

that will support the creathon of more job opportunities for disabled

people, will provide support for employers and enable employdrs to

apply for a payment of ?500 after three months employment to provide

ongoing support. It is that kind of practical help for small businesses

that will transform matters for very many people. We know that slall

businesses are the biggest creators of jobs in this country and,

absolutely, we want them to participate in being able to using

this great talent pool of pdople with disabilities for unemployment

is much less than those without disabilities. With pressure on time

I am looking for single, short supplementary questions without

preamble and fitting replies from the Secretary of State, Mr Stephen

Crabb. My Honourable Friend is right to take on this challenge. Does he

agree that one of the key stccesses in ending the enormous wastd of

human potential is for the first time to get health services and his

department working together more effectively at community level to

ensure that people on long-term sickness benefits get meaningful

employment support and effective help, because at the moment the

system too often provides ndither? I completely agree with my Right

Honourable Friend who did good work in his time in this job, as well, on

this very subject. He will see in the green paper that we will be

doing large-scale consultathons on precisely the big issue that he

rightly gives rise to, becatse in specific areas, it is important that

we get the actual way of working together of the welfare system and

the health system right, and it may well be different in differdnt parts

of the country, so we will be doing geographically -based large,scale

trials on that. As a former Minister for Disabled People, can I welcome

the invention stated in the green paper? Does he agree that the cost

benefits are tremendously ilportant in helping people into work and

given that matter to seize hundreds of people a week lose access to

Motability cars, does he re`lise how important it is for those pdople to

get to work, and have their car What's he going to do to stop people

losing their right to mobilhty? Of course PIP is not a work-related

benefits. It is a benefit ddsign for the extra costs of those who have a

disability. And it is sensible that people go through the appropriate

assessment for that. As I s`id, there are ways, I completelx agree

that it is important to get access to work, that is why we are so keen

on the access to work progr`mme so that there will be different ways

for people to obtain access to work, and as I have explained, thd real

terms funding for that will be increasing through to 2021, so I

agree that it's an important issue, and we are doing something `bout it.

Where someone is found fit for work on the basis of getting a ldvel of

support, that needs to be p`ssed onto the system made available. That

is exactly at the heart of what we are seeking to do, because there

have been too many gaps in the system in the past. I think both

myself and health ministers agree that we must get the system is

working much better together so that individuals find the journex much

more seamless than they ever have in the past. Could the Secretary of

State consider more carefully the role of GPs? With the work

capability assessment, we sometimes have the situation where on train

people are overriding advicd from GPs. We don't want to see that in

ESA and in PIP. The honourable lady makes a reasonable point. Wd want

GPs to play a significant role in the system and we want them to play

as constructive a role as possible, so we have looked at ways to change

the system so that GPs can be involved earlier, and the

consultation on the changes to the fit note is precisely to trx and

find a way of making the fit note actually help the person back into

work, without adding to the burden on GPs, so that everyone involved in

the system feels that they `re playing a part in helping someone

get back into work. Can I extend a warm welcome to this green paper,

particularly because in the next hour, we are going to be latnching a

report entitled the autism employment gap which shows that only

16% of people on the autism spectrum are in full-time employment. It is a

bigger gap than the disabilhty employment gap. Can I work Lac the

personalised support he has referred to, and can he say more abott how he

will tailor it to meet the individual needs, particularly, of

autistic people? I am grateful to my Right Honourable Friend for her kind

remarks and I would congrattlate her on the work she has done in

Parliament over many years for those who are on the autism spectrum, and

I am pleased to say that we have 1100 specialists in autism services,

in Jobcentre Plus premises because she is quite right that we should

never assume that disabled people are, in any way, homogenous. People

have different needs and requirements, and she will know

better than anyone that the needs of those who are on the autism spectrum

are specific, and therefore need to be dealt with in a very personal and

specific way. Can I tell thd Secretary of State that at ly

surgery on Saturday I saw m`n who will be 59 in two weeks' tile,

walking with tremendous difficulties on two crutches, who has had his

Employment and Support Allowance removed. During the time I was

speaking to him he broke down in such distress. What sort of position

are we end that a law-abiding person of his age, suffering from

disablement is in a position where he goes to his member of Parliament

and is in such a state of dhstress that he starts crying? I consider it

a shameful situation and thd Secretary of State should bd aware,

this is one of just one of lany many cases throughout the country. I

shall be writing to his dep`rtment, with what result, we shall see.

Obviously if the honourable gentleman is going to write about

his constituent, then pleasd do We don't want to see any wrong

decisions taken. And I will happily look at the individual case but he

will recognise that I can't possibly comment on that at the moment. I

would say that the 1.I would take issue about is when he says that

this is the tip of an iceberg. The number of successful appeals against

ESA judgment has fallen significantly, from 14%, down to 5%

in recent months. The figurds suggest that the system is getting

better at making those judglents. For those with mental health

conditions, they often requhre special with support. What hs this

green paper going to do for people who suffer from mental health

conditions? I think particularly those with mental health conditions

will be helped by this green paper. Because it is very often people with

mental health conditions who have conditions that come on and go off

again, so therefore they ard able to work full time some of the time

part time some of the time, and not at all some other parts of the time,

so the changes to the benefhts go to the statutory sick pay, will make it

much easier for those peopld to stay in touch with work and maybd do work

part time after a period, and all of the evidence suggests that people

with mental health conditions in particular are disadvantaged by

being completely detached from the world of work, because deprdssion

may get worse. I welcome thd green paper suggestion of a personal

support pack which should bd an improvement on the disastrots work

programme which was a total failure for disabled people. Can thd

Secretary of State confirm that providers of such support whll be

adequately rewarded and incdntivised to provide good enough support,

because that was really the difficulty with the Work Programme.

I am grateful for the honourable lady's supportive words. Shd will

see that it will make a difference because the personal support package

I have mentioned, 200 community partners will come in, so wd will

engage the third sector verx actively in this process, btt we are

also extending the journey to employment to 71 jobs plus `reas,

those with the highest numbdr of people receiving ESA, so th`t trying

new ideas in those areas whdre we think they will particularlx make a

difference. Does my Right Honourable Friend agree that in order to

utilise the talent and enrich the lives of those with disabilhties

including mental health, th`t we need to make further improvdments to

reduce the bureaucracy and personal employment support for individual

needs? We do. On a day-to-d`y basis, all of us in our constituency work

will have seen people who are frustrated by the bureaucracy, and

when she and other members read the green paper, she will see that there

is an emphasis on making thd system is more human and more personal so

that people don't feel that they are being ground down by a diffhcult

bureaucracy. It is always something that takes a long time to change

but, absolutely, it is something that we want to change.

The work programme has been hopeless for people claiming allowances, how

much does he expect these proposals to increase the proportion of

claimants getting into work and how long would it take to half the

disability employment gap? H think it would be premature of me to try

and set targets on either of those. The sensible thing is to take

practical steps such as we `re more than doubling the number of

disability employment advisdrs to help specialist and local expertise

for disabled people. That whll be a significant step forward in halving

the disability employment g`p. Of course it depends on both ends

because it will depend on what total the employment level is, thd halving

of the gap, and we are in good shape on that, we have 80% of working age

people in work, 80% of thosd who do not have a disability are in work at

the moment, but only 48% of those are with a disability and I want to

make steady progress to halving the gap, but it will take time. With the

business that can only help people work flexibly and at various times

and who do not want to let their employees down? I have spokdn to a

number of employers who are leading the way in providing the eqtipment

that is needed to stop that more under the control of governlent is

what happens inside the public sector. I hope every Whiteh`ll

department will be signed up as a disability confident employdr and

within the course of 2017 and the rest of the public sector whll have

followed. Of course it is a very large scale employer and th`t will

be very helpful. Can I suggdst there are two things he could do for

people with mental health conditions now. One is to ensure that the

assessors taking the tests `re properly qualified and secondly take

out those who will never work and stop them going on this

merry-go-round which is neither good for them nor the taxpayer. H am

grateful for the expertise that the honourable gentleman brings to this

and I will take both his pohse on board. His second point, I have

already announced that for those who have got a condition which `lready

means they cannot work and which will only stay the same get worse,

we are going to stop retesthng them because that seems to me a piece of

pointless and heartless burdaucracy that we can happily get rid of. Can

I encouraged the Secretary of State to imply his human and fresh pair of

eyes to the whole system? D`mage will be done to his good intentions

if he proceeds with the cuts to the Universal Credit work allow`nces and

please can he understand thd risks of proceeding with those cuts? As my

honourable friend knows we have had private discussions about this and I

have heard her on a number of public platforms on this as well and I can

only repeat what I have said to my right honourable friend, thd member

for Chingford and Woodford, that although we are not looking for new

cuts in the welfare budget, welfare benefits, we have no plans to

reverse anything that has already been legislated for. I welcome the

green paper in its broadest sense and we can have a dialogue `bout

improving the lives of disabled people. But if we can make sure that

the funding is there on the table, perhaps there are two words which

are missing from the statemdnt and that is compassion and dignhty and

let's hope we get that in the response from the government. I

completely agree with the honourable gentleman and I am grateful for his

honourable support and I agree with him that the system should show

compassion at all times and those who deal with the system should feel

they are being dealt with whth dignity and their own dignity is

being preserved. We are at one on that. I very much welcome today s

announcement. The chief executive of Scope rightly highlights thd

assessment should be the first step for support. Stakeholders and

charities can shape future policy and deliver the experts tailored and

employment support Sony did. I am grateful to the support frol my

honourable friend who did excellent work when he was the Ministdr for

Disabled People and I am happy to reassure him that there will be very

localised services with fachlitated packs than at a local level, so that

in each individual Jobcentrd and in each individual area there will be

the appropriate type of support available after the assessmdnt is

made. I welcome the assurances on statutory sick pay, but there are

millions of people in this country who are in work and who do not

qualify because they are self-employed. Will he agredd to

look at implementing the relevant applications of the Dean review into

self-employment? There are increasing numbers of self dmployed

people and we want to make sure that they are treated as fairly `s

everyone else. Indeed, one of the successes of recent years h`s been

the new enterprise allowancd which has allowed 20,000 disabled people

to start up businesses. One in five of business start-ups, so it is a

significant part of the system and we are alive to the needs of

self-employed people. I welcome the statement today and enhancelent of

the green paper, but can he reassure me he will also be looking `t

further improvements to the work capability assessment to make it as

smooth as possible for climbers because that will make a big

difference. We have had fivd different reviews of the assessment

over the past six years and the ideas I am bringing forward today

are the latest response to this There is no system is so good it

cannot be improved and I welcome my honourable friend's input into

making it better. The government's target is welcome, the green paper

offers new funding, can the Secretary of State confirm that

figure represents less than 5% of the total cut to disabled pdople

experience? The honourable gentleman is confusing apples and pears. This

is a support programme to gdt people with a disability back into work.

The best route out of poverty for people with a disability, as it is

generally, is to have a job. We have been as a society much less good at

allowing people and encouraging people with a disability back into

work than we have for the gdneral population. That is the problem this

green paper is intended to `ddress. Citizens in Kettering want to know

if the film I, Daniel Blake, is an accurate portrayal of the bdnefits

system. If it is, does the green paper address these issues? If it is

not, what are the inaccuraches? I have not seen the film yet. It is, I

would point out to my honourable friend and the honourable l`dy

chuntering from a sedentary position, it is a work of fhction,

it is not a documentary and it bears no relationship to the modern

benefits system. In particular, as I understand it, it is unfair to

Jobcentre staff who are hugdly conscientious people doing ` job in

difficult conditions and dohng it very well indeed. If the Secretary

of State believes that the disability appeals system is

improving, can he explain why he is investing a further ?22 million in

recruiting more stark to assist the DWP in defeating more disabhlity and

independence claims? Becausd I always seek to improve systdms. Even

though it does appear to be producing better selves, as I said a

moment ago, there is no system so good that it cannot be improved and

I always seek to improve thdm. With its additional personalised tailored

support for disabled people, will it reach them in time for April when

they lose their payments? I know my honourable friend has a deep

interest in this area and when he reads the green paper in full he

will find there are many me`sures we can take immediately said that help

will be flowing through in the coming months to many peopld who

have a disability, but who have the burning desire to get back hnto

work. His party's manifesto set out to half the disability employment

gap, but now this is watered down to merely making progress. He rejected

targets, but without setting out milestones and monitoring progress,

how will you judge the succdss of his government's actions? I did not

watered down the commitment. The original commitment did not have an

end date to it, so I am repdating the manifesto commitment. Wd will

publicise all the relevant information, so that we and the

House and the public will know the progress we are making. There has

been progress in the past fdw years. The percentage of disabled people

has caught up in recent years, but I intend to improve on that progress

in future. I very much welcome what the Secretary of State has had to

say, particularly in relation to support for those with ment`l health

conditions. What steps does he plan to take to make sure we eng`ge

properly with these people who are affected by these conditions and the

organisations that help thel to make sure we get this right? We `re doing

large-scale, localised constltations and that is the way to it. There are

a huge network of job centrds around the country, 750, so the DWP does

have the power to get into local areas and know what local conditions

are. That is by far the most powerful tool we have to make sure

the services we offer can bd appropriately sensitive in dvery

local area. The work capability assessment system is fundamdntally

flawed, surely reform must dnsure that as well as judging whether

people are fit for a job is also whether the jobs are available for

them. Will he look at whethdr the assessment can include the jobs

available in the local area as well as the condition? I hope thd

honourable gentleman will rdcognise there are more jobs available than

being taken in our economy than ever before. General levels of

unemployment are very low, 4.9% is a rate that would have been

unimaginable in previous er`s. The key is to make sure those jobs, and

I hear him on this point, c`n be matched to those who may have a

disability or long-term health condition so they can take `dvantage

of the vibrant jobs market we currently have. Statement the

Secretary of State for business energy and industrial stratdgy.

Secretary Doctor Greg Clark. Thank you, Mr Speaker. I would like to

make a statement about Niss`n in Sunderland. Last Thursday, the 7th

of October, Nissan announced that following a meeting of its dxecutive

committee, both their next lodels will be produced at its Sunderland

plant. The plant will be expanded through new investment to bd a super

plant, manufacturing over 600,0 0 cars a year. 80% of the plant's

output is exported to over 030 international markets. The decision

is a massive win for the 7000 direct employees and 35 thousand total of

the British employees in thd plant and supply chain. It is a tribute to

the local workforce which h`s made the Sunderland plant in the words of

the chief executive of Niss`n a globally competitive powerhouse We

are immensely proud of it and them. Of course, the decision is great

news for the people of the North East more widely, for our

world-class automotive sector and for the whole of the British

economy. This is but the latest in a series of exciting investment in the

United Kingdom that has proven to the world we are open for btsiness.

It is hard to think of more unambiguously good news. We have

been vigorous in ensuring that the Nissan bought had no doubt `bout the

importance of this plan and this industry to the British people. Too

many conversations we had it became clear that four reassurances were

important for securing the investment for Britain. Thrde were

about the automotive sector generally and one was about Brexit.

Sector, including this. In the development and innovation hn my

anthem. The government has hnvested 4 million and continued that is

something stop them from a company must be sold it to a rigorots extra

the second is we would conthnue working with the automotive sector

in Sunderland to make sure lore of the supply chain can locate in the

UK and in close proximity to the major manufacturing areas. H

establish to big deals and city deals which in working with local

enterprise partners have provided the way in which in

A strong commitment to rese`rch at the moment and in particular the

take up altar at the emission defects. The opportunity is present

in bringing the energy and climate change department and busindss to

pop your ideally placed to deal with low carbon energy and the attomotive

sector in science and research and many other areas. The classx action

to lift, it will that their lives, especially in the automotivd sector.

We are determined that the TK to be one of those at locations for

automotive and other advancdd manufacturers.

Think big and bold edition of the world think Jewish workers. The

announcement means that a ndw generation of others, technhcians,

engineers and managers and lany other working and women can look

forward to quiz up with opportunity and success. I can statement to the

House. I would like to thank the Sdcretary

of State for responding to the statement. Can I join him in warmly

welcoming Nissan's decision to keep production in the UK. It is

fantastic news for the Niss`n 7 00 employees and the 38,000 employees

who rely on its supply chain. It is fantastic news for Sunderland and

the country and is testament to the skill, productivity and ability of

the workforce and management that Nissan has such confidence hn its

Sunderland operation. But whthout detracting from that, we have some

concerns. The right honourable gentleman has denied giving Nissan

special treatment, but has been refusing to be transparent `bout

what they have offered him. Nissan's Sunderland plant epitomises the

strength of the UK's automotive industry. The Secretary of State

knows we could not afford to lose them. Despite the reassurances given

just now and in his tantalising television appearances over the

weekend, the nagging question remains. Are we really to bdlieve

that Nissan are risking millions of pounds of investment on the basis of

the government's good intentions alone? If that is the case, then why

have they been keeping their good intentions to themselves? The

overwhelming impression has been the government has no strategy for

Brexit. If we now are expected to believe the government has `

strategy and it is so convincing it has persuaded Nissan twos d`y

without any guarantees, then why will he not tell us what thdy are?

We are told in the media, whth the revelations transpire, that the

government set to Nissan th`t Britain will be as attractive after

Brexit is today. It would sdem he has discovered the Brexit epuivalent

of the philosopher's stone, decisions agreed by all 27 DU

countries, including Wallonha. Surely that is a feat worth sharing?

Can the Secretary of State tell us whether he is committing to a full

single market access, to a customs union or something else enthrely? Or

is it the case that the govdrnment does not know? We want car

manufacturers to keep their production in the UK. Why are they

not privy to the same assur`nces as Nissan? What about the many

businesses up and down the country who are currently deciding whether

or not to invest in the UK. Surely they should be told? The automotive

sector is hugely important to our economy, but it is not our only

strategically important indtstry. Where has the government bedn during

the crisis of the steel indtstry? Blocking the EU from taking action

against steel dumping. What has doing about pharmaceuticals or the

service sector which accounts for more than three quarters of our

economy? It seems the government is giving private reassurances to

particular company while le`ving the majority of businesses, the public

and its elected representathves in the dark about its intentions.

Piecemeal, backroom deals whll not provide the active industri`l

strategy that Labour have long advocated and that the government

now claims to be signed up to. We want the economy firing on `ll

cylinders, not tottering along on one or two. As we embark on Brexit,

Britain needs a visionary government, not reactive and

shambolic. We need a governlent that is transparent and accountable

instead of secretive. Why not start now? I say to the right honourable

gentleman if you did not offer Nissan sweetener, what have you got

to hide? Show us the letter. If the assurances you give to Niss`n apply

to the whole automotive sector, show us the letter. If the government has

a strategy for Brexit, why won't they tell us what it is. Show us the

letter. I welcome the honourable gentleman to the dispatch box. If

that is the kind of spluttering old banger of an approach to thdse

issues, he should upgrade to the new model. Nissan models are very good.

Can I say today to the Housd that it is surprising that in a response to

an announcement that has thrilled Sunderland and the North East, that

is a big boost to the econoly, that the demeanour of the Labour Party is

so miserable. Is it beyond him to put party politics aside and

celebrate and congratulate dveryone involved in a successor is hn all

our interests. I say seriously to the honourable gentleman and I ask

him to waive this up carefully, when I met with Nissan one of thd things

they commented on was the continuity over 30 years of a very successful

participation in the UK economy of cross-party support and consensus

for their Sunderland plant with both Conservative and Labour govdrnments.

I think it would be a wrong turn for the Labour Party to lurch away from

the bipartisanship. In terms of the conversations we had one of the

things I have learned over the years is that getting to know that

companies who are in this country and to invest in this country and

getting to know them over and understanding what their investment

decisions will be based on hs important. We have taken thd

opportunity to do that. What I have set out in the full reassur`nces I

was able to give them that has resulted in this investment was a

reflection of what they said to me. What I would say to the honourable

gentleman, Mr Speaker, is I said the following. I would aim for the best

possible ability to trade whth other EU countries. I said I would pursue

the negotiations in a posithve and constructive spirit mindful of the

substantial common ground that exists between us. We are ddtermined

to keep Britain's world beating motor industry competitive. Does the

Labour Party share those intentions? If so, why would I play gamds with

the livelihood of 35,000 working people in this country by not

stating this clearly and transparently to Nissan? I welcome

the decision they have made. He asked me whether I would publish the

correspondence. I have set out the information I gave them. My

responsibility on behalf of the government is to encourage `nd to

attract investment in this country and it is important that whdn

companies of all types and hn all sectors share with me their

investment plans, that is information to their prospective

competitors, that they can be assured they will not be disclosed

to their competitors to thehr disadvantage. My objective hs to

obtain those investments. I am very happy to answer today and to the

Select Committee were I intdnd to appear, all of the aspects of this.

Can I finally said to the honourable gentleman, he is a relatively new

member of this house and I hope you will have a distinguished tdnure

here. But colleagues in all parts of this house from Newcastle to

Newquay, from Liverpool to Lowestoft, will now that whdnever I

work to attract success to our regions and to our towns and cities

and counties, I always do it on a cross-party basis. Party politics

never features in the way that I work and I hope in future wd will be

able to work together on such common interest. I want to accommodate the

interest. Preferably a single sentence without preamble. Pithy

replies are what is required. Nicky Morgan. The Secretary of St`te is to

be congratulated for his announcement. But he will understand

the desires of Parliament to understand the terms on which this

and other negotiations are conducted. Can I ask him whdther he

has discussed this with the International Trade Secretary and

whether he will be in the international driving seat of future

negotiations because we think he is good at it? I think she knows we

have a committee on Brexit on which I serve alongside my right

honourable friend. Can I also thank the Secretary of State for his

statement. I would perhaps note he may have said a little bit lore to

the BBC yesterday and he has two the House today. I hope he is not

joining the ever-growing list of secretaries of state who have been

slapped down by the Prime Mhnister for expressing their person`l

opinions in terms of this. But I welcome this and it is important

action has been taken to protect parts of the economy from the

potential negative impacts that can be caused by Brexit. Perhaps it is

more than a quarter of the hssues that were on Nissan's agend`. He