I have always been a Europhile and before becoming an MP would not have imagined voting to leave the European Union. So why am I heading towards the door? I am in love with the possibilities of the EU but can no longer ignore the grinding reality of the institution.
The Prime Minister has set out the terms of his provisional deal with the leaders of our EU partners and it is a threadbare offering. What use are 'emergency breaks' when the driver has no control or 'red cards' that have no credible chance of being deployed? Apart from a small concession on sham marriages, the truth is that the proposals will have no significant impact on our ability to limit inward migration from the EU. They will however, usher in rafts of bureaucratic cost and complexity with sliding scales for length of residency and nationality for child benefit.
David Cameron was right that the EU will need further reform but if this is the best that can be grudgingly conceded when there is a serious risk of a British exit, what chance of any meaningful further reform if and when we are tied-in long term by the referendum? The proposed red card system to halt unwanted EU diktats will need a majority of other leaders in support...so it is vanishingly unlikely to be of use if future policies are imposed against our national interest.
I am glad there has been recognition that we will never join the Euro and that non-Eurozone countries are on a different course rather than ever closer union but the safeguards remain too weak. It is inevitable that the Eurozone bloc will make decisions in their best interests. We have in effect already opted for life on an outside track, tolerated largely for our considerable net financial contribution but the renegotiation has made clear that we are powerless to change the rules of the club.
Those who wish for us to remain in the EU, are ramping up the rhetoric, warning about a risk to our national security in the event of Brexit due to a collapse in cooperation. It will clearly be in everyone's best interests for such cooperation to continue and to foster positive relationships on both security and trade. We are warned that we will become like Norway, subject to all the rules and fees but with no hand on the levers of power but arguably that sounds pretty much like the current situation, except of course that Norway control their own fishing grounds. In the event of Brexit there would be every incentive for Norway and others to join Britain in a different and more positive relationship with the EU based on trade and cooperation.
The case is often made that we should vote to remain in order to prevent internal conflict in Europe, but the anti-democratic nature of the EU is already fomenting the rise of extremism across the continent. When it comes to external threats, our national security has long depended on our membership of NATO rather than the EU.
When I ask at public meetings, few can name a single one of their six MEPs, fewer still have ever contacted one. Why would they bother when their representatives are powerless in comparison to the elite corps of unelected, remote and unaccountable commissioners?
Referendums have a habit of delivering the status quo, especially as project fear gets into gear. If they are to have any hope of persuading the undecideds, the leave campaigns must settle their differences and inspire. We need a clear blueprint for Britain working alongside the EU in a constructive new partnership. We would join as the world's fifth largest economy, not isolated but confident, outward looking and open for business.
I wrote the following article for PoliticsHome
On the morning of the 2012 track cycling Olympics, the architect of Team GB's victory, Sir David Brailsford, attributed their success to the relentless pursuit of 'marginal gains'. He looked at absolutely everything that goes into riding a bike, from the rider and their bike to the environment around them. It was by improving every aspect, even if that was by a small margin, that the sum total struck gold.
There is no single easy solution to the crisis of obesity which is blighting the lives of our nation's children and I hope that David Cameron will look at the success of team GB and apply the same principle of marginal gains.
Some firmly believe that tackling obesity is all about education and information, others that exercise is the answer. Some will focus on the role of marketing and promotions, tackling super-sizing and reducing the levels of sugar in food or the role of taxation.
The fact is that we need all of the above, and far more. We need a bold and brave obesity strategy because of the sheer scale of the problem and the implications both for individual children, their families and wider society.
A third of children are now moving on to secondary education obese or overweight. Independent data also highlights the stark and widening health inequality associated with obesity. A quarter of children from the most disadvantaged families are leaving primary school obese, more than twice the rate for children from the most advantaged families.
The consequences for the physical and mental health of the individual children who are falling down that gap are serious: they face a significantly increased risk of type two diabetes, heart disease and cancer and they are more prone to bullying and marginalisation.
There are costs too to wider society and the NHS because of our failure to take effective action - diabetes care already consumes around 9% of the NHS budget and the total cost of obesity is estimated to exceed £5bn per year.
It makes sense to prioritise the measures that will produce the greatest gains and especially where they can produce those changes quickly.
The greatest gains lie in tackling our food environment because, whilst exercise is important whatever a child's weight, no strategy can succeed without tackling the prime culprit; too many calories. That is why we must tackle promotions, advertising and marketing, portion sizes and reformulation. The government must also take into account the potential of a sugary drinks tax.
Price helps to determine choices and relatively small changes can have an enormous impact.
The 5p plastic bag levy has driven a 78% reduction in the use of plastic bags at Tesco. It changed behaviour in part because most of us just needed that final nudge to change the way we shop and its acceptability was increased because all the money raised goes to good causes. One paper suggested that apparently outraged customers could defy the imposition of the tax... by taking their own bag... which was of course the whole point of it in the first place.
The same applies to a sugary drinks tax. No one would need to pay it at all because its primary purpose is to nudge consumers to low calorie alternatives. It should be included because we know that it works and that it works quickly. It particularly helps the heaviest consumers as demonstrated by the 17% fall within this group in Mexico one year after the introduction of a 10% levy on sugary drinks. If every penny raised went to funding programmes to benefit children and young people, it could provide financial backing for additional school sports, education and to teach cooking and nutrition skills.
The Prime Minister is right to focus on a childhood obesity strategy and his action list will need to be far longer than space in this article allows, including clearer information for consumers and giving local authorities and schools greater powers to tackle obesity. My plea would be to follow the lead of British Cycling on marginal gains and make a lasting and positive difference to our children's future.
There is a single fact which demonstrates the compelling case for bold and brave action on childhood obesity. A quarter of the most disadvantaged children in England are now obese by the time they leave primary school. This is double the rate among the most advantaged children, setting out in stark terms the scale of the health inequality from obesity – and that has profound implications for children's health and wellbeing both now and in the future.
Obese children are at greater risk of bullying and of developing heart disease, diabetes, cancer and joint problems later in life. The cost to the NHS of obesity is estimated to be £5.1bn annually, and treating diabetes accounts for about 10% of its entire budget. Prevention is a central theme of the NHS's own long-term plan, yet there has been a further cut in the resources for public health under the November spending review. This places an even greater responsibility on the prime minister to make sure the policies in his obesity strategy can make a lasting difference to children's wellbeing and life chances. This cannot be stuck in the "too difficult" box just because effective action requires politically difficult decisions.
There is no individual course of action that will solve this epidemic; the scale and consequences of childhood obesity demand bold and brave action in as many areas as possible.
In our report published today, the Common's health committee urges David Cameron to include a 20% tax on sugary drinks. We do not believe that this is an attack on low-income families as industry lobbyists will no doubt claim, but rather an essential part of trying to reverse the harm caused by these products. That harm is not confined to obesity; we know for example that dental decay is the commonest reason for hospital admission in children between the ages of five and nine.
While not the only source of dietary sugar, sugar-sweetened drinks account for around a third of intake in four to 18 year olds. A levy on these products need not hit the pockets of low-income families as there would always be an alternative, untaxed and cheaper equivalent. One of the main purposes of a sugary drinks tax would be to encourage healthier choices, and that has clearly been the effect in countries such as Mexico.
There is also a compelling case for any revenue raised to be used entirely to support children's health, and to be especially directed to the most disadvantaged schools and communities. A sugary drinks tax would also have the advantage that it could be introduced quickly – and given the scale of the problem, there is no time to lose.
A successful strategy must include education and increasing physical activity but it would be a huge mistake to imagine that obesity can be tackled wholly by this approach. There needs to be an unequivocal message that exercise is enormously beneficial for children and adults alike, whatever their weight. When it comes to preventing obesity, however, no policy will be effective without tackling our food environment.
To be effective, the strategy has to get to grips with the saturation marketing and promotion of junk food and drink. Price promotions have reached record level, with some 40% of our spending on products consumed at home now coming from these apparent deals. The evidence is that they do not save us money, just encourage us to spend more on unhealthy food and drink, where the bulk of promotions are targeted. Who benefits from junk food promotions at the point of sale alongside non-food items or the chicanes of junk alongside checkout queues?
Reformulation has reduced the amount of salt in processed foods, and its time to ask industry to do the same for sugar – and to go further in "downsizing" rather than "supersizing" standard portions. While voluntary agreements have some advantages, industry will need a level playing field with regulation if that does not succeed.
Education messages are dwarfed by the power and persuasion of junk food and drink advertising. Our children are not protected by regulations as they stand, and these must be extended to include internet advertising, especially through so-called "advergames". It is also time to end the TV advertising of unhealthy food and drink before the 9pmwatershed and the use of celebrities and cartoon characters to peddle junk food.
No one would add 14 teaspoons of sugar to a cup of tea, so why not make it clear when that is what is hidden in a small bottle of sweetened drink? Information is powerful when it comes to making choices. Finally, our report recommends giving our local authorities the power to put health at the heart of their planning decisions, be that the design of active communities and safer travel, or the density of fast food outlets near schools. Its time too for a consistent policy for the latter with food standards applying wherever our children are educated.
There are no single or simple answers, but an obesity strategy that is thin on action will condemn another generation of children to a lifetime of obesity.
I wrote this article that appeared in the Telegraph today
Two years ago, I voted to oppose military action against the Assad regime in Syria. If David Cameron returns to the Commons next week, I will be voting to stand with our allies in extending air strikes against Isil, wherever they hide. It has not been an easy decision because, whatever the accuracy of our weaponry, the innocent are likely to be among the victims of future bombing. Right now, however, countless thousands across Syria and the wider region living under Isil barbarity are subject to systematic enslavement, rape, torture, murder and genocide. Isil cannot be reasoned with and it shows no shred of humanity or mercy to those under its barbarous control.
The first duty of any government is to protect its people and, unlike Assad, Isil also poses a direct threat to all of us here in the UK. Far from making it more likely, the threat of mass casualty attacks remains irrespective of any decision to extend our operations. Seven terrorist plots against the UK have been disrupted in just 12 months and 30 of our citizens were murdered on the beaches of Tunisia. The same carnage we witnessed on the streets of Paris is being actively planned against us here at home. We need to do everything we can to disrupt Isil at the nerve centres of their operations in Syria as well as Iraq.
There are those who claim that our action will be meaningless tokenism. I do not agree. We have an important contribution to make through our precision Brimstone missile systems and the capabilities of our Tornado aircraft. Our Reaper drones are providing a significant amount of intelligence from the skies above Syria but cannot currently deploy their missiles against targets which have been identified. Our action in Iraq has already helped to prevent ISIL taking control of a far wider territory and pushed them back from key strongholds. We have learned the lesson that Western forces should not intervene on the ground but we can play a crucial role in supporting local forces from the air.
The cloud of the Iraq war has long hung over decision-making but at long last the UN has woken up to the horror of the humanitarian crisis. Resolution 2249 states unequivocally that "Isil constitutes a global and unprecedented threat to our international peace and security" and it calls on all member States to take "all necessary measures" to prevent and suppress their terrorism and to "eradicate the safe haven they have established over significant parts of Iraq and Syria."
Military force alone cannot defeat Isil and we have to step up international efforts to disrupt the flow of Isil's finances and their internet poisoning of young people. There is also a pressing need for regional States and religious leaders to acknowledge and address the vicious sectarian divide and bigotry which ultimately fuels the bloodshed.
International efforts must be redoubled to work towards a just peace if the millions of refugees are ever to be able to safely return to their homeland. But however desirable it would be to see a change of Assad's leadership in Syria, we cannot wait for that to happen before we act because Isil is too great and present a threat to us here, right now, in the UK.
It is time in my view to stand with our allies and the countless thousands living in fear, and to play our full part in a just war against an unspeakable evil.
I wrote this article which appears in today's Telegraph
Britain spends 8.5% of GDP on health care, just below average among the OECD group of rich nations. But while our spending on health has been virtually static in real terms since 2009, the same is not true of demand, which has risen inexorably. Anyone listening to those on front line will hear the unequivocal message that our NHS is under unprecedented strain from the increase in the number of patients with complex long-term conditions, and the shortage in staff and funding to cope. Hospital trusts are heading for a record end of year deficit of around £2bn.
George Osborne faces enormous pressures as he tries to balance the books but he is right to commit an additional £3.8bn to the NHS next year, bringing forward a significant down payment on the £8bn promised by 2020. No one should be under any illusion, however, that this £3.8bn will solve the financial challenges facing our health service.
The fate of the NHS will also depend on the settlement for social care funding outlined in today's spending review. Any Accident & Emergency department will tell the Chancellor that winter pressures are mainly the result of so-called "exit block". Staff time is taken up caring for patients with complex problems who cannot be admitted to wards because those already in beds cannot be discharged due to the lack of social care packages. Social care cannot be divorced from health care and if you combine budgets for both, overall heath and social care spending has seen a worrying decline.
The widening gap in social care funding is set to become wider still as councils fund the living wage. Any further squeeze on their already thin payments to care providers risks prompting a mass exit from the sector. The NHS would then, even more regularly, become the default backup, incurring wasteful and disproportionate costs when people would far rather be at home.
Can more money be set aside for social care provision? There are suggestions that the Chancellor may allow councils flexibility to raise revenue themselves to do just that. But doing so will be most challenging in the very areas with greatest deprivation and need.
Without the ability to manage these extra costs, hospitals will have to make tough choices about priorities.
This is not the time to push for routine seven-day NHS services without the realistic funds to match. The extra costs of routine services on a Sunday were not included in the NHS's own long term plan, the "Five Year Forward View". So any promise that the service can operate at the same level of convenience on a Sunday as on a Tuesday is simply unrealistic. We must prioritise safety and follow the evidence about the measures which will genuinely make a difference. With staffing stretched, there is a danger of unintended consequences and we have to make sure that improving weekend services does not simply result in worse outcomes for patients treated on a weekday.
Today we will see the small print of the spending review. Boosting funding for NHSEngland should be transparently achieved with "new money", not at the expense of bodies like Public Health England or Health Education England, which is responsible for workforce training.
Public Health is the front line of the NHS. Further cuts would hit already stretched services like mental health, drug and alcohol addiction services and sexual health. Action on prevention and early intervention was central to achieving the savings set out in the "5 Year Forward View" as these are key to stemming the rise in demand from preventable disease. Obesity, for example, is estimated to cost the NHS over £5bn per year and the wider economy £27bn, yet we spend a tiny fraction of that on prevention.
Public Health England is not some dry outpost of the NHS, it is both core clinical business and crucial to future savings. Driving it onto the rocks could sink the ship.
Meanwhile it hardly needs saying that it would be unwise to scupper our ability to train the future workforce by cuts to Health Education England.
I really welcome the Chancellor's boost to NHS funding but the time has come to look at how much more we could do to reduce the future costs to individuals and society through preventing illness. We must also follow the evidence when it comes to getting the best out of a tight budget and that requires a serious plan for social care and a review of the key priorities for a seven day NHS.
Many people have contacted me about VAT on sanitary products. Of course I am opposed to VAT being placed on these essential items but I did not support Paula Sherriff MP's amendment on this topic to the Finance Bill as this matter is entirely devolved to the EU and it would have been entirely misleading to pretend otherwise.
Unfortunately, we are in this situation as VAT replaced the UK scheme when we joined the then European Economic Community. Anything we already had as zero rated tax was allowed to remain that way but the EU have not allowed the UK to add new categories for zero rating since then. I am pleased that the European Commission has now stated that a review of VAT rules will take place next year, which is the realistic opportunity we have to tackle this issue and I would urge those who have concerns to contact our MEPs to ask them to lobby for sanitary products to be zero rated for VAT and you can do so via the following link.
This article appeared first on Huffington Post
We all want to be able to access effective treatments as quickly and safely as possible. Why then do the overwhelming majority of research and medical bodies alongside the Patients Association and Action against Medical Accidents so firmly oppose the Access to Medical Treatments (Innovation) Bill?
In a nutshell because it will do nothing for genuine innovation or to improve access to treatments but it will confuse the legislation, remove important protections for patients from reckless practitioners and undermine research.
This bill is a reheated version of the half-baked Medical Innovation Bill which was thrown out in the last Parliament. If it was a turkey pie, you wouldn't touch it.
It starts from the false premise that fear of litigation is the key impediment to innovation. The Academy of Medical Royal Colleges, The Academy of Medical Sciences, Cancer Research UK, The Wellcome Trust and a very long list of other research charities have all made it clear that they disagree...that they do not see the need for this legislation and that they do not believe the bill will achieve it stated aims. They all speak of the unintended consequences for patients and for medical research alike.
It is hard to see why the government is not firmly opposing this bill.
Existing legal and professional ethics arrangements already allow responsible innovation. Action against Medical Accidents set out the risk of creating a 'Heaton Harris' legal defence which would make it easier for rogue doctors to carry out risky but 'innovative' procedures or 'have a go' treatments. Under the proposals, these doctors would only be required to obtain the views of at least one other doctor with experience of patients with the condition in question. There is nothing to protect patients from doctors who selectively seek the views of peers who are themselves profiting from newly permissive experimentation.
Faced with a dreadful diagnosis, people are at their most vulnerable to the siren call of innovation. Why take part in a clinical trial if seeing a private clinic would guarantee something innovative? The problem of course is that innovative treatments may turn out to be more harmful than existing treatment or none but a series of anecdotal treatments means that neither we nor patients will ever know.
The bill seeks to address this by tagging on powers for the government to set up a database of these anecdotal treatments. If publicly searchable it would make for wonderful free advertising for private clinics but a vast sprawling register of treatments is no substitute for a proper evaluation of evidence and simply fails to understand the science.
There is no need for legislation to create a database that would be of genuine value to patients and the research community alike, it does however, require funding.
Clinical trials already struggle to find enough participants without this undermining legislation; far better for government to build on improving access and information about clinical trials for those who would like to take part and to focus on their 'Accelerated Access Review' which is examining how to speed up access to new drugs, devices and diagnostics for NHS patients.
When I worked on a children's ward as a junior doctor in the late 1980s, the outlook for childhood leukaemia was grim. That so many of those diagnosed with the same conditions today will survive and thrive is not thanks to a series of anecdotal treatments but because of the meticulous research which allowed us to discover the best treatments. Patients today benefit thanks to the thousands who took part in clinical trials before them and very many go on themselves to take part in the studies that will help others in the future.
None of us will benefit from undermining clinical research with unwanted and ill-judged legislation. MPs should send it to the sluice.
I wrote the following article for the Telegraph that appeared this morning.
Sitting on the desk of Jeremy Hunt is a detailed and impartial review of the international evidence on measures which could reduce our consumption of sugar.
But the Secretary of State for Health is refusing to publish this study - compiled by Public Health England (PHE) - despite repeated requests to make it available to the public.
This matters because the public health community and campaign groups need to be able to access unbiased evidence to fully contribute to the Government's forthcoming childhood obesity strategy before the ink is dry on the paper.
It also matters because an important principle is at stake around the transparency of evidence and data.
The Secretary of State regularly speaks of the need for timely publication of data by NHS staff, even if that is inconvenient or embarrassing for the organisations concerned - and we rightly no longer accept that pharmaceutical firms delay or conceal evidence from their clinical trials.
Leadership on transparency however, has to come from the top.
It sends a dangerous message when NHS staff see delayed publication of data on NHS finances and now an unreasonable refusal to share key evidence on reducing sugar.
This week the Commons health committee begins its inquiry into what should be included in the childhood obesity strategy. This will also be Parliament's response to the e-petition signed by 147,000 people, initiated by Jamie Oliver and Sustain, which calls for a tax on sugar sweetened drinks.
Why should campaigners be denied access to an important evidence base paid for by the public purse for the benefit of the nation's children? Given the refusal of Mr Hunt to publish, the health committee has formally requested Duncan Selbie, the chief executive of PHE, to use his powers to do so. At the time PHE was set up as an executive agency of government, there were concerns about the possibility that ministers might lean on officials.
For this reason it was made explicit that its credibility would be based on its "expertise, underpinned by its freedom to set out the evidence, science, and professional public health advice it presents without fear or favour".
Mr Selbie has, however, agreed with Mr Hunt it is inappropriate to publish in advance of the obesity strategy.
He should re-read the framework agreement which sets out PHE's operational autonomy and which requires him to operate "transparently and proactively and provide government, the NHS, Parliament, public health professionals and the public with expert, evidence-based information and advice".
The wider public health community will not understand a refusal to use his powers to publish this evidence.
Mr Hunt must practise what he preaches on timely transparency of data and evidence.
If he will not do so, the chief executive of PHE needs to act in the public interest and do so in his place.
Aylan Kurdi is not the first child to drown in the Mediterranean Sea or to suffocate in an airless lorry at the hands of people traffickers but his image burns into our humanity. As we witness the scenes of refugees desperate to reach the sanctuary of our shores the question is whether Britain could and should do more to help and if so in what way?
A mass movement of people is underway, not only of those fleeing conflict in the Middle East and North Africa but of others trying to escape from conditions of grinding poverty. Children just like Aylan die every day from malnutrition and disease but we cannot provide a home for everyone.
In the year ending March 2015 we received 25,020 applications for asylum but just 2,222 of these were from Syrian nationals. Those accepted make up a tiny fraction of the 330,000 annual net migration into the UK and yet, in a democratic country, there is a need to listen to the expressly articulated concern about our ability to cope with the scale and pace of change. I do not believe there is support for us to match the 800,000 refugees welcomed by Germany in addition to our existing migration from other sources and we simply could not provide housing on that scale. Neither is there support for delegating compulsory decisions about quotas to the EU without the leadership to look at all the options. At a time of such humanitarian disaster however, we can and I believe that we should accept more refugees There is also a case for the EU suspending the rules on free movement to seek work to allow greater flexibility to offer those opportunities instead to refugees in desperate need.
International leadership is paralysed despite the scale of the unfolding disaster and there are so many factors beyond our control. Britain cannot force an end to the vicious regional religious sectarian struggles; that will take their own religious and political leaders to actually show true leadership. In the meantime Russia's shameful ongoing support for Assad blocks a negotiated transition of power in Syria. The UN has been entirely impotent in effecting an international military response to the situation and the hard reality is that ground intervention by Western nations acting alone would become a recruiting sergeant for the likes of ISIS and Al-Qaeda. In short, the exodus of desperate refugees is set to continue.
There are clear dangers if a perilous journey with traffickers becomes the surest way for those escaping the conflict to gain asylum and, even if they cannot agree a means to end the war, it is time for the international community to review the way that we assist and prioritise help for the civilian victims. Recognised refugee assessment centres in countries jointly funded to host them should be established in addition to the existing mechanism from refugee camps as the only routes to gaining asylum from conflict zones but that would take a change in international law. If nothing changes then we will continue to play into the hands of the criminal gangs profiting from their trade in human misery. There is also a question about who is in greatest need, the (mostly) young men trying to break through the fences at Calais or the unaccompanied children out of sight in refugee camps? We should in my view prioritise those in the refugee camps.
Unless there is a clear message that arriving by sea will not result in direct entry to the EU, we will simply condemn more people to attempt these treacherous journeys. Fast track assessment centres would also need powers to repatriate those who are are not granted asylum. The current situation is placing intolerable and growing pressure on countries at the front line and countries like Greece cannot possibly cope especially in the midst of their own financial crisis.
We can all be proud that Britain is one of the few countries to commit 0.7% of our income to international development and that we are the second highest financial contributor to the relief effort for Syrian refugees. Yet there are loud and growing calls for overseas aid to be slashed in favour of spending at home. In a democracy consent matters and my sense is that there would be greater support for our aid if the rules for spending the budget could allow it to include humanitarian relief and operations like Mare Nostrum by our armed forces. There is also a case for it to fund onward support in their countries of origin for those denied asylum alongside continuing efforts to prevent the need to leave in the first place.
Britain has a long tradition of welcoming people fleeing persecution. Our anxiety about net migration and especially about EU economic migration has hardened attitudes but this is hitting the most vulnerable. We cannot help every child in need but we could play our part by accepting an increase to 10,000 refugees. In particular I hope that David Cameron will consider the call for a modern day equivalent of the Kindertransport, which was a beacon of hope in Europe's darkest hour.
For anyone hit with a debilitating illness, it comes as a huge shock to find that there is no entitlement whatever to receive help with the costs of social care if their assets are worth more than £23,250.
Through no fault of their own, around one in 10 people aged over 65, many of whom have saved all their lives, face catastrophic costs especially if they need long-term residential care. This was not an issue at the general election in May because, during the last Parliament, the Government responded to the Dilnot Commission and passed ground-breaking legislation through the Care Act to place a cap on the total amount that anyone would have to pay, alongside a major increase in the asset threshold.
The Government has now kicked that promise into the long grass. The announcement was silently delivered via a written statement, snuck out in the Lords on a Friday afternoon, two working days before the Commons went into its long summer recess. Despite affecting thousands of families, the timing effectively prevented this major shift in policy being properly debated in Parliament.
There were many unanswered questions, and the Health Committee, which I chair – wrote to Jeremy Hunt, the Health Secretary, to ask them.
In his response, Mr Hunt noted that it was important to announce the decision as soon as possible after it was taken. This was, he explained, because many organisations were continuing to work to deliver the reforms to the original timetable.
I believe these organisations, and all of us, deserve to know when and by whom these decisions were taken.
The Local Government Association (LGA) requested the delay – but this was because of the financial reality of implementing the policy, rather than an argument against the principle of protecting people against overwhelming care costs.
The resulting delay is unacceptable, but it is not the fault of local government. Throughout the passage of the Care Bill, the need to fully fund the proposals, which would have greatly increased the number of people entitled to free care, could not have been made clearer. Reassurances were given at the time that the government understood and had allowed for those costs. Since then, however, the LGA received no indication that new funding would cover both mainstream adult social care and the cap reforms. In the absence of funding for both, they therefore made it clear that existing care, which is already at breaking point, must be the priority.
The LGA estimate that the already yawning funding gap for social care is growing by a minimum of £700 million a year, chiefly as a result of rising demand. Implementing the National Living Wage may add an extra £1 billion to their costs by 2020 to pay the wages for residential and homecare staff. This may have been the straw that broke the camel's back.
Thousands of eldery men and women could still be forced to sell their homes
In a further blow, Mr Hunt's response to the Health Committee confirms that the asset threshold limits will remain at their current levels of £23,250 for the upper limit and £14,250 for the lower limit. This has long been a bitter pill for anyone who has done the right thing and saved for retirement, only to face what amounts to unlimited care costs.
The care costs lottery looks set to continue until at least 2020 but there can be no excuse for any delay in clamping down on the absolute disgrace of cross subsidies. Those who fund their own residential care are too often being charged extra to top up shamefully unrealistic fees paid by local authorities for those who do not. In his response on that point, Mr Hunt maintains that there may be "good reasons why councils can often pay less than self-funders for care: they often buy in bulk and have responsibilities to drive the best deal possible to ensure value for taxpayers' money." This grossly underplays the appalling scale of the practice.
There is now statutory guidance setting out how local authorities must consider the actual costs of care and support when negotiating fee levels. The Health Secretary says he will be taking action in partnership with local authorities and providers to make sure this happens. I hope that care homes and affected individuals alike will send him the evidence, wherever and whenever that continues not to be the case.
The government promised fairness for those who have saved for decades only to see their assets decimated because they need to rely on social care. The delay may have been a reflection of the financial reality that councils would have been bankrupted by the costs of the National Living Wage alongside the bill for fully implementing the Care Act. The government claims that the delay is in response to a direct plea from the LGA. A better answer would have been to address the gross underfunding of social care. Instead they have used the LGA's request as covering fire to ditch a cornerstone of legislation and a clear promise to older people and their families.
The Care Act should not have been shelved and certainly not in this manner.
My article first appeared in the Telegraph today.