by Dick Barry
Prime Ministers’ Questions 4 May 2016
PMQs included a heated exchange between Corbyn and Cameron on anti-semitism and terrorism during which Cameron continued to label Corbyn as a terrorist sympathiser. There was also an admission by a government minister that the UK owes other European countries £674 million for the health costs of UK born residents living in Spain and elsewhere. In contrast the UK is owed just £49.5 million for the costs of NHS use by so-called ‘health tourists.’ This information was not reported by the anti-immigrant Daily Mail or any other right-wing paper.
Jeremy Corbyn (Islington North) (Lab)
Later today, commemorations begin for Holocaust Memorial Day in Israel. I hope that it is agreed in all parts of the House that we should send our best wishes to those who are commemorating the occasion, and also send a very clear statement that anti-Semitism has no place in our society whatsoever and we all have a duty to oppose it.
The Prime Minister
First, I join the right hon. Gentleman in saying that we should always support Holocaust Memorial Day, whether here in the UK, where we have a number of commemorations, or in Israel. But I am going to press him on this point, because he said “it will be my pleasure and my honour to host an event in parliament where our friends from Hezbollah will be speaking… I’ve also invited friends from Hamas to come and speak as well.” Hamas and Hezbollah believe in killing Jews, not just in Israel but around the world. Will he take this opportunity? If he wants to clear up the problem of anti-Semitism in the Labour party, now is a good time to start. Withdraw the remark that they are your friends!
I have made it very clear that Labour is an anti-racist party and that there is no place for anti-Semitism within it. We have suspended any members who have undertaken any anti-Semitic activities or work or made such statements, and have established an inquiry led by Shami Chakrabarti. The point the Prime Minister makes relates to a discussion I was hosting to try to promote a peace process. It was not an approval of those organisations. I absolutely do not approve of those organisations.
The Prime Minister
I am afraid the right hon. Gentleman will have to do this one more time. He referred to Hamas and Hezbollah as his friends. He needs to withdraw that remark. Let me give him another chance: are they your friends or are they not? Those organisations, in their constitutions, believe in persecuting and killing Jews. They are anti-Semitic and racist organisations, and he must stand up and say they are not his friends.
Obviously, anyone who commits racist attacks or who is anti-Semitic is not a friend of mine. I am very clear about that. I invite the Prime Minister to think for a moment about the conduct of his party and his candidate in the London mayoral elections and their systematic smearing of my right hon. Friend the Member for Tooting (Sadiq Khan), our candidate for Mayor. I wish him well, and I invite the Prime Minister to undertake to ensure that the Conservative party in London desists from its present activities in smearing my friend.
The Prime Minister
I completely reject the right hon. Gentleman’s comments about Labour’s candidate for the London mayoralty. As I have said before at the Dispatch Box, we are not responsible for everything someone says when they share are platform with us, and we cannot control everyone who appears in a picture, but there is a pattern of behaviour with the right hon. Member for Tooting (Sadiq Khan). He shared a platform with Sajil Shahid, the man who trained the ringleader of the 7/7 attacks and accused the United States of bringing 9/11 on itself. He shared a platform with an extremist who called for Jews to be drowned in the ocean. When this was put to the right hon. Member for Tooting, he described it as mere “flowery” language. If he wants to know why he has a problem with anti-Semitism, let me tell him: it is because his candidates share platform after platform with extremists and anti-Semites and then excuse their words. One more time: say you withdraw the remark about Hamas and Hezbollah being your friends!
Last week, the Prime Minister tried, as he often does, to smear my right hon. Friend the Member for Tooting for his association with Sulaiman Ghani. It turns out that Mr Ghani is actually an active Conservative supporter who has shared platforms with the hon. Member for Richmond Park (Zac Goldsmith). The Prime Minister should also reflect on the words of Lord Lansley some years ago when he said that racism was “endemic” within his party. We have set up a commission of inquiry; I suggest that the Prime Minister might think about doing the same thing.
The Prime Minister
But I am not going to let the issue about the right hon. Member for Tooting rest. The Leader of the Opposition raised the case of Suleiman Ghani, whom the right hon. Member for Tooting shared a platform with nine times. This is a man who says that it is wrong to stop people going to fight in—[Interruption.] No, as long as it takes. Do you want to know the views of a person that your leader has just quoted? He has described women as—[Interruption.] The hon. Member for Islington South and Finsbury (Emily Thornberry) might be interested in this. He described women as “subservient” to men. He said that homosexuality was an “unnatural” act. He stood on a platform with people who wanted an Islamic state. That is why the Leader of the Opposition’s attempts to deal with anti-Semitism are utterly condemned to failure. He will not even condemn people who sit on platforms with people like that.
I did point out to the Prime Minister—I was trying to help him—that the gentleman concerned is actually a Conservative. Maybe he would care to think about that. He might also consider that Shazia Awan, a former Conservative parliamentary candidate, has said this of the Tory mayoral campaign: “I’ll be voting Labour. A lifelong Tory voter and ex-candidate, I’m ashamed at the repulsive campaign of hate”.
Healthcare Costs (EU and UK Citizens)
Mr Philip Hollobone (Kettering) (Con) How much was (a) collected in payment for NHS care received in the UK by EU citizens and (b) paid for healthcare received by UK citizens in other EU countries in the last 12 months.
The Parliamentary Under-Secretary of State for Health (Jane Ellison) For 2014-15, it is estimated that the UK owes other European economic area countries and Switzerland £674 million and is owed £49.5 million by other EEA countries and Switzerland for healthcare activity received in that year.
Mr Hollobone My constituents in Kettering are increasingly fed up with our national health service paying for the healthcare of foreigners who come to this country to freeload on our system. What more can be done to make sure that hospitals and other healthcare providers bill foreign citizens for the NHS services that they use in this country?
Jane Ellison The Government take extremely seriously the issue of making sure that only those who should have access to NHS services do access them. Let me make an important point about the figures that I have just given. Some 80% of that imbalanced statistic represents our pensioners who choose to retire to Europe, typically for sunnier weather. The figure is 80% because many more UK pensioners retire to Europe than European pensioners retire here, and there will always be an imbalance. I am sure that even the keenest Brexiteer would not claim that Britain would be sunnier outside the EU.
Her Majesty’s Most Gracious Speech 12 May 2016
The Speech was as follows:
My Lords and Members of the House of Commons
My Government’s legislative programme has pursued a one nation approach; helping working people by supporting aspiration and opportunity.
My Ministers have continued in their long-term plan to deliver economic stability and security at every stage of life. To this end, work has continued to bring the public finances under control and to reduce the deficit.
To support working people, legislation was passed to guarantee that key taxes would not rise during this Parliament, to ensure that those working 30 hours a week on the National Minimum Wage will not pay income tax and to increase the provision of free childcare to working families.
To support aspiration and opportunity, legislation was passed to grant housing association tenants the right to own their home.
My Ministers have pursued policies to reform the welfare system to modernise and deliver equity to tax-payers, including measures to cap welfare payments.
In the first year of this Parliament, my Ministers have driven forward important constitutional reforms.
Landmark legislation was enacted to enable a referendum on membership of the European Union to be held later this year.
My Government has sought to develop a productive working relationship with the devolved administrations. In relation to Scotland, legislation was passed to implement the recommendations of the Smith Commission, devolving substantial new powers to the Scottish Parliament. A draft Bill was published setting out a new framework for devolution in Wales in accordance with the Saint David’s Day Agreement. Legislation was enacted to implement the Fresh Start Agreement and reform the welfare system in Northern Ireland.
With regard to England, ground-breaking legislation was passed which will allow significant powers to be devolved to directly-elected Mayors, helping to create a Northern Powerhouse.
In the House of Commons, changes have been implemented to create fairer procedures to ensure that decisions affecting England, or England and Wales, can only be taken with the consent of the majority of Members of Parliament representing constituencies in those parts of our United Kingdom.
Modernising the public services continues to be a priority for my Ministers. Newly enacted legislation will deliver transparency to the way in which trades unions operate and will protect essential public services from strike action.
Legislation was passed to improve schools, with new powers to turn around failing and coasting schools and create more academies. This legislation also made provision to establish regional adoption agencies in England to ensure every child can be provided with a stable home.
It has been a key priority for my Government to achieve a strong, sustainable and balanced economy where the benefits are more evenly shared across the country and between industries.
New legislation passed in this session will ensure that the Bank of England is well equipped to fulfil its vital role of overseeing monetary policy and financial stability.
A Small Business Commissioner was established in statute to help small businesses compete and grow. Legislation was also passed to ease the regulatory burden on businesses.
To help build a modern competitive workforce, the Institute for Apprenticeships was established as part of the drive to create three million high quality apprenticeships.
In recognition of the vital role charities play, legislation was passed to give the Charity Commission new powers to protect the integrity of such bodies by preventing abuses of charitable status.
The defence of the Realm is an utmost priority for my Government. In this session legislation has been passed to support our gallant armed forces. My Ministers will continue with legislation to provide a new framework to govern the use and oversight of investigatory powers by law enforcement and the security and intelligence agencies.
My Ministers have pursued policies to reform the criminal justice system, including new legislation to improve the integrity and effectiveness of the police, and a comprehensive new framework to ban the new generation of psychoactive substances.
The new Immigration Act will provide powers to tackle illegal working and the exploitation of workers, and make it easier to deport those with no legal right to remain.
The Duke of Edinburgh and I were pleased to welcome His Excellency the President of The People’s Republic of China and Madame Peng in October, during whose visit my Government launched a new partnership with China. We enjoyed our fifth State Visit to Germany in June, and our visit to Malta in November, for the Commonwealth Heads of Government Meeting.
My Government has continued to play a leading role in world affairs, promoting British interests and values, and protecting British citizens abroad, including in response to terrorist attacks in Tunisia, France, Belgium and elsewhere.
My Ministers have been at the forefront of the European Union and international response to Russian aggression in Ukraine, successfully ensuring the maintenance of tough sanctions.
My Government has played a leading role in the Global Coalition against Da’esh and co-hosted the London Syria conference which secured commitments to help refugees in Jordan, Lebanon and Turkey. With European Union and other international partners, my Ministers have worked to address irregular migration across the Mediterranean and its causes.
The United Kingdom played a key role in delivering the Paris Climate Change Agreement.
Members of the House of Commons, I thank you for the provisions which you have made for the work and dignity of the Crown and for the public services.
My Lords and Members of the House of Commons
I pray that the blessing of Almighty God may rest upon your counsels
The NHS And TTIP: Cameron Accepts Amendment To Queen’s Speech
David Cameron was forced to accept an amendment to the Queen’s Speech on 18 May to remove the threat to the NHS from TTIP. The Queen’s Speech had excluded reference to TTIP. Consequently, Labour MPs, with 25 Tories, mostly pro-Brexit, and a handful of SNP members, indicated support for an amendment saying that the House of Commons should: “respectfully regret that a Bill to protect the National Health Service from the Transatlantic Trade and Investment Partnership was not included in the Gracious Speech.” The amendment was to be debated on 25 May. If carried it would have been the first time since 1924 that a government had been defeated on the Monarch’s Address to Parliament. The defeat in 1924 led to the resignation of Prime Minister Stanley Baldwin and Ramsay MacDonald formed a Labour Government.
With a government defeat inevitable, a Number 10 spokesman said: “As we’ve said all along, there is no threat to the NHS from TTIP. So if this amendment is selected, we’ll accept it.” The amendment was tabled jointly by former Conservative health secretary Peter Lilley, and Labour backbencher Paula Sherriff. Lilley said: “ I support free trade. But TTIP introduces special courts, which are not necessary for free trade, will give American multinationals the right to sue our government (but not vice versa) and could put our NHS at risk. I cannot understand why the government has not tried to exclude the NHS.” Paula Sherrif described the government’s support for the amendment as “another humiliating climbdown. They will now be the first government in history to officially ‘regret’ their own programme within days of announcing it, just months after doing the same on their budget.”
Speaking in Stroud at the launch of an event about workers’ rights Jeremy Corbyn, who urged Labour MPs to support the amendment, said: “Yes we will be backing that”, (but) “I would personally go much further because my concerns about TTIP are not just about the effect on public services but also the principle of investor protection that goes within TTIP—planned rules which would in effect almost enfranchise global corporations at the expense of national governments. This protection of the NHS is an important step but it’s not the whole step.”
Junior Doctors Contract 19 May 2016
Jeremy Hunt reported to the House of Commons that a revised JDC has been agreed between the Government, NHS Employers and the BMA. However, his statement omitted to say that the new contract had to be approved by the Junior Doctors. A point made later by Dr Sarah Woolaston.
The Secretary of State for Health (Mr Jeremy Hunt) With permission, Mr Speaker, I will make a statement on the junior doctors contract. For the last three years there have been repeated attempts to reform the junior doctors contract to support better patient care seven days a week, culminating in a damaging industrial relations dispute that lasted for more than 10 months. I am pleased to inform the House that after 10 days of intensive discussion under the auspices of ACAS, the dispute was resolved yesterday with a historic agreement between the Government, NHS Employers—acting on behalf of the employers of junior doctors—and the British Medical Association that will modernise the contract by making it better for both doctors and patients. The new contract meets all the Government’s red lines for delivering a seven-day NHS, and remains within the existing pay envelope. We will publish an equalities analysis of the new terms alongside a revised contract at the end of the month, and it will be put to a ballot of the BMA membership next month, with the support of its leader, the chair of the junior doctors committee of the BMA, Johann Malawana.
I express my thanks to the BMA for the leadership it has shown in returning to talks, negotiating in good faith, and making an agreement possible. I also put on record my thanks to Sir Brendan Barber, the chair of ACAS, for his excellent stewardship of the process, and to Sir David Dalton for his wisdom and insight in conducting discussions on behalf of employers and the Government, both this time and earlier in the year. The agreement will facilitate the biggest changes to the junior doctors contract since 1999. It will allow the Government to deliver a seven-day NHS, improve patient safety and support much needed productivity improvements, as well as strengthening the morale and quality of life of junior doctors with a modern contract fit for a modern health service.
The contract inherited by the Government had a number of features badly in need of reform, including low levels of basic pay as a proportion of total income, which made doctors rely too heavily on unpredictable unsocial hours supplements to boost their income; automatic annual pay rises even when people took prolonged periods of leave from the NHS; an unfair banding system that triggered payment of premium rates to every team member even if only one person had worked extra hours; high premium rates payable for weekend work that made it difficult to roster staff in line with patient need; and risks to patient safety, with doctors sometimes required to work seven full days or seven full nights in a row without proper rest periods.
The Government have always been determined that our NHS should offer the safest, highest quality of care possible, which means a consistent standard of care for patients admitted across all seven days of the week. The new contract agreed yesterday makes the biggest set of changes to the junior doctors contract for 17 years, including by establishing the principle that any doctor who works less than an average of one weekend day a month—Saturday or Sunday—should receive no additional premium pay, compensated for by an increase in basic pay of between 10% and 11%; by reducing the marginal cost of employing additional doctors at the weekend by about a third; by supporting all hospitals to meet the four clinical standards most important for reducing mortality rates for weekend admissions by establishing a new role for experienced junior doctors as senior clinical decision makers able to make expert assessments of vulnerable patients admitted to or staying in hospital over weekends; and by removing the disincentive to roster enough doctors at weekends by replacing an inflexible banding system with a fairer system that values weekend work by paying people for actual unsocial hours worked, with more pay for those who work the most.
The Government also recognise that safer care for patients is more likely to be provided by well-motivated doctors who have sufficient rest between shifts and work in a family-friendly system. The new contract and ACAS agreement will improve the wellbeing of our critical junior doctor workforce by reducing the maximum hours a doctor can be asked to work in any one week from 91 to 72; reducing the number of nights a doctor can be asked to work consecutively to four, and the number of long days a doctor can be asked to work to five; introducing a new post, a guardian of safe working, in every trust to guard against doctors being asked to work excessive hours; introducing a new catch-up programme for doctors who take maternity leave or time off for other caring responsibilities; establishing a review by Health Education England to consider how best to allow couples to apply to train in the same area and to offer training placements for those with caring responsibilities close to their home; giving pay protection to doctors who switch specialties because of caring responsibilities; and establishing a review to inform a new requirement for trusts to consider caring and other family responsibilities when designing rotas.
Taken together, these changes show both the Government’s commitment to safe care for patients and the value we attach to the role of junior doctors. While they do not remove every bugbear or frustration, they will significantly improve flexibility and work-life balance for doctors, leading, we hope, to improved retention rates, higher morale and better care for patients.
Whatever the progress made with today’s landmark changes, however, it will always be a matter of great regret that it was necessary to go through such disruptive industrial action to get there. We may welcome the destination, but no one could have wanted the journey, so today I say to all junior doctors, whatever our disagreements about the contract may have been, that the Government have heard and understood the wider frustrations they feel about the way they are valued and treated in the NHS. Our priority will always be the safety of patients, but we also recognise that to deliver high-quality care we need a well-motivated and happy junior doctor workforce. Putting a new modern contract in place is not the end of the story. We will continue to engage constructively to try to resolve outstanding issues, as we proceed on our journey to tackle head on the challenges the NHS faces, and make it the safest, highest-quality healthcare system anywhere in the world. Today’s agreement shows we can make common cause on that journey with a contract that is better for patients, better for doctors and better for the NHS. I commend my statement to the House.
Heidi Alexander (Lewisham East) (Lab)
I start by putting on record our thanks to Sir Brendan Barber and ACAS for the role they have played in finding agreement between the two sides in this dispute. I also pay tribute to the Academy of Medical Royal Colleges, which proposed these further talks and encouraged both the Government and the BMA to pause and think about patients.
I have not been shy in telling the Health Secretary what I think about his handling of this dispute, but today is not the day to repeat those criticisms. I am pleased and relieved that an agreement has been reached, but I am sad that it took an all-out strike of junior doctors to get the Government back to the table. What is now clear, if it was not already, is that a negotiated agreement was possible all along. I have to ask the Health Secretary why this deal could not have been struck in February. Why did he allow his pride back then to come before sensible compromise and constructive talks?
When he stands up to reply, he may try to blame the BMA for the breakdown in the negotiations, but he failed to say what options he was prepared to consider in order to ensure that the junior doctors who work the most unsociable hours are fairly rewarded. It was a “computer says no” attitude, and that is no way to run the NHS.
Why did the Health Secretary ignore my letter to him of 7 February, in which I asked him to make an explicit and public commitment to further concessions on the issue of unsociable hours? I was clear that if he had done that then, I would have encouraged the BMA to return to talks. Why did he insist instead on trying to bulldoze an imposed contract through, when virtually everyone told him not to, and the consequences of doing so were obvious for all to see—protracted industrial action, destroyed morale and a complete breakdown in trust?
On the detail of the new contract, will the Health Secretary say a little more about the agreed changes that will undo the discriminatory effect on women of the last contract he published? Does he now accept that the previous contract discriminated against women? Will he be clear for the record that he now understands this was never “just about pay”? Can he confirm that concessions have been made not only in respect of the mechanism for enforcing hours worked and breaks taken, but in ensuring that the specialties with the biggest recruitment problems have decent incentives built into the contract?
Moving on to what happens next, can the Health Secretary tell us what he will do if junior doctors vote against this offer? Will he still impose a contract, and which version of the contract will he impose—his preferred version or this compromise one? Can he say whether the possibility of losing a case in the High Court about his power to impose a contract had anything to do with his recently discovered eagerness to return to talks? We all know that the High Court told him he had acted above the law when he tried to take the axe to my local hospital, so I can understand why he does not want that embarrassment again.
Finally, let me caution the Health Secretary on his use of language both in this Chamber and in the media. His loose words and implied criticism of junior doctors is partly the reason why this has ended up being such an almighty mess. May I suggest that a degree of humility on the part of the Secretary of State would not go amiss? May I recommend a period of radio silence from him to allow junior doctors to consider the new contract with clear minds, and without his spin echoing in their ears? I remind him that he still needs to persuade a majority of junior doctors to vote in favour of the contract for the dispute to be finally over.
I hope with all my heart that yesterday’s agreement may offer a way forward. Junior doctors will want to consider it; trust needs to be repaired, and that will take time. I hope for the sake of everyone, patients and doctors, that we may now see an end to this very sorry episode in NHS history.
Mr Hunt The hon. Lady is wrong today, as she has been wrong throughout this dispute. In the last 10 months, she has spent a great deal of time criticising the way in which the Government have sought to change the contract. What she has not dwelt on, however, is the reason it needed to be changed in the first place, namely the flawed contract for junior doctors that was introduced in 1999.
We have many disagreements with the BMA, but we agree on one thing: Labour’s contract was not fit for purpose. Criticising the Government for trying to put that contract right is like criticising a mechanic for mending the car that you just crashed. It is time that the hon. Lady acknowledged that those contract changes 17 years ago have led to a number of the five-day care problems that we are now trying to sort out.
The hon. Lady was wrong to say that an all-out strike was necessary to resolve the dispute. The meaningful talks that we have had have worked in the last 10 days because the BMA bravely changed its position, and agreed to negotiate on weekend pay. The hon. Lady told the House four times before that change of heart that we should not impose a new contract. What would have happened if we had followed her advice? Quite simply, we would not have seen the biggest single step towards a seven-day NHS for a generation, the biggest reforms of unsocial hours for 17 years, and the extra cost of employing a doctor at weekends going down by a third. We would not have seen the reductions in maximum working hours. We would not have seen many, many other changes that have improved the safety of patients and the quality of life of doctors.
The hon. Lady was also wrong to say that the previous contract discriminated against women. In fact, it removed discrimination. Does that mean that there are not more things that we can do to support women who work as junior doctors? No, it does not. The new deal that was announced yesterday provides for an important new catch-up clause for women who take maternity leave, which means that they can return to the position in which they would have been if they had not had to take time off to have children.
The hon. Lady asked what would happen if the ballot went the wrong way. What she failed to say was whether she was encouraging junior doctors to vote for the deal. Let me remind her that on 28 October, she told the House that she supported the principle of seven-day services. As Tony Blair once said, however, one cannot will the end without willing the means. The hon. Lady has refused to say whether she supported the withdrawal of emergency care, she has refused to say whether she supports contentious changes to reform premium pay, and now she will not even say whether doctors should vote for the new agreement.
Leadership means facing up to difficult decisions, not ducking them. I say to the hon. Lady that this Government are prepared to make difficult decisions and fight battles that improve the quality and safety of care in the NHS. If she is not willing to fight those battles, that is fine, but she should not stand at the Dispatch Box and claim that Labour stands up for NHS patients. If she does not want to listen to me, perhaps she should listen to former Labour Minister Tom Harris, who said: “Strategically Labour should be on the side of the patients and we aren’t.” Well, if Labour is not, the Conservatives are.
Dr Sarah Wollaston (Totnes) (Con)
I congratulate both sides on returning to constructive negotiations and on reaching an agreement. I pay particular tribute to Professor Sue Bailey and the Academy of Medical Royal Colleges for their role in bringing both sides together. I welcome the particular focus, alongside the negotiations around weekend pay, on all the other aspects that are blighting the lives of junior doctors. I welcome the recognition that we need to focus on those specialties that it is hard to recruit to and on those junior doctors who are working the longest hours, as well as the focus on patient safety.
However, we are not out of the woods yet. We need junior doctors across the country to vote for this agreement in a referendum. May I add my voice to that of the Opposition spokesman on health to say that what is needed now is a period of calm reflection? We need to build relationships with junior doctors into the future.