Catherine McKinnell
MP for Newcastle upon Tyne North · Labour · United Kingdom
“The family of a terminally ill constituent contacted me in desperation last month after trying to resolve the pension issues of their family member since January. She died yesterday, with her pension still unresolved. Can the Minister be more specific for that family about what will be done to resolve this issue?”
“As the UK trade envoy to Italy, I thank the Secretary of State for confirming the GCAP funding in his statement. As MP for Newcastle upon Tyne North, I add my voice to those who want to see this as an opportunity to genuinely spread investment and opportunity that will build strength and resilience in our people right across the UK—they a…”
“This report is welcome, but that does not make its existence any less tragic. Far too many mothers and babies have been failed, including mothers like my constituent Amie, who late last year was turned away repeatedly, despite reporting reduced movements. Her baby Seren was born stillborn.”
“Failures to address these issues have significant effects, both on the public finances and on the most vulnerable people in society, and, indeed, they are issues that are often reflected in our constituency mailboxes. I was contacted recently by a young woman who had reported child sexual abuse to the police last year.”
“Her husband was the victim of an assault by the defendant, who had raped his wife. They were forced to wait four hours for the trial to begin. They were eventually told that the defendant would arrive and that the delay to his delivery was causing the delay, but it had a knock-on effect on additional days in court.”
“Friend has said, we need a court estate that is fit for purpose in order to maximise the use of these additional days. I too have visited my local court, in this instance Newcastle Crown court.”
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“Despite the pressures on the NHS driven by an increasingly aged and frail population, nurses, and all our hard working NHS staff continue to put patients first, keeping them safe whilst providing the high quality care patients and their families expect.” How have we found ourselves in a situation in which hard-working, dedicated, exhausted nurses, midwives and other healthcare professionals are genuinely struggling to make ends meet?”
“I very much share the right hon. Gentleman’s concerns. He anticipates some of the points that I would really like to get across. My view of the importance of those who work in our NHS is shared not only by Opposition Members. The Department of Health stated in its response to the e-petition: “Agenda for Change staff are vital. They work incredibly hard for patients and deserve to be fairly rewarded. We are committed to ensuring trusts can afford to employ the staff the NHS needs. NHS staff are our greatest asset.”
“According to NHS Employers, the system allows NHS organisations to “design jobs around the needs of patients rather than around grading definitions” and individual NHS employers are better able to define the skills and knowledge that they want the staff in those jobs to develop. Importantly, in relation to this debate, Agenda for Change was also designed to enable employers to address more local recruitment and retention difficulties. However, as with hundreds of thousands of people who work in the public sector, all Agenda for Change staff have been affected by the previous and current Governments’ imposition of pay restraint.”
“My right hon. Friend is absolutely right. It is also a false economy to lose professionals, given all the money that has been invested to make them a well-trained, well-performing workforce. As hon. Members will be aware, Agenda for Change was introduced in 2004 as a system of pay, terms and conditions, and it applies to more than 1 million directly employed clinical and non-clinical NHS staff, with the exception of doctors, dentists and some very senior managers. It was designed with the intention of delivering fair, transparent pay that is better linked to career progression, skills and competencies. Agenda for Change is based on the principle of equal pay for work of equal value.”
“My right hon. Friend makes an important point. There was a two-year pay freeze from 2011-12 and a 1% increase in 2013-14 and 2014-15, followed by confirmation in the Budget of summer 2015 that the Government would fund an average public sector pay award of only 1% for the four years from 2016-17. As has been pointed out, the Government decided to reject the independent NHS Pay Review Body’s recommendation of a further 1% uplift to all pay scales from 2014-15, stating that there would be an annual increase of at least 1% for Agenda for Change staff in England through either contractual incremental pay or a non-consolidated payment.”
“The extended nature of the pay restraint imposed first by the coalition Government and now by the Conservative Government also throws up this question: what is the point of having an independent NHS Pay Review Body, given that the Minister is clearly content to impose a figure on NHS Employers and staff each year? Indeed, the Royal College of Midwives has warned that the policy “undermines the integrity of the system; and will cause lasting damage to the morale and motivation of staff, worsening the staffing crisis in the NHS.” Despite the widely promised but yet to materialise extra £350 million a week for the NHS, we all know that our health service faces real and significant challenges in financial terms, both now and in the years ahead.”
“I thank the hon. Lady for that intervention—I think that many of us are surprised that we agree so entirely with the hon. Member for Kettering (Mr Hollobone). She raises an important point about the concern that many people up and down the country feel about some of the Prime Minister’s early actions in her time in office. There are real concerns that the continuation of pay restraint in the NHS threatens to undermine the very benefits that Agenda for Change was supposed to bring to employers and staff. A centrally imposed cap on pay rises limits employers’ ability to respond to recruitment and retention problems while compromising the extent to which skills and competencies acquired by staff throughout their careers can be properly recognised and rewarded.”
“The hon. Gentleman raises some important points. I would never admit to having strayed into the subject of Brexit in this important debate on the NHS, but his comments are on the record and should be noted by the Minister. As NHS Employers stated in its 2017-18 submissions to the NHS Pay Review Body: “The NHS continues to face unprecedented financial and service challenges. The majority of trusts fell into deficit during 2015-16 and the overall shortfall has now reached over £2.5 billion… The financial settlement for the NHS up to 2020 is extremely challenging, with employers set ambitious targets to deliver efficiency savings. At the same time, demand for services continues to rise. Performance indicators show the service is under great pressure as demands for care increase and other public services reduce provision.””
“The reasons people cite for leaving are varied and include pay and reward, and the stressful nature of the job.” That very much ties in with the concerns the hon. Gentleman raised.”
“I very much agree. That is a factor right across the NHS and the social care sector, and it is an issue we see arising increasingly as staff come under increasing pressure, with the increased pressure to make efficiency savings, which ultimately compromises the health and safety of staff who find themselves in such situations. Just last week the National Audit Office published its report into NHS ambulance services, which concluded, among other things, that: “Increased funding for urgent and emergency activity has not matched rising demand, and future settlements are likely to be tougher”. Crucially, in the context of this debate, it also concluded that: “Ambulance trusts face resourcing challenges that are limiting their ability to meet rising demand. Most trusts are struggling to recruit the staff they need and then retain them.”
“I look forward to hearing him explain how continued pay restraint for Agenda for Change staff will help resolve the staffing crisis.”
“Again, that addresses neither the fact that there is currently a shortage of about 24,000 nurses in England and Wales, nor the shortage of nearly 3,500 midwives across the UK. Nor indeed does it address Health Education England’s worrying confirmation that last year some 8.8% of nurses left the NHS—the highest number since 2011. All that surely shows that the NHS is facing a perfect storm, not least in the light of the Minister’s ludicrous decision to axe bursaries for new nursing, midwifery and allied health students—I should perhaps say “Ministers’ decision”, rather than directing that comment at the Minister of State—the Government’s continued disgraceful failure to confirm the long-term future of 33,000 nurses from other EU countries working in the NHS, and the fact that one third of nurses are due to retire in the next 10 years.”
“We therefore have the nonsensical situation whereby nurses are leaving the NHS because of increasing workloads, stress and feeling undervalued following years of pay restraint, so the NHS has to turn to expensive agency nurses to fill the gaps left behind. Those concerns are mirrored by the Royal College of Midwives, which, following a freedom of information request, uncovered that NHS trusts in England spent almost £72.7 million on agency, overtime and bank midwives in 2015—enough to pay for 2,063 full-time experienced midwives or 3,318 full-time, newly qualified midwives. The Minister might also refer to an increase in the number of nursing and other NHS staff since 2010.”
“Indeed, Ministers confirmed only last week that NHS England will face a 0.6% real-terms fall in per capita funding in 2018. How would an end to pay restraint for Agenda for Change staff help address the enormous difficulties the NHS faces? As the Royal College of Nursing has highlighted, chronic staff shortages have led to an “over-reliance” on “expensive agency staffing” to the extent that spending on agency nurses equates to about one tenth of the NHS’s total nursing pay bill. Indeed, the Royal College goes on to state that “the over-reliance on agency staffing is a reflection of a nursing shortage and a direct consequence” of the limit on pay for nurses working in the NHS.”
“The hon. Gentleman makes an important point, which is why it is important that staff under Agenda for Change have the opportunity to have their voices heard today. When the Government look at how the NHS’s limited resources are distributed among the workforce, they need to approach the matter very much in the round. I have no doubt that the Minister, when he responds to the debate, will be tempted to repeat the Prime Minister’s mantra that the Government are putting an additional £10 billion into the NHS by the end of this Parliament. However, as we all know, that figure has been comprehensively debunked by the hon. Member for Totnes (Dr Wollaston) and her fellow members of the Health Committee, and more recently by the chief executive of NHS England, Simon Stevens, when he appeared before that Committee.”
“More than 80% said they had considered leaving the NHS in the past year.”
“To put that in context, the trade union Unison has calculated that it is equivalent to annual pay cuts of £2,288 for a cleaner, £4,846 for a nurse, £6,134 for a midwife and £8,364 for a clinical psychologist. Indeed, ahead of the 2017-18 NHS pay review process, Unison surveyed its members working in the NHS and received the following responses, which are a matter of deep concern: nearly two thirds felt worse off than they did 12 months ago; 49% had asked for financial support from family or a friend; 13% had used a debt advice service; 11% had pawned possessions; 11% had used a payday loan company; 15% had moved to a less expensive home or remortgaged their house; and just under one fifth took on paid work in addition to their main NHS job, 64% of whom did so because their NHS salary was not enough to meet their basic living costs.”
“The hon. Gentleman makes another valid point. I hope that the Minister is listening, because although we are focusing specifically today on pay restraint for Agenda for Change staff, there is a much wider issue for the Government to take on board. A variety of factors is affecting recruitment and retention of NHS staff. The axing of bursaries is just one significant factor that the Government should seriously examine, and reverse. What has the pay restraint for Agenda for Change staff meant to individual nurses, midwives, paramedics, cleaners and other healthcare professionals since 2011? Depending on the measure of inflation used, it has resulted in a drop in real-terms earnings of up to 14%.”
“How can we expect people to continue to provide high-quality care to us and our loved ones in what are already increasingly challenging circumstances when they are also facing this level of stress and anxiety at home? I strongly urge the Government to look at this situation again and to take on board the concerns being raised not only by organisations such as Unison, the RCN and the RCM, but by NHS frontline staff who are saying loud and clear that this pay restraint simply cannot continue.”
“We have an NHS workforce currently willing to work as hard as the service asks them, but this goodwill is now eroding faster than I have ever seen in all my years’ service. I am retiring within a couple of years. This request comes not for me, but for those who come after me and who will be caring for me and my family in the future.” It is clear that our NHS is facing a crisis, yet the people the Government entirely rely on to make the NHS work are being badly let down. Nobody would suggest for a minute that those working in the health service do it for the money. However, we have reached a situation in which nurses, midwives and other invaluable NHS staff are struggling to pay their bills or put food on the table, or are pawning their possessions or taking out high-interest loans just to get from one month to the next.”
“This month I was paid £1,450 after tax—from that £300 is childcare; £400 is rent; leaving £750 for the month covering gas, water, phone, food, insurance etc. I also receive £35 tax credits a week which covers my daughter’s bus fare to college and her lunch money. I am a qualified professional and yet I would class myself as being on the breadline. I know there are others in greater need than I am; however I feel like I work hard and sacrifice my family time for nothing.” Finally, a senior sister with 30 years’ experience in an acute trauma unit explained: “After six years of pay restraint, I now see nurses struggling day to day to make ends meet. Those who have stayed are now planning to leave the NHS early and newly qualified nurses are unable to stay without reasonable remuneration. I feel like I grieve every day for my profession now.”
“To maintain complicated machinery/equipment that is keeping a person alive whilst watching the newly-qualified staff nurse who doesn’t feel confident and make sure they don’t do anything dangerous.” Another constituent painted a very concerning picture about her financial situation. She recently qualified as a nurse—a year and four months ago. She is a single parent of three children, and commented: “After studying hard for 3 years mixing university, placements and guided learning, I gained my degree only to find myself in more dire financial circumstances than I was as a student. I live to a tight budget, I drive a car that is 16 years old, I don’t smoke or drink, and I rarely socialise with my friends unless it’s a special occasion.”
“On a daily basis we deal with and see things that are devastating and can be difficult to switch off from. Our pay should reflect this.” Another constituent challenged the claim made in the Government’s response to the e-petition: “Average earnings for qualified nurses were £31,214 in the 12 months to June 2016”. She described herself as an average nurse in her 40s with a partner and a child: “I have been qualified and working in the NHS for 11 years. I don’t earn £31,214. The top of my band (band 5) is £28,464. So, I am paid about £14.50 an hour to clean up faeces, vomit, blood and other bodily fluids. To hold the hands of patients who are dying. To comfort the relatives of patients who are dying.”
“4-5 years ago I was in a comfortable position, I could afford the basics and if I wanted extras like holidays or treats I would just do overtime or extra shifts to afford these luxuries. However, due to the fact my pay against my cost of living has reduced by 14%, I now struggle to afford the basics and am having to do extra shifts just to be able to provide food and pay my bills… I am missing out on valuable time with my family as I have to work nearly every weekend in order to be able to get a wage that can cover our costs. It is now becoming such a stretch each month that I may have to leave nursing and find a job that pays me better... Working as a children’s nurse in a busy A&E unit is amazing and worthwhile, but it is very stressful.”
“This contact from our members focuses predominantly on dealing with unmanageable consumer debt.” It is shocking and depressing stuff. It is bad enough that the Government continually expect NHS staff, many of whom are at breaking point, to do more with less and treat more patients with fewer resources in what are usually physically and psychologically demanding roles, but to expect them to do so while they face such anxiety and stress over their own financial situation is completely unacceptable. We do not need to take Unison or the RCN’s word for what is happening. I have received emails containing powerful testimony from NHS staff in my constituency. One explained: “I have been qualified as a children’s staff nurse for 12 years and I reached the top of my pay scale four years ago. I have not had a pay rise since.”
“Yes, I share those concerns, particularly about the significant shortage of nurses in London. The issue affects places throughout the country, but I fully appreciate the acuteness of the situation in London. The findings that I have set out are mirrored in the most recent Royal College of Nursing employment survey of its members. It found that 30% had struggled to pay gas and electricity Bills, 14% had missed meals because of financial difficulties, 53% had been compelled to work extra hours to increase earnings, and 32% were working extra night and weekend shifts to help pay bills and meet everyday living expenses. The RCN stated: “This corresponds with our year on year increase of 30%, over the past five years, on the number of our members seeking specialist money advice from our RCN Welfare Service.”
“I thank the Minister for giving way. I am slightly concerned by his response, in that he does not seem to be taking on board the very significant concerns that have been raised right across the board, not only by unions but, significantly, by the National Audit Office. Last week, in its report on ambulance services, the NAO said: “Ambulance trusts face resourcing challenges that are limiting their ability to meet rising demand.” One of the “challenges” that is specifically cited is “pay and reward”, which is hampering recruitment. It is not just the unions and NHS staff who are saying these things; it is the NAO and other bodies as well.”
“On the softer side, they are turning to agency work to top up their pay—not to afford the luxuries in life, but the basics. It is a completely unsustainable situation, and the Government must take urgent action to lift this burden off our NHS staff so that they can do their job, which is caring for us and our loved ones without the fear of financial insecurity hanging over their every working day. Question put and agreed to. Resolved, That this House has considered e-petition 168127 relating to pay restraint for Agenda for Change NHS staff.”
“I have received a number of testimonies and seen the evidence—the Government seem to deny the figures, even though they are there in black and white and I set them out clearly in my opening speech— about the real-terms pay cuts that NHS staff are facing. They simply cannot manage, and that is a shameful situation. I said in my speech that it is the very people the Government rely on to deliver a high-quality NHS service in extremely challenging circumstances who are being badly let down by the Government’s current policy. How have we reached a situation where nurses, midwives and other invaluable NHS staff are struggling to pay their bills and put food on the table? They are pawning their possessions and turning to payday loans.”
“I feel very strongly that we have won the argument today. There is a high degree of cross-party consensus on many of the issues we have outlined, and the Government are either burying their head in the sand or deliberately not facing up to significant challenges regarding pay, recruitment and retention for NHS staff. As my right hon. Friend the Member for Leigh (Andy Burnham) pointed out, by failing to address the issue we are taking advantage of those who work in the NHS and are pushing their good will to the limit. What disturbs me even more is that not only their good will is being tested; their very ability to survive in the job is being tested, too.”
“I do not think that anyone could argue with what the Minister has just said about NHS staff being proud of what they do and wanting to continue. But even while this debate has been going on, I have seen several tweets. For example, one asks: “please tell me what the RCN” —it says the Royal College of Nursing, but I say the Government— “is going to do. I am seriously starting to struggle now”. Others say that they “know so many young people who would be great nurses but lack of bursary & low pay put them off”. Those tweets reflect NHS staff’s real live experiences of the current pay situation under Agenda for Change and the continued pay freeze. I thank all right hon. and hon. Members who have contributed knowledgeably and passionately to this very important debate, whether in speeches or interventions.”
“The Green Paper rightly identifies the crucial role that better connectivity to regional airports could play in growing economies and highlights the vital importance of the Emirates route from Newcastle airport, which has significantly increased exports from the north-east. What discussions is the Secretary of State having with Treasury colleagues about the impact on airports such as Newcastle of devolving air passenger duty to the Scottish Government?”
“Towards the end of last year, I visited Auschwitz with a group of students from my home town of Newcastle. It was an incredibly challenging and moving visit, but it was made really powerful by the presence of so many young people from the region. Does my hon. Friend agree, therefore, that we also owe a debt to those at the Holocaust Educational Trust, who make this visit possible for so many young people to ensure that we never forget and that we never repeat?”
“Changes to the rateable value for solar panels for organisations mean that business rates for organisations with solar rooftop installations, such as schools, hospitals and SMEs, could increase dramatically—six to eightfold—in April. Do the Government recognise the huge damage that this will cause to organisations that have installed panels in good faith, as well as the solar panel industry?”
“Some 58% of north-east exports are destined for the EU—10% more than the UK average—which leaves our region the most exposed to leaving the single market, so will the Secretary of State say what assessment he has made of the risks and what conversations he has had with business organisations and others in the north-east to ensure that our voice is heard in these discussions and that the jobs that depend on our access to the single market are not put at risk?”
“Access to broadband is an issue not just for rural areas, but for areas such as Dinnington village, which lies on the edge of my constituency, and for new-build housing areas such as Newcastle Great Park, where capacity simply cannot keep up with demand for this vital service. How will the Government speed up delivery to such areas?”
“Newcastle international airport plays a vital role in the north-east’s economy, by facilitating over £300 million-worth of exports every year. Like other English regional airports, however, it faces unfair competition on tax as air passenger duty is devolved to Scotland. The Government have failed to commit to mitigate that. What discussions will the Department have with the Treasury to ensure that airports such as Newcastle can continue to play a vital role in international trade?”
“As the Prime Minister mentioned yesterday, Newcastle City Council performs well on social care in the face of continued punitive cuts, but that will all be put at risk if the Government do not act responsibly to plug the £15 million funding gap. Today’s plan relies on local areas being able to build new homes and raise local taxes to solve a crisis in social care funding. Can the Secretary of State not see that this will entrench inequality across the country and that it is playing politics with vulnerable people’s lives?”
“Will the Secretary of State confirm whether an area cost adjustment multiplier will be applied as a result of the new formula? The funding gap between the national average and what is received by schools in the north-east stands at £45 million a year. Will that gap increase or decrease as a result of the formula?”
“I congratulate those who have secured this debate. A UN spokesperson stated this morning that there had been a “complete meltdown of humanity” in Aleppo. If that does not mean that we have reached the point of last resort, does my hon. Friend, like me, want to hear from the Foreign Secretary exactly what that point would be?”
“My hon. Friend makes a powerful speech that rings true in the light of the many testimonies that I have seen and heard. Christmas is special because people who might not normally be able to spend time with family can do so. Is it not another issue that many people who work in retail do not have the option of travelling to see their family, because now they must travel so early on Boxing day to make it back in time for the sales?”
“I very much agree with my hon. Friend. I will put on the record another thing that, like childcare, is not generally available on Boxing day: the usual support for those whose family members require care. There is testimony from retail workers who are in the difficult position of both having to care for their family and being forced to go to work or ultimately risk not being able to bring the bread home.”
“I hesitate to interrupt my hon. Friend, because she is making a brilliant speech. Who has less power in this world than children? It means everything to them to spend Christmas with their family. One retail worker said in testimony: “I’ve got a little girl and these early years are such a magical time for her. I feel that I miss out on her enthusiasm and wonder by having to work over Christmas.” That says it all.”
“They continue to fall in the face of an increasingly elderly population and therefore increasing demand. I have no doubt that the Minister will want to champion the social care council tax precept that the Government have allowed local authorities to raise for this purpose, but I gently remind him that that is anticipated to raise £1.4 million a year in Newcastle, yet the city council faces a social care shortfall of some £15 million.”
“Marie Curie states that in its own services, it is seeing people waiting weeks in hospitals and hospices for social care packages to be put in place so that they can get home or into a care home to spend their final days in the place of their choosing. Very sadly, that situation means that it is not uncommon for people to die while waiting. This does, of course, have a terrible human impact, not only on the person dying, but on their families, making what is already a hugely traumatic situation immeasurably worse. This state of affairs is also totally cost-inefficient for our NHS, which could be using those hospital beds for people who need acute care. The situation I have outlined will come as no surprise to any hon. Member, given that adult social care budgets have been cut by some £4.6 billion, or 31% in real terms, since 2011.”
“Written evidence submitted by Age UK to the same Health Committee inquiry highlighted that while one third of all deaths are of people aged over 85, only around 15% of the people who gain access to specialist palliative care fall into that age group. Worrying inequalities already exist regarding the quality of end-of-life support available, depending on a person’s illness, age and, as ever, where they happen to live. A growing concern is that the existing system, which is already unable to provide care for all who need it, is coming under ever greater pressure as our social care services fast approach breaking point.”
“Indeed, written evidence submitted by the National Council for Palliative Care to the Health Committee’s inquiry into end-of-life care, which was published last year, drew attention to the fact that people with cancer access over 75% of specialist palliative care services, although cancer causes around 30% of all deaths. Concerns about the availability of palliative care for people with non-cancer diagnoses have been raised with me by a constituent living with idiopathic pulmonary fibrosis. Others who are likely to miss out are people aged over 85, including those with dementia, despite the fact that dementia is now identified as the leading cause of death in England and Wales.”
“Despite the incredible efforts of these charities and the NHS for people who are dying, the risk that they will not get the care that they need to manage their symptoms and to maintain their quality of life until the end of their life is worryingly high. Research undertaken last year by the London School of Economics on behalf of Marie Curie found that a deeply concerning 92,000 people who need palliative care in England each year are not receiving it. That means that one in four people are not getting the good end-of-life care—care for managing pain and other symptoms, alongside psychological, social and spiritual support—that they clearly need. The people who miss out most frequently on this support are those with a terminal illness other than cancer, such as heart failure or chronic pulmonary disease.”
“Of course, not all Marie Curie’s nursing care takes place in a hospice setting, because the charity’s nurses also provide overnight care in people’s own homes. Marie Curie is certainly not the only charitable organisation providing end-of-life care in the Newcastle area. Other vital organisations include Macmillan Cancer Support, with whom I recently had the pleasure of enjoying coffee and cake at the Lemington Centre and St Cuthbert’s Primary School in Walbottle, as well as St Oswald’s hospice in Gosforth, which has worked to “make the most of time and improve quality of life for everyone in the North East living with an incurable condition, and their families” for the past 30 years.”
“What I took away most from my visit, however, was the hospice’s absolute dedication to celebrating life and to ensuring that those using its services—whether terminally ill parents with young children or those, such as my constituent Don, who use their day services and activities—receive the best possible support and enjoy the best possible quality of life as their time comes to an end. Don told me he was concerned that once he stepped inside the hospice, he would never leave, but that is just not the case. Thanks to the helper service and Faye, he was signposted to the care and support provided at all stages of terminal illness. That support is not negative about death and dying, but treats them as a part of life.”