25/10/2017 House of Commons

I hope there are points of order,

Chuka Umunna?

Thank you, can I refer

you to the debate of the European

committee stage in the 7th of

February, it was a Tuesday, well

remembered. The Minister of State

for exiting the European Union gave

a commitment in this house that this

House of Commons would have a vote

on the arrangements of our

withdrawal from the European Union

before our exit from the European

Union and he said and I caught we

intend that the board will cover not

only the withdrawal arrangements but

also the future relationship with

the European Union, further more I

can confirm the government will

bring forward a motion on the final

agreement to be approved by both

houses of parliament before it is

concluded. He then went on to say Mr

Speaker, and I quote, it will be a

meaningful vote, as I have said it

will be the choice between leaving

the European Union with a negotiated

deal or not. This morning the

Secretary of State for Exiting the

European Union told the relevant

select committee that that vote that

the minister committed to happening

before we leave could indeed happen

after we leave the European Union

and as such that is in clear breach

of the commitment given by his own

minister that it will be a choice

between leaving the European Union

with the negotiated deal or not.

Obviously we will not have that

choice if we have already left the

European Union by the time of a

vote. It seems to me Mr Speaker this

house on the half of the people we

represent cannot take back control

unless we have that vote. Can you

advise on what we as a House of

Commons do about that at best

contradiction and at worst false

impression given to the house?

Point

of order sir.

Very well.

They were

there.

We will come to him in a

moment, I am saving him up. Point of

order.

I was present at the

committee this morning and heard

exactly what the Secretary of State

said and the questions that were put

to him and I am sorry to have to say

that the honourable gentleman has

misunderstood the situation. Can I

explain Mr Speaker that the question

the Secretary of State had was

whether or not he thought that there

would be an agreement before

midnight on the 29th of March 2019

and he indicated that he thought it

might be a nanosecond before

midnight on that day and he was then

asked whether that meant that this

house would not be able to vote on

such an agreement until after the

29th of March and he said obviously,

they will not be able to vote an

agreement until after the 29th of

March if there hasn't been an

agreement until the 29th of March,

that is the point he was making and

it was perfectly sensible.

Providing

a bit of extra information to me

which in one form or another he's

been doing for over 30 years,

greatly obliged. I don't think at

this point we need the intervention

for the honourable member of

Wellingborough, but what I would say

to the honourable gentleman is that

put very simply, what he is seeking

is an assurance that there will be a

vote on a final deal before Brexit

happens, it that if I understand

correctly is what he is asking and

what I would say to the honourable

gentleman is that these are matters

of political debate, he quoted a

very clear commitment from several

months ago, different

interpretations have been placed

upon proceedings in a committee this

morning but the honourable

gentleman, beyond advertising and I

don't mean that any pejorative

sense, Buffon advertising his

considerable irritation with what he

had this morning is presumably keen

to ensure he gets what he thinks he

was promised. He is also presumably

keen to get my advice on how to go

about it and the answer to that is

there will be a great many debates

on European matters in this chamber

in respect of the withdrawal bill

but on many other occasions as well

and I absolutely anticipate that the

honourable gentleman and others will

be making the same points,

repeatedly. That also is not

pejorative, repetition as I often

say is not an unknown or rare

phenomenon in the House of Commons.

People have a point and they tend to

return to it again and again and

again, almost if you will in the

spirit of campaigning and that is

perfectly proper. So there will be

lots of opportunity for the

honourable gentleman here in

Parliament and outside as well to

press his case with the intellect

and eloquence that he has brought to

bear on our proceedings over the

last seven years. I keenly

anticipated his contributions from

one side of the argument and those

of the honourable members for

Christchurch and Wellingborough to

name but two on the other. I would

feel that if you will the sequence

was incomplete unless we heard from

the former Europe minister himself,

Mr Pat McFadden.

I am grateful to

you, I was at the evidence session

this morning and listened carefully

to what the Secretary of State said.

He said that Parliament would not be

likely to get a vote on the future

arrangements with European Union

until after March 2019. This makes a

material and significant difference

to this house is ability to have a

meaningful input and a meaningful

say on the content of those

negotiations. So at the risk of

repetition following up from my

honourable friend the member for

Streatham asked advice on what this

house can do to make sure it has a

meaningful say and input into these

most important of negotiations

rather than being used as an after

the fact rubber-stamped. Further to

that point of order Mr Speaker?

Very

well. Thank you, as the person who

asked the question of the Secretary

of State. My

would it not be in order Mr Speaker

that if the government had changed

its position on something of such

constitutional significance that

that change in position should be

brought before this house in a

ministerial statement?

It is, the

point of order only another matter,

on this matter? Very well.

It seems

different members of the committee

heard different things from the

Secretary of State this morning.

Would it not be better Mr Speaker to

wait until we actually have

published the record of the meeting

and then it can be quite clear what

the Secretary of State did say

because I did not hear what the

members have alleged.

Thank you for

the honourable gentleman, I know he

likes to be helpful to the chair and

the house. He anticipates me that he

is right in doing so. There will be

a transcript of proceedings and I

rather imagine that that transcript

will be published sooner rather than

later. I know it will then be

subject to the BDI use of colleagues

on both sides of the chamber and on

both sides if I can put it that way

of the Brexit argument. They will

read into it what they wish and

pursue their cause as they choose.

What I will say to the honourable

member for Felton and Heston is that

if there is a material change in

government policy or intended

practice on a very significant

matter its customary that there

should be a statement to the house.

It would not always be an oral

statement but it might very well be.

The house knows very well that there

are means by which to secure the

attendance in the chamber of a

minister if such a statement is not

offered. The position of the cheer

is that they do not seek to take

sides on this matter, the chair

seeks to facilitate the exchange of

opinion. In addition to all the

other debates he might have on these

matters there will in due course be

legislation returning to the house

and it's a matter of public record

there are large numbers of

amendments which have been tabled to

the European Union withdrawal bill,

at committee stage the chairman of

ways and Means will make a proper

and judicious selection based upon

advice and deploying his own

judgment and that report states that

responsibility will fall to me. I

think members know that I always

will, offering the fullest possible

debate on the widest range of issues

pertinent to the bill. So both sides

of the argument can always feel they

have a friend in the chair.

Mr Speaker I don't know if you

recall what you were doing six years

ago today, I suggest you were

recovering from a mammoth session in

the chair where a backbench business

committee debate occurred in prime

time and 81 Conservative members

declined to accept the advice of the

whips and voted for a referendum on

the European Union. How could we

mark that event and doesn't not sure

that backbench business motions have

an effect on government policy?

Well, not for the first time the

honourable gentleman is right on a

matter of parliamentary history and

precedent. I well recall that

debate, it was a very significant

debate and I am going to vouch it

safe to the honourable gentleman

something he probably did not know.

You may not even want to know. But

he's going to know. That is that I

regularly refer to that debate

amongst others and together with the

debate on Hillsborough and a number

of others as an example of a very

significant debate under the

auspices of the backbench business

committee, significant not just

because of the quality of the debate

but because it had an impact on

public policy. These references are

in speeches that I make at

universities and in front of other

for around the country and I think

most recently at the invitation of

the Hannes Arch society. I don't

suppose the honourable gentleman is

such an anorak that he wishes to

attend to all my speeches on these

occasions but I'm giving him the

highlight. Diana Johnson.

Point of

order about another issue of public

policy, the contaminated blood

scandal with Sky News today running

a story about what appears to be a

cabinet Coronet in 1987 related to

the contaminated blood scandal and

the consultation having ended last

week I wonder if you had any

indication when the government were

going to come to the house to make a

statement about when that public

enquiry will be set up as they

promised it would be done in a

speedy manner.

The answer is I have

received no such indication but the

honourable lady has raised this

matter many times in the house if I

remember correctly, including on an

urgent basis. I seem to recall she

did so at the tail end of the 2010 -

15 Parliament and on a number of

other occasions since. The

honourable lady is a most versatile,

experienced and dextrous

parliamentarian and knows the

opportunities open to her and I just

have this hunch she is quick to try

to take advantage of them. If there

are no further points of order...

Perhaps we can come to the ten

minute rule motion for which the

Right Honourable Lady the member for

Chipping Barnet has been so

patiently waiting, ten minute rule

motion. Mrs Theresa Villiers.

Thank you, Mr Speaker, I beg to move

that leave be given to bring in a

Bill to prohibit the expert of live

farmed animals for slaughter or

fattening and for connected

purposes. Mr Speaker, the export of

live farm animals can cause immense,

unnecessary suffering to many of the

animals involved. There is evidence

that public concern on this issue

dates back as far as the 1950s and

even further back in the particular

case of export of horses.

Indeed, I'm sure many in this

chamber will remember the mass

protest which featured on our TV

screens during the 1990s. The key

objection to live export of animals

for slaughter is essentially two

fold; firstly some countries in

Europe have far weaker rules on

animal welfare than we do, secondly

there's a real risk that the rules

on transport and slaughter of

animals which are supposed to apply

across the EU will not be

effectively enforced once the

animals leave our shores.

Figures from the animal and plant

health agency show that around

40,000 sheep are exported from

Britain for slaughter on the

continent every year. The long

journeys are stressful for the

animals and in some cases they can

result in suffering caused by

overcrowding, high summer

temperatures and animals sustaining

injuries en route. Many of these

40,000 sheep are sent to France.

Regular film reports by the

organisation L214 have revealed

inhumane and illegal slaughter

practices in French slaughterhouses.

In one shocking case, a slaughterman

is seen stabbing a knife into the

eye of a conscious sheep. A report

in 2016 by the committee of enquiry

of the French national, concludes

there are serious welfare problems

in French abattoirs. Mr Speaker, in

my view, and in the view of many of

my constituents, it's not acceptable

for the UK to send animals to die in

such horrendous conditions. 3,000

are exported from Scotland to Spain,

as regards Scotland, the animals are

first shipped to Northern Ireland,

then they are taken by road to the

republic from where they are sent on

a 20-hour sea journey to northern

France, finally they are driven all

the way through France to Spain.

Scientific research indicates that

young calves are not well adapted to

cope with such lengthy journeys.

Their immune systems are not fully

developed and their bodies' capacity

to control their internal

temperature is also limited. That

makes them particularly susceptible

to both heat and cold stress.

Morbidity and mortality following

transport can therefore be high, Mr

Speaker.

Of course, once in Spain, it's

entirely per misable for calfs to be

reared in barren conditions without

bedding and keeping animals in these

conditions would be illegal in the

United Kingdom where we apply

tougher rules than the EU minimum.

Turning to some of the mechanics of

the bill, it's drafted to cover

All

parts of the United Kingdom, animal

welfare is devolved but ex-pores are

a trade issue and therefore a

reserved matter. Whilst the Bill

would not cover exports whilst the

Bill would cover and ban exports for

slaughter or fattening, it would not

prohibit the export of animals for

breeding because of their higher

value breeding animals are generally

transported in better conditions and

so this business does not give rise

to the same concerns regarding

animal welfare.

Because it only deals with exports,

the Bill would not prevent the

transport of animals from the

Scottish Highlands to the mainland.

An exception is also include in the

Bill to allow cross boarder export

of live animals from Northern

Ireland to the Republic of Ireland

to continue. This is essentially a

local trade and aisle seen no

evidence to indicate the journeys

are excessively long. However, the

exception is framed to try to ensure

that the Republic of Ireland cannot

be used as a back door route to

continued live exports from the UK

to mainland Europe. Mr Speaker, the

fear has been expressed that if a

ban were to be brought forward,

there's a risk of challenge under

the rules of the World Trade

Organisation. WTO provide rules on

trade restrictions, one of which

covers public morals. The WTO body's

ruled that animal welfare matters

are capable of falling within the

public morals exception. For

example, the US ban on the import of

cat and doing fur and the EU ban on

seal fur remain in place despite

both being members of the World

Trade Organisations. There are good

grounds to believe therefore that

the UK would be able to defend a WTO

challenge if it were to be made by

showing that the export ban proposed

in this Bill would be a

proportionate response to deeply

held concerns by many in the public

in the UK with strong opposition to

live exports dating back around half

a century.

Indeed, only recently, the RSPCA

delivered a petition with over a

million signatures to the European

Commission, expressing grave concern

about the suffering caused by poor

enforcement of rules on long

distance transport of animals. Over

the years, there have been repeated

calls for this harsh trade to be

brought to an end. I first got

involved in this issue some 18 years

ago when I was a member of the

European Parliament. But all

attempts to ban this trade have so

far failed. They failed, Mr Speaker,

because a ban would contravene EU

law. In 1992, the Conservative

Government then in power sought to

restrict live exports and refused

licences to export sheep to Spain.

Their decision was overturned by the

European Court of Justice on the

grounds that it would breach EU

rules on the free movement of goods.

Now that the UK has voted to leave

the European Union, we have the

opportunity to make the decision

here in this House on whether to

allow or prohibit the export of live

farmed animals.

But that will only be the case if we

leave the customs union and the

single market, if we do not, we'll

remain subject to the restrictions

that make such a ban impossible

today and that provides a further

important reason to respect the

result of the referendum and create

a new partnership with our European

neighbours outside the customs union

and the single market.

The case for a ban has been made

clearly by a wide ranging coalition

of animal welfare organisations,

including compassion in world

farming, the RSPCA, the concern to

animal welfare foundation and world

horse welfare. The Conservative

manifesto states "as we leave the

European Union, we can take early

steps to control the export of live

farm animals for slaughter". This

Bill, Mr Speaker, provides the

Government with an opportunity to do

exactly that. But we need to deal,

not just with the slaughter trade

but also the export of calf force

fattening which can willed lead to

unnecessary suffering -- calfs for

fanning. We shouldn't wait until the

UK leaves the EU to take action, we

should put a prohibition on the

statute book now to come into effect

on exit day as soon as the United

Kingdom leaves the European Union.

Mr Speaker, the time has come to end

this inhumane cruel and unnecessary

trade which has no legitimate part

to play in modern farming. Exports

should took place on the hook, not

the hoof, and I commend this Bill to

the House.

THE

SPEAKER:. Thank you. The

question is that the Right

Honourable member have leave to

bring in the Bill. As many are of

that opinion say aye. Of the

contrary no. I think the ayes have

it, the ayes have it.

Who will

prepare and bring in the Bill?

Zac

Goldsmith, Craig McKinly, Richard

Graham, Henry Smith, Caroline Lucas,

Angela Smith, Kelvin Hopkins, Sir

Roger Gail, Kate Hoey, and myself,

Sir.

THE SPEAKER:

Mrs Theresa Villiers.

Live animal exports prohibition

Bill.

THE SPEAKER:

Second reading what

day?

2nd February.

THE SPEAKER:

2nd February, 2018.

Thank you. We come now to the first

opposition day motion on social

care, to move the motion I call

Barbara Keeley.

Thank you, Mr Speaker. After the

debacle of the dementia tax, there's

been continuing concern that the

current and future issues about the

funding of social care are not being

addressed. The worries stirred bum I

the party opposite during the

general election are not going to be

resolved without a better idea about

what the future holds for social

care -- stirred up by. One place

people were expecting to hear

discussion on this was at the Party

Conferences in September, but if we

thought we were going to hear about

this in the conferences, by the

Secretary of State responsible for

social care, we were sadly let down.

At the Labour Party Conference, I

talked about the crisis in social

care and how it was failing those

who need care and their families

failing unpaid family. People

needing care and their carers face

the greatest impact. Since the party

opposite came to power in 2010,

there are 400,000 fewer people

receiving publicly funded care.

Sadly, over 1.2 million people now

live isolated and lonely. I will

give way.

She's raising a very

important issue. Would she make

reference to the Royal Commission on

long-term care which almost two

decades ago recommended free

long-term care for all, which is

where we should be at?

I thank my right honourable friend

and I will be talking about how this

party will be taking forward

proposals on the future of social

care. We wait to hear from the party

opposite what they choose to do. But

he's right, it's a very driving need

now.

That is a number, the 1.2 million

people living with the care needs

that will rise without an injection

of new funding. The lack of publicly

funded care means that the task of

meeting care needs falls more

heavily on to unpaid family carers.

Many carers have to give up work

because of the demands of caring

with a real impact on finances and

future career prospects. The case

for listening to carers and giving

them more support is overwhelming.

We were expecting new carers

strategy this spring or at the

latest in the summer. 6,500 carers

have taken the time over and above

their caring responsibilities to

respond to the Government's

consultation. However, the Care

Minister told me their responses are

now merely going to be taken forward

into a new consultation on social

care.

Kayleigh Styles is a carer and she's

a campaigner for the M & D

association who contributed to the

consultation and who hoped her voice

would be heard alongside 4 6,500

other carers -- Katie. She told me

not publishing the national carers

strategy has made me extremely

angry, it sends a message that

carers' lives are unimportant, it

sends a message that Government

thinks we can carry on as we are. It

sends a message that my own time is

of little worth. That is a shabby

way to treat carers. The people who

provide more than 50% of the care in

this country. Yes, I will give way.

She refers to unpaid carers and the

emotional reference to the report in

care which allows payments to be

made to family members to remunerate

them for that care. Has she read

that report and is she willing to

look at it in further Dell tail on a

cross party basis?

I'll come on

later to how we should proceed,

whether we should proceed on a cross

party basis and how, Mr Speaker, but

I think the point he makes about

carers and family carers is an

important one. The plain fact of the

matter is, there was nothing in his

party's manifesto for carers,

absolutely nothing. We anountsed we

were going to lift carers allowance

to the level of JSA at least --

announced. That was the only

improvement talked about in the

general election. He ought to turn

really to his own minister and party

and ask them what they are going to

do for carers.

The tone in which she is setting out

her remarks I think is very

valuable, I know she has taken an

enormous interest in the subject but

these debates are very helpful for

educating people about the difficult

issues. The disappointing thing

about the motion and I am happy to

accept we did not handle this issue

well in the general election but the

mistake we made was not being clear

about the current system and that is

why her reference here to what we

propose without setting of the

current system where people can

potentially lose all but £23,000 of

assets I think is something which

would have helped contribute to the

public debate.

Mr Speaker we will

come onto that, but if the Minister,

the honourable member wants to get

into the mess his party made of this

the truth is we legislated, we

legislated a number of years ago to

lift the asset floor to hundred and

18,000, what his party did during

the general election is dropped back

to 100,000 and in fact we learned at

the weekend there was an intention

to make it only 50,000 so I think

you should be clear and perhaps

speak to his front bench colleagues,

what were they trying to do. And

then we have heard is a deafening

silence. We need action on social

care now. There are two aspects. On

the side of the house we have raised

many times how fragile the care

sector is after years of budget cuts

from the party opposite. Sergei by

the Association of directors of

adult social services reckons over

one third of councils have reported

closures of and nearly half of those

councils have had home-care

providers handing back contracts.

Yes indeed.

She refers again to

local authority care homes, in my

constituency three superb local

authority care homes were forcibly

closed, effectively by government

policy which were loved by the

residents, with full-time permanent

employed trade union staff and were

supported and applauded by the local

health care professionals. They were

all closed and now we have the

private sector which is in crisis.

I

think it's a very important factor

that we should bear in mind that the

1.5, 1.45 million workforce in care

will have been local government

employees in the past and will have

enjoyed local government terms and

conditions. We have talked in many

times in this house that they are

now not paid minimum wage, often not

paid travel time, very badly paid

with no pensions in prospect. Yes

indeed.

As she knows in my

constituency which neighbours hers

we have a real problem as a result

in recruiting and retaining key

workers. Many tell me they can get

better paid working in the local

supermarket than doing the job they

love. There she not agree that in

part because private providers would

like to pay their staff more but

cannot do so because of the

insufficiency of the value of the

contracts they receive from local

authorities?

That absolutely the

case, in fact I had a very recent

meeting with Unison and they told me

that in our area in greater

Manchester one person can be paid

more forbidding toppings onto pizzas

at Morrisons than they can for

providing care often for people with

dementia or who really need it. Yes.

The honourable lady talks about the

squeeze on funding, on that basis

would she agree that it would be

right to asked those who do have the

means to contribute more towards

their social care in the home?

I do

not agree with that and I think it

is one of the reasons his party's

policy, the dementia tax policy

fails so badly. To suddenly bring

hundreds of thousands of people into

means testing using their homes was,

I can say to the honourable

gentleman, one of the biggest flaws

in the policy has party floated. I

want to make progress now on the

state of care because the fragility

of the care sector is a key factor.

We heard from my honourable friend

about closures in his area but it is

the case that councils are not even

able to influence this any more

because providers and home-care

providers are handing back

contracts. Indeed one in five of the

councils reported closures in all

three services, home-care,

residential care and nursing home

services. There are also serious

issues with care quality in many

areas of the country. The survey

reported 70% of the councils

surveyed had experienced quality

issues across all three types of

care services. It is estimated this

means 20,000 people have been

affected by care quality issues are

by a change of service due to

contract been handed back and we

know, don't we, that for a person

with dementia are continual change

in the people visiting them is a

really big issue. So those arguing

in favour of cuts and to think about

was 28,000 lives affected negatively

by cuts to local authority budgets.

Worryingly the Care Quality

Commission now report almost a

quarter of care services are not

meeting standards on safety and

almost a fifth of services require

improvement overall. I spoke earlier

about how budget cuts mean over

400,000 fewer people are now getting

publicly funded care. Of course that

means councillors, council leaders

and social workers have had to make

difficult decisions on cutting

budgets and support the local people

in their area. It's a great credit

to councils and council leaders that

so many are continuing to prioritise

adult social care in the budget

setting but the overall position is

one of cuts. The real terms loss of

£6.3 billion to adult social care by

the end of this financial year and

we heard earlier from my honourable

friend for Manchester Gorton on the

level of cuts for the city of man

you are. These cuts have an impact

on staff working in social care...

On that point will the honourable

lady give way? I am grateful. Mr

Speaker, the government and HMRC

have acknowledged that care workers

who sleep in giving a loving care to

those badly in need of it are now

entitled to the national living wage

but as a result a crisis confronts

the centre, the final nail in the

Coughlan for many providers, jobs

lost and also a real risk of

bankruptcy for a whole number of

people who have personal care

packages, does the honourable lady

agree with me that the government

that created this problem should

solve this problem and not expect

local authorities to pick up the

bill?

I absolutely do agree. I think

it's very helpful that he has

intervened to make that point. This

issue has been a real cause of worry

for many organisations for many

months. It just goes to the heart of

our assertion that people who work

in care should be paid the minimum

wage and should be paid the minimum

wage when they are working at night

which is what sleep ins are. I have

a constituent who is looking after

two households, two affected

properties, adjoining properties of

people and she will not get normal

sleep during the night when alarms

can go off in any part of the

property and it's not right that all

that fixed amounts, not the minimum

wage, is paid to those people. It's

the case that the government must

find the funding for that decision.

I apologise for intervening so often

but would she not agree, my

honourable friend as they have

hinted at, that we are to have in

the longer term at least the whole

care sector in the public sector

provided on the same basis, free at

the point of need like the National

health service?

I will come as I

said earlier to our proposals, I do

not want to jump around too much

more in my speech. Going back to

staff working in social care we have

to think about social workers and

it's important we remember not just

care staff as we have talked about

but social workers. A recent survey

found that less than half of the

social workers surveyed felt

decisions about a personals care and

support Rabin led to their

professional judgment. It's now all

about budgets. More than a third

said they felt unable to get people

the care they need and less than

half of social work role spurt

supported to have the difficult

conversation is needed with people

needing care and their families. The

social care crisis is a direct

result of the cuts this government

has chosen to make. The King 's

fund, the health foundation and the

Nuffield trust have estimated a

funding gap of £1.9 billion for this

year but the extra funding in the

budget was only 1 billion so we

still have a funding gap of £900

million this year. This is why

Labour pledged extra £1 billion for

social care this year the star to

deal with the funding crisis.

However the government has chosen

instead to put the pressure onto

local authorities and hard-pressed

local council taxpayers to deal with

the social crisis which was in

Downing Street. The lady transferral

of care increased by more than a

quarter putting extra pressure on

local councils. But now sadly we see

government ministers threatening

councils with fines and further

funding cuts to social care if

targets on cutting delayed transfers

of care cannot be met. It's reported

that half social services director

as they surveyed believe their

targets on delayed transfers were

unrealistic. It is barely believable

that the government 's response to

the social care crisis is to

threaten to make the situation worse

by cutting funding for social care

even further. Some councils

experiencing problems meeting

targets were even summoned by NHS

leaders last week to a meeting to

review the performance challenges.

Many different people have said that

this approach, blaming and

penalising local councils and it is

not sustainable. The Conservative

chair of the local government

Association said of those warning

letters now council wants to see

anybody stay in hospital for a day

longer than necessary. These letters

are hugely unhelpful at a time when

local government and the NHS need to

work together to tackle the health

and social care crisis. The

president of the Association of the

directors of adult social services

has described the government 's

actions in making these threats of

further sanctions as frankly

bizarre. David Oliver, clinical boys

president of the Royal College of

physicians said this about the late

transfers of care, some of these

delays are due to systematic cuts to

social care budget and provision and

others are due to a lack of capacity

into Canadian health care services.

He also said attempts to solve the

problem through better care fund or

NHS England have failed. I think

interestingly the Chief inspector of

social care at the Care Quality

Commission Andrew Sutcliffe said I

worry that if people focus on moving

people through the system, quickly,

doesn't mean they will force the

discharge of someone old and frail

into a service we have rated

inadequate. We now have a government

driving the NHS to be obsessed with

dealing with the late transfers of

care are seemingly above all else

and this obsession causes further

problems if patients are discharged

without planning for what they need

outside a hospital. Age UK give an

example brought to them. Terry's

father Richard 85 is in hospital

following a stroke, he is ready for

discharge and assessed as needing

rehabilitative care to two home

visits a day but he was then told

there are no services available in

his area. Terry has been told to get

his father out of hospital and to

look for and fund the care himself.

My own local hospital, Salford

Royal, seems sadly to have similar

issues. Last week I spoke to a

constituent who described her

discharge like this: I was thrown

out of hospital. Having had surgery

for an infected bite which caused

sepsis my constituent was given no

discharge summary, no advice on how

to manage her wind or her recovery.

When she struggled to get dressed

she was told she had to get out

quickly otherwise this would count

as a field discharge. This is a

theme we might remember from last

winter. I want to remind the

Minister the British Red Cross top

then they can manage it in crisis

which saw people sent home without

clothes or into chaotic situations

which saw them falling and not been

found for hours or not being washed

because there were no care staff to

help. Ordering patients out of

hospital where there is no Rhys

Gowman service for them without

advice about wounds or recovery or

to care facility rated inadequate

just to meet unrealistic targets on

delayed discharge is a recipe for an

even worse crisis this winter. Yes

indeed.

In East Sussex where I

represent the social care and the

hospital budgets have been merged

together and as a result of that the

accident and emergency is now the

fastest improved in the whole of

England because it is working, would

perhaps her local authority were she

is perhaps consider the same model?

My local authority has the most

advanced example of an integrated

care organisation in the country. We

have already transferred all of our

social care staff to work for

Salford Royal so we have the most

advanced model of integration is

anyway I think and I have just

quoted a situation where the

pressure that's been put onto

hospitals because of delayed

transfers is causing them to treat

people like my constituent in the

way they had. I think members

opposite ought to listen to that

because it is the government and

their ministers causing this

pressure. We now demand is

increasing as more people live

longer with more complex conditions

and the number of people aged 75 and

over is projected to nearly double

by 2039. That ought to be something

to celebrate but instead the

government have created fear and

uncertainty for older people by

failing to address the health care

challenges raised by those

demographic changes. Indeed the

party opposite is spending less

money on social care now than when

Labour left office in 2010. They

seem to have no plan to develop a

sustainable solution to the funding

of social care in the longer term,

they have talked on the other

consultation followed by a green

paper. Furthermore and this is

raising real feel rushed that the

focus has been entirely on the needs

of older people without considering

the needs of the 280,000 working age

people with disabilities are

learning disabilities who are in the

social care system. This is

profoundly short-sighted because now

financial pressures on local

authorities due to the increase in

care needs of younger adults with

disabilities or with mental health

problems are greater than those due

to supporting older people.

I'm very glad she's mentioned the

issue of younger adults. Would she

not agree that investing in the care

that they need will facilitate the

Government's achievement of its

ambition to have more disabled

people who can work in paid

employment, relatively low levels of

expenditure for care with those

people would pay great dividends for

the Government and the country?

That's very much so, I thank my

right honourable friend for making

that point. It's concerning that

consultations planned or discussions

about future policy should actually

focus so much just on older people

when the needs of people with

disabilities, learning disabilities

are so important and we talked in a

debate last week about learning

disabilities. Mr Speaker, Labour

will fill the policy vacuum which

currently exists with this

Government around social care. Over

the coming months, we will consult

experts to advise us on how we can

move from the current broken system

of care to a sustainable service for

the long-term. We will look at

funding options for social care in

the long-term, including wealth

taxes and employer care

contribution, or a new social care

levy. These experts will help

clarify the options for funding our

planned National Care Service. Our

approach will be underpinned by the

principle of pooled risk, so that

no-one faces catastrophic care costs

as they do now, or as they would do

under the dementia tax of the party

opposite. Our plans are for a

National Care Service. They were

based on a consultation, the big

care debate, which involved 68,000

people. People in that consultation

told us they needed a system that

will support them and their families

to live the lives they want, that

will treat everyone with dignity and

respect and that will give them

choice and control over their care.

I believe that those needs still

remain the same and they will be at

the heart of our ambition for social

care. Mr Speaker, I urge honourable

members from all parties to vote

with us today so that we can set the

foundations for a safer, more

sustainable and higher quality care

system for the future and reassure

those people who become worried

about the dementia tax mess of the

party opposite. I'll give way.

I

thank the honourable lady for giving

way. I'm always very impressed with

her knowledge in this area. Just to

clarify, did I hear her say she was

considering wealth taxes as a means

to pay for this? The honourable lady

talked about a policy vacuum. I

would be very interested to hear

where the money vacuum is going to

come from and I was somewhat

concerned and I hope she will

explain it, that a national sort of

care system rather puts families

aside. I'm somewhat concerned to

hear that.

Mr Speaker, I'm obviously coming to

the end of my speech. I can

recommend that the honourable

member, if he's interested, reads a

number of documents. We produced a

White Paper for our National Care

Service, I know it's still

available, I advice him to look at

that. There is no way that we would

not include carers given everything

I've said about carers in this

speech, as an important part of

that. But the burden should not just

be dumped on carers, they should be

partners in care and they should be

support sod they have a life of

their own. It's said about his own

Governments, his own party's

proposals for dementia tax that in

terms of the manifesto, that the

only numbers that were put on that

were actually the page numbers. We

produced a document, this document,

funding bring's future, with a fully

costed manifesto. Yes, he is right

to say... I advise him if he has a

bit more time for reading to go to

our manifesto and look how we laid

out the options. We laid out the

options, we didn't get into a mess,

as the party opposite and try to

change it after four days.

We will take this forward, we will

not kick it into the long grass as

the party opposite is trying to do.

No, I'm just going to finish. Our

motion also asked, Mr Speaker, for

action to make sure the care sector

gets the urgent funding it needs to

prevent collapse and it will ensure

that hard-pressed councils are not

penalised for failing to meet

unrealistic targets for delayed

transfers of care.

THE SPEAKER:

The question is as on

the order paper, I call the minister

Jackie Doyle-Price.

Thank you, Mr

Speaker, I'm grateful for the

opportunity to answer this debate

because I think it gives the

Government an opportunity to set out

exactly where we are in this place

and it's not, as has been

characterised by the honourable lady

in her opening remarks. She is, as

ever, characteristically

challenging, and I hope to answer

some of the issues she's raised

today. Some of the messages that

she's given, I have some sympathy

with but I again, through my

remarks, I hope will reassure her on

some points. But no speech really

should start without paying tribute

to everyone who works in social

care. Everyone from the care

assistants, managers of the care

businesses, occupational therapists,

social workers, nurses, trusted

assessors and the many officials in

local authority who is organise care

packages and adaptations to people's

homes. As the honourable gentleman's

just said, an increasing number of

people all with the best of

motivations to care and we should

celebrate the work that they do to

support those who find themselveses

in vulnerable situations across our

society and I would like all to

recognise the excellent work that

they do. Now, the quality and

provision of care has been hitting

the headlines ever more recently.

It's therefore reassuring and

humbling to see the care and support

sector respond with such resilience,

commitment and compassion. I was

delighted to see the Care Quality

Commission's rated 80% of social

care settings as good or

outstanding.

Would the minister on

that note give way, please. I'll

thank the Minister for Raising that

because I would like madam deputy

speak tore say we shouldn't be so

negative about this area and in the

latest report from the Care Quality

Commission it's said that four out

of five institutions are offer good

or outstanding services. In my

constituency of Taunton Deane, I

recently visited Abbeyfield, the

staff are well-paid and loved their

jobs and the people were very happy

there. Somerset Care House, an Cream

Care recently rated outstanding for

its services. I took Jeremy Hunt

there, relatively recently, and this

is kind of old people in Somerset

need to know they can have and this

Government is doing it.

I think my

right honourable friend highlights

one of many examples up and down the

country but we shouldn't be

complacent about the 20% that

require improvement and there will

be lots of work that we can do to

raise the standard there, not least

the work that we are doing in

collaboration with the voluntary

sector and the LGA to spread

examples of good practice and

quality and we'll obviously continue

to do that. We should celebrate

other good work going on around the

country. In Sutton, for example, in

just within year, even though the

number of beds for care homes

supported by GPs supported by the

CCG increased 14%, there was an

overall reduction in residents

attending A&E. They had better

coordination of care and in-house

training of staff and better support

for older people actually in the

homes. It shows that with

collaboration, we can get better

care standards. Social care

continues to be a key priority for

this Government. Yes.

The honourable

lady's right, none so noble as those

who care but can I press her on this

- the care sector is facing a

disaster as a consequence of having

to pick up a £400 million bill

because of the confusion in the

ranks of Government and likewise in

that of the HMRC in terms of the

entitlement to nose who sleep in to

the national minimum wage. Can the

honourable lady say today that that

burden which was not the creation of

the care sector, that burden will

not fall upon Local Government but

will instead, the funds necessary

will be met by central Government?

Well, the honourable gentleman

raises an extremely important point

and one that

I am very actively

thinking about. He's absolutely

right in the sense that the

providers have been following

guidance which has changed. It's

clear from our perspective that

employers are obliged to meet their

obligations under minimum wage

legislation but I'm very clear of

the challenge that's giving to the

sector and we will work with them to

develop a solution.

I'm not used to this, clearly.

Turning to the substance of the

motion, we announced in the Queen's

speech that we'll work to address

challenges of social care for our

ageing population and we will bring

forward proposals for consultation

to build widespread support for

future provision.

I'll give way to the honourable

lady.

I thank the Minister for

Taking my intervention. At least 60%

of those receiving social care in

the home and 70% of those in care

home places are people living with

dementia and the underfund of course

social care's meant the burden falls

disproportionately on those very

people. Does the minister agree with

me that whatever the system social

care provided it's unacceptable that

those living with dementia and their

families should be

disproportionately affected?

I'd

invite the House to just reflect on

what the honourable lady has just

said because that is exactly the

issue we really need to tackle. It's

very clear there are one in ten

people who face very significant

costs that they have to meet from

their own resources. With only

14,000 ultimately protected. She's

right to point out that most of

those, the vast that swrort of those

are people suffering with dementia

and Alzheimer's. I think we have now

reached the time where it's critical

that we have a consensus about how

we address the funding of social

care so we can address the injustice

she's ably highlighted.

On that, am

I right in thinking that under

current statute law, from the

financial year 21-22, a cap of

£72,500 will apply and if that

settlement is to be altered, it will

require primary legislation in this

Parliament?

The honourable gentleman

is indeed correct. The ageing

population presents one of the

nation's most profound challenges,

it raises critical questions as to

how a society will enable all adults

to live well into later life and how

we deliver sustainable Public

Services that support them to do so.

Will my right honourable friend give

way on that point. On a spirit of

cross party consensus, can I add my

support to what the honourable

member for Stretford and Urmston

raised which is to make sure that

when we bring forward our

consultation, we do cover something

close to 50% of the social care

spending that's spent on adults with

disabilities because I share the

view that we must make sure they are

properly supported and able to lead

full lives including where able move

into work. That's something that

sometimes gets lost in the debate

when we completely focus on people

towards tend of the their lives, we

must deal with everybody, this's a

really important point the

honourable lady made.

I couldn't agree more and I share my

right honourable friend's support

for what the honourable lady said. I

think there's still many

opportunities to get people with

ageing adults with disabilities into

work. It's challenge that woeful set

ourselves a target of getting a

million more people with

disabilities into work. -- it's a

challenge we have set out. The

honourable lady in her opening

remarks, much of the debate has

focussed on the how we care for the

elderly, but as the honourable lady

laically will be aware, support for

working age adults is becoming an

increasingly bigger proportion of

local authority spending in this

area. It's very important that we

focus on it. I can say that

alongside the preparations we are

making for the consultation in the

New Year, we have a parallel work

stream looking specifically at

working age adults because some of

the solutions will be similar and

some of them will be different.

I thank the Minister for Giving way.

It's very important we have got to

this point today because she should

know that very many organisations

and individuals have been worried

for months about this. In the

Queen's speech, and the talk has

been of a consultation around social

care for older people, but I think

that the wording needs to change if

it's to encompass, as it should,

working age people with disabilities

or learning disabilities. Let's stop

the focus on just older people if

she would stop using it in letters

we could have clarity on this, it

would be helpful. I wonder whether

it has to be a separate work stream?

I think it does need to be a

separate work stream because it's

connected to the desire to get more

people into work, but the two

programmes are working in parallel

and, as I said, it's a great

opportunity today to actually get

that on the record. Certainly my

conversations with voluntary groups

in the sector, this has been very

much a focus of our conversations.

The reason I think it is important

to picking up the point about making

sure it is separate but parallel is

everything about how we are funding

this one of the really important

things is to make sure we do not

inadvertently put in place any

barriers to work were somebody would

find if they moved into work because

of their care would increase to the

extent they are finding work of no

consequence. That would not be an

issue when it comes to funding care

for older people so there are

different challenges so I think a

separate but parallel structure may

be the one to go for.

Again, I agree

with everything said and to reassure

the Honourable lady we will have

plenty of opportunity to discuss

these issues in the New Year because

one of the ways we want to progress

this is by building a real

consensus. This is a strategic

challenge facing us all because not

only are we all living longer but

working age adults with disabilities

are living longer and it's a matter

for celebration. We must do

everything we can to make sure we

can honour all our obligations to

them.

I am glad we are spending time

on this subject and I apologise for

intervening again, she will

recognise I am sure that for working

age adults it may be that relatively

modest amounts of care enable them

to participate more fully in the

workplace and in wider civil

society. Will she say that this

separate but parallel work stream

will acknowledge that because I fear

there will be a pressure to look at

the most severe and critical level

of need and that means many people

who could work with the most severe

and critical level of need and that

means many people who could work

with a small amount of help will be

shut out from doing so.

I have to

say I could not do that better

myself. We can get a lot more return

by putting, as she says, good value

for money measures which will

support people to live independently

and be able to work. Very keen to

explore those things. I will take

one more but I do need to make

progress.

I do appreciate the

minister giving way, just on the

point about getting older with the

Minister give me advice on my

constituent who when her daughter

who is quite disabled with epilepsy

when the mother was retiring she

realised she would lose her carer 's

allowance as she went on to state

pension and when she rang HMRC and

the Department to enquire they said

by your age they are normally shoved

into a home. Could you give me some

advice on how I could support my

constituent?

Well I have to say I am

not impressed by the tail she

requires but I would like in to look

into that more directly and get back

to you, thank you. The government

has in a more stable footing and

alleviate short-term pleasures

rhythm

one equipped to meet the challenges

of increasing numbers of people with

care needs. To address these

questions the government will work

with partners including those who

use services, those who work to

provide care and all other agencies

to bring forward proposals for

public consultation. The

consultation will consult on a wide

degree of options to encourage a

very wide debate. The consultation

will set out options to improve the

care system and put it on a more

secure financial footing, supporting

people families and communities to

prepare for old age and address

issues related to quality of care

and variation in practice. It will

include proposals with options for

caps on overall care costs and means

tested floors. But it is a

consultation and the government

wishes to approach the future of

social care in the spirit of

consensus. Our consultation is

designed to encourage a grown-up

conversation in order that society

can rise to the challenge.

I am

grateful for giving way, there are a

number of options the government

will consider, would the government

also considered as contained within

that report a system of social

insurance which would provide a

sustainable and simple system and

would deal with some of the points

raised about those adults of working

age, all of that in the scheme

providing protection for people who

are on low incomes as well, it's a

system that seems to work very

effectively and garnered cross-party

support in Germany when it was

introduced.

We do want to learn from

examples from other countries, I

would agree with that and the spirit

of the consultation, it will be to

inform a well-informed debate that

can establish consensus and in that

sense we will consider a wide

variety of options and not just

about funding but also about

lifestyle solutions and other

issues. Could I make some progress,

I have taken many interventions, I

apologise.

On funding adult social

care funding is made with government

grants, council tax and business

rates.

Has further help join a

health care services so people can

manage health and well-being and

live independently in their

communities for as long as possible.

The 2015 spending review introduced

an adult social care precept

enabling councils to raise council

tax specifically to support social

care services by 201920 this could

raise up to £1.8 billion extra per

year for councils. And as a further

boost social care the Chancellor

announced in the budget this year

that local authorities in England

will receive an additional 2 billion

for social care over the next three

years. £1 billion has been provided

this year in ensuring councils can

start to feel more care packages

immediately. The additional money

means local authorities in England

are estimated to receive an increase

in the dedicated money available for

social care over the next years of

£9.25 billion. Statistics produced

today show that spending on adult

social care increased in real terms

last year due in part to the precept

by one and a half percent.

I think

this is an important point Madam

Deputy Speaker because it's in our

motion about closing the funding

gap, it was not 1 billion it was 1.9

billion, so there is 900 million

left not covered which is what

councils are struggling with up and

down the country. She makes a point

about extra funding, because it

falls onto local taxes but though

she except there is still this gap

which means people cannot be paid

for the national living wage and we

are going to struggle all the way

through winter and unless there is

an acceptance that there is that gap

and will her party work to close it?

I don't accept that actually. Let's

recognise it has been hard in the

past, we have made money available

in recent years and the local

authorities have faced challenges

but as one local authority leader

who did to me austerity has been the

mother of invention and I

congratulate local authorities on

the very efforts we have made. As

for the point about the national

minimum wage it is enforceable so

again I don't accept that point at

all. That's come from the local

authority leader. I agree, I agree

local authorities have shown

considerable initiative by

implementing savings.

Just a final

point on that, though she except

that our government is funding

social care less now than 2010, she

can check that with NHS digital, it

is less in real terms, does not

matter that it has increased this

year because of the social care

levy, it is less. Given the growing

demographic challenge it is clear

why we have this gap.

We have made

£9.25 billion available. Turning now

to delayed transfers of care... I

need to make progress I apologise.

On delayed transfers of care this

government is clear that no one

should stay in a hospital bed longer

than necessary. It removes people's

dignity and juices the quality of

life, it leads to and is more

expensive for the taxpayer. I am now

going to set out in more detail the

work we are doing on reducing

delayed transfers of care. This is

critical because he well running

social care system enables the NHS

to provide the best possible

service. We are clear we must make

faster and more significant process

to free up hospital beds for the

sickest patients and reduce

pressures on overcrowded AMD

departments. Last year there were

2.25 million delayed discharges, up

24 and a half percent from the 1.81

million in the previous year. Just

over a third of these delays were a

tribute to both the social care. The

proportion of delays has increased

by four percentage point to 37%. We

have put in place and agile and

supportive improvement structure and

I have been clear on priorities.

First of all this year 's mandate to

NHS England we set out a clear

expectation that delayed transfers

of care should equate to know more

than 2% of all hospital beds by

September. The system has worked

incredibly hard to agree spending

plans and put in place actions to

make use of additional funding and

they deserve real congratulations

for the efforts which have been

made. Since February there have been

significant improvements within the

health and care system, where local

governments and the NHS are working

together to tackle the challenge of

delayed transfers of care with a

wrecker deep crease in month on

month delayed discharges in April

2017. I must make progress.

Giveaway!

THEY TALK OVER EACH OTHER

In early July NHS England

improvement local government and

Association published the definitive

national offered to support both the

NHS and local government to reduce

delay. This package supports all

organisations to make improvements

and includes the integration of

better care fund planning

requirements of how this and other

aspects of the planning process, I

have limited time and I must get

this on the record. A joint NHS

England improvement and service

guidance on him commenting just

assessors and greater transparency

through publisher in a dashboard

showing how local areas in England

are performing against the metrics.

It also includes plans for local

government to deliver an equal share

to the NHS of the expectation to

free up to and half thousand

hospital beds. This package set out

expectations for each local area

that reducing such delays must be

shared endeavour across NHS and

social care. These expectations are

stretching but they are vital for

people's welfare are particularly

over the winter period. We have also

asked the chief executive of the CTC

to undertake reviews of the most

challenging areas to consider how

well they are working at the health

and social care boundary. Reviews

are underway and a further eight

will be announced in November based

on the performance dashboard and

informed by returns from July. These

reviews

INAUDIBLE

By November identifying the issues

and driving rapid improvement.

Assessment arrangements which can

allow more efficient discharge from

hospital by avoiding gibbet patient

assessments by different

organisations. All areas have

submitted plans which include

trajectories for reducing delays and

finally in October we have asked NHS

England to extend the GP and

pharmacy influenza vaccination

service to include all care workers

working any nursing and residential

care sector. They will be able to

access the service through local GPs

and pharmacy is free of charge. The

honourable lady will be concerned

about the provisions on those who

failed to improve and I just wanted

to tackle head-on the suggestion

will be fines. We're not talking

about fines at all. The money which

has been deer will continue to be

returned by local authorities, I

will give way.

I am very grateful to

the minister forgiving way.

Leicestershire County Council fears

it could have £22 million removed

from its budget because of fines or

delayed discharges when the reality

is the government have cut their

funds. The Conservative deputy

leader says I cannot think of

anything more stupid and the

Conservative leader says how long

can we put up with the Secretary of

State? That is the reality of the

policy, what is the minister going

to do about it?

I reject the

suggestion will be any kind of

fines, the £22 million will be

returning to spending within

Leicestershire but that funding has

been allocated for a specific

purpose and where local authorities

are not showing the improvement we

expect we will work collaboratively

with them and advise them how to

make that money but let me put on

record exactly what we're going to

do. There is significant variation

in performance across local areas,

we do now 31 health and well-being

roles are collectively responsible

for percent of adult social care

delayed transfers of care. That

cannot be right when other local

authority areas have none. Newcastle

has now adult social care delayed

transfers of care and if they can do

it others can too provided we have

good partnership and good

leadership. I have just demonstrated

the extent to which the government

is supporting the best performing

systems where local government and

the NHS are working together to

tackle the challenge. But we are

clearly must make faster and more

significant progress to free up

hospital bed for the sickest

patients and reduce pressures on our

AMD departments. It's right there

should be consequences for those who

fail to improve, or local authority

areas informing them that if their

performance does not improve the

government may redirect spending. It

is not a fine we will direct

spending and reserve the right to

review allocations in the future but

it's important to note that those

allocations will remain with local

government to be spent on adult

social care. It is not a fine, it's

about making sure public money

delivers the outcome is intended for

it. In conclusion...

Revising allocations is not a fine.

Is that what she is saying? Revising

allocations, presumably not upwards

but downwards, but that is not a

fine? Sorry, but...

Sorry but that

is not the case. That money will be

retain bid Local Government and what

we'll be doing, we'll be directing

spending to achieve the outcome that

the money is intended for. That is

exactly wa we should do at the

moment, that's how we establish

value for money.

In conclusion, Madam Deputy Speaker,

the health and care system's

committed staff and managers up and

down the country working every

single day to deliver the best

outcomes for people. Hard working

workforce and leaders clarity on how

the Government expects the NHS -

I've already taken too much time

actually - I've given the hard

working workforce and leaders

clarity on how the Government

reports instrumental in delivering

high quality care.

To summarise, we accept there are

significant challenges in the health

and care systems. That is why over

the lifetime of this Parliament we

are increasing funding in real

terms. It's not just about money.

It's about sharing innovation and

best practice, it's about

integration defining new mod olds of

care and thinking about a long-term

sustainable solution to the care

system. Most important of all, it's

about supporting the weep that work

in the care system, as well as those

with little or none. We are

committed to all of this. -- the

people that work in the care system.

Before I bring in the holt that

speak force the SNP, we have a lot

of speakers really a lot of speakers

this afternoon so after the

honourable lady for the SNP, I'll be

bringing in a time limit of five

minutes to start with, but that may

have been reduced. Dr Fill la

Whitford.

Thank you. We have all

seen the figures about people

getting older -- Philippa. The

number of people over 65 is due to

double, the number of people over 85

will have increased by ten times.

Yet the number of funded places for

care has gone down by a quarter. So

those two things simply don't match

up. What we are seeing is that also

as the minister mentioned, those

under 65, those with disabilities or

learning libels are also thankfully

living longer. But the problem is

trying to provide that care.

Obviously, I tried, as a doctor, to

do my little bit for people living

longer and we shouldn't look upon it

as a catastrophe. We must celebrate

it. But we are all heading there, so

we need to make sure, for our own

vested interests, that those service

are there for us. We know that a lot

of the health you will have in older

age is laid down in early years, so

we are focussing in Scotland on the

early years collaborative from the

baby box for every newborn child,

the 30 years early learning

entitlement, doubling act of

transport and rolling out through

schools what's called the daily

mile.

But you don't get a financial return

on that for 50 or 60 years, so we

also have to invest in our older

citizens. While in Scotland, we are

trying to expand the elective

services to meet the demands of

hips, knees and eyes, the King's

Funds report rationing of hip and

knee joint replacements, we know

that three quarters of trusts from

set strict limits to access cataract

surgery that someone is in essence

losing their sight and certainly

losing the ability to drive.

Half of those Trusts will only fix

one eye. So what we are doing when

you do that is, we are driving

people into their own homes, driving

people into isolation and actually