Defending Public Services — House of Commons, 2016-05-23
Topic: Health
Alan Patrick Vincent Whitehead (Labour, Centre-left): We can all recognise that this Queen’s Speech contains a thin raft of legislation and that it is perhaps a Queen’s Speech in hiding for obvious reasons. It is certainly one that misses out many things that people might have thought would be included. It may not contain some terribly bad things, but we can ask a central question about it, following on from the thoughtful contribution by the hon. Member for Salisbury (John Glen). It is not just a question of changing services and ensuring we get the best out of them, because we need to think about who actually achieves the things set out in the Bills We should ask ourselves whether it is good enough to pass legislation and then say, "Get on with it; it is down to you. We have done our bit on the legislation, and it is your job now." Here lies an increasingly central flaw in the roster of Bills presented for our inspection. They certainly do not come with any "how to do it" impact assessment. It is important to recognise that we can have good public services only if we have good public servants carrying them out. When it comes to many of the measures in the Queen’s Speech, one cannot say, "That is a good thing." One should increasingly say exactly how to make it more than just a good thing, so that it actually becomes a good thing achieved The title of today’s debate is "Defending Public Services", but there seems to be a disjunction between what a service can do and what is coming its way as a result of this and other recent Queen’s Speeches. We discuss this one against a background of a crisis in funding for the NHS. We know that the NHS simply cannot do what is required of it as a public service with its existing funding. Deficits are rising for hospital trusts, and it is not sufficient to answer, as the Prime Minister did in his opening speech, that it is necessary to do "more with less". The people who are doing more with less are the public servants who have to carry out the services Statistics show the number of doctors per 100,000 head of the population between 2009 and 2015. There were 70 per 100,000 in 2009 and 65.5 in 2015. The same figures for nurses are 680 in 2009 and 664 today. That shows exactly what is happening. Public servants are doing more with less and continuing to have more and more piled on them with less and less resource—until, I suspect, the service starts to break down Social care is the other part of the health service revolution that we have debated today, but £1 billion has been taken out of social care budgets in the past year alone, with £4.5 billion taken out over the last five years. Local government is generally responsible for social care and social services, but councils have lost something like 79% of their direct funding between 2010 and 2020, with a further £3 billion of cuts announced in last year’s autumn statement. The most deprived areas of the country, those with the most pressing concerns on social care and the most disadvantaged seem to suffer the worst cuts. How can it be that nine out of 10 of the most deprived areas are seeing cuts above the national average? We face a Queen’s Speech, on the other hand, that places substantial new requirements on those desperately stretched services in the areas of the country that need them the most. In my authority, by no means one of the most deprived parts of the country, £72 million has been cut from the budget since 2010, and there is expected to be a further £90 million a year by 2020 The services that we seek to defend are, frankly, in a position of near starvation as they seek to provide us with the cover and the response to statutory responsibilities that we require. For example, the Queen’s Speech contains a requirement for further responsibilities to be put on local government and social care departments under the Children and Social Work Bill. This is what the Prime Minister said: "So, in this Queen’s Speech we are saying to care leavers: you will get guaranteed entitlements to local services, funding for apprenticeships and a personal mentor up to the age of 25. All this will be included in our care leavers covenant, so that our most disadvantaged young people get the opportunities they deserve."—[Official Report, 18 May 2016; Vol. 611, c. 26.] Who could disagree with that? On the other hand, who could disagree with the people who are going to do those things I declare an interest in that my daughter is a social worker. I am very proud of her hard work in becoming a social worker in the first place and her dedication in carrying out her duties and responsibilities. I see her on a daily basis, so I can see the effect as her case load gets stretched and the authority has to cut corners increasingly just to keep the service going. These new requirements are going to be a huge strain on her; she will be one of the many people who will have to carry out this new piece of legislation as part of her local authority responsibilities. I know, by the way, who will get the blame if services fail because departments cannot stretch themselves far enough to take on those new responsibilities. It will not be the Government who presided over that near-starvation, but the poor social services departments that were worked into the ground while they were just trying to cope The Prime Minister spoke of the services that local authorities would provide, but they are decreasingly in a position to do so. New responsibilities are coming their way, not just for social care but for planning, as a result of the neighbourhood planning and infrastructure Bill, and for buses, as a result of the bus services Bill. Moreover, authorities apparently have an interesting future in connection with the devolution of business rates. It is being suggested that the local growth and jobs Bill will enable them to retain 100% of business rates, and who would disagree with that? I have championed the idea for many years. However, when it comes to who will implement the retention, there is as yet no indication of how business rate devolution will be married up with local equity. It appears that the authorities with the highest business rate bases will do much better than those in the most deprived areas which have much lower bases, and whose public servants will suffer as a result. It has been announced that combined authorities will be handed powers from above, but they will be left with the same responsibilities and the same costs. How will they be funded? An authority that takes on devolved powers in south Hampshire, for example, will do so through a levy from a pooled business rate, which means that other authorities will have less money with which to support their already stretched services. I suspect that "more out of less" will not redound to the benefit of the public servants who are working in those authorities This is the central problem for our services. We can talk all we like about the sunny uplands, and about what shiny new words in shiny new pieces of legislation mean for people, but if those words are not followed by a commitment to make the services that will deliver on the promises work, they are hollow promises, and that, I think, is what this Queen’s Speech suffers from.