I am one of many speakers in this debate who feel that in significant ways this Queen’s Speech falls short of addressing some of the big challenges of our time in this country. I want to address two of those.
The NHS and the social care system face an existential challenge. I agree with the right hon. and learned Member for Rushcliffe (Mr Clarke), who says that it is not just about money. The system often seems to be completely dysfunctional as a result of the inappropriate divide between health and social care, between physical health and mental health, and between primary care and secondary care. This must be addressed so that we can shape care around the needs of patients.
There is no escaping the fact that there is a financial issue. It makes no sense that between now and 2020 we are projected to spend a decreasing percentage of our national income on the health and care system, at a time when demand is rising rapidly. There are consequences from that trend. I believe the Secretary of State for Health when he says that he cares passionately about patient safety, but as the hon. Member for Dulwich and West Norwood (Helen Hayes) pointed out so effectively, the underfunding of mental health services in our country has massive consequences. As we heard last week, there has been an increase in the past year in the number of people who are shunted around the country in search of a bed. That is a scandalous practice. We know that it is associated with an increased risk of suicide, yet it continues to happen in increasing numbers.
When the pressure increases, crisis management takes over. We cut preventive services in order to prop up acute hospitals, and the services that we cut are the very services that prevent people from going into hospital in the first place. It makes no sense and it needs to change. I have two proposals which the Government need to consider.
I repeat again that I think this is the time for a 21st-century Beveridge report, bringing the parties together to come up with a new long-term settlement for the NHS and, critically, for the social care system. Also, we should consider the case for a dedicated health and social care tax. That has been proposed by people from across the political spectrum. It is the only area of public policy where there is an inexorable rise in demand, yet by protecting the NHS we disproportionately cut other areas of public service. It therefore seems to me that there is a very strong case for carving health and social care out and introducing a dedicated tax. Lord Patten on “Any Questions?” last week made the case for it. Lord Finkelstein for the Conservative side has also argued for it, as has the right hon. Member for Birkenhead (Frank Field).
We are losing pace with other European countries in our spend on health and social care, and there are consequences from that. I know, as I have said, that the
Secretary of State cares about patient safety, but the safety of patients is being put at risk by the financial pressure that the NHS faces.
Finally, I want to address the prison reform Bill. I welcome the reforms in it, but something much more fundamental is needed. I encourage the Secretary of State for Justice, with his reforming instincts, to go further. A fundamental failure of public policy is reflected in the number of people in our prisons with mental ill health, learning disability and autism, and the number of people in prison in connection with drug addiction or offences relating to the criminal market in drugs. We are seeing a spike in the number of suicides in our prisons, which should horrify all of us. We need to do something about that.
The Secretary of State needs to go beyond the civilising proposals that he has for our prisons and look at radically reducing the number of people who end up inappropriately in our prisons. Germany and Finland imprison about half the number of people that we do. Those are not lawless countries, yet they manage to adopt a much more civilised approach. There should be a presumption against short sentences. We know that people leave prison and reoffend in vast numbers. That does not protect the public. There should be a much greater use of mental health treatment orders as an alternative to putting people in prison, and a renewed focus on restorative justice to address the causes of crime.
There needs to be the long overdue declaration of an end to the war on drugs, which has failed so fundamentally internationally. It criminalises vast numbers of our fellow citizens. Every year in our country, it puts billions of pounds—about £7 billion—into the hands of organised crime. It is associated with extreme violence in our communities. This makes no sense, and too many people end up in our prisons as a result of this misplaced policy. Just as many states in the United States are now moving towards a much more rational policy, and just as Canada has now committed to legislating to regulate the market for cannabis rather than leaving it in the hands of organised crime, I believe that in this country we should follow the same route, with a rational, evidence-based policy that does not criminalise people inappropriately for doing exactly the same as many members of this Government will have done in their youth. Instead, we need to take money away from criminals and collect tax revenue to spend on our essential and vital public services. It is time for a more rational approach. I hope that at some point this Government recognise that if they are to address the problems of crime in our society, ending this futile war on drugs is one of the steps that they must take.
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