House of Commons
Wednesday 27 January 2010
The House met at half-past Eleven o’clock
[Mr. Speaker in the Chair]
Business Before Questions
London Local Authorities Bill [Lords] (By Order)
Motion made, That the Bill be now read a Second time.
Bill to be read a Second time on Wednesday 3 February.
Oral Answers to Questions
Duchy of Lancaster
The Minister for the Cabinet Office and Chancellor of the Duchy of Lancaster was asked—
Youth Citizenship Commission
I am co-ordinating the Government response to the Youth Citizenship Commission. I have been impressed by the breadth of commitment of all Government Departments in engaging young people as active citizens in their communities and as they go through the transition to adulthood. I expect to publish my findings in response to the YCC in February, when I shall report on the significant amount of Government initiatives on delivery for young people.
I thank my hon. Friend for that answer. As she knows, the UK Youth Parliament is absolutely key to delivering on the proposals outlined by the YCC. Will she press the House authorities to provide core funding for the UK Youth Parliament to secure its future, so that it can deliver on those proposals?
I would like to congratulate my hon. Friend on all her work for the all-party parliamentary group on youth affairs. She does an excellent job. The UK Youth Parliament is a real success story: my hon. Friend will know that it held a great debate here in the House, and one of its key priorities is to lower the voting age to 16. She makes a valuable point, and I will indeed press the House authorities to try to ensure that we get some core funding for the UKYP.
We are all very keen to get more young people involved in the electoral process, and to ensure that they vote and participate. An election is near, so what more can the Government do to fulfil the commission’s recommendation that eligible pupils should be encouraged to register via school to make sure that they participate when it comes?
The hon. Gentleman makes another valuable point. We do not need any changes in law to ensure that young people are registered in schools, colleges and universities. We need to encourage those institutions to make sure that young people are encouraged to sign on and be registered to vote when they reach 17, so that we have the maximum number participating in the next election.
Get Safe Online Initiative
By sponsoring the Get Safe Online initiative, my Department continues to work with private sector partners to raise the very important issue of public awareness of internet safety. The Get Safe Online initiative has won two prestigious awards for this joint working, and it continues to increase the number and length of visits to its website. There have been more than 605,000 links to the site—far more than its US counterpart, which has achieved only 25,000.
I thank my right hon. Friend for her reply. A lot of people in my constituency still enjoy using cheques, which is a good thing, but more and more people—especially elderly people—are seeking to shop online because it is easy. What additional support and advice can she offer older users of the internet, who may be less familiar with the systems? What protections are in place?
My hon. Friend has been a long-standing campaigner on this issue on behalf of her elderly constituents. It is an extremely important matter, as people over 65 are the fastest growing group of internet users. That may seem slightly counter-intuitive, but that group of users grew by 15 per cent. in 2009 over the previous year, whereas the number of younger people using the internet grew by only 3 per cent. in the same period. Get Safe Online works specifically with Age Concern and has focused precisely on the important issue of security in banking and other financial transactions. It is important that the technology and content of websites always keeps ahead of fraud’s capacity to cause great anxiety and distress.
I thank my hon. Friend for that question. Get Safe Online is a joint initiative, involving the Government and important private sector sponsors such as HSBC and Microsoft. Indeed, the Minister for the third sector, my right hon. Friend the Member for Basildon (Angela E. Smith), recently hosted a sponsorship event as a result of which two new sponsors came on stream. It is clear that sponsors understand the initiative’s potential public benefit when it is presented to them. It is a very attractive sponsorship proposition.
The Minister mentioned fraud. With an increasing number of people being used as money mules, what are the Government doing to track down the foreign international gangs behind those schemes, and in particular to prosecute UK citizens who take their cut of the money?
I would like to refer the hon. Gentleman’s question to the Home Office, which takes the lead on this. I do not think that I referred specifically to money mules; I referred to protection for elderly people doing their banking and other financial transactions online. I hope that, as far as there is operational responsibility for this, his point about anticipating crime and future forms of fraud is taken into account in the constant review under the auspices of Get Safe Online working with the relevant organisations.
There has been a dramatic increase in cyber crime related to online transactions, as the Minister mentioned. Treasury figures show that transactions have more than doubled in the last three years, but the amount of identify theft and fraud has nearly quadrupled in the same period. What are the Government doing to tackle this growing problem, and what assessment has been made of the Payments Council’s decision to phase out cheques?
I have discussed the accounting arrangements for NHS charities with the Charity Commission and with the Minister of State, Department of Health, my hon. Friend the Member for Corby (Phil Hope). The funds of an NHS charity are, and will continue to be, controlled by the charity’s trustees for charitable purposes. The international financial reporting standard will have no effect on the independence of those funds. My hon. Friend the Member for Corby, however, has engaged with colleagues in the Treasury to seek to delay the implementation of that requirement for a further year.
The hon. Gentleman may operate in a world in which yes or no does it for him, but most things in life are a bit more complex. However, I can give him a categorical assurance that the finances of NHS charities will remain entirely controlled by the trustees of those charities, which is appropriate. All that we are talking about, and the source of the confusion and misunderstanding, is a technical change to accounting and reporting arrangements. I can give the hon. Gentleman an absolute assurance that funds will remain controlled by the trustees, and will continue to be controlled by the trustees.
My right hon. Friend will know that many communities give a great deal of support to NHS services, both in the hospice movement and in general health services. People would be dismayed if they thought that the moneys given voluntarily would be used against the NHS hospital budgets.
I agree with my hon. Friend, and they will not be. This is purely a technical accounting matter, so I am sorry about those concerns, because they are unfounded. There is no intention whatsoever that anything should be done with charity funds, which should remain with those charities. It is a purely technical accounting matter, and I hope that those assurances will satisfy my hon. Friend.
I can assure the hon. Gentleman that there is no such intention. This arrangement will not centralise any funding or any control of those charitable funds at all.
I welcome my right hon. Friend’s statement that she is going to defer implementation for 12 months, but may I persuade her to go back and have further meetings, and support the Sunday People campaign not to introduce the new arrangement at all, and ensure that people feel happy to give freely and openly to charities in the NHS without any issues?
First of all, I do not have the power to introduce it or not. It is a matter for the Treasury, because it is a technical—
If I can finish answering the question that my hon. Friend asked. [Hon. Members: “Oh!] I would always wish to respond to my hon. Friend in full, and I will continue to do so. I am sorry that there is misunderstanding about this, because we do not want people not to give to charities in the NHS because they think that the money will not be used appropriately. It is purely a technical matter but, as I said, the Health Minister, my hon. Friend the Member for Corby, has asked the Treasury to defer implementation for a year to provide the reassurance that is required.
The Charity Commission does not agree with the Government. It warned 18 months ago that the proposals risk undermining public confidence in the independence of NHS charities, but still the Government dither. Those accounting standards were never meant to be applied to charities. Other countries have chosen not to apply them in this way. They are being imposed because of bureaucratic diktat. The issue needs gripping by Ministers, so will the right hon. Lady pledge to work with colleagues in the Department of Health and Monitor to persuade the Treasury not just to defer a decision for another year, but to drop this whole nonsense altogether?
I am not sure that there is any disagreement in the House on the principle of what the Government seek to do. NHS charities should have their funds independently administered by the trustees, which is the law. As I said, the Health Minister, who has been dealing with the matter with the Treasury, fully understands the views of the House and will ensure that they are represented at all times.
The census rehearsal, unlike the 2011 census, was voluntary and was carried out in just three areas. To date, the provisional percentage response is 38 per cent. overall and analysis of the rehearsal returns is still ongoing.
The Minister, knowing Southend well, will know that I am appalled by those low figures, given that the 94 per cent. average at the last census was even lower in Southend. We felt that we undercounted by about 20,000 people, which cost us £7 million each year. Will the Minister agree to meet me and Southend council in the time before the general election to make sure that we are fully prepared for 2011?
I would be happy to meet the hon. Gentleman. In fact, I would be happy to meet him after the general election as well, to discuss the matter. I understand the points that he makes, but the census rehearsal is voluntary. There was no publicity about it and it does not in any way reflect the response rate that we will get for the census, which I anticipate will be much the same as at the last census. What I can tell the hon. Gentleman, which will be helpful in terms of the points that he raises, is that additional work is ongoing by the Office for National Statistics, which undertakes the census, to ensure that the response rate is as high as possible. That is part of the reason for the rehearsal—to look at the actions that the ONS can and will take in areas that traditionally send in fewer response forms. So action is being taken to address the very points that he made. Indeed, the ONS has been meeting Southend council and others to look at increasing the response rate.
The ONS has put additional work into that. More than £2 million will be spent to encourage organisations and individuals who have been more reluctant to respond to the census to encourage them to do so. Billions of pounds of public money is allocated in expenditure each year, and it is right that we have projections of where the population lives and what the needs of future populations will be. That applies to all populations in this country, so every effort will be made and extra resources will be put into ensuring that those people are able to respond.
How can the cost of half a billion pounds, which is double the cost of the last census, be justified at this time of fiscal crisis? In 2001, 10 per cent. of the data was not even counted; it was imputed. Is this not a thoroughly wasteful and inaccurate exercise?
Absolutely not. It is a very valuable and important exercise. The cost is about £482 million, but we estimate that the benefit to the economy of the work that has been done is about £700 million, so the benefits outweigh the cost. The cost is about 87p per person per year. For every person in the country to pay 87p per year for the benefit that we get from the census is good value.
The census is not even accurate. Why are Ministers rushing to send millions of the 32-page census forms to the printers this March, a full 12 months before the census date? Should not a responsible Government be scaling the census back? Is not the answer a less intrusive, much cheaper census that offends the public less, increases compliance and therefore yields much more accurate information?
I think the right hon. Gentleman struggles to make his point. If we look at the costs of censuses across the world, our census is better value for money and cheaper than those conducted in such countries as New Zealand, Canada, Australia and the USA. In the USA the census costs more than £2 per person per year—significantly more than in this country. [Interruption.] Hon. Members may find that amusing, but I find value for money quite an important aspect. The Government are doing everything they can, working with the ONS, to ensure that the information is accurate. It is important that the response rate is as high as possible. We use the information to help to allocate Government priorities and Government expenditure, so I totally refute the right hon. Gentleman’s comments.
Voluntary Sector (Government Funding)
I regularly meet third sector organisations to discuss various issues, including any potential changes to the levels of Government funding. Owing to the third sector’s value to the community, public funding increased to £12 billion in the most recent financial year, an increase of more than £3.5 billion over seven years. The Government have further increased their support to the sector with a recession action plan, which is worth up to £42.5 million, and the £17.4 million hardship fund provided additional support. We have also funded a website that provides a one-stop shop for information about funding and financial opportunities, including advice and guidance on sustainable funding opportunities.
I am very grateful to the Minister. Whoever wins the next election, there are likely to be spending cuts in national and local government, and that will inevitably reduce the amount of funding for the third sector just at a time when its burden of social care is on the increase. How does the Minister intend to square that circle?
The issue of local government funding has caused the third sector considerable concern, and we have been working with local government and those who commission services from the third sector to ensure that commissioners are aware of the value of the third sector and how they can best apply for the work that it undertakes on behalf of local government. In terms of social care, that is the most crucial consideration.
There are issues with Government funding, but council budgets are under huge pressure, too, and, in the drive to enable the third sector to undertake core social services, that is leading to a double pincer movement for many local charities. What will the Minister do to ensure that councils do not simply say, “We cannot fund you,” and that we do not lose the core social services that councils used to run?
If third sector organisations are undertaking core social services, they will be doing so on behalf of the local authority, which will fund those services. I say to all local authorities, look for the third sector’s value for money and its contribution to the overall objectives of the council and the overall benefits of the area. I am convinced that, when those issues are taken into account and councils see the value that the third sector brings to their area, it will impact on their funding decisions.
It is gratifying to receive so much support for Government funding of the third sector; it has not always been forthcoming from the Opposition. We have addressed those funding issues. During the recession, the Government have given an extra £42.5 million to the third sector, and that support has been absolutely crucial. We want to ensure that we still support the third sector, but we will not regard it as a cheap option for the provision of public services. It is a quality option that deserves to be properly funded.
Government Information Service
The Government Communication Network is the successor to the Government Information Service, which was disbanded in 1997. Over the next 12 months, the permanent secretary at the GCN will improve the professional skills of communicators throughout the civil service, maintain professional standards, increase efficiency and deliver maximum value for money. Effective communication performs a critical role in providing important information to the public and improving access to public services. The Government will continue to use communications in support of their policy agenda, building on current successful campaigns.
I am grateful to the Minister, and I am sure that the Government Communication Network does a marvellous job, but at a time when we are looking to ensure that public money is well spent, will she explain why, for example, it is necessary for the Ministry of Defence to have 255 people employed in communication?
Over the years, there has been a lot of demand on press officers’ time. I will give the hon. Gentleman some figures. There are 374 media personnel in the Press Gallery and more than 3,000 journalists at the BBC, and each of their queries demands a response. On average, the Department for Children, Schools and Families, for instance, receives 600 calls a day. The increase in numbers is a direct response to the increased number of questions to Departments.
Charities (Regulatory Burden)
The Government are committed to cutting burdens on charities and other third sector organisations. Further plans outlining how this will be achieved were published last month. The changes that we have already made to charity law and to the accounting and reporting thresholds have resulted in savings for up to 5,000 charities.
Gift Aid is a matter for the Treasury. However, I have regular meetings with representatives from the third sector, as well as with Treasury Ministers, who are reviewing the operation of Gift Aid to see what more they can do to assist charities in this regard.
Is it not the case that the Charities Act 2006 brought rationalisation to the regulations governing the charities sector and therefore made it much easier, in many ways, for them to function? Is it not also the case that where third sector organisations are delivering other services such as hospices and so on, they must be regulated in terms of the service that they are delivering? What is important, therefore, is not the quantity but the quality of the regulation that we have imposed.
My hon. Friend, who has vast knowledge of the charitable sector, makes a valid point. This is a matter of balance. We need to ensure that there is adequate regulation to protect donors’ money and the services that they provide, but we do not want to overburden those organisations with unnecessary regulation.
I will start again, Mr. Speaker.
As charities are finding it increasingly difficult to maintain income streams, would not now be the very best time to try to reduce the regulatory burden even further to minimise the adverse effects on all charities, including NHS charities?
I do not think the hon. Lady heard my answer to the original question as regards exactly what we are doing. We are publishing plans outlining what more we can do. However, the measures that we have taken to date in relation to charity registration, and other matters, have been welcomed by charities, and we will continue to do what we can to support them.
Advice and Advocacy Services
Because of the third sector’s value to the community, public funding increased to £12 billion in the last financial year, which amounts to more than £3.5 billion extra over the past seven years. During the recession, we have provided additional funding to advice centres and to the communities they help. That includes an extra £13 million for legal aid, an extra £10 million for additional hours of service by citizens advice bureaux, and more than £6 million for information, advice and guidance services and hardship funds. These services are open to those in every community irrespective of their employment status.
The national minimum wage protects the earnings of vulnerable workers, but during the recession bad employers have sacked low-paid staff or unfairly changed their working conditions, especially in non-unionised workplaces. What have the Government done to support vulnerable workers to ensure that they get good advice and representation about their rights at work?
I would urge every member of the public in employment to be a member of a trade union that protects their rights. However, the Government provide additional support to ACAS, to the pay and work rights helpline, and to the Directgov website. We also have a campaign to ensure that workers are aware of their rights at work so they cannot be discriminated against and treated as my hon. Friend describes.
Grassroots Grant Programme
The £130 million grassroots grants programme has already provided more than 13,000 grants to small charities and voluntary organisations, totalling more than £33 million. Those grants have enabled small groups across England to do what they think is best to meet the needs of their own communities. More than £13 million has been received in donations from businesses and individuals, which has been boosted by the Government’s provision of £25 million through match funding.
Does my right hon. Friend agree that voluntary organisations in receipt of that money are best placed to provide opportunities for young people to get employment through sport and training opportunities, and that that provides people with an excellent opportunity to participate in making their communities better?
I would commend my hon. Friend for the work that he has done in his constituency on this issue, working with the third sector and encouraging young people to volunteer and engage. He is absolutely right that the ability to volunteer seems to be a route into employment because of the skills and confidence that people gain through volunteering.
Charities (Regulatory Burden)
I refer the hon. Gentleman to the answer that I gave to the hon. Member for Kettering (Mr. Hollobone) a moment ago about how the Government are reducing burdens on charities and the voluntary sector.
I recently visited a mental health charity that was getting its funding from 27 different sources and having to fill in 27 audits and 27 accounts of how it was doing its job properly every year. It was having to employ at least one full-time person just to do the paperwork. Surely that is a nonsense and we can streamline that whole system.
We can to an extent, and one thing that we can do is consider having one reporting system for such organisations. However, I do not think for a minute that the hon. Gentleman is suggesting that some of the independent funding organisations should not give money to such charities. I commend the charity that he has in mind for being so successful in gaining funding from every source. We are looking into the issue of reporting and forms and working with the sector on it.
The Prime Minister was asked—
I have been asked to reply.
As the House will know, my right hon. Friend the Prime Minister is in Northern Ireland, where talks are ongoing to secure agreement on the devolution of policing and justice powers. The Prime Minister will make a written statement to update the House later and place it in the Library of both Houses.
I am sure the whole House will wish to join me in paying tribute to Rifleman Peter Aldridge from 4th Battalion the Rifles, serving as part of 3 Rifles Battle Group, and acting Lance Corporal Daniel Cooper from 3rd Battalion the Rifles, who have died in Afghanistan. They were both heroes who displayed extraordinary courage, spirit and absolute commitment to the tasks that were before them and their colleagues, who, along with their families and friends, will remember them with great, great pride.
May I join the Leader of the House in paying tribute to those who have lost their lives in the service of their country? Is she aware that the compensation paid by the Ministry of Defence to the families of those killed in action is then taken into account when calculating benefit assessments, with the result that some families receive no compensation at all and others are actually left worse off? Will she look at that as a matter of urgency to see what can be done to put it right?
The Ministry of Defence has been very concerned indeed to ensure that we support those who have been injured in the line of service. The Secretary of State for Defence produced a Command Paper that particularly addressed the issue of support for veterans. There has been a big upgrading of the compensation scheme and a further review of the scheme is under way. The Secretary of State for Defence has been working closely with the Secretary of State for Work and Pensions on this.
We recognise the importance of manufacturing in South Derbyshire, where between them the aerospace, automotive and railway sectors in the area directly employ more than 32,000 people and account for more than £10.3 billion of economic output. My hon. Friend strongly supports manufacturing in his area, and we have an advanced manufacturing package of support for skills and a manufacturing advisory service. We look forward to strong growth ahead in this sector.
We wish the Prime Minister well in his endeavours in Northern Ireland because we all want the devolution of policing and justice to be completed and progress in Northern Ireland to continue.
I join the Leader of the House in paying tribute to Lance Corporal Daniel Cooper and Rifleman Peter Aldridge, who have joined the lengthening list that is read out in the House of members of the armed forces who have died serving this country.
On that subject, we welcome the appointment of a new NATO civilian representative in Afghanistan, and the fact that it is the current British ambassador to Afghanistan, Mark Sedwill, whom we all hold in very high regard. Are the Government confident that his work will be closely co-ordinated with that of the United Nations so that, this time, military gains will be followed by effective reconstruction?
Indeed, and I thank the right hon. Gentleman for his commendation of that distinguished diplomat. It is precisely to support that work that the conference is to be held in London to look at taking forward issues on Afghanistan. There are 70 countries attending, as well as the UN Secretary-General, Ban Ki-moon.
Looking ahead to that conference tomorrow, should we not recall the lessons of the previous Afghan conference in London in 2006, which set dozens of extremely ambitious objectives for Afghanistan, most of which have never been met? Do the Government agree that, this time, the conference should focus on realistic goals that can be delivered, concentrating on improved governance and reintegrating former Taliban members? Will the Government seek regular reviews of the progress made, including at the conference proposed for Kabul in a few months?
Of course, we are looking to ensure that we play our part so that, in Afghanistan, we have the right military action to tackle terrorism, we support the Afghanisation of the armed forces and the police services, and we have economic and political development. I would have thought that the right hon. Gentleman would take the opportunity to support the work that will go on tomorrow instead of simply carping.
The right hon. and learned Lady should know the position. Immediately after Question Time, my right hon. Friend the Leader of the Opposition and I will visit President Karzai to push forward exactly the same agenda as the Government, so there is no need to make party political points about that important subject.
Doubtless, President Obama will mention Afghanistan in his State of the Union address tonight, but he is also expected to talk about reforms to the regulation of the banking system. No country was left more exposed to the failure of the banking system than the United Kingdom. President Obama has called for retail banks to be prevented from getting involved in large-scale proprietary trading. Why are the Government not supporting the President’s proposals enthusiastically and working with him to realise them?
We are working very closely internationally, including, of course, with President Obama. The United States has different structures and different problems in its banking system, which the US Government are seeking to address. We have been addressing the problems in our banking system, and it is important that we all work together internationally to ensure that we can deal with the problems that have so affected all our economies.
Well, of course it is important to work together internationally, but the Prime Minister said that he did not envisage a
“divide in future between… retail and corporate deposit taking… and investment banking and trading conducted at an international level.”
That is the Prime Minister’s stated position, which is very different from the President’s, and I put it to the Leader of the House that the Prime Minister is probably wrong.
Let me ask about something else for which President Obama has called. There is a clear case for a levy to compensate taxpayers for what happened in the past and what may happen in future. Is it not time to work with the President on agreeing the sort of levy that he proposes and drop the Prime Minister’s Tobin tax on transactions, which has been rejected throughout the world and was ridiculed yesterday by the Governor of the Bank of England?
We have never argued for a one-size-fits-all solution, with every single country taking the same action. We have always agreed that all countries should work together—whether in the G20 or the European Union—to tackle the global economic crisis. We agree with President Obama and just about every other country in the world that we need a fiscal stimulus to support the economy in recovery. The only people who seem to disagree with that are the official Opposition.
President Obama has just announced a freeze on spending in the United States and the UK Government have just raised the rate of VAT, which is hardly a fiscal stimulus. The Governor of the Bank of England said that President Obama’s proposal is much more serious than the Prime Minister’s Tobin tax. In fact, the Governor said that he could not think of anyone internationally who was enthusiastic about the Prime Minister’s idea, so let me ask about a third aspect of banking reform.
There is a growing consensus that only central banks have the authority, ability and know-how to maintain proper supervision of the banks. The Prime Minister took that power away from the Bank of England in 1997 and created a system that failed. Given that countries such as the United States and Germany want their central banks to have more responsibility for banking supervision, will the Government now change their policy and adopt that approach?
Obviously, what America has been doing is dealing with a very fragmented system of regulation, which involved no fewer than eight regulators. We have already rationalised the system of regulation. What is important is that the organisations have the right powers within the right framework, and that is what the Financial Services Bill and other measures are determined to ensure. The Conservatives said they wanted less regulation when they were in government, so it is good to hear that they are supporting firm action to tackle irresponsibility in the markets.
It was the Prime Minister in 2007 who trumpeted his record—as he thought of it—of deregulation in the City and said we could look forward to a
“golden age for the City”
from then on. Is it not clear that the Prime Minister was wrong and is wrong now on the system of financial supervision, wrong on the Tobin tax, wrong to build an economy based on debt, and wrong not to back the United States on banking reform? Are not those failures just another part of a miserable record, in which we have the biggest budget deficit in peacetime history, the largest bank bail-out in the world, the deepest recession since the 1930s and the weakest recovery in the G20? Does the right hon. and learned Lady think it is time to back some of the United States’ proposals to sort out the banks in future?
We have helped the economy through the recession and supported the recovery. When the right hon. Gentleman was in government and sitting in the Cabinet, there were double the number of repossessions; when he was in government, there were three times as many bankruptcies; and when he was in government in a recession, there were four times as many job losses. I have to say that his reversing is even worse than mine. We are building up Britain, and the Conservatives are trying to talk it down.
Could the Leader of the House have discussions with her colleagues in the Treasury and the Department for Transport to ensure that we get a decision on the high-speed rail link this side of the general election, and that, when we get that decision, Birmingham and the west midlands get the links they deserve?
May I add my condolences for the loss of Lance Corporal Cooper and Rifleman Aldridge?
May I congratulate the Leader of the House on her foresight in establishing the National Equality Panel, which reported today? It helpfully reminds us that after 18 years of Conservative Government, inequality had widened and reached the level described in the report as “shocking”. Will she explain why now, after 12 years of Labour Government, income inequalities are the same—still shocking—wealth inequalities in shares and property are worse, and, as we discovered on Monday of this week, child poverty is growing?
I join the hon. Gentleman in thanking Professor John Hills and his panel for the important report by the National Equality Panel. The hon. Gentleman is right to say that the report states that under the Conservatives—[Interruption.] Under the Conservatives, inequality widened, and as a result of the effect of this Government’s policies, most particularly on tax and benefit, the growing inequality has been stemmed. We have also tackled poverty, especially child poverty and pensioner poverty, but we think that inequality, which persists and can be handed down the generations, matters for the individual, for opportunity, for the economy and for a more peaceful society, so we are determined to do more to tackle it.
Well, the Government may be determined, but the brutal truth is that economic inequality is getting worse. Part of the problem is the failure to reform the unfairness of the tax system. We all understand why Conservative Governments might wish to give top priority to rewarding the wealthy, but why have the Labour Government given overriding priority to cutting the tax rate that wealthy people pay on their capital gains to a lower rate than the tax paid by working people on their earnings, and why have they left wholly unreformed a property tax system under which ordinary families pay the same amount of tax on a modest family house as billionaires pay on their multi-million pound mansions?
The hon. Gentleman is simply wrong in what he says about the report’s findings. It says that over the 13 years that we have been in government the effect of our tax policies, combined with our benefit policies, has been to narrow inequality. We have tackled poverty, in particular pensioner poverty and child poverty. One thing that would not help those on low and modest incomes would be the savage cuts proposed by the hon. Gentleman’s party.
The threat of the third runway at Heathrow continues to blight my community. Although a compensation scheme has been introduced that will protect the homes of some residents, many residents are excluded from it. It also does not cover people such as the local shopkeeper, the hairdresser and the publican who live above their premises and who will lose their homes and their livelihoods. Will the Leader of the House facilitate a meeting between local MPs and Ministers to discuss what compensation can be provided to those people?
These matters, which were debated and decided on in this House of Commons, are now the subject of the Chilcot inquiry. It is choosing the evidence to be brought before it and that it requires to be examined. It is independent and I suggest that we thank it for its work and await its report.
I agree with my hon. Friend that education is important, not only for every individual to achieve their potential, but to ensure that we have a dynamic economy. I am delighted that Woodhey high school has seen such a big rise in its results, not only last year but in the last three years, and I join him in congratulating the school. Those results are due to the hard work and dedication of the teachers and pupils, but they are also thanks to the extra investment we have put in. We will continue to sustain and support investment in education.
We are determined to ensure that there is social mobility, and one of the important findings of the NEP report is that more unequal societies have less social mobility, which is why we are determined, with Government action, to continue to support policies that spread fairness and equality.
I will support my hon. Friend’s urgings to my colleagues in the Department for Communities and Local Government, and I am delighted to join him in congratulating the Coalfields Regeneration Trust on its first 10 years of operation. I know that he has worked with fellow MPs in former mining constituencies to ensure significant regeneration in these areas, which face such challenges, particularly after the devastation of the Tory years.
The right hon. and learned Lady was right the second time.
In March, the Lord Chancellor himself said that the sort of anti-Catholic and anti-woman provisions at the centre of our constitution have no place in a modern society, and that the Prime Minister was ready to consult Commonwealth Heads of Government. Will the right hon. and learned Lady suggest that he write to them, if he is too busy to consult, so that we can get on with this reform?
As the Prime Minister has said, people recognise the need for change, but that change can be brought about only by the Prime Minister working with the 16 other countries. The discussions are continuing. We cannot speak for those other countries, but we are sure that progress will be made.
Equitable Life policyholders lost out as a result of mismanagement that went back to the 1980s. There is concern on both sides of the House about that. The hon. Lady knows very well that there has been an ombudsman’s report on the matter, that we have apologised for the regulatory failures that caused loss, and that we have set up a system to establish how there should be ex gratia payments. Sir John Chadwick has got this work under way and will be making his interim findings in the spring.
May I put it to my right hon. and learned Friend that one of the causes of the growth in inequality has been the extension of outsourcing of jobs that were previously done in-house? A class of working people has grown up that no longer qualifies for pensions, sick pay, redundancy pay and all the other things that in the 20th century we used quaintly to associate with civilisation. Is it not time that the Government started to discourage outsourcing?
The transfer of undertakings regulations were designed to give protection where work was transferred out from direct employment in the public sector to the private sector. However, the Equal Opportunities Commission has documented evidence to show that this has acted as a downward pressure on women’s wages and their income in retirement. We are determined to ensure not only that people in public services can give a good service to the public, but that they are fairly treated in employment.
Today is Holocaust memorial day, 65 years after the liberation of the Auschwitz-Birkenau death camp. Does my right hon. and learned Friend agree that although the evil of the holocaust is unique, its lessons must be applied to the racism and anti-Semitism of today, so that a better society can be enjoyed by everyone?
I support absolutely what my hon. Friend has said. We in this House regard Holocaust memorial day, which is today, as very important. There will be a debate in the House tomorrow and there is a book of remembrance that can be signed. The work of the Holocaust Educational Trust is very important indeed, but we must also bear in mind the lessons that come out of the holocaust about prejudice, discrimination and anti-Semitism, which we must fight wherever they rear their head in this country.
Like my hon. Friend, the Government are strong supporters of the Royal Mail and want it to have a secure and prosperous future at a time of big change. We are committed to the universal service six days a week and to a post office network. We are also committed to changing the regulations to allow more ability to compete, and we obviously want to ensure that the pension liabilities are secure as well.
Each year, 1,000 women die from cervical cancer. In Scotland, Wales and Northern Ireland young women can get screening at the age of 20, yet in 2004 the Government sought to increase the age for women in England to get screening to 25. Why do the Government discriminate in that way, and will they consider redressing that injustice?
We are very concerned indeed to make sure that we prevent, and have early detection for, as many cancers as possible. In that, we ensure that the necessary resources are available but we are guided in the application of those resources by clinical judgments. The hon. Gentleman is no more a scientist than I am; what we have to do is take the best advice and act on it, and make sure that there are the resources to back it. That is why we have trebled investment in the national health service.
We need that day even more now. Before the earthquake in Haiti, many of the 200 orphanages there were actually fronts for child trafficking. Since the earthquake, we have a new problem: 380,000 children at risk. Will the right hon. and learned Lady speak to her international aid contacts this afternoon and establish a network for children at risk, so that they have somewhere safe to be until they can trace their family or until there is time to set up some kind of arrangement to ensure their safety? The traffickers are circling. We need to make sure they do not catch the children.
I pay tribute to the hon. Gentleman for his work on the issue, which he has consistently and intelligently raised in the House. I agree that there is work to be done by the police and prosecutors internationally. There is also the work of voluntary organisations, which I know he supports, helping to bring the message warning people of the dangers of trafficking, and protecting those victims. I congratulate him on his suggestion. We will look into it.
Point of Order
On a point of order, Mr. Speaker. I have given prior notification to the Member concerned.
In Communities and Local Government questions yesterday, the hon. Member for Sheffield, Attercliffe (Mr. Betts) put a question with a wholly erroneous set of comments attributed to the leader of my council, Hammersmith and Fulham, including the statement that
“one problem with social housing was that it was hard to get rid of these people”.—[Official Report, 26 January 2010; Vol. 504, c. 669.]
That comment is entirely false. The leader of the council never said any such thing, so I should be grateful for your guidance, Mr. Speaker, on how we might set the record straight for what is, after all, one of Britain’s best-loved and best-run local authorities.
I thank the hon. Gentleman for his attempted point of order, but as he will know, on the strength of his experience in the House, it was not a point of order but a most interesting point of debate, which has now been placed fairly and squarely upon the record.
School Admissions Bill
Presentation and First Reading (Standing Order No. 57)
Mr. Paul Burstow, supported by Tom Brake, presented a Bill to enable admission authorities to have regard for local authority boundaries and other defined localities when allocating school places; to provide for the appointment of an independent lay majority on local school admission forums; and for connected purposes.
Bill read the First time; to be read a Second time on Friday 12 March, and to be printed (Bill 57).
Young People Leaving Care (Accommodation)
Motion for leave to bring in a Bill (Standing Order No. 23)
I beg to move,
That leave be given to bring in a Bill to make provision for minimum standards in respect of accommodation for young people leaving care; to impose a duty on local authorities to ensure that such standards are met; and for connected purposes.
This Government have made considerable progress in the support of vulnerable children and put in place exemplary legislation and regulation to improve the outcomes for those children. The Children and Young Persons Act 2008 established laudable principles and objectives to improve the experience of young people in care, to deliver high-quality corporate parenting, to listen and respond to young people, to bring stability and continuity into every aspect of a child’s care, and to create an uncompromising culture of high aspirations.
Those are incredibly laudable objectives, but they need to be underpinned by detail. Indeed, the Act is largely underpinned by extensive regulation, one aspect of which is currently out for consultation. It relates to young people between the ages of 16 and 18 who are in the care of a local authority and who are being placed in accommodation in an unregulated setting—that is, not in a children’s home or a foster home. This is the first time that there will have been a definition of suitable accommodation for those young people.
I shall refer to those plans in detail in a moment, in the context of my Bill, which would put in place minimum standards for young people of 18-plus who are leaving the care of a local authority and making the transition to independent living. As we all know, that time of a young person’s life involves an awful lot of support needs. They depend on other people to help out when they are trying to take those first steps. They are trying to work out whether a particular course of action is the sensible one, and whether it will take them where they want to go. They are asking themselves, “Where do I want to go?” or, in some cases, “Who do I want to be?” and “How can I take the steps to achieve that?”
At the moment, there is a gap between the laudable aspirations that I have mentioned and the direct experience of people in care and leaving care, and it is our responsibility to sort that out. A young person should not have to try to second-guess the system when they have no experience of these things. They need to be supported in the same way that they would expect to be supported by a caring parent. Such a parent would ask, “Is this accommodation suitable? Is it where you want to be? Where do you want to be? Where do you want to go to school and university? Where do you want to go to college? What do you want to achieve? Have you got a job? How can we support you?” We need to be able to work effectively to provide somewhere safe and secure in which a young person can fulfil their aspirations and do as well as they possibly can. We are not in that situation at the moment.
I have an example of a young woman who got in touch with the Who Cares Trust. She started a job in London, her first job. The work was hard and involved a lot of hours, and she had a lot of things to take into account. She needed a lot of help from her foster carers, even though she was at an age when they did not have to provide it. The flat that she had been offered was dirty. She said, “Don’t tell me people live in this filth.” Her foster carers could not believe it when they went in. It took a whole set of them a week to clean the place up. She said that there was grime, dust and growth on the walls, that the walls had holes in them, that plaster was missing and wallpaper was peeling off, and that there was damp and mould everywhere. She could not believe that she was expected to live in such a place, but it was the only option offered to her.
I recently had a meeting with a group of young people who came to Parliament to tell me about their experiences, along with a group of social workers. The social workers were great people; they were helpful and supportive. They said, however, that young people up to the age of 21 were being supported. One of the girls then asked a question, and it is a question that we need to find an answer to. She asked why, if young people were being supported up to the age of 21, she had been placed in a bed and breakfast with her baby when she was 18.
We talk about the intergenerational problems experienced by vulnerable young people, but we have the ability to help them to break out of them. We must mind the gap. At the moment, young people are telling us that they can be placed in bail hostels alongside people who have problems with drug addiction, or in places where prostitution is actively taking place. These are places where they would never have been allowed to go when they were in the care of a local authority, yet they are being placed in them by the authorities because there are no effective minimum standards.
Some authorities are brilliant—they have worked it out and know how to do it. Some agencies are incredibly effective: the National Care Advisory Service, which works directly with local authorities and young people, has tremendous experience of what works and what can be done well. Crucially, it has involved a considerable number of young people with experience of care in drawing up what they believe should be the minimum standards for accommodation. I have been in several meetings with them and gone through these matters in detail. What I have noticed most is the close correlation between what good local authorities and children with experience of care say is the minimum standard needed, and minimum student accommodation standards drawn up by universities and colleges in consultation with their students. It defies logic that an 18-year-old at a university or college now benefits from extensive, detailed minimum standards on whether accommodation is suitable, but an 18-year-old leaving care does not.
What is provided for an 18-year-old leaving care and going to university or college? During their time at university they have minimum standards, but during the holidays they have nothing. The basic need for standards of the most vulnerable children who go to university or college is unmet. Why must there be standards? If there are standards, the expectation is set. The Bill would define not good practice but what is safe or legal for anybody else. For a house in multiple occupation, a set of legal standards is required. Those standards must be available to our most vulnerable children.
Significantly, I do not have the considerable time necessary to go through the recommendations of the National Care Advisory Service in detail, but young people currently have to make a decision on the hoof, on one choice. Everyone in the House knows that there is a difference between an unfair tenancy agreement and a fair one. There is a difference in terms of safety between somewhere with a lock on the door to which the person concerned has the key, and somewhere that does not. Who would feel comfortable going to sleep in a place where they did not have a lock on the door? Who would feel comfortable going to sleep in a bail hostel without a lock on the door? I have had horrifying discussions with young people about their experiences in bail hostels where they cannot lock the door. That is not good enough, it is not acceptable, it is our responsibility to do something about it, and we have the opportunity to do so.
Currently, regulations are being put together for young people aged 16 to 18. As far as they go they are good, but they do not specify that a young person should have a private room, or that they should be able to secure it. That is not good enough, but it is significantly better than the provision for young people aged over 18. To mind the gap for young people leaving care from the age of 18, we should bring in legislation that is sufficiently robust for them to be able to challenge a poor decision, and to prevent predators moving into the market and exploiting the vulnerability of such young people. Beyond that, it must also be sufficiently robust to ensure that they are secure, safe, able to achieve, and able to grow into who they want to be and should be.
Question put and agreed to.
That Helen Southworth, Derek Twigg, David Cairns, Ms Karen Buck, Ann Coffey, Mr. Kevin Barron, Mrs. Janet Dean, Christine Russell, Mike Hall, Mr. Russell Brown and Annette Brooke present the Bill.
Helen Southworth accordingly presented the Bill.
Bill read the First time; to be read a Second time on Friday 12 March, and to be printed (Bill 56).
[3rd Allotted Day]
I beg to move,
That this House wishes to see the quality of life improve for the 700,000 people in the UK with dementia; pays tribute to their families and carers and all those who campaign and fundraise for dementia charities; is concerned about the findings published in the National Audit Office report on Improving dementia services in England, HC 82, that showed the Government had failed to implement robustly the Dementia Strategy; calls on the Government to publish the report of the Nutrition Action Plan Delivery Board, which was submitted in July 2009, and in particular to respond to the inappropriate tube feeding of those in dementia care; deplores the inappropriate use of anti-psychotic drugs in the care of those with dementia; is concerned that 50,000 elderly people are forced to sell their home every year to pay for their long-term care; is concerned that the effect of the Personal Care at Home Bill will not help those with dementia in residential care; calls on the Government to prioritise research to combat dementia; proposes that the National Institute for Health and Clinical Excellence assess the wider societal value of treatments in its appraisals; and further calls on the Government to adopt a social care insurance model for residential care costs and to recognise dementia within a wider reform of social care.
We have brought this motion before the House because we are deeply anxious about the welfare of the rising number of dementia sufferers and their families, and of every elderly person in the UK who is having to live with the effects of an unreformed social care sector. Let us be clear about the scale of this issue. Of the 8.2 million people who are over 65 and of the 6 million people who use social care, 700,000 people have been diagnosed with dementia in the United Kingdom—and that figure is set to double over the next 30 years. In other words, about one in 10 of all social care users has dementia. In the context of a rapidly increasing awareness generally, the Government have promised much but delivered little to this group of people.
I am most grateful to my hon. Friend. He is absolutely right to have spotted that I said that 700,000 was the number of people who have been diagnosed with dementia. I did so precisely because of the under-diagnosis that occurs and the cases that will doubtless shortly be diagnosed.
On that point, the Parliamentary Office of Science and Technology says that 700,000 is the current estimate but that in fact only one in three of those people has had a formal diagnosis from a doctor, so the previous intervention was not correct.
The hon. Gentleman attempts to be more precise, but he will find that 700,000 is the figure for the number of people whose diagnosis has been accepted by all the agencies that need to make calculations and predictions, not least the Government. Some of that diagnosis may not have been done through a formal medical diagnosis, but it has become accepted through the other agencies as the appropriate diagnosis.
Is not this issue of diagnosis the precise point, because one of the things we were promised in the national dementia strategy was better training for general practitioners and earlier diagnosis, and that has not happened? That is why so many people are still not being properly diagnosed.
I am grateful to my hon. Friend for making that excellent point. He is right and he anticipates one of the issues that I hope to develop a little later in my speech.
There are specific measures that could improve the outlook for people with dementia, and for their families and carers, but it is important to bear in mind the fact that these social care reform issues affect all our fellow citizens who need to access and use social care services. Sufferers of advanced dementia represent some of the most vulnerable older people in our society. As we consider the challenge of meeting their needs, we must pay careful attention to the wider social care reforms that could protect the health and well-being of all elderly people. I hope that we can keep that bigger picture in mind as we debate this matter today.
First, let us consider dementia specifically. There is no masking the truth that dementia is a frightening and debilitating disease that plays havoc with the lives of those who come into contact with it, be they the sufferers of the illness, the families or the carers. The trauma of a diagnosis and the difficulty of coming to terms with the gradual loss of memory is only intensified when patients discover that little co-ordinated support is available for sufferers.
I pay tribute to all those in the third sector—in particular the Alzheimer’s Society and the Alzheimer’s Research Trust—who have supported sufferers and championed their cause. I also pay tribute to the work of my hon. Friend the Member for Rugby and Kenilworth (Jeremy Wright) and the all-party group that he founded and chairs, which has been so influential. We should also pay tribute to hard-working elected members of councils across the country and their officials who are working to provide this care at a local level, as well as to all those operating in the local government departments.
I cannot give enough praise to the family members, neighbours and friends who, as informal carers, love and care for vulnerable and elderly people and for those with dementia, who face even greater challenges. We should keep them uppermost in our deliberations and not forget the real human lives that these policy debates represent.
Two weeks ago, the National Audit Office published a broadly critical report on the Government’s dementia strategy. Among its many misgivings, it noted that
“there has not yet been a robust approach to implementation”
of the strategy; that
“it has not been given the levers or urgency normally expected for such a priority”;
and that it is clear
“that value for money will remain poor unless these weaknesses are addressed urgently.”
The National Audit Office reported, of course, to the Public Accounts Committee. We had a very good hearing on this subject in October 2007. I was promised 10 times by Sir David Nicholson, the head of the NHS, that the matter would be a national priority. That commitment was given 10 times. There have been three framework directives since then and it is still not a national priority—it is only a strategy. If my hon. Friend is fortunate enough to become a Minister for Health in May, will he consider making it a national priority?
I am grateful to the Chairman of the PAC for that intervention and for the work that he has overseen, as well as to the NAO, which has done that work. In answer to his specific question, I am glad to confirm that we have already said that, should that happy occurrence take place, this matter will be a priority. Part of my argument will be to stress how much, if one is going to state—as the Government have—that this is a priority, that needs to be followed through with actions rather than words, including operating frameworks.
Let us be absolutely clear. Is the hon. Gentleman saying that he would make it a national target or that he would leave it to local discretion? He cannot stand there, make suggestions and posture on this issue without being absolutely clear on that point.
I hope that the Secretary of State will reflect on the fact that he did not use the word “priority”, which was the word that I used. For some reason, he felt compelled to use the word “target”, which is always a potential distortion. That was a distortion. My answer is that the issue, as I am about to make clear, concerns how the actions flow from the word “priority”, once we have called it that.
I must say to the hon. Gentleman that, as vice-president of the Alzheimer’s Society, patron of my city’s Alzheimer’s group and someone who is contributing to the Alzheimer’s Research Trust, I am surprised that he is making this a party political issue. Let me ask him a simple question. The thrust of the Audit Commission’s review was that the strategy was good and that the new appointment of the director in charge of this matter will help, but that the £150 million allocated had not reached the parts for which it was intended because of the nature of decentralisation and the lack of ring-fencing. Given the Conservative party’s commitment to the new NHS board and to even more decentralisation to professionals from the Secretary of State or politicians in this House, how could the hon. Gentleman possibly determine what a priority would be locally when he could not even determine it nationally?
I am grateful to the right hon. Gentleman—no doubt he will seek to catch Mr. Speaker’s eye later, as that was a speech. Let me return to the intervention that he made at the beginning of it. He clearly needs to recognise that if anybody was making a party political point it was the Secretary of State, who intervened in the most tribal manner, as is fairly typical. The answers to the right hon. Gentleman’s questions will, happily, become clear from what I am about to say.
The NAO’s report came on the back of a disappointingly vague Green Paper on social care and a personal care pledge by the Prime Minister that the Labour party’s own Lord Lipsey has described as a “gimmick”.
Let me correct the claim in the Government’s amendment that
“the Personal Care at Home Bill will help some 400,000 people”.
It is offering free care to only 270,000 people, of whom 160,000 already receive it free. It will take only 2,384 people out of care homes—the stated aim of the policy on the human rights grounds that are critical for its intra vires—from a population of more than 500,000. It will help less than 3 per cent. of social care users. In other words, the Government have not grasped the nettle: we have an ageing population on our hands, cases of dementia are on the rise and time is running out.
By contrast, the Opposition have led the way in recognising that if a Government are to be serious about addressing the needs of dementia sufferers and older people across the country, reforming older people’s care services across health and social care in a way that is both socially and fiscally responsible must be a priority. That was precisely the answer that I gave. To cover one of the points mentioned in the intervention by the right hon. Member for Sheffield, Brightside (Mr. Blunkett), which was rapidly developing into a speech, our policies on Alzheimer’s research and pooled personal budgets, our proposals to reform the National Institute for Health and Clinical Excellence’s drug assessments, our home protection scheme for affordable guaranteed residential care and our commitment to a reinvigorated public health agenda have forced the Government to pick up the pace of reform.
The hon. Gentleman mentioned fiscal responsibility and other matters. Has he had a chance to consider the approach taken by Conservative Nottinghamshire county council? Is he learning from it? The council is privatising dementia care homes, which will mean automatically that the day care service provided for dementia sufferers, which it is also cutting, will be removed in its entirety. What would he say to that county council, which has a budget meeting coming up in a few weeks’ time?
The hon. Gentleman will no doubt have to answer to his right hon. Friend the Member for Sheffield, Brightside for introducing a party political element in his intervention. Clearly, what matters is that we should recognise that local services reflect the national priorities that have been set. If a national priority is for a dementia strategy delivered through actions on the ground rather than words, no doubt that would be more persuasive to a local council as it reached its decisions.
The National Audit Office raised four main criticisms of the dementia strategy. First, will the Secretary of State make clear just how much of the £60 million of dementia strategy funding for 2010-11 will be spent on additional dementia services? Does he have any plans to undertake a baseline assessment to see from what starting point those services are being run? We need only look at the recent carers strategy to see how urgently this assessment is needed. It emerged before Christmas that the £50 million disbursed for emergency respite care this year never reached the front line; instead it got soaked up in local primary care trust bureaucracy. Not only does that leave dementia sufferers with little hope of benefiting from resources, but it seems particularly disingenuous for the Government to take the plaudits for pledging taxpayers’ money without the funds ever reaching the front line.
On the second criticism, will the Secretary of State tell the House what the source of funding is for meeting the £1.9 billion cost of implementing the strategy over its 10-year lifespan? To date, the Government’s impact assessment has identified only £533 million of efficiency savings over 10 years, which leaves nearly three quarters—
I shall make progress, I think, as I have already answered the hon. Gentleman.
To date, the Government’s impact assessment has identified only £533 million of efficiency savings over 10 years, which leaves nearly three quarters of the budget unaccounted for. Does the Secretary of State agree that those diagnosed with dementia today need to know that there is a safety net of funding for their care and treatment as they face the years ahead?
Thirdly, the Government have yet to tackle the gaping hole in the skill set of all professionals who encounter dementia patients as part of their job. The £1.9 billion dementia strategy budget covers diagnosis and early intervention in people’s homes, but the NAO report points out that no estimate has been given for the cost of the pledges that the strategy makes for the training of NHS and social care staff.
Fourthly, can the Minister explain why dementia was not included in the Department of Health’s fixed national and local spending priorities—Vital Signs—in 2007? That serious omission—
Perhaps I can make sure that the Secretary of State knows the point that he has to answer: why was dementia not included in the Department’s fixed national and local spending priorities, Vital Signs, in 2007? The vital point is that that serious omission took place only a month after the Department had asserted in a statement to the PAC that dementia was a national priority. Is dementia really a priority?
The answer to that is, of course, no. That is because Vital Signs is the Secretary of State’s target system, and it has been discredited for distorting health provision. The precise point of this debate is that the Government are not delivering the results on the ground, even when they come out with something called a dementia strategy.
I am most grateful, Mr. Speaker. Does my hon. Friend agree that it is important that PCTs see dementia as a priority? In the NAO report on the NHS operating framework for 2010-2011, the office’s director of health value for money, Karen Taylor, said that trusts would concentrate on other issues if they were not made to focus on dementia. Is not that a fundamental flaw of the present Government’s strategy?
That is precisely the problem that arises when something is called a priority but is not then backed by action. It is why we have the motion before us today. Most importantly, we already have the evidence of what happened with the national carers’ strategy, given that the Princess Royal Trust has said that it could not find out where the £50 million for this year had gone.
The collective amnesia of Health Ministers is remarkable. My hon. Friend will remember that about a year ago my distinguished constituent Sir Terry Pratchett led a delegation to No. 10 on behalf of the Alzheimer’s Research Trust. We met the Prime Minister and the Minister of State, the hon. Member for Corby (Phil Hope), who is in his place. The Prime Minister, the Minister of State and the good and the great of the dementia strategy who were present said that the Government recognised that this was a finite, predictable problem that they would address. They have not done so. They have failed to get the money to where it is needed, whether that is training people in hospitals to cope with dementia patients in there for other reasons, or helping the voluntary sector to provide vital services.
I am grateful to my hon. Friend, who has always taken a keen interest in this important area. He is right to remind us about the visit of Sir Terry Pratchett, not least because that followed his address to the Conservative party conference’s main hall debate about dementia and how we must care for our elderly population. We were very pleased to see that that had been followed through with an invitation to 10 Downing street. Indeed, we wish to see the earnest of what was discussed there translated into action.
The Secretary of State asked my hon. Friend whether dementia should be part of the NHS tier 1 priorities. Does he agree that that was an odd question, given that dementia does not feature specifically in any of the Government’s tier 1, 2 or 3 priorities?
My hon. Friend is an expert in this subject and fully understands the difficulty that that entails. Most importantly, he recognises the priorities going forward. If we were to be given the chance to do so, we would look very carefully at the preventive agenda under the public health budgets. We would also ensure that the priorities are given to the NHS board, thus avoiding the target-based strategy that the Government have manifestly failed to deliver.
With respect, the right hon. Gentleman, who intervened earlier, should wait until I have made more progress. I will give way to him later.
The most important thing is to recognise that, in addition to the four criticisms that I outlined earlier, the Government have also made an announcement about memory clinics. I hope that the Secretary of State will tell us what is going on with the memory clinics that were promised in every town. How many towns does he think that there are in England, and how many currently have such clinics?
Despite reams of questions from me and other Opposition Members—
It is interesting that the hon. Gentleman seems to have a question about every single point that I am making. I shall come back to him, if I may, after I have made sure that the Secretary of State is aware of what I am saying. Despite questions from Opposition Members on the budget for memory clinics and the number of staff expected to be employed to deliver them, the Government could only answer:
“Decisions about the nature, number and funding of the memory clinics will be made locally by primary care trusts, depending on local circumstances.”—[Official Report, 23 February 2009; Vol. 488, c. 202W.]
What sort of a promise is that? The question for the Secretary of State today remains this: what is the precise number of planned and existing memory clinics and how many specially trained staff are there in the country?
I thank the hon. Gentleman for giving way. I discussed memory clinics, among other issues, with my PCT last week. Nottinghamshire’s Tory county council has privatised care homes in my constituency and elsewhere, with the result that day care services will go, among them day care memory clinics. Does he agree with that approach? Is it what we will see should he ever be in power, or would he adopt a different approach? We want to know.
I note that the hon. Gentleman did not answer his own question about whether there were any memory clinics in his constituency’s towns. It is vital that he applies that scrutiny to his Government’s policies. This debate is taking place because the Government have to be held to account.
I am a member of the PAC, and we took evidence on this issue on Monday. However, another issue arose that cannot wait—the appointment of dementia champions. We asked the civil servants before us how many of them there were, and where. They could not answer, although I believe that they will respond in writing to my hon. Friend the Member for Gainsborough (Mr. Leigh). The practical implementation of many aspects of the strategy does not need to wait and the Government can get on with that. Having dementia champions in PCTs and hospitals saves money and introduces the efficiency savings needed to implement the strategy.
I am grateful to my hon. Friend for that excellent point. It is an example of how we need to make sure that people at the front line get actions rather than words.
It seems that the Government have got into a habit of making unfunded pledges of late. Not only was their dementia strategy riddled with spending loopholes, but the Minister’s announcement last week of safeguarding vulnerable adults boards for every local area was equally vague about where the resources to implement the boards would come from. He made no mention of how the boards would co-ordinate with the dementia strategy, despite dementia sufferers being some of the most vulnerable people in our communities.
I hope that the Secretary of State will take this opportunity to explain why he claimed in a statement last week to be implementing a system of registration for home care workers with the General Social Care Council, when the GSCC has informed some of its stakeholders that plans for the system are actually on hold. Clearly, the Secretary of State is too busy trying to bolster his party’s manifesto to worry about making sure that these ambiguous claims are given the necessary detail, and the action points that have been highlighted.
Last week, we uncovered figures on malnourishment in our hospitals. The problem has not been dealt with, despite repeated pledges from Ministers. Evidence shows that it is the elderly who are most at risk from malnourishment in hospital, as they are often unable to express their needs to nurses. Over the last three years, I have been hammering away at this outrageous and scandalous issue. We need only look at the new year press coverage of the widespread unnecessary tube-feeding of the elderly in care homes—particularly those with Alzheimer’s—to see the harm that can be done to patients if the caring professions are under-equipped to meet the demands of dementia, both in terms of training and resources.
No, I will not give way to the hon. Gentleman any more. He is clearly rather excited.
The Royal College of Physicians undertook a review of tube feeding and deplored the practice as “completely unethical”. That the Government is content to let the elderly and Alzheimer’s sufferers be subjected to such appalling treatment as a result of overworked and under-trained care home staff is simply unacceptable. The Government have been sitting on the report of the nutrition action plan delivery board since July last year. I am glad that the amendment states that it will be published “shortly”. Given that it is six months overdue, I hope that the Minister will undertake to publish it tomorrow.
If the unnecessary tube-feeding of the elderly was not enough of a wake-up call for the Secretary of State, in November, the Government published a report overdue by 10 months on the inappropriate use of anti-psychotic drugs to treat dementia patients. Such drugs have a number of serious side effects that pose a particular risk to the elderly. They make patients unsteady and increase the risk of falls, they cause individuals to become socially withdrawn and they can accelerate cognitive decline, exacerbating the effects of dementia. Can the Secretary of State tell us what, if any, action has been taken as a result of the report? After three months, and after an initial delay of a year, all that the Government have done is appoint a national clinical director this week, although that is a welcome move.
It is a sobering thought that the suffering of millions could be prevented if we found a cure for dementia. That might or might not be possible in future, but today anything that can be done to slow the onset of the disease is to be encouraged and welcomed. The Opposition believe that the Government should not resign themselves to the status quo but press ahead in support of research into new treatments for Alzheimer’s, which is why we pledged in 2007 to increase the proportion of research budgets for work on dementia. Our policy has put Ministers under pressure to focus the Government’s attention on dementia, and I was pleased see that in November, a new ministerial group was launched to support dementia research and to help increase the proportion of the Government’s £1 billion research budget that is assigned to dementia research.
Hon. Members will be aware of the concerns recently expressed by third sector groups that the Personal Care at Home Bill will hit those research budgets very hard. I have secured a categorical commitment from Ministers that that will not be the case, but until the details of where the money is coming from for the Bill are completely disclosed, inevitably the third sector will continue to raise those concerns. Will the Secretary of State undertake to place in the Library detailed accounts to show where the money is coming from?
On where the money is coming from, the hon. Gentleman will be aware that the health budget has risen from £32 billion to more than £100 billion over the past 13 years. Dementia services are an important issue, so can he guarantee the funding that will be available if he is fortunate enough to become a Health Minister in May or June this year?
It would be very nice if the Government would match our promise and say that there will be real-terms increases to the NHS budget going forward. It is an interesting point to be made by someone from Wales, which is a devolved region. My constituency borders Wales, and my constituents are aware of the differences between health services in Wales and services in England.
Investing in high-quality research is a vital step towards discovering new and better dementia treatments. However, making drugs available to the wider population, to people who have just received a diagnosis of dementia, and to people with advanced dementia already in need of full-time care, is an altogether different challenge. Uniquely, we have pledged to change the remit of the National Institute for Health and Clinical Excellence to include a calculation of the wider societal costs of a given treatment when undertaking NICE appraisals. It is clear that dementia, as with other diseases, has an impact on local authority budgets and on public spending as a whole. Along with our commitments to value-based pricing, and to streamlining the NICE process, that will pave the way for dementia sufferers to access better drugs.
We need to offer those who are faced with a diagnosis today, and those for whom a cure may not be found for a number of years, the chance to guarantee their care needs so that they can be reassured that whatever the impact of dementia on their lives and their loved ones, they will be able to access residential care should they ever require it. I have explained to the House before the merits of our home protection scheme, and the careful calculations behind what we have promised. It was designed precisely to meet those concerns and allay the fears first raised by Tony Blair 13 years ago about a need that has remained unmet over a period of Labour government. People can now look forward to a Conservative Government delivering a well-designed scheme that deals with people’s fear of going into residential care. We need to look at the context of social reform—
The Secretary of State knows that that intervention was completely unnecessary, because it has never been claimed that it would help people to stay in their home. The idea is to meet the fears of people who have to go into residential care, by making it affordable and so that we do not discriminate against those who cannot afford it. It would not have the perverse incentive that he suggested, because of the national assessment criteria on care needs. The Prime Minister’s knee-jerk reaction in the Personal Care at Home Bill did nothing to address that issue, and deliberately discriminates against people who need residential care. Doubtless that will be debated in the other place on 1 February.
What my hon. Friend says about the proposal is interesting, because in my constituency of East Devon, we are dealing with the case of Mr. Mejor, a former Spitfire pilot, which has attracted national attention. His care is being reassessed at the moment. His daughter is his carer and he has an elderly wife, but they may have to forfeit their home. Such isolated cases are becoming increasingly prevalent around the country, but they could be avoided if we adopted Tory policies. [Interruption.]
Order. I am grateful to the hon. Gentleman. I was not disputing the word of the hon. Member for Tiverton and Honiton (Angela Browning)—I was simply making the point that I did not hear it. What I would say—and I am grateful to her for her point of order—is that it would be a good thing if the House settled down. I know that this is a highly charged matter on which strongly held views are being expressed, but that must be done in a seemly way that will command the respect of the country.
It is indeed a serious subject, Mr. Speaker. I am grateful to my hon. Friend the Member for East Devon for raising a case that has become widely known. Our reforms would enable his constituent to be better served and to receive the care appropriate for his needs.
To summarise, the issue of how we provide sustainable and affordable options for residential care is part of a wider debate on social care reform. The Government have played fast and loose with the challenge of reforming social services. Despite promises made in 1997, they ignored their own royal commission and, indeed, the whole problem, until 2008. We have had a vague Green Paper following an even vaguer consultation which has, in Lord Lipsey’s words, been blown out of the water by the Prime Minister’s announcement of free personal care late last year.
Having rushed the Personal Care at Home Bill through the House, the Government have still not given any assurances on the costings of the Bill, or its robustness in the face of a potential legal challenge under the Human Rights Act 1998. Nor will the Bill help any of the significant number of dementia sufferers already in care homes. With the Secretary of State keen to make the Bill a top-three issue in Labour’s election campaign, the House would do well to acknowledge the fact that dementia sufferers and, indeed, all older people with care needs, deserve more than political posturing on something that has not yet been properly costed.
I hope that the Government will treat today’s debate as an opportunity to discuss how we can work together to ensure that the public reap the benefits of the dementia strategy through action on the ground, and to reflect on how we build on the strategy to meet the demands that dementia will inevitably make on our health service in the coming years. We need such action, rather than words, and the Government must act quickly. It is time for Government to step up to the challenge posed not only by this devastating disease but by an unreformed social care sector, not with words or another vacant pledge, but with action at the grass roots of the NHS and social services and a concerted leadership effort at the helm of Government. A national care service does not simply come about or, indeed, become a national service simply by our using those words. It is important that the Government answer serious questions about provision, portability and, not least, who will pay. We are not just talking about the prioritisation and allocation of funding within the health budget. We are talking about supporting the work that funding enables: offering tailor-made training to staff at the front line; researching a cure; ensuring that the public have easy access to the best drugs on the market; and enabling all older people, no matter what their care needs, to guarantee their residential care in old age. All that will greatly enhance the quality of life for those diagnosed with dementia and for all elderly people seeking dignity and security in old age.
The Government announced the establishment of memory clinics, rather than memory centres, in every town. That has been amended, on occasion, to memory services. Clearly, what matters is not the building, but the training and the skills of the people offering all the NHS and care services, who need upskilling so that those services are better known by all who come into contact with patients. That will enable them to deal with many who remain undiagnosed, which was one of the earliest points made in the debate.
The issue of dementia and the challenge posed by our ageing population cry out for leadership. It is one of the greatest and completely known and predictable challenges for our political generation. I urge all Members across the House to come together on the issue and to make the difference for some of the most deserving and vulnerable people by supporting the motion.
On a point of order, Mr. Speaker. When the House adopted the Nolan principles and rules, which it did by resolution, there were two specific requirements on hon. Members, were they to receive finances or other assistance from outside bodies. The first was that the interest should be registered, which is signified by the letter R by convention and has been done in a fairly widespread way. The second is more important.
The second Nolan rule adopted by the House, as I recall, is that for 12 months after receiving such money, the Member is not able to initiate any legislation whatsoever that impacts directly or indirectly on the donor of that money. It is my understanding that a company called Care UK donated £21,000 to one of the signatories to the motion. If that were the case, can you confirm that it would not be in order for the motion to go forward?
I am grateful to the hon. Gentleman for his point of order. I will respond as follows, and I hope this is helpful to the House.
First, of course, responsibility for the registration of interests rests with individual Members. Secondly—I listened very carefully to what the hon. Gentleman said—if any Member has anxieties or is discontented about the conduct of another Member, the Member who is dissatisfied should complain to the Parliamentary Commissioner for Standards. At this very tense and competitive time, I should hope that Members would not air these matters on the Floor of the House when they are matters not for the Chair, but for the Registrar of Members’ Interests and the Parliamentary Commissioner for Standards.
If Mr. O’Brien wishes to respond to the point of order, he is welcome to do so, but he is not under any obligation to do so.
I am happy, Mr. Speaker, to take the opportunity to say that that is an extraordinary thing to be raised as a point of order, as you somewhat indicated. I can assure you, and through you the House, that any money that has been received by the office of any right hon. or hon. Member, particularly in opposition, to support their parliamentary work and particularly in relation to research, has been fully, openly and transparently declared at all times with the Electoral Commission and with the Registrar of Members’ Interests, on time and in proper conformity with all the rules, and that no possible conflict of interest could arise.
I am very grateful to the hon. Gentleman. The point of order has been raised. The response has been made. I hope that if it is pursued, it will be pursued elsewhere.
Before we proceed, I should like to say that the hon. Member for Eddisbury (Mr. O'Brien) gave way generously in the course of his contribution. I am sure that was appreciated by the House. This is an Opposition day. There is another debate to follow. Several Back-Bench Members wish to speak in this debate, and I hope that further Front-Bench contributions will be tailored accordingly.
I beg to move an amendment, to leave out from “charities” to the end of the Question and add:
“welcomes the Dementia Strategy launched in 2009 which contains a programme of work to transform services for those with dementia over five years and is backed by funding of £150 million over two years; notes that the Government will shortly publish the report of the Nutrition Action Plan Delivery Board; rejects the use of tube feeding on any grounds other than clinical need; welcomes the independent clinical review of anti-psychotic drugs which contains recommendations for the reduction in the use of these drugs for people with dementia; further welcomes the appointment of a National Clinical Director for dementia to promote better care and provide leadership for the implementation of the strategy; welcomes the creation of a ministerial group to develop dementia research; recognises that the enactment of the Personal Care at Home Bill will help some 400,000 people with the highest need; supports the Government’s proposals to create the National Care Service, the first national, universal, entitlement-based system for care and support in England; and acknowledges that the Government’s Dignity in Care campaign is working to engage local people in a social movement and to put dignity of those in care at the heart of services.”
It is hugely encouraging that today the House is again debating the care and support that we provide to older people, particularly those with dementia. Let me start on an uncharacteristically non-partisan note by congratulating the Opposition on calling today’s debate. This is the third occasion since the publication of our Green Paper that we have debated these issues. Since then, we have also passed the Personal Care at Home Bill.
In its long history, the House has never given such focused attention to this subject, which in time will touch the lives of all our constituents and arouses such raw feelings among those families most affected. When I introduced the Green Paper to the House, I said that we wanted to build an unstoppable momentum for reform of social care in England. It is beginning to feel that we are now getting close to achieving that momentum, but we need to do more. As the hon. Member for Eddisbury (Mr. O'Brien) said, we must build confidence among patients and carers groups, which have done such wonderful work in raising awareness of these issues while the political spotlight was elsewhere, that this time we are serious about change.
In these debates, I have often used general national figures to illustrate the challenge and the nature of the ageing population. Today, I want to share with the House some stark figures presented to a meeting that I attended in Wigan last week. This local presentation of figures puts things in a sharper focus. In the Wigan borough today, 49,700 people are aged 65 and over, and 5,200 people are aged 85 and over. In just 15 years, those figures will have increased to 63,900 and 9,300 respectively. Twenty years from now, there will be 75,500 over-65s and 11,900 over-85s.
If we leave the current unfair system to cope with demographic change in my constituency in the Wigan borough, it would have three social consequences. First, more older people in Leigh would be living in a more vulnerable condition with their personal care needs not being adequately met, placing a strain on other public services, particularly the local NHS. Secondly, a generation of older people in Leigh who, as in many former mining areas, are the very first in their families ever to own their properties outright, would be asked to draw on those assets to pay for care in old age, with the most unfortunate standing to lose all they have worked for. Thirdly, more people in Leigh would have to act as informal carers under even more strain as public support is spread more thinly, and would face an ever bigger battle to get help from the support system.
I understand my right hon. Friend’s commitment to his constituency, Leigh, and his use of statistics from there. Will he drop over the border and visit the important constituency of Chorley in Lancashire to see the need for a memory clinic there and the benefit that it would bring Chorley and its constituents? Will he come early and support that?
Chorley is just over the border and I would be happy to do that. Across the north-west we have seen real demographic change and a break with the past. In many communities in the north-west, people of the older generation were living in social or council housing. Today we have a generation of pensioners who have worked for and own their homes outright. It is my argument that if we leave the system unreformed, the unfairness felt by that generation will be far greater than anything we have seen so far. That is a key part of my argument for change. I would be happy to talk to my hon. Friend’s constituents about how they see the issue and how it would affect them if we failed to act this time.
May I raise a pragmatic point with the Secretary of State? Does he agree that people who need adaptations such as showers or stair lifts in order to continue to live in their own homes with dignity and independence should be able to get those without having to wait for months and sometimes even years? Can we address that point? By spending just a little money, we would save much greater sums in the longer term and give those people dignity.
The hon. Gentleman raises an important point. We have all probably seen in our constituencies how the disabled facilities grant has been stretched and has had to go round an ever-increasing number of people. In a constituency like mine, where there are lots of traditional old terraced properties, those properties need adaptations if they are to be made fit for purpose to enable people to get around. He is helping me to make my point. I am prepared to say that more money should come from my budget to invest in those homes to give people the support that they need. If we do not make that investment, the end result will be the national health service seeing those people in the accident and emergency department because they are not being adequately helped at home. That is the argument that I am advancing with some passion.
All public bodies should come together. Will my right hon. Friend comment on Tory-run Nottinghamshire county council, which, in its budget next month, proposes to cut 20 occupational therapy posts? They are precisely the people who need to make the disabled facilities grant assessment, which is a statutory requirement of councils, and, should the council’s cut succeed, it will automatically lead to more delays in my constituency.
Given that my hon. Friend has been determined to raise that issue three times, somebody ought to comment on the situation in Nottinghamshire. The Opposition studiously avoided it. Conservatives councils, by their actions, do something very different from the fine words that we heard delivered at the Opposition Dispatch Box not only in my hon. Friend’s constituency; they do something very different locally, and we should inform people of what is going on there.