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PhilHunt2015.jpgPhilip Hunt on his Regret Motion against the government’s expansion of NHS fees

On the face of it, charging overseas visitors to use our hard pressed NHS seems entirely reasonable. But the government’s latest plans to extend charges to community services will raise little money, place a huge burden on staff and deny healthcare to very vulnerable people.

The UK already charges some overseas visitors for most NHS hospital care after treatment. Patients ineligible for free care include short-term visitors, undocumented migrants, and some asylum seekers whose claims have been refused. Processes are already in place for hospitals to identify and bill these patients and Ministers are considering extending charging into A&E and GP services.

Under the new regulations came into force last month, community services receiving NHS funding – including charities and social enterprises – are now legally required to check every patient’s paperwork before they receive a service. For those who have to pay, charges are up-front with non-urgent care refused.

As paperwork or a passport is necessary to prove eligibility, there is a distinct possibility that those entitled to free care will be denied treatment because they don’t have the information to hand. (Especially vulnerable groups such as the elderly, asylum seekers, the homeless and mentally ill.) Having to to constantly provide details could also lead to longer waiting times and further bureaucracy.

In addition, introducing more overseas charges might lead to an increased risk to public health, if migrants or short-term visitors with contagious diseases or those requiring sexual health services can’t afford treatment. Even though certain diseases will be exempt, anyone unfamiliar with the internal workings of the NHS will find it hard to know whether or not the policy covers their disease.

There is also a fear that the NHS will rely on racial profiling as a means of identifying chargeable patients. Some hospitals are already targeting patients who don’t sound or look British, with staff directed to scan booking lists. There’s also a risk that the rules become so complex that staff may turn down those who are eligible for free treatment.

Nearly 200 organisations, including the BMA, Royal College of Paediatrics and Child Health (along with NHS England’s former CEO Sir David Nicholson), have signed a letter to the Health Secretary warning: "by denying healthcare to the most vulnerable in our society, these regulations will have negative consequences for us all".

Ironically, this policy fails on its own terms, as it won’t help solve the NHS’s funding problems as the number of overseas visitors using the NHS is negligible. Just £200,000 a year is the estimated saving – 0.00016% of the annual budget and about £13.64 for each provider.

While the rules have already become law, it is vital these fundamental changes receive parliamentary scrutiny and that plans for assessing their impact are carefully examined. In the House of Lords later today, I will be using a regret motion to press Ministers to agree to an early independent review. Until then, there must be no question of extending charging to yet more services.

Lord Philip Hunt of Kings Heath is a member of Labour’s health team in the House of Lords. He tweets @LordPhilofBrum

Published 16th November 2017

Charging points

Philip Hunt on his Regret Motion against the government’s expansion of NHS fees

LeslieGriffiths.jpgLeslie Griffiths on a new report from the Lords Communications Committee on young people and the Internet

Today’s debate on the Lords Communications Committee report, Growing up with the Internet couldn’t be timelier. Not only is the House currently debating the Data Protection Bill – the very legislation that is anticipated in the report – but my colleague Doreen Massey has also facilitated a two day conference on the mental health of children.

Both the report and the conference have listened carefully to the voices of children and this is to be applauded. We can only hope that those parts of the Bill which address their needs will draw on some of the wisdom found in these separate and discrete exercises. The case for joined up thinking couldn’t be stronger.

The imminent application of the General Data Protection Regime (GDPR) will impact on children’s digital rights and activities. It is vital therefore, that implementation actually strengthens the safety and avoids watering down existing protections. I hope the cross-party, NSPCC-backed amendment proposed yesterday by Baroness Kidron for an age-appropriate design of online services – including default privacy setting, clear and accessible terms and conditions, and robust reporting procedures – will be factored into the Bill as it moves forward.

The Communication Committee report highlights how this is the first generation born into the world of the Internet. 59% of young people have had their first social media accounts at age 12 or under – despite guidelines for sites (including Facebook, Twitter, Snapchat, YouTube and Instagram) which all state that a child must be 13 years old.

It is the air our children breathe. They are natives of this brave new world and the report insists on recognition of this fact. The Internet must be considered an integral and fundamental aspect of the school curriculum. It should no longer be taught in specific IT classes, but a part of the Personal, Social, Health, Economics (PSHE) programme. A fourth pillar of a basic education alongside Reading, (w)Riting and (a)Rithmetic. (I long to find another word centred on the letter “r”!)

This conclusion is key to the whole report, and it is worth emphasising the concerns expressed. School budgets are under great pressure and, again and again, PSHE programmes are coming under threat – an easy target for “saving” money. Ministers have said PSHE should be compulsory but the reality is quite different. The prevalence of the Internet is obvious and its benefits widely recognised.

We must however, be in the best position possible to take advantage of that potential. A survey undertaken this year for the British Chamber of Commerce revealed significant shortages of digital skills and calls for this deficiency to be addressed. The potential for harm on the Internet is equally obvious and more attention needs to be given to the impact of over-exposure on young people’s mental health.

The addition of ‘Digital’ to the title of the Department of Culture, Media and Sport is indicative of the fact that the Internet and technology now inhabit the same space; and indeed contribute to all of these activities. But adding a word isn’t enough.

The government needs to take decisive action to develop a safe and robust online environment for children, whilst at the same time better integrating digital skills into our education and workforce. If we continue to treat the Internet and digital innovation as an ‘add on’, we risk exacerbating divisions in society. As Professor Robin Mansell puts it, “The challenge isn’t only whether digital communication … is explorative or liberating, inclusive or exclusive, it is to keep in mind that … human agency still matters. It isn’t digital technology that makes society but human beings in their institutional settings who make the world.”

Lord Leslie Griffiths of Burry Port is a member of Labour’s frontbench team in the House of Lords

Published 7th November 2017

The air they breathe

Leslie Griffiths on a new report from the Lords Communications Committee on young people and the Internet

PhilHunt2015.jpgPhilip Hunt on an important report that remains silent about the damaging impact of government policies on children and families

The dreadful consequences of family breakdown, including the long term damage to children, is well documented. It is also the theme today of a House Lords debate today. The debate, led by Lord Farmer, is aimed at promoting a Manifesto to Strengthen Families produced by a group of Conservative parliamentarians. Unfortunately, sensible suggestions are undermined by a glossing over of the damage done by their colleagues in government.

There’s also a risk that in emphasising couple relationships, their recommendations stigmatise one parent families and completely fail to acknowledge the different types of families that exist. The charity Stonewall has estimated that today, approximately 20,000 children have same-sex parents and many more have an LGBT family member.

While the last Labour government took hundreds of thousands of children out of poverty, the current Conservative one has put 250,000 back. This is bound to impact on family relationships. A national survey carried out by Relate, Relationships Scotland and Marriage Care, found 26% of respondents citing financial matters as a strain on long-term relationships. Meanwhile, council leaders have reported that spending on children’s services have fallen by 9% since 2010, even as the number of children in need has increased by 5%. This clearly makes it harder for some families with the greatest difficulties to access the support they need.

Ministers makes much of their policy of 30 hours free childcare for the three and four year old children of working parents. But it is chronically underfunded, with provision patchy and hard to navigate. Plus it doesn’t actually extend to over 100,000 children whose parents are on very low incomes. More generally, the cost of childcare has risen more than twice as fast as wages since 2010, making it increasingly difficult for many working families to access what they need. And many parents will actually be worse off upon returning to work, because they aren’t able to earn enough to cover the fees.

The manifesto promotes the use of ‘Family Hubs’ to help children in need. But there is silence on the impact of closing 1,200 Sure Start centres in the past five years. One of the greatest achievements of Labour’s time in government, these centres benefited hundreds of thousands of young children and their parents – particularly those from a poorer background.

There is silence too, on the freezing of benefits. As my colleague in the Lords, Ruth Lister pointed out in the chamber earlier this week, independent assessments of the four year freeze indicate losses of over £800 a year for many two child families (both in and out of work), and significantly worse poverty, inequality and homelessness.

Then there’s the bedroom tax and the much vaunted Universal Credit system. As Polly Toynbee has observed, for all the promise of strong work incentives, the taper rate was always going to see claimants lose 63p from every pound earned. And the cruel six week payment delay leaves those without savings, both debt ridden and trapped in rent arrears, with many forced to use loan sharks of food banks. Hardly a way to strengthen families.

The manifesto is also silent on the insecurity of many parents at work. The problem of low pay, weak contracts and zero hour terms are the reality for hundreds of thousands. I am sure Lord Farmer and his Conservative colleagues are genuinely concerned to support families. Their case would be more convincing however, if they showed some understanding of the devastating impact of their own government’s actions.

Lord Philip Hunt of Kings Heath is a member of Labour’s frontbench in the House of Lords. He tweets @LordPhilofBrum

Publishing 2nd November 2017

Silent witnesses

Philip Hunt on an important report that remains silent about the damaging impact of government policies on children and families

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