Debbie Abrahams
MP for Oldham East and Saddleworth · Labour · United Kingdom
“I thank my right hon. Friend for his statement and congratulate him on not just the content, but the tone of his delivery. He has elevated the status of not just this Parliament and this Government, but this country, by ensuring that everybody—all states and all individuals—are seen as equal before the law and in terms of human rights.”
“I welcome my right hon. Friend to his place and thank him for his statement. I particularly agree with what he was saying about social security and tackling the drivers of the high rates of young people not in education, employment or training.”
“] I have just about half a minute left, if that is convenient, Madam Deputy Speaker. The Committee recommends a more holistic approach to future assessments. The Department should consider the cumulative impact of policies on individuals.”
“We also heard that almost half of people aged 60 to 66 in the lowest income quintile were already classified as frail. These are people who are vulnerable to deterioration in physical and cognitive functioning.”
“The evidence that we received was clear: financial resources, the capacity to work, and good health help people manage the transition to a higher state pension age. However, many people reach their early 60s in poor health and unable to work, after years in low-paid and often physically demanding work.”
“There are other reasons why people leave work before state pension age, including becoming family carers. On the flip side, we heard about older workers who wanted to work but could not find a suitable job, and people who had left employment because of illness or caring responsibilities and could not get back into work.”
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“We need a clear commitment to the 1948 principles of the NHS, under which it is funded from general taxation, and a funding allocation based on need.”
“An annual report on the state of our health and the state of our NHS, presented to Parliament before each Budget, would pick up on the points that have been raised about cross-departmental impacts on health. We should have a prospective assessment of the impacts of the Budget and the Finance Bill on poverty and inequality, and subsequently on health and the NHS. That can be done; others are doing it. We should have a strategy to identify and address health equity issues in the NHS. We have seen a bit of that through covid, in the inequity around the use of oximeters. We should introduce something like “Improving working lives” for our staff. That had a massive effect on staff when I worked in the NHS.”
“As a former public health consultant, I would obviously agree with my hon. Friend. I have similar health inequalities across Oldham. I was about to talk about the impact of other issues, such as social security cuts, which meant greater poverty, including in-work poverty and children from working families living in poverty. That has had a consequential impact on our health as a whole. We have flatlining life expectancy, and in areas such as mine, life expectancy has got worse. That impacts on our productivity and the wealth of our country. I will briefly mention a couple of points that I know my right hon. Friend the Secretary of State recognises, and might want to consider.”
“I, too, welcome the Solicitor General to her position. She will be aware of the appalling increase in crimes against women and girls throughout the United Kingdom, including my constituency and Greater Manchester more widely. More than a million such crimes were recorded last year, constituting both 20% of all crimes logged and an increase in the number of violent crimes against women and girls. Given the seriousness of the situation, what plans do the Government have to ensure that we prosecute effectively and quickly?”
“For the sake of openness and transparency, I will just mention that I am a former chair of an NHS trust and a public health academic. I recognise the real issues that are raised in the findings of the Darzi rapid review. I am grateful to Lord Darzi for referring in particular to the inequalities that we have experienced, and how those inequalities were laid bare during covid. Will the Health and Social Care Secretary expand on the cross-departmental work that he is doing? I agree with my hon. Friends the Members for Walthamstow (Ms Creasy) and for Eltham and Chislehurst (Clive Efford) that people’s socioeconomic circumstances drive their health status. We do not want a situation where, for every 1% increase in child poverty, six additional babies per 100,000 live births do not reach their first birthday.”
“We know that four in 10 older people in Oldham East and Saddleworth have a disability, and almost half have a long-term health condition. We also know that, even before the escalation of energy costs, over one in six households were living in fuel poverty. Although pension credit provides extra financial support for the poorest pensioners, and opens up help such as housing benefit and council tax discounts for those who are eligible for it, only 5,500 of the 9,000 households in Oldham are eligible to claim it. Again, I welcome the automatic linking of pension credit to housing benefit to increase the uptake, but this again will not happen in time—in the next few months.”
“The setting up of a new energy production company, Great British Energy, alongside making homes more efficient, is a fantastic initiative that will contribute to our net zero targets and reduce energy bills for millions, but again that will not be in time to offset the 10% increase in energy bills this winter. I support our focus on growing our economy, but again that will not happen overnight. The Joseph Rowntree Foundation estimated in its report earlier this year that there are 2 million pensioners living in poverty—about one in six of all pensioners. In areas such as my constituency, poverty rates are much higher. We have one in two children living in poverty. From the figures, we estimate that will be the same for pensioners.”
“I recognise the serious economic context of the debate today. The Institute for Fiscal Studies, for example, has estimated that 320,000 people are being pushed into poverty because of mortgage interest rate rises triggered by the disastrous autumn 2022 mini-Budget, and of course the then Prime Minister made many unfunded policies. I recognise that the policy measures in the King’s Speech will go a long way to reduce household costs and increase incomes in the medium term, but those tackling the appalling poverty that we are seeing will not come in time for this winter. I am proud that Labour are continuing with the triple lock on pensions, something that will be worth an extra £460, but that will not happen until next spring.”
“As we did in previous Labour Administrations, I know we will tackle this, but again it will not happen overnight. Could I point out what we know about the health effects of the cold? The Lancet published a very good paper reviewing data from the last 20 years, and it showed the extra deaths—the excess deaths—as a result of cold. I could mention dozens and dozens of cases from my constituents who have written to me and who, again, are just clinging on following the last 14 years. Is my right hon. Friend the Secretary of State able to say not just what other options she may have considered for offsetting the loss of the £300, but what alternative ways there are of raising the £1.4 billion we will get from means-testing the winter fuel payment?”
“I am not going to give way. I thank the right hon. Member, but I cannot because I am under strict guidance from the Deputy Speaker. One in three pensioners living in poverty are in the private rented sector, so what are we going to do about that? Even if everyone eligible for pension credit were claiming it, according to Age UK, there would still be another 2 million pensioners slightly less badly off who will not be eligible for pension credit and now the winter fuel payment. The cut-off threshold for pension credit is just under £12,000 a year for a single person. These are not wealthy pensioners. Poverty is poverty whoever experiences it, and we know that we have 8 million working people living in poverty, as well as 4.5 million disabled people, 4 million children and 2 million pensioners.”
“I commend my right hon. Friend on his excellent, moving speech, which is his first from that Dispatch Box. My condolences about his mum. He will be aware that during the pandemic, the evidence review commissioned by the former Health Secretary exposed widespread inequity and racial bias in the use of oximeters—little gadgets used to look at oxygen in blood. It also revealed that algorithms used in artificial intelligence—in social security, for example—have inequity potential. How can we ensure that, along with all the benefits that he correctly mentions, there is also protection around equity?”
“I welcome my right hon. Friend and all the team to their place. I thank him for calling for a ceasefire when he visited Israel; that has had a profound impact in my constituency. Does he agree that a permanent ceasefire in Gaza is essential for the future of the people in Gaza, and would help to cool tensions in the middle east, in particular given the attack on the Golan Heights and the escalating tensions between Hezbollah and Israel, and even the Houthis?”
“I welcome my right hon. Friend’s statement, and particularly what she said about the public sector pay award. Could she share a little more about how, given the appalling economic conditions that we now face, she will incorporate equity in her decisions on how to address the in-year deficit?”
“I thank my right hon. Friend for his response and welcome all the team to their places. Will he expand a little bit more on exactly what the terms of reference might include? For example, will they also include participative and deliberative democracy methods that might also help to restore trust in politics, which, as he knows, is at an all-time low?”
“May I associate myself with the remarks of my constituency neighbour, my hon. Friend the Member for Rochdale (Paul Waugh), about the appalling incident at Manchester international airport yesterday? I congratulate the Leader of the House and her team on their appointments. Could we have a debate in Government time specifically on the cross-Government mission to reduce the appalling health inequalities that we have inherited, which are particularly prevalent in my constituency?”
“Will my right hon. Friend explain the relationship between the Modernisation Committee and the ethics and integrity commission that is being set up?”
“My right hon. Friend has mentioned the inequalities experienced by children with special educational needs and disabilities. What is she able to say about what we will do, and the difference that we will make to their lives?”
“Does the shadow Education Secretary accept the Institute for Fiscal Studies’ recent report? It says that although we have seen an improvement in average attainment, there remain educational inequalities, particularly for children on free school meals, children from ethnic minority backgrounds and disabled children. We have not seen any improvements, and the educational inequalities are stark”
“And then there are other disabled people for whom the possibility of working is unrealistic. Those who are disabled or who live in a household with a disabled adult or child are more likely to live in poverty. Over the past 14 years, disabled people have been absolutely battered by consecutive Conservative Governments. As the UN Committee on the Rights of Persons with Disabilities described, there have been systematic violations of their rights under the UN convention.”
“Our plans to enable 1.5 million new quality homes to be built while at the same time ensuring legislation to end no-fault evictions will be a huge relief to tenants and mortgage holders everywhere. Collectively, these measures will help improve the living standards of millions of people, but they will not happen overnight or for all people. Some 2.6 million working-age people are out of work because of an illness or disability. While many sick and disabled people want to work and will benefit from the extra NHS appointments and therapies, it will be many months before we see inroads into these waiting lists. Similarly, I would like to think that the attitudes of employers towards hiring disabled workers will shift quickly, but we recognise that is unlikely to be the case.”
“There are many Bills and initiatives that will make a positive difference to our lives and living standards, and these include the new deal for working people that will make work pay, ending the outrage of over 8 million working people living in poverty and 3 million children in poverty living in working households, transforming the lives of millions of people up and down the country, including in Oldham East and Saddleworth. The new GB Energy company will not only support new quality jobs but provide cheaper, cleaner energy, reducing the energy bills of my constituents and millions of others. The children’s wellbeing Bill, with free breakfast clubs and 100,000 extra nursery places, will also help to reduce cost pressures for young families while making life a bit easier for families.”
“We also have growing levels of economic inactivity due to this ill health, and the International Monetary Fund has revealed that there is a causal impact from these health inequalities on economic growth. For every 1% increase in the income share of the richest 20%, growth is reduced, whereas increasing the income share of the poorest 20% increases growth. Ensuring a vibrant, stable and fair economy with sustainable growth will enable us to renew and restore our overstretched public services. With fair funding formula and public spending allocations based on need, there is an opportunity to improve health in areas, such as Oldham, that have fallen behind.”
“The impact of these inequalities on health has been described by Professor Sir Micheal Marmot in his latest report, “Lives Cut Short.” He wrote in The BMJ : “if everyone had the good health of the least deprived 10% of the population, there would have been 1 million fewer deaths in England in the period 2012 to 2019.” Poverty and inequality are not inevitable; they are the result of political choices. The choices of consecutive Conservative Governments over the past 14 years have led to not only our flatlining economy, but our flatlining life expectancy and healthy life expectancy. In deprived areas such as mine, life expectancy and healthy life expectancy are actually declining.”
“Thank you very much, Mr Deputy Speaker. It is a surprise to be called so early, but I am absolutely delighted. I welcome the King’s Speech and its focus on fairness and opportunity for all—quite the antidote to the last 14 years when things have been anything but fair. The UK now has the highest level of income inequalities in Europe and the ninth highest of 38 OECD countries. Inequality in wealth is even worse, with the top fifth of the population having over one third of the country’s income but two thirds of the country’s wealth. These inequalities in income and wealth are particularly concentrated in the north but also among disabled people and ethnic minority communities.”
“This Labour Government are a Government for everyone, and the King’s Speech is a starting point on that. I look forward to working with the Government to deliver the change that all our country needs.”
“Children living in poverty now will be affected by the experience for the rest of their lives. There is evidence that living in poverty changes the wiring of their brains. Many will not reach their first birthday. Shamefully, we have the worst infant mortality rate in northern Europe. There is no law of nature that decrees that children from poor families have to die at more than twice the rate of children in rich families. I welcome that the Secretaries of State for Education and for Work and Pensions have established the child poverty taskforce to deliver the cross-Government child poverty strategy, and I look forward to it reporting in the early autumn. We cannot forget the 1.6 million children across the UK with special educational needs. SEND education is in crisis and that cannot continue.”
“My hon. Friend is absolutely right, and I am absolutely convinced that under a Labour Government we will see these changes. I think it is important that we put on the record where we are at the moment. We need to ensure that the right to adequate social protection and social security is in place, and we know that is not the case at the moment. We must do better not just in changing the culture of the Department for Work and Pensions, but in recognising the extra costs, the fear and the poverty disabled people face and feel, because otherwise I fear that we will be seeing more deaths of disabled claimants. Similarly, while I support the measures in the King’s Speech to improve our lives, that cannot happen soon enough for the nearly one in two children living in poverty across Oldham.”
“With a recess fast approaching, the next DWP orals over a month away, and discussions this week in the Chamber about the importance of a duty of candour for all public servants, has Mr Speaker been given information about when we can expect to question the Government regarding this?”
“On a point of order, Madam Deputy Speaker. Today, the Equality and Human Rights Commission, the country’s equalities watchdog, launched an investigation into the Department for Work and Pensions over its potentially discriminatory treatment of sick and disabled people within the social security system. This is absolutely unprecedented. The investigation has been escalated following two years of the EHRC trying to agree remedial action with the Department, following the section 23 notice issued to it by the EHRC regarding potentially discriminatory action against disabled people. The EHRC will investigate whether the Department has acted unlawfully by failing to protect disabled people over a number of years, including by failing to prevent their deaths by suicide or other means.”
“Labour believes that international law must be observed. As such, we want the sale of arms and components to be suspended, and we want the perpetrators of violence against innocent civilians, whether Israeli or Palestinian, to be held to account. I am still unclear on what the Deputy Foreign Secretary and his Government believe. Do they believe in upholding international law?”
“I absolutely support all that the Deputy Foreign Secretary is saying about military equipment, and so on, to support Ukraine in its efforts. Going back to the previous question, surely there needs to be a two-pronged approach, with sanctions to put economic pressure on Russia, in addition to the military pressure. It cannot be just one on its own. Should we review the effectiveness of sanctions, and potentially extend them?”
“My hon. Friend is making a powerful speech. I was informed by the Shared Health Foundation about a woman who had to flee her home with her three children because of domestic violence. She has been put into temporary accommodation that is unfit for human habitation, and has been told that she is likely to be there for 10 years. Is that not absolutely inexcusable?”
“Alzheimer’s Society reported earlier this week that 91% of people with a dementia diagnosis saw real benefits to having received one. However, the dementia diagnosis rate in England dropped from 67.6% to 61% during the covid pandemic. Currently it is 64.8% in England—below the national target of two thirds.”
“I reflect on where we are in relation to our social care system and the opportunities that we have had, for example through the Dilnot proposals back in 2015, and I really do hope that focused the minds of all of us in what we do. I certainly will be supporting, and have for many years been supportive of, a national care service. Diagnosis is the key that unlocks vital care and support for people living with dementia, particularly those who are struggling to manage their symptoms alone. It helps people to understand their condition. It allows them and their loved ones to start planning for the future but, as I mentioned earlier, currently just one in three people estimated to have dementia receive a formal diagnosis. The benefits to receiving a diagnosis are massive—access to new treatments and to the care and support that is needed.”
“Right now, more than 900,000 people live with dementia in the UK, as I mentioned. Due to our ageing population, that figure is set to rise to 1.6 million by 2040, but I need to stress that dementia is not an automatic part of ageing, although it is more prevalent in older populations. People with dementia account for more than 70% of the residential care home population over the age of 65 and 60% of people receiving home care. Meanwhile, as revealed by NHS performance data published earlier this year, it is estimated that a quarter of NHS beds are occupied by people with dementia. They remain in hospital on average twice as long as people who do not live with the condition. Unfortunately, that reflects the crisis in our social care system and not being able to safely discharge people back into the community or to residential care.”
“Those facts may come as a surprise to many, including many commissioners, but I will focus today on two important inequalities in dementia: the inequality in dementia diagnosis rates between different parts of the country and different groups of people, and the inequality between those who do and do not have access to post-diagnostic support. First, I will share some information that hon. Members will hopefully find useful. When we talk about dementia, we are using a collective term covering the common symptoms associated with a range of brain diseases. Alzheimer’s disease is the most common of those, but they also include vascular dementia, which my mother-in-law had, Lewy bodies, frontotemporal dementia and many others. Each of those brain diseases has different pathology and as a consequence will have different therapies.”
“I was really reassured that the approval of lecanemab and donanemab is going through the regulatory cycle at the moment, and we hope to hear when they will be available in the next couple of months. The fact of the matter is that dementia is a monumental pressure on our health and social care system, but it is all too often an afterthought in commissioning. It is not commonly known that dementia is the leading cause of death in the UK. Nearly 1 million people have dementia, but of those one in three currently live without a diagnosis. Dementia costs the economy more than £40 billion each year, and more than 60% of that cost is borne by individuals and families.”
“Yesterday I had the pleasure of sponsoring the Alzheimer’s Society’s reception in Parliament for Dementia Action Week, where we welcomed many Members to hear about the importance of a dementia diagnosis and the transformative potential of new treatments for dementia. Back in January, I spoke in another Westminster Hall debate looking at the advent of new treatments, particularly lecanemab and donanemab. Those drugs have caused huge excitement, as they mark the first ever treatments for people in the early stages of Alzheimer’s disease and could change the way that we see dementia forever. However, even in that debate I highlighted the barriers to those drugs being delivered to patients and sounded a note of caution that they are neither a cure nor a quick fix.”
“My other co-chair is Baroness Angela Browning, and like Angela I became involved in the APPG because I became a carer of a loved one who developed one of the brain diseases that cause dementia. In my case it was my mum, who was also called Angela. She was diagnosed with Alzheimer’s disease in 2002, when she was just 64, and I cared for her along with my stepfather and brother. After she died in 2012, I became the first MP to train as a Dementia Friends champion and was subsequently elected as co-chair of the APPG on dementia in 2015. This debate could not be more timely. As you know, Ms Rees, this week marks Dementia Action Week.”
“I beg to move, That this House has considered inequalities in dementia services. It is a pleasure to serve under your chairship, Ms Rees. I thank the Backbench Business Committee for granting me this debate to discuss the huge inequalities in dementia diagnosis and other services across the country. I also thank the Alzheimer’s Society for providing the secretariat to the all-party parliamentary group on dementia and for supporting our many inquiries, including the inquiry we conducted into dementia diagnosis last week, which was published in our “Raising the Barriers” report. My particular thanks go to Lewis and Connor for their briefings and for helping me to prepare for this debate. It is a real honour to have recently been re-elected as co-chair of the all-party parliamentary group on dementia, a position that I have held since 2015.”
“Returning to our APPG inquiry, we received input from more than 2,300 people and I thank them sincerely. Those people have gone through—either themselves or with a loved one—a dementia diagnosis process. They shared their experiences in our survey and we found that every part of the country produced different experiences of the diagnosis system. In Somerset, for example, people were most likely to report that they were satisfied with the time it took for them to receive a diagnosis but were least likely to say that they received satisfactory post-diagnostic support. In London, respondents had the best access to brain scans but found it most difficult to access GP appointments. I know that £17 million was invested in dementia diagnosis by the Government in 2021-22 and that part of that money was to develop best practice advice.”
“Alzheimer’s Research UK also undertook an analysis and published a report last October—“Towards Brain Health Equity: Tackling Inequalities in Dementia Risk”—and this highlighted research identifying vulnerable groups and the dementia risk that they face. That is also an inequality. It referred to research in England and Wales that showed that socioeconomic deprivation and ethnicity are linked to increased dementia mortality, younger age at death from dementia and poorer access to specialist diagnostics. A number of recommendations were made around that. We know that there are 12 modifiable risk factors associated with dementia, and the report focused on action around reducing air pollution, lowering smoking rates, healthy eating, tackling higher blood pressure and identifying and treating hearing loss.”
“There are significant differences in the dementia diagnosis rates between integrated care system areas in England. The report referred to a recent Alzheimer’s Society survey of clinicians, clinical commissioning groups—the predecessors of the ICSs—and dementia support workers. Poverty and health inequalities were identified as major barriers to getting a dementia diagnosis. This was also borne out by analysis by the Office for Health Improvement and Disparities. I have to say I do not particularly like the title of that organisation; I think it should be the “Office of Health Improvement and Inequalities”. Similarly, there were lower rates of diagnosis in ethnic minority populations. For example, the City of Wolverhampton has an overall diagnosis rate of 70%, but just 35% for people from an ethnic minority community.”
“I am very grateful to my hon. Friend for his intervention. This is the absolute crux of the issues we are facing. First of all the target is not ambitious enough, but as he rightly says there are these inequalities. I prefer calling a spade a spade, so these are inequalities and we need to call them what they are. Although the national picture is poor, if we dig further into the data we can see that there is a huge regional inequality in dementia diagnosis rates. In my Oldham constituency, for example, the rate is above 75% and in Devon it is just 40%. Where you live has a massive impact on whether you get a timely, accurate and high-quality dementia diagnosis. A postcode lottery on this scale for a condition that will affect one in three of us is not acceptable. The APPG’s dementia diagnosis inquiry revealed several issues.”
“National strategies should not just reflect the evidence and data for a national profile around dementia, so we should agree that that needs to change.”
“As I said before, 2,300 people filled out our online survey and shared their stories to inform our work. Sadly, just 5% of people’s stories were positive. Five per cent: that is awful, is it not? After a constituent came to see me regarding concerns about the delay for her mother’s diagnosis—it took her 15 weeks to get an appointment for her mother to attend for a dementia diagnosis, during which time she noticed a considerable decline in her cognitive health—I tabled some written questions on the proportion of people waiting more than 15 weeks for an initial dementia diagnosis and the average waiting time for an assessment. I was told in response on 22 January 2024 that those data were “not held centrally”. I find that extraordinary.”
“The hon. Member is absolutely right; there is less money going into research. On why there is not more done about it, the hon. Member really needs to direct that question to the Minister. I have set out all the evidence that says it should be a priority for the families and individuals affected and a priority for our society, and it should also reflect how we organise our care system, given that predominantly the people in the care system are those living with a diagnosis. The hon. Member will therefore have to direct that question to the Minister. Going back to my point about the investment made in 2021-22, can the Minister update us on how that is going and the improvements that she may not see immediately but which she hopes to see? Clearly, that is something we need to see as part of the levelling-up agenda.”
“Dementia is a monumental health and social care challenge, and will be the defining test of our system in the decades to come—I have absolutely no doubt of that. We have spoken in this place about planning for the next generation of dementia care in the context of the new, potentially transformative drugs that are currently under appraisal, but almost 1 million people are living with dementia in this country today, and much more can be done to get them the care and support they need and deserve at the earliest possible moment. I would like to thank the Backbench Business Committee and those who have joined us on a Thursday afternoon when a lot is going on in Parliament. I look forward to the Minister’s response.”
“First, what will the Department do to ensure that where someone lives, their socioeconomic status or their ethnicity do not negatively affect their likelihood of getting a dementia diagnosis? Secondly, what will the Department do to ensure that everyone with dementia has access to high-quality, post-diagnostic care, regardless of where they live? Thirdly, it was two years ago this week that the right hon. Member for Bromsgrove (Sir Sajid Javid) announced a 10-year plan for dementia, which was then folded into the major conditions strategy. However, we still do not know when that strategy will be published. Can the Minister update us on when we can expect publication of the strategy?”
“The average cost of care for someone in the early, or milder, stages of dementia is about £28,000 a year; in the later, severe stages of dementia, it rises to well over £80,000 a year. Caring well for people with mild dementia can prevent falls and infections, which cause unnecessary hospitalisations and deconditioning, which increase the speed of deterioration in people with dementia. Early identification and increased spend in the early stages of dementia pay dividends further down the pathway. I would like to end by putting three questions to the Minister, and I would be grateful if she could address them in her response or in writing at a later date, if that is easier for her.”