14 SEP 2017

Local Housing Need

Sarah Wollaston Chair, Health Committee

The South Hams has one of the highest house prices to earnings ratios in the country. I know that the Secretary of State wants to help young people to get on the housing ladder by introducing the earnings ratio, but that will be of no help to young people in my constituency if all the homes become second homes. Will he set out his plans to deal with areas of exceptionally high second home ownership?

Sajid Javid The Secretary of State for Communities and Local Government

My hon. Friend makes a good point. She will know that schemes are already in place to help people to get on the housing ladder, such as the Help to Buy scheme, which has helped more than 400,000 people. On her specific point about second homes, measures have already been introduced but, as she highlights, this issue needs to be considered carefully and kept under review to see what more we can do.

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13 SEP 2017

Higher Education (England) Regulations

Sarah Wollaston Chair, Health Committee

The Leader of the Opposition reneged on his clear pledge to deal with historic debt. Does the Secretary of State agree that that policy would have meant graduates repaying not only their own debt but the future debts of others?

 

Justine Greening Minister for Women and Equalities, The Secretary of State for Education

Indeed. The Labour party has a confused, muddled, counterproductive and anti-social mobility policy on student fees and student debt that would put at risk much of our higher education sector. It would be absolutely disastrous.

The bottom line is that, even now, across the border in Wales, the Labour colleagues of the hon. Member for Ashton-under-Lyne are implementing the very increases, in line with inflation, that she is opposing here today. That shows a level of hypocrisy that is becoming a hallmark of the current Labour Front Bench. The bottom line is that they are in—[Interruption.] I am taking no lectures from the hon. Lady about taking interventions when she was scared to take more than two. The bottom line is that Labour's student finance policy is a cold, calculating con trick on young people. It is shameless politics.

I have three serious questions for the Opposition on the policy of no fees, and they are questions that they need to answer. How many of the poorest children in this country are they going to prevent from going to university under that policy? How many world-class universities will shut down because they run out of money? If highly paid graduates do not have to pay to go to university to get their degrees, who is going to pay the bill? Those questions have never been answered. The Opposition have no answers, because having a sensible approach that has the best interests of students, universities and taxpayers at its heart is not their objective, is it? Driving social mobility is not Labour's objective. Enabling more disadvantaged young people to go to university is not their objective. Properly funded universities are not their objective. It is just a cynical con trick. That is Labour's objective. Far from Labour being the friend of students and universities, its policy would destroy opportunity and destroy our world-class universities. This House should see straight through it. Frankly, the motion is not even worth the paper it is written on.

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13 SEP 2017

NHS Pay

Sarah Wollaston Chair, Health Committee

It is a pleasure to follow Dr Whitford. I pay tribute to her for her work on the Select Committee on Health in the previous Parliament. That work was inevitably full of expertise and always constructive; I thank her for that. I agree with her that the NHS is a team, but that team should also include the wider social care staff because we cannot continue to look at the two systems in isolation. I echo her point, thanking all our NHS and care staff for the contribution they make not just to our wider economy, but—most importantly—to patients. Those are the people we should keep at the heart of this debate.

I welcome this debate. I also welcome the relaxation of the cap because we need to give the NHS Pay Review Body greater flexibility to make recommendations about what we need to put in place for our NHS staff. I agree with the hon. Member for Central Ayrshire that we should look at the impact of pay on morale, recruitment and retention—this is an international workforce, as well as a national one—but we also need to look at pay across regions and within specialties because there is great variation. We should focus our efforts on ensuring that we are looking at the situation from the patients' perspective by, for example, looking at the greatest areas of deprivation, which very often have the lowest ratios of NHS and care staff and who are under the greater pressure.

Seven years of sustained pressure on NHS pay is taking a toll. Nobody anticipated that it would go on for this long, so it is time to relax the cap. We should look not just at the issue of pay, but at the wider pressures within the NHS. I am delighted to announce that the Health Committee, which held its first meeting just before Prime Minister's Question Time, has agreed that its first inquiry of the Parliament will be on the nursing workforce. We will look not just at pay, but at the wider workforce pressures, including the increased workload that comes from increasing demand across the system, morale and all the other non-pay issues that contribute to the pressures on nurses. We will also look at bursaries and the new routes into nursing, and at their impact on people entering the nursing workforce. We have heard about that already today. For example, we know that those who drop out of nursing courses are more likely to be in the younger age groups, whereas those who go into nursing as mature students are much more likely to stay. We need to look at all those wider impacts.

Maria Caulfield Conservative, Lewes

I really welcome the news that the Select Committee is going to do a review of nursing. Will the Committee look into pay structure? The current Agenda for Change structure is being used by some trusts, in hospitals and communities, as a way of downgrading nursing roles. For example, a senior sister in one place may be paid a band 7 salary, whereas someone in the same role somewhere not too far down the road may be paid a band 5 salary. There is inequity in the current system.

Sarah Wollaston Chair, Health Committee

That is an important point. I very much hope that my hon. Friend will contribute to the Committee's inquiry. As well as looking at the new routes into nursing, we will look at the skills mix, roles within health and social care more widely, the impact of Brexit and language testing, workload and morale. We will be seeking contributions from hon. Members across the House and from people outside.

As I said, we will miss something if we just look at the issue as one of pay. Pay restraint is estimated to contribute between £3.3 billion and £3.5 billion of the five year forward view efficiency savings up to 2019-20. If that goes, what will fill the gap? We have to be careful that there is no loss of services or losses in the workforce, because workforce pressures—probably more than any other issue—contribute to nursing staff leaving the profession. We have to look at the bigger picture.

Eleanor Smith Labour, Wolverhampton South West

I have been a nurse for 40 years, but this is not just about nursing. There are other groups as well, including occupational therapists and physiotherapists, who are also registered professionals. Along with everybody else, they are just as important as nurses.

Sarah Wollaston Chair, Health Committee

The hon. Lady is absolutely right. Look, for example, at the applications for nursing courses. Even though the number of applicants has gone down, it may not ultimately result in a loss of numbers entering nursing. Some of the applicants from that overall drop in numbers might have gone on to other courses, so we need to look at the bigger picture. In opting to look at the nursing workforce, the Health Committee is not saying in any way that other parts of the workforce are not important. The NHS is a team, but it would be difficult for us to report within a certain timeframe if we looked at the entire workforce. I have no doubt that we will look at other aspects of the workforce over the course of this Parliament. I assure the hon. Lady that we will not lose sight of the bigger picture and I hope that she will contribute to the inquiry.

We need to look at the big picture regarding the total budget for health and social care. Norman Lamb has long made this point, and we have both made it clear that it is time for us to take a cross-party approach to sustainable funding for health and social care in the long term. I look forward to working with him on that over the course of this Parliament.

Norman Lamb Liberal Democrat Spokesperson (Health), Chair, Science and Technology Committee (Commons)

I totally agree with the hon. Lady and I am keen to continue working with her. Did she see the Independent Age survey that showed that well over 80% of Members of Parliament on both sides of the House agree that there needs to be a cross-party settlement for the future of the NHS and the care system?

Sarah Wollaston Chair, Health Committee

I welcome that and I look forward to working with the right hon. Gentleman over the coming months to try to encourage colleagues on both sides of the House, including the Front Benches, to agree to the idea. Next year is the 70th anniversary of the NHS, and I cannot think of anything more constructive we could do than to work across political parties in order to deliver sustainable long-term funding for health and social care.

I will bring my remarks to a close because I know that many hon. Members wish to speak. I look forward to hearing suggestions from colleagues in the House and outside this place about the points they would like the Health Committee's inquiry into the nursing workforce to cover.

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13 SEP 2017

Education Finance

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Education, what assessment she has made of the effect of maintaining current levels of core educational funding for 16 to 18 year olds on (a) educational outcomes and (b) further education provision; and what plans she has for (i) funding and (ii) resourcing further education in the next five years.

Anne Milton Minister of State (Department for Education)

The post-16 system is performing well and a record proportion of 16 to 18-year olds are now participating in education or apprenticeships. The results in the first of the reformed A levels were released last month, with students continuing to achieve effectively against the high standards of the qualification and demonstrating their readiness for the demands of higher education. Overall A level results this year were stable compared to last year.

A record number of 18-year olds applied for places in Higher Education this year and the entry rate for English 18-year olds from disadvantaged backgrounds is at a record high.

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13 SEP 2017

Medicine: Education

Written Questions

Sarah Wollaston Chair, Health Committee

  • To ask the Secretary of State for Health, what steps he is taking to support the development and growth of smaller and non-London medical schools
  • To ask the Secretary of State for Health, when he plans to announce the criteria and timetable for allocating additional undergraduate medical student places.
  • To ask the Secretary of State for Health, when allocating the 1000 additional undergraduate medical student places, what steps he plans to take to ensure that medical schools outside London receive a fair allocation of those places.

Philip Dunne The Minister of State, Department of Health

The Government has announced a historic expansion of medical school places in England, with an increase of 1,500 medical school places in England. The first 500 places have already been allocated and will be available to students in September 2018.

The Government response to the recent consultation was published on 9 August 2017, confirming that 1,000 additional medical school places would be available to medical schools in England via a competitive bidding process to be managed jointly by the Higher Education Funding Council for England (HEFCE) and Health Education England (HEE).

It also set out the priority areas bidding criteria would need to focus that include aligning the expansion to local National Health Service workforce need with an emphasis on priority geographical areas, including rural and coastal areas.

HEFCE and HEE are currently finalising the design of the bidding process and will publish details in the autumn.

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11 SEP 2017

EU Withdrawal Bill

Sarah Wollaston Chair, Health Committee

Without the Bill we cannot respect the will of the British people, as expressed in the referendum, and repeal the European Communities Act 1972. Without the Bill, as many Members have pointed out, we will see legal chaos. Given the sheer volume and complexity of the EU law that will have to be converted into UK law, I accept that the Government will need relatively wide delegated powers to amend legislation, but there is a distinction between necessary amendments as a consequence of our leaving the EU, many of which will be technical and minor, and those that implement entirely new policies. The delegated powers in the Bill will touch every aspect of our lives, as many colleagues have said—their use could be unprecedented in scale, scope and constitutional significance—so I am glad to hear that Ministers are in listening mode.

I will support the Bill tonight in the expectation that it will be amended in Committee and that there will be support for reforming the way delegated legislation is handled, so that Parliament, rather than the Government, can decide the appropriate level of scrutiny. Without that, we simply will not be able to bring control back to Parliament. It may be useful to those who are following the debate from outside this place if I explain how delegated legislation works and why it is important that we amend it.

I was first introduced to Delegated Legislation Committees when I was appointed to one dealing with draft double taxation relief and international tax enforcement orders. I thought there must have been a horrible mistake, so I sent a note to the Whip to ask about my duties. I received the following three instructions: “Turn up on time, say nothing and vote with the Government.”

People might argue that no one died as a result of my ignorance of international law on double taxation relief in Oman and Singapore, but what makes the system so absurd is that the very next Committee due to sit was a Delegated Legislation Committee examining the draft Medical Profession (Responsible Officers) Regulations 2010. It might be argued that, as someone who had just come to the House having been teaching junior doctors and medical students and having been an examiner for the Royal College of General Practitioners with an interest in doctors who were failing, I was better placed to be on the second Committee. It seems to me that there is an expectation that Members should not have any expertise at all. I think the general public would find that absolutely extraordinary; they expect Members to be able genuinely to scrutinise legislation.

There are many other reasons why the procedures should change. It is a great concern to people outside this place that many statutory instruments are subject to the negative procedure rather than the affirmative procedure and do not get any scrutiny at all—not even the current defective scrutiny. The power to change that does not necessarily need to come from legislation; we could use the Standing Orders. I commend the Hansard Society for the excellent work it did in advance of the Bill to set out how the procedures could be amended. Even though it is in our power as a House to put in place Standing Orders, for example to set up a Delegated Legislation Committee with the powers of sift and scrutiny that we have discussed today, it would help if Ministers indicated that they are in listening mode about that, too, and that they would support it happening over time. I genuinely feel that the Government do not want to obstruct sensible debate. All Members from across the House should work with Ministers to put in place something that genuinely works. We know that delegated legislation needs reform even without this Bill, so let use this as an opportunity. As we have heard, up to a thousand statutory instruments will be coming before the House, and we need the House to decide whether the procedure will be negative or affirmative. We need reform so that we can genuinely develop expertise along the lines suggested by the Hansard Society and so that MPs with a genuine interest scrutinise the proposals. The point is that a delegated legislation Select Committee could have the power to send a statutory instrument to a Committee of the whole House—not just a small Delegated Legislation Committee in a Committee Room, but with all of us here, similar to what we are doing today. It could also have the power to suggest sensible amendments that the Government would have to take away and consider.

I have said that I will support the Government tonight, but I do so only in the expectation that they will support sensible amendments.

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11 SEP 2017

Medicine: Education

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what estimate he has made of the number of extra UK medical school places that will be made available to international medical students after the removal of the cap on the number of such places.

To ask the Secretary of State for Health, what steps he plans to take to ensure that additional medical student places are fairly allocated to students from (a) the UK and (b) other EU countries.

Philip Dunne The Minister of State, Department of Health

The Government has announced a historic expansion in domestic supply of the medical workforce by funding an additional 1,500 medical school places in England available to domestic students from 2018-19. In addition, from 2019-20 English universities will not be limited in the number of international students they can recruit on a full fee paying basis.

For medical school intake targets, the only distinction that is made is between home or European Union students and those from outside the EU. As such, the additional 1,500 medical school places the Government is funding will be available to students from across the United Kingdom and all European Economic Area countries subject to the usual residency requirements.

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Hansard

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, for what reasons the Service Increment for Teaching funding allocation process is subject to the market forces factor; and what steps he plans to take to ensure that there is not an excessive regional disparity in allocations of that funding between London and non-London medical schools.

Philip Dunne The Minister of State, Department of Health

The funding for training placements in secondary care is allocated to placement providers by Health Education England using a tariff payment mechanism. These tariffs are calculated on the basis of average costs and do not take into account some features of cost that are likely to vary across the country. The tariffs are therefore adjusted by the Market Forces Factor in order to compensate for the cost differences of providing training placements in different parts of the country.

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19 JUL 2017

Department for Education: Vocational Guidance

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Education, when her Department plans to publish the careers strategy.

Anne Milton Minister of State (Department for Education)

We will publish a careers strategy in the Autumn. The strategy will have a clear focus on improving social mobility.

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12 JUL 2017

The Ambulance Service in Devon

Today I managed to secure a Westminster Hall debate on the Ambulance Service in Devon

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11 JUL 2017

The Future of the NHS

I delivered a lecture today in the Speaker's House on the future of the NHS

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