Wednesday 30 April 2014
[Mr Dai Havard in the Chair]
Type 1 Diabetes (Young People)
Motion made, and Question proposed, That the sitting be now adjourned.—(Claire Perry.)
May I take the usual step of thanking you for chairing this sitting, Mr Havard? I know that that is something of a ritual, but on this occasion I am sincere. You may be aware that I was originally on the list to chair this sitting, so you have saved me the embarrassment of having to congratulate myself.
I begin with some acknowledgements. I am particularly grateful to the staff and patients at the diabetes centre at Aintree university hospital and the specialist diabetes services team at St Helens and Knowsley. I also thank the young people with diabetes who took the time to speak to me; the Juvenile Diabetes Research Foundation; Diabetes UK; Diabetics with Eating Disorders, known as DWED; Circle D; and Dr Mike Merriman in my constituency.
I sought this debate on behalf of children with type 1 diabetes in the UK, but I should point out that the condition does not affect children only. There are 400,000 people of all ages with type 1 diabetes in the UK and, currently, 35,000 children and young people have diabetes, 93% of whom have type 1 diabetes. It is important that we understand the difference between type 1 and type 2 diabetes, because, all too often, the two conditions are dealt with in the media as though they were one and the same thing. For example, a prominent businessman, Jim Ratcliffe, was recently quoted in The Sunday Times as saying:
“Childhood diabetes didn’t exist when I was growing up. It was an old man’s disease. But now lots of kids have diabetes. They are eating so much sugar that by the time they are 16, the pancreas is giving up the ghost”.
That is quite simply a misunderstanding of type 1 or childhood diabetes. Type 1 diabetes has absolutely no connection to dietary habits or a lack of exercise; it is an auto-immune condition and, as such, cannot be prevented. All people who suffer from type 1 diabetes have to deal with the consequences, which, for the most part, are inescapable and unremitting. A daily battle must be conducted to maintain blood glucose level within the medically safe range, balancing food and insulin intake, while taking into account physical activity, stress levels and temperature.
Young diabetics can take up to eight daily insulin injections and often have to perform invasive blood testing even more frequently. Yet according to research by JDRF, even those who stick rigidly to the prescribed regime will fall outside the medically safe range on more than three occasions in any 24-hour period.
Not staying within safe blood glucose levels has consequences. In the short term, high levels, which are known as hyperglycaemia, at the very least cause fatigue, and continued high levels can lead to diabetic ketoacidosis—known as DKA—which is a potentially fatal condition. Longer-term consequences include heart disease, kidney failure, neuropathy, blindness and amputations. Low blood glucose levels, known as hypoglycaemia, cause dizziness, incoherence and potential loss of consciousness and are often followed by severe headaches.
Blood glucose levels can alter dramatically, and apparently inexplicably, at any time of the day or night and require immediate attention. According to research undertaken by the National Paediatric Diabetes Audit, 85% of children and young people aged over 12 with diabetes have blood glucose levels higher than the recommended targets. That is perhaps unsurprising, because only 6% of those in that sample received the recommended care, services and support to which they were entitled.
Some children are diagnosed with diabetes in infancy, or when they are too young to take responsibility for managing their condition. Inevitably, the responsibility must be taken by family members, most commonly parents. For many families, having a child with type 1 diabetes affects them all and many adjustments have to be made to support that young person. As one young type 1 diabetes sufferer told me recently, until she was 18, she was almost entirely dependent on her mother monitoring her blood glucose and ensuring that she injected the right amount of insulin at the right time.
In advance of this debate, people contacted me about difficulties they have experienced with the Department for Work and Pensions and the disability living allowance system. Some of the problems raised arise from the fact that the DWP does not fully understand the complex needs of young people with type 1 diabetes. I would be grateful if the Minister raised that with the relevant Minister at the DWP to see whether that could be satisfactorily resolved.
Two young type 1 diabetics, Lauren and Nicole, both told me that they had experienced bullying at school as a result of their condition. Nicole, who is 16, states that she
“frequently experienced bullying because of my diabetes and because everyone thought it was because I was fat”.
Several young people have commented on the embarrassment that they feel at having to inject insulin in public. In some cases, they have been referred to as drug addicts, or been asked not to inject or test their blood, as others find it offensive.
I made two visits recently to the diabetes centre at Aintree university hospital and the specialist diabetes services team at St Helens and Knowsley Teaching Hospitals NHS Trust, both of which provide outstanding services for type 1 diabetics. They have a different range of specialisms to call on beyond the use of nurse specialists and diabetologists. For example, they can refer to psychological or, where appropriate, psychiatric services.
I pay tribute to the work that my right hon. Friend has done in this area. Before he moves off the stigma issue, does he agree that we need to think about how we can raise awareness among young people? Does he also agree that social media organisations need to be responsible but not afraid about stigma arising from the use of needles and so on? We need to talk frankly and honestly about type 1 diabetes and its consequences for young people, so that those with the condition do not feel in any sense as though they must hide away.
I am grateful to my hon. Friend for that intervention. She is quite right to say that social media has an important role to play. I will say more about that shortly, but one example was drawn to my attention where Facebook removed an image of someone injecting on the grounds that that was offensive. That is offensive, but not in the way that it thought. I will say something more positive about how social media can be used in a few moments, but it is important that more people understand exactly what we are saying.
I was talking about psychiatric services. On a national scale, psychological support is not necessarily integrated into the diabetic service, and the practitioners are therefore unlikely to have sufficient understanding of diabetes. Psychiatric services are even more difficult to access, and I am told that patients can wait up to two years for an appointment. In some cases, that is a matter of life and death. The diabetes attitudes, wishes and needs survey, known as DAWN, published in Diabetic Medicine, interviewed 15,000 people in 17 countries and found that people with diabetes are more likely to suffer from depression. Those services are therefore very important.
I want to say a little about young people with type 1 diabetes who also have an eating disorder. According to the charity Diabetics with Eating Disorders, as many as 40% of young women between the ages of 15 and 30 admit taking insulin as a means of achieving weight reduction. The phenomenon sometimes referred to—although it is not a medical term—as diabulimia is increasing. Rapid weight loss is achieved when diabetes is left untreated, but the consequences can be catastrophic. DKA, a potentially fatal condition where the body turns on itself for energy, rapidly develops. Even if it does not prove fatal, it can result in serious health complications.
Diabulimia is difficult to diagnose and there are no current NHS guidelines on how to deal with the issue. Young people can be treated for their diabetes and for an eating disorder, but there is no integrated thinking to cover the two elements of care. Yet the treatment for a diabetic with an eating disorder is quite different from that for a person without diabetes. DWED has provided an example of a young woman who was admitted to a unit dealing with eating disorders, where no insulin needles were available and where the patient was fed via a tube without any insulin being administered. That exacerbated the problem that the unit was supposed to be treating.
There is a clear need for a more integrated service, with mental health professionals who have a knowledge of diabetes. A further and tragic example from DWED illustrates the point well. Jane, the mother of Rhys, a young man who was suffering from diabulimia, repeatedly requested that he be assessed psychiatrically. She did so every time her son was admitted to A and E suffering acute DKA, which happened on several occasions. She repeatedly raised it with the diabetes clinic and with the community mental health team. Unfortunately, her pleas were ignored, despite her saying that she was terrified that she would find her son “dead in bed”, and her son lost his battle with diabulimia on 25 July 2009. The ombudsman concluded that
“had a more coordinated and holistic care plan been put place it might have resulted in a different outcome.”
Jane has been fighting for recognition since 2009, and says that there was never an investigation into why her son died, which she attributed to his mental health problems. That was another complaint upheld by the ombudsman.
There is a serious need for a much more integrated service, so that all aspects of the treatment of type 1 diabetes can be dealt with together. There must be greater investment to ensure that emotional and psychological support becomes an accepted and routine part of management for all children with diabetes and that appropriate services are in place. Incorporating psychological services with routine clinic visits would avoid much of the stigma associated with treatment for mental health problems. In addition to regular clinic attendances, young diabetics require separate appointments for special eye checks and chiropody. Those should be available under one roof in an effort to improve the care achieved.
I am grateful that the urgent need to improve access to and integration of services is now being recognised with the introduction of the best practice tariff for paediatric diabetes. From April this year, the standards included in the best practice tariff are mandatory for all paediatric diabetes units, and the tariff has been extended to cover in-patient care, which will hopefully incentivise lower admission rates. However, I would argue that the best practice tariff should be extended to include all young patients up to the age of 25. Each young person is different, and transition from child to adult services must happen at a stage and time appropriate to them. The current cut-off for the tariff is 19, but the available data suggest that that is too soon, because 25% of all hospital admissions for diabetic ketoacidosis involve young people aged 16 to 25; the annual cost is £5.3 million. Extending the best practice tariff to 25 would provide an opportunity for better alignment of the service with the needs of young people.
My right hon. Friend is making a powerful speech on an issue close to his heart. I hope that hon. Members will know his family circumstances. He is raising an important matter; there is a need to inform a much wider audience, not only so that everyone will be more aware of problems and issues to do with type 1 diabetes, but to inform people with the condition who believe they can manipulate their insulin intake for one reason or another. Does he believe that more should be done to highlight the problems that can arise when people do not stick rigidly to their insulin intake regime?
My hon. Friend makes his point well, in support of my argument, and I am grateful.
One in four children are diagnosed with type 1 diabetes when they are already in DKA, and the rate is even higher for children under the age of five. A number of clinicians I have met recently have advocated the removal of barriers between primary care and specialist teams, arguing that primary and secondary care teams should be sharing their expertise with one another in an attempt to close the skills and knowledge gap. In Merseyside, for example, specialist nurses have been working as mentors in practices to support primary care development and tackle deficits of knowledge, skills and confidence. Education is a major component of the improvement of care and outcomes. In many European countries, diabetes-specific training is mandatory for health care professionals who provide paediatric diabetes care. That is not the case in the UK. Although there has been a huge amount of work in the past five years to improve education for health care professionals, investment is needed to ensure that all paediatric units can access nationally standardised and accredited training.
I congratulate the right hon. Gentleman on securing the debate. There are young teachers in schools in my constituency who are reluctant to inject children who are insulin-dependent. Surely, something more in the way of education and awareness needs to be done about that. Parents cannot come in to do that, so it needs to be done by someone such as a teacher or a nurse in school.
There are a number of problems to do with primary care. Sometimes, the lack of knowledge is appalling. The fact that on many occasions young people can go to a GP with what turn out to be classic diabetes symptoms without being diagnosed is a serious problem and needs to be addressed. The hon. Gentleman is right that education programmes for health professionals are important. It is equally important for people working in GP practices or other primary health care settings to be aware of the phenomenon that they are dealing with; otherwise they will make wrong decisions and give wrong advice, which in some cases can make things even worse.
We must prioritise access to education for self-management for children and young people. I am optimistic about the introduction under the best practice tariff of the requirement that children and young people will have access to education. There is, however, huge concern about the variety and standard of education. Considerable work is needed to ensure that what is offered is nationally standardised and tailored to meet the needs of children and young people, as well as their families. Unfortunately, there is no single best practice model throughout the NHS, although I am aware that the Government’s national clinical director for obesity and diabetes, Dr Jonathan Valabhji, understands that and is working with diabetes groups to find the best way forward. Today, I simply ask the Minister to take an active interest in Dr Valabhji’s work and to provide the support necessary to make progress.
I am told by those involved in diabetes that much research is focused on type 2 diabetes and that the principal source of funding is often pharmaceutical companies. That is of course welcome, but whereas with type 2 diabetes pharmaceutical companies can see long-term benefit in new and existing products, such a link is less clear with research into type 1 diabetes. There are some counter-examples, but it is an issue that needs addressing, so it is crucial for central Government to invest in type 1 diabetes research. Despite the UK having the fifth highest incidence of type 1 in the world, our contribution to type 1 research per capita is currently less than half that spent in the United States or Australia.
A more positive story can also be told, however. Many young people now use insulin pumps. Last week, I met 23-year-old Alex, who told me how her pump had changed her life: “It’s a little like you don’t have to think about it anymore. I don’t have to get my needles out; I don’t have to offend anyone. I can have a biscuit, go to the gym. I can change it to temporary settings and go out with friends. I can do things now. Before I used to say, ‘I can’t be bothered having to plan around it.’ It only takes two seconds; it’s hidden.”
One of the research projects that holds the most hope for people with type 1 diabetes is the work to develop an artificial pancreas, which is known as an AP. The AP is in essence a combination of an insulin pump and a continuous glucose monitor. The clever part is that the two devices talk to each other via a complex algorithm. The monitor automatically checks blood glucose levels and then, in effect, tells the pump exactly the right amount of insulin needed by the body. Such technology holds great promise to help people to safely achieve the recommended blood glucose control, as well as alleviating an enormous amount of the burden associated with self-management. Recent trials of the device have been encouraging.
A consortium led by the type 1 diabetes charity JDRF is leading the development of the AP. JDRF’s artificial pancreas consortium encompasses 22 institutions worldwide participating in the study. It is a great credit to the UK’s life sciences sector that we can count Cambridge, Leeds and University college London among the contributors, alongside Harvard, Yale and Stanford. Another artificial pancreas, developed by Professor Joan Taylor of De Montfort university, could have its first human trials by 2016. It has a reservoir of insulin kept in place by a special gel barrier, which liquefies when glucose levels rise, releasing insulin to the liver, thus mimicking a normal pancreas. As the insulin lowers the glucose levels, the gel reacts by hardening again and preserving the reservoir. Such research is an important step towards developing a portable, usable and safe AP system.
To return to the point made by my hon. Friend the Member for Wirral South (Alison McGovern), social media are increasingly used to help and support young diabetics. Many young people with diabetes experience a sense of isolation and have no contact with others who share their condition. A good example of young diabetics helping themselves is the 18-to-30 support group Circle-D, which was founded by the inspirational Shelley Bennett and is celebrating its sixth birthday today—congratulations to Circle D. They have regular social activities and a rant room where people can have a rant and share experiences before going to the pub. Their motto is “you are not alone” and they now have a massive network of diabetics of all ages offering support online, via Facebook and in person. Another group, targeted at teenagers and young adults, is Hedgie Pricks. Information about both organisations can be found online, and I would certainly encourage young diabetics to get involved and to share their experiences with others in a similar position.
The debate today is an opportunity to praise the steps that are being taken to improve paediatric diabetes care and to pinpoint where we need to do more. With that in mind, I reiterate my support and optimism for the best practice tariff. Given that the tariff was only introduced recently, I hope that the Minister agrees that it would be sensible to return to the subject of type 1 diabetes in young people once we have had a chance to see how well that is working.
In the immediate future, however, the Government can and must do more. I would welcome the Minister commenting on extending the best practice tariff to 25, ensuring that children and young people with type 1 diabetes get the psychological support that they need and ensuring that educational standards for health care professionals and for children and young people with diabetes and their families are nationally standardised and accredited. I will be grateful to learn of any steps that the Minister can take to increase our contribution to type 1 research.
I have one final point to make. I feel strongly that the issue of type 1 diabetes needs a champion within the Government. I hope that the Minister will rise to the challenge and provide the political leadership that is so needed if we are to tackle this important matter.
Six people wish to speak. I am looking at the time for planning purposes. We have just over an hour left, with 10 minutes each for the Front Benchers. I am trying to gauge the time, but you can do the mathematics for yourself. To be fair to one another, if you could plan for about seven minutes or something of that nature, that would be helpful.
From our joint experience on the Intelligence and Security Committee, I am well aware that the right hon. Member for Knowsley (Mr Howarth) has a robustness at times, and perhaps he would have liked to be judge and jury in today’s debate. I congratulate him, above all, on bringing the subject to the House. I am well aware that, as alluded to earlier, these are issues that are very close to his heart, and he speaks with immense knowledge and passion about this particular affliction.
I wish to contribute a few words to the debate, because the subject has been raised a number of times with me at constituency level in recent months. As we have heard, type 1 diabetes is a chronic and life-threatening auto-immune condition, which is caused when the body mistakenly attacks the insulin-producing beta cells in the pancreas. It is a separate and distinct condition from the more common and perhaps more widely known type 2 diabetes.
Estimates put the number of people in the UK with type 1 diabetes at as high as 400,000, which means that each and every MP in the UK has, on average, some 500 constituents suffering with type 1. As recently as 2010-11, it was thought that the direct and indirect cost of type 1 diabetes alone to the UK was around £1.9 billion; judging by the growing rate of increase, it is feared that by 2036 that figure could rise to some £4.2 billion each and every year.
A few months ago, a mother in my constituency wrote to me explaining exactly what life was like, day by day, hour by hour, caring for her young child with type 1 diabetes. She described how her experience reminds her daily of the urgency and importance of finding a cure. My old friend and colleague on Kensington and Chelsea council, Rupert Cecil, has a delightful 10-year-old daughter, whom I have got to know throughout her life; she has similarly suffered from type 1 since infancy and requires constant monitoring. Rupert and his wife, Juliet, have tirelessly raised funds for and awareness of the condition since Polly was diagnosed with this life-threatening and incurable illness at the age of two and a half.
From the outside, Polly is just like any other 10-year-old, but a close look may reveal a wire poking out from under her school uniform and attached to something resembling a money belt. This is the insulin pump that Polly relies on from day to day. It is the artificial pancreas to which the right hon. Gentleman referred. She is attached to it each and every day and will be for the rest of her life. Without it, she could not survive longer than 24 hours. In addition to her insulin pump, her parents must test her blood by pricking her finger at least five times a day. They often have to wake her in the middle of the night to give her glucose if her sugar levels have dropped dangerously, or some insulin if they are running high. That is the daily tightrope that is walked by each and every parent of a young child with type 1 diabetes.
I understand what the hon. Gentleman is saying about his friend’s young child, but many young people, particularly in areas of social deprivation, cannot access insulin pumps unless they buy them, and I believe that they cost around £1,500 or £2,000. If people do not have the money, many of them suffer greatly.
That is a fair comment and I hope the Minister will comment on it.
I want to touch on an imaginative and innovative scheme in my constituency at St Mary’s hospital, Paddington, which is part of the Imperial College Healthcare NHS Trust and which I visited recently. I hope that it will not only raise awareness, but reduce the cost to which the hon. Gentleman referred. During my recent visit, I discussed the everyday realities for diabetes sufferers.
The International Centre for Circulatory Health is based on the St Mary’s hospital campus of the Imperial College Healthcare NHS Trust, just behind Paddington station. Imperial college has published some of the lowest amputation rates in the world from its diabetic foot service, led by Dr Jonathan Valabhji. It has a large diabetes technology centre that is closely linked with a research programme developing closed-loop insulin delivery for type 1 diabetics and novel continuous glucose sensor devices. Its clinical technology research is led by Dr Nick Oliver, who talked me through the pioneering work he is doing to develop the artificial pancreas system for everyone with type 1 diabetes. I hope that that will also reduce the costs to which reference was made earlier.
That ground-breaking research aims to offer the next best thing to a cure for type 1 diabetes patients in the future. I saw for myself how a small, discreet device, connected to the blood stream via micro-needles, can monitor glucose levels. When paired with insulin and glucagon pumps, the artificial pancreas should be able to give diabetics an approximate response to blood sugar levels close to what a body would normally produce. With consistent levels of insulin delivered, sufferers are liberated from the constant monitoring and worrying that comes with the daily management of the disease. The St Mary’s site is just one research centre forming part of a global effort that could help to change the lives of many of the 400,000 people who are living with type 1 diabetes, and save the NHS a significant proportion of the money that is currently spent on treatment.
The artificial pancreas system has three components. Two, the insulin pump and continuous glucose monitor, are available. However people with type 1 diabetes face difficulties trying to access insulin pumps despite a supportive technology appraisal from the National Institute for Health and Care Excellence. Indeed the national uptake of insulin pump therapy stands at just under half the NICE benchmark, set as long ago as 2008, which is extremely low and means the UK is lagging behind many western countries. There seems to be consensus among those working in diabetes research that greater investment from the Government is vital to drive developments in this area. At present, our Government invest less per capita than the US, Australia and Canada in type 1 diabetes research.
I am aware that there is some joined-up thinking, not least by my right hon. Friend the Minister for Universities and Science, but I would be grateful if the Minister here told us how the Government will work to ensure that the sort of treatment for type 1 diabetes sufferers will be matched up to the level of other western nations, what more can be done to fund pioneering research, and how we can roll out the level of service received by patients at Imperial college to patients throughout the country.
I am pleased that so many hon. Members are here today. We all have our contribution to make and I look forward to hearing what they have to say. The 400,000 sufferers and their many millions of relatives and carers will be cheered that we are treating the issue seriously.
As ever, Mr Havard, it is a pleasure to serve under your chairmanship. I am grateful to my right hon. Friend the Member for Knowsley (Mr Howarth) for securing this important debate and for the way in which he opened it. He knows better than almost anyone else the terrible price that this condition sometimes forces sufferers to pay and its impact not only on individuals, but on their families. If the Government need a champion for the matter, they could not find a better one than my right hon. Friend.
My short contribution will support many of my right hon. Friend’s points, but first I want to thank the health care professionals involved in the management and treatment of this condition, particularly those at my North Tyneside General hospital. As we have heard, diabetes affects around 35,000 people aged under 19, 90% having type 1 with a peak age of diagnosis between 10 and 14. We are making good progress in the treatment and management of type 1 diabetes, including among young people, but we have a long way to go. I am no scientist, but my fervent wish is that we find a cure not just in my lifetime but much sooner. Important work is being done in this country and elsewhere on stem cell research, which is a possible route to finding that cure.
I welcome the Prime Minister’s interest in promoting the work of the UK-Israeli partnership. It is important when Prime Ministers take an interest in a particular issue, but I echo the points made by my right hon. Friend that we must look at where the funding is coming from, where it is being directed, and the overall amount.
My first brief point is about timing. Type 1 diabetes in young people often occurs at a difficult time in young people’s lives when they are struggling to cope with the physical changes that come with being a teenager. After an acute episode they often find themselves managing a chronic condition. They may be struggling to come to terms with a new health regime and may suddenly find themselves being treated in the NHS as an adult. That difficult transition may lead to a break in service, and add to complications further down the line with damaging consequences.
The statistics for young women with type 1 diabetes are startling. Young women between the ages of 15 and 34 have a mortality rate seven times higher than the general population. I welcome the introduction of the best- practice tariff up to the age of 19, but ask the Government to consider extending it to 25. That would allow greater continuity of care and a more flexible transition, which should be based on clinical need and not age.
Type 1 diabetes is more than simply a physical condition, although it is that, and health care has improved in many ways with advice on diet, the massive impact of accessing eye tests and checking feet regularly, but there is a psychological impact. Anyone with a serious chronic condition that will last the whole of their lifetime will think about that and may become depressed at some point. I do not know enough about anorexia or bulimia to comment, but I do know that type 1 diabetics must at some point in their lives not only think about it but become depressed as a result. Therefore, access to psychological services should be part of the offer that is made. That should, when necessary, involve family members as well, because it is not just about the individual, but about their family.
I very much welcome the professional pathway that has been created for paediatric diabetes as a specialism, but, as my right hon. Friend and the hon. Member for Cities of London and Westminster (Mark Field) mentioned, we need to ensure that health care professionals are also aware of the condition and are supported by clear national standards. I would like that to be extended to teachers and other staff in schools as well. It is as important that the person looking after the dinner queue knows about diabetes in young people as it is that the person at the front of the class teaching them knows. That is why I support very much Diabetes UK’s “Make the Grade” campaign. I want every young person with type 1 diabetes to get the health care that they need, but I want them to get the educational opportunities as well. I want them to do well and go on to further and higher education. I want them to be able to take part in school sport and school visits without being worried and without the member of staff with them being worried.
The Government have produced figures—we have heard them today—about the cost to the NHS of diabetes. We have heard that the figure is £1.9 billion and rising, but, as ever, behind those statistics are thousands of young people with type 1 diabetes. Frankly, we could do more, and Government could do more, to make their lives not only better, but longer.
It is always a pleasure to serve under your chairmanship, Mr Havard. I add my congratulations to the right hon. Member for Knowsley (Mr Howarth) on securing an important debate. He will recall that previously—I think that it is now nearly two years ago—I led a debate in this place on eating disorders. He came along and enlightened everyone present about the problems with diabulimia—a condition that until that point I had never heard of—and he has done the same today. As the chairman of the all-party group on body image, I am very conscious of the way in which young diabetics—I have said “young” and I shall probably focus on women; I appreciate that people of all ages have type 1 diabetes and that eating disorders affect men as well as women—and, in particular, young women are manipulating their use of insulin to achieve very rapid weight loss, which poses a very significant risk to their health.
Diabetes is an entirely manageable disorder. It takes some time, experience and a lot of work for the sufferers to come to terms with it, but they can manage it. However, when it is combined with body-image issues, it can have terrible and long-lasting effects and, in some tragic cases, it can be fatal. Today, therefore, I want to focus on the issue of eating disorders among those with type 1 diabetes.
Of course, I appreciate that young people with diabetes face many issues and problems. I had a great Easter card from a six-year-old constituent of mine, Isabelle. She uses an insulin pump, as many people do, but she still has to test her blood sugar levels six times a day. I know from her letter that she is a fantastically brave young lady. She has specifically asked me to raise with my hon. Friend the Minister the issue of research funding and has highlighted the work of JDRF, which we all agree does amazing work in this area.
The all-party group on body image does a great deal of work to emphasise the pressures that young people in particular are under to conform to our so-called beauty norms, and part of that of course is about weight. It is shocking but true that too many people are prepared to sacrifice their health and well-being just to be thin. I have a view on the role that the media play in that. I am talking about the manipulated images—the use of Photoshop and airbrushing to create digitally an image of so-called perfection that of course in the real world is impossible to achieve.
Many young people fall victim to eating disorders, which can wreck lives. Nearly 4,000 people under 18 have been admitted to hospital with eating disorders in the past four years. That includes 270 boys and 163 girls under 10. And the situation is getting worse, not better. As the chairman of the all-party group, I have seen some of the most horrific consequences of eating disorders, but if they can have that effect on otherwise healthy young people—those who have previously been in good health—what effect can they have on someone who is already vulnerable?
Most children diagnosed with diabetes receive their diagnosis between the ages of 10 and 14, which as we all know is a hard time, as it is for any teenager. They are going through puberty, experiencing physical and emotional changes and, crucially, trying to fit in with their peers. Let us now take ourselves back to those years—that may be hard for some of us—and imagine reeling from a lifelong diagnosis, a diabetes diagnosis, and having to deal with the other pressures on us at that stage in life. Suddenly, the weight-loss benefits that can be had from diabulimia might seem highly attractive.
We have heard about social media and how that can be a force for good. Sadly, it can also be a very detrimental force. A quick scan of Google will show that there are many forums and chatrooms where advice is given on how to control diabulimia and how to use it to drop weight dramatically.
The prevalence of depression is twice as high among people with diabetes as it is among the general population. Particularly when people are at this vulnerable age, a diabetes diagnosis can cause dangerous levels of depression. Other hon. Members have mentioned the stigma. I was very upset to hear of a primary school in my constituency that did not want to manage a young lad’s diabetes through his being allowed to have tests and insulin injections in the classroom. It felt that that would upset other pupils. My ex-husband is a diabetic and routinely injected in front of our at that point very young daughter and, indeed, her friends. They were never upset by that; in fact, they had a morbid fascination with it and were all gripped to watch it go on. I think that it is a positive thing for children to learn from a very young age that other children have conditions that they can manage perfectly safely, that involve injections and that are not a reason for fear or stigma.
Obviously, diabulimia—the practice of reducing insulin injections to reduce calorie absorption and therefore cause rapid weight loss—is hugely unhealthy. It is one reason why the mortality rate for women with diabetes who are aged 15 to 34 is seven times higher than that for their non-diabetic counterparts. Of course, death is the most extreme consequence of diabulimia, but it is not the only one. One hundred amputations are carried out every week as a result of diabetes, and diabetics are 20 times more likely to go blind than non-diabetics. With poor management, those disabilities become far more likely. After those effects are seen, it is often a steeply downhill slope: 70% of amputees die within five years of the operation.
The combination of eating disorders and diabetes is so deadly that groups such as Diabetics with Eating Disorders have been formed to deal directly with the issues. They have found that far from a tiny minority, about 40% of 15 to 35-year-olds regularly omit the use of insulin in order to lose weight. Some people might try to pass that off as young people simply forgetting, but when we factor in that 25% of all hospital admissions for diabetic ketoacidosis are in the 16-to-25 age group, it becomes hard to believe that such a consistent and extreme lack of insulin is entirely a result of forgetfulness.
Clearly, the problem of diabetes in conjunction with body-image issues is a more widespread threat, especially to young people, than is widely known. There are some fairly obvious conclusions. Young people must be convinced to adhere to strict care processes, but efforts must also be made to identify those who might have psychological issues and who could do with support by means of a united, combined approach to both their diabetes and their eating disorders. It is unusual to find a diabetes nurse with experience of eating disorders and an eating disorders practitioner who knows about diabetes. We must address that, and I urge the Minister to make a response on it. I hope that this debate has drawn his attention to these issues and that he will share with us his views on what more can be done to identify, assist and properly care for this important group of young people.
I thank the right hon. Member for Knowsley (Mr Howarth) for bringing this issue to our attention in Westminster Hall today. It is good to have a subject that we can all relate to and on which we can speak on behalf of our constituents. The right hon. Gentleman has knowledge of it on a very personal basis.
I was just sitting here and thinking about those deep sleeps that people get into—not that we often have them, Mr Havard. Young children who are diabetic are woken out of their sleep and will wonder what is happening to them. Someone—one of their parents—takes their hand, pricks their finger and checks their blood. That is the reality that many children in the UK face today, and many parents have the same reality because they have to wake them up during the night and have to set the alarm for that purpose. They have regularly to monitor and check their child’s blood sugar levels. It is surprising just how many children have to go through that every day.
The UK has the fifth highest rate in the world of children with type 1 diabetes. In Northern Ireland, there are 1,092 children with type 1 diabetes. The hon. Member for Cities of London and Westminster (Mark Field), who has just left the Chamber, referred to there being 400,000 diabetics in the United Kingdom. In Northern Ireland, we have almost 80,000; one fifth of the diabetics are in Northern Ireland.
When my hon. Friend refers to the high prevalence of diabetes in Northern Ireland, as well as across the UK, does he agree that need for greater emphasis on research, which has been repeatedly raised this morning, is a fundamental way to address the increasing problem? The UK, and the various regions thereof, must place greater emphasis on higher expenditure and greater research to ensure that future generations do not suffer in the same way as the present generation.
I thank my hon. Friend for that contribution. He and other hon. Members have reiterated the need for research, including stem cell research, to enable us, I hope, to come up with a cure for diabetes. The prevalence of diabetes in Northern Ireland is now more than 4%. In addition to almost 80,000 people in Northern Ireland who have diabetes, some 10,000 have not yet been diagnosed. As an elected representative, I have had the opportunity to fight cases on behalf of parents who are under intense pressure because they have a type 1 diabetic child. In Northern Ireland, health is devolved. We have been able to speak to the Minister, Edwin Poots, and through his office and through the pressure that we and others have created, we have succeeded in getting the health service in Northern Ireland to provide 400 insulin pumps for type 1 diabetics. Getting the pumps is only one part of the story. The second part is to train people to use them, so the second stage of the process has been training parents how to do that. Good things have happened.
Diabetes has increased in Northern Ireland, but it has also increased worldwide. Type 1 and type 2 diabetes have increased by 33% in Northern Ireland, by 25% in England, by 20% in Wales and by 18% in Scotland, and some 24.5 children in every 100,000 aged 14 and under have diabetes. That shows the magnitude of the problem. The Minister is responsive and has a particular passion for health. He has attended, as have others in the Chamber, the type 1 diabetes events that have taken place here with young children. Those events have given us all a chance to see how important the issues are. We have far higher rates of diabetes in children than do Spain or France. In Northern Ireland, there are 1,092 children under the age of 17 with type 1 diabetes, and almost one in four of them experienced diabetic ketoacidosis before a diagnosis was made.
In my constituency, the number of diabetics has gone up by 30%, with 800 people becoming diabetic in the past seven years. I should have registered an interest at the beginning of my speech. I am a type 2 diabetic, and I am one of those 800 people who were diagnosed in the past seven years. In our small part of the United Kingdom, the total number of adults aged 17 and over who have diabetes and are registered with GPs is just shy of 76,000, and there are a further 1,092 under the age of 17. Diabetes UK Northern Ireland has launched a report that highlights the latest findings into diabetes in Northern Ireland, and I think it is important to put those figures on record. The Diabetes UK Northern Ireland national director Iain Foster said:
“The State of the Nation report is a timely and important piece of work which highlights, not only that Northern Ireland has seen the biggest rise in people being diagnosed with diabetes compared to the rest of the UK but that there is a real difficulty in collecting data as Northern Ireland is not included in the National Diabetes Audit. Our State of the Nation report gathers limited local information and we have found that there are now over 80,000 people living with diabetes in Northern Ireland.”
The official figure is just shy of 76,000, but the latest figures from Diabetes UK Northern Ireland indicated that more than 80,000 people are affected. Therefore, within the past five years, there has been a 33% increase in Northern Ireland in the number of people living with type 1 or type 2 diabetes. More than 100 new diagnoses are expected each year if the current trend continues, and 4% of the local population now has a diagnosis of diabetes.
I cannot emphasise enough that diabetes is a ticking time bomb, which has the potential not only to destroy lives, but to bankrupt the NHS. The financial cost of diabetes cannot be discounted. I agree with Iain Foster:
“It is not enough to shout from the side-lines: ‘something must be done’”—
we have been talking today about what must be done, and we want to see what will be done—
“so instead we have outlined ways in which we think the situation could be helped, for example, working to enable access to available treatments including insulin pumps for both adults and children and integrating diabetes clinical databases to create an accurate diabetes register.”
My hon. Friend the Member for Upper Bann (David Simpson) and the right hon. Member for Knowsley referred to education. It is so important, as hon. Members have said, for teachers, classroom assistants and staff in our schools to be aware of what it means to be a diabetic in school. In Northern Ireland, we have implemented a system of training for teachers and classroom assistants to ensure that they have the knowledge to deal with the condition.
In conclusion, I ask the Minister to outline what co-operation exists between regional assemblies to deliver a better strategy for the whole United Kingdom. He will be aware of the 10-year strategy that ended in 2013. I have asked on a number of occasions for a new strategy to be put in place, because it is important that all the regions of the United Kingdom of Great Britain and Northern Ireland work together to deal with the problem. To address the issue of the many children who suffer from diabetes, and many more who are predicted to be diagnosed, we must take action and take it now. I congratulate the right hon. Member for Knowsley on bringing the matter forward, and I urge the Minister to do more than simply talk about it. He must take action quickly, while there is still time to make safe this ticking time bomb.
I congratulate the right hon. Member for Knowsley (Mr Howarth) on securing this important debate and on his comprehensive introduction to the problem. As has been said, the UK has the fifth highest rate of diabetes in the world and the fifth highest rate of diabetes among children aged up to 14 in Europe. It is important for us to do the best we can to help people with the condition.
I cannot emphasise enough the importance of getting across the difference between type 1 and type 2 diabetes. They are both chronic conditions, but type 1 is known to be genetic while type 2 is a consequence of lifestyle and diet, and is not necessarily related to genetics. Consequently, the treatments for type 1 and type 2 are varied. People with type 2 can be treated mostly with a change in diet and exercise, and some medication. Increasingly, however, insulin injections are being prescribed for people with type 2. People with type 1 are those whose pancreas has basically stopped producing insulin, and they have to take insulin via subcutaneous injections. There is no alternative to that treatment for people with type 1. Additional medication can be added to the insulin regime to reduce the risks of common complications that can affect all people with diabetes, such as stroke, heart disease, sight loss and limb amputations.
Only one in five people with diabetes is type 1, and most are diagnosed before the age of 40. I was fortunate to have been diagnosed after I had finished full-time education, because type 1 diabetes can have a major impact on a young person’s life and health in many ways—educationally, socially and psychologically. One of the major problems for children is how they treat themselves for their condition at school. There are three stages through which a young person has to go. There can be problems at primary school, which have been referred to, where teachers may refuse to help the child medicate. Some schools will not admit a child because they have diabetes. Others will admit the child but will insist that the parents come in to do the blood test and help the child deliver the insulin. That is not fair to the parents, and it increases the overall cost of the condition to the taxpayer.
In secondary school, there is the problem of the young people themselves, which has been mentioned. There are psychological difficulties inherent in having to set themselves apart from the rest of the school because they have a condition that requires them, from time to time, to test their blood sugars—that means a simple finger prick to take blood out of their finger and put it on to a test strip—and find somewhere healthy and clean to use their pen, which looks like a normal pen but is in fact an injection device, to make an injection.
The next stage is higher education, where the young person will move from their GP setting to a student health service. Transition is a major issue, and every young person with diabetes should experience a smooth transition to adult diabetes services at a stage and time right for them. Adolescents with diabetes have unique health requirements. They must cope with the biological, psychological and social transitions to becoming an adult while managing a chronic condition. Many people experience deterioration in their control of their diabetes in adolescence, and they are particularly vulnerable as their care is transferred from child to adult services.
Adolescence is also a time when lifelong health behaviours are laid down, so transition must be carefully instigated at a time when the young person has sufficient clinical understanding of managing their condition to get the most out of the adult diabetes service. If that does not happen and young people are simply transferred to adult services, they will often disengage with the service, leading to poor control and an increased risk of long-term complications.
The importance of getting transition right for young people with diabetes is increasingly acknowledged across the international health care arena. That is reflected in the best practice tariff, which includes the criteria that provider units must have a clear policy for the transition to adult services. Will the Minister explain why the best practice tariff cannot be extended—as was asked for earlier—to include all young people up to the age of 25?
The other big issue is the regional disparity of care. The problem is not just about access to medical equipment such as insulin pumps, although really that should not be an issue at all. All children diagnosed with type 1 diabetes should be offered pump treatment on diagnosis, and I would like to ask the Minister a second question: why is that not so? Parents who have engaged with the paediatric diabetes peer review have expressed to me their concern at the plan to discontinue the programme this September.
As we have heard, there is huge regional discrepancy in the provision of care for children with diabetes, in terms of both patient experience and outcomes, with the number of children achieving target HbA1cs falling woefully short in some areas and compared with other countries. Parents have been very impressed by the work of the networks to try to address variation and achieve considerable improvement. However, there is still a long way to go, and the audit can provide only benchmarks and goals, not strategies for achieving higher standards.
The peer review programme, on the other hand, has been meticulously and carefully designed to address the causes of discrepancies in care standards. The programme managers and lead clinicians in each network have worked hard to design a set of measures that enable teams to understand more fully how to provide the highest standard of care for the children who attend their clinics. It seems that the peer review programme has the power to drive change and raise standards across the country, ensuring that children with diabetes can lead healthy and productive lives.
My third question to the Minister, therefore, is why is the paediatric diabetes peer review programme being discontinued? The lifetime cost to the UK economy of everyone living with type 1 today will be more than £55 billion. With the incidence rising, that figure will only increase, and remember that only one in five people with diabetes is type 1. The three priorities for type 1 or type 2 diabetes, whatever a person’s age, must therefore be prevention, early diagnosis and the best treatment to avoid expensive complications. Where young people are concerned, whether children or young adults, we can and must do better.
It is a pleasure to serve under your chairmanship, Mr Havard. Like other Members, I congratulate the right hon. Member for Knowsley (Mr Howarth) on securing such an important debate. It is interesting how much cross-party agreement there is on this issue—I hope that that clear message is reaching the Minister.
I shall be repeating some points that other Members have made, but first I want to say a little about a young constituent of mine in Brighton with type 1 diabetes, with whom I have been working closely. We have been focusing particularly on good practice support for young people in schools. As a result, the local authority in Brighton and Hove is now convening separate groups of parents, teachers and young people to talk through ideas. My constituent, Izzi, is especially keen to develop a system of mentors, where older pupils with type 1 can support younger pupils in school, particularly at stressful times such as transition or during exams.
Some of the proposals we have been discussing are not rocket science—they are very simple, but would make a huge difference. For example, young people should have a safe and pleasant place to go and inject. That place should not be locked, as sometimes such places have been; it has meant that young people have had to inject in the toilets. That gives the impression that people are trying to push the issue away. As many others have already said, we must address stigma, and one way to do that is to make injection far more normal and provide much greater support for it in schools.
As others have said, it is important to stress that type l diabetes is not just a medical condition. It can have severe psychological and educational implications and affect people in very different ways. Type 1 young people need to have medical and educational support tailored to their individual needs. Just because a person does not look ill, that does not mean that they are not juggling a vast number of factors to try to keep themselves well.
Izzi has warned that, increasingly, type 1 young people are being refused disability living allowance, despite the massive extra burden on them and their families to maintain their health. She had a DLA application turned down when she was 16, and it was obvious from the assessor’s comments that there was very little understanding of her condition and how it needs to be managed. For example, the assessor judged that Izzi’s age and the fact she has had her condition for many years meant that she was able to deal with taking her medication without help. Izzi very much wishes that that were the case, but when she is severely hypo or hyper, it simply is not.
After a great deal of extra work, she appealed against the decision and was awarded the lower rate of DLA for a further year—she had previously been on the middle rate. Many people would not have challenged that decision and might therefore be missing out on vital support. Izzi will still be only 17 when her DLA stops—not legally classified as an adult, but still supposed to be able to totally self-administer a potentially lethal drug several times a day, without any help or supervision—even when she is not able to concentrate because of high or low blood sugar levels. On behalf of many other type 1 teenagers who are or have been in the same position, she wants Ministers to understand that reality.
Izzi also wants to raise the issue of plans to scrap the national peer review programme, which the previous speaker mentioned. There are real concerns about the risk that that programme will end, as NHS England has committed funds only until September. Across the country, there is a huge difference in the provision of care for children with diabetes, in terms of both patient experience and outcomes. The peer review system provides important information and opportunities to help improvement. I would like to draw my remarks to a close by identifying a couple of areas in which peer review is important and working for children, and the benefits that it brings to families, as set out by the Families with Diabetes National Network.
Peer review measures the extent to which teams can provide 24-hour cover as prescribed under the best practice tariff. That cover is essential for families because it avoids expensive hospitalisations, and serious concerns have been raised where cover is inadequate. Peer review highlights the extent of paediatric ward staff training to ensure that children with diabetes who are admitted to hospital can be looked after safely. That is a huge issue for families, and the peer review programme has helped teams to understand better how to achieve ward staff training. Peer review also highlights the ongoing training of team members, ensuring that they are all trained to an appropriate level, which is key to the provision of good care for children.
Peer review measures the extent to which teams review patient feedback and take action accordingly. Families can help teams to improve by providing that feedback, and peer review ensures that it is both used and acted on. It also measures the extent to which teams provide self-management education to families. Self-management education is essential in keeping children out of hospital and enabling them to achieve good control and avoid complications.
Peer review measures the extent to which teams support children in school, which is an essential pillar of good self-management, and the programme has enabled teams to share strategies and documents and therefore to disseminate best practice. Finally, peer review examines arrangements for the transition to adult care—arrangements that, as we know, are key to ensuring that young people do not fall out of the system and develop complications at such a critical age. The peer review programme has encouraged teams to work together to address the issues relating to transition.
For all those reasons, along with the many others raised by Members this morning, I hope that the Minister can assure us that he will look again at peer review. There is real concern about it, as well as about the level of research funding, and I would like to add my voice to those who have said that the UK must do more research, particularly for type 1 diabetes.
In conclusion, I welcome the opportunity to have this debate and very much hope that it will increase awareness of the needs of young people with diabetes. There are more than 25,000 young type 1 sufferers in the UK, and, like Izzi in my constituency, they all deserve the very best chance.
I, too, thank my right hon. Friend the Member for Knowsley (Mr Howarth). I know how much this means to him and his family. I am genuinely grateful for all the work that he does in this regard.
This is a vitally important debate. We have had a tremendous debate today, involving hon. Members from all parties, providing us with a brief opportunity to deal with important issues that have stood neglected for too long. People with type 1 diabetes are not receiving the services they need or the support that they deserve; this is a fact. Often—let us be honest about it—we debate pure opinion, but it is an absolute fact that people with type 1 diabetes are not getting the level of services that they require.
I declare an interest as someone who has lived with type 1 diabetes for four years, after being hospitalized as an undiagnosed type 1 diabetic suffering from advanced diabetic ketoacidosis, two weeks before the last general election. The things people do to get out of it! I have never particularly enjoyed talking about the condition, principally because our medical histories are our own private business, but also because of the risk this poses of allowing others to define me as a person and as a politician. As the hon. Member for Torbay (Mr Sanders) has proven, reservations that people might have about people with the condition are unfounded. The longer I live with the condition—it is important to point out that this is a condition and not a disease—the more angry and frustrated I become with the treatment I receive and, more importantly, about the treatment that other people living with the condition receive.
The National Institute for Health and Care Excellence recommends that type 1 diabetics should receive nine key tests for diabetes care every year, yet thousands are missing out on these tests. In the four years that I have been a type 1 diabetic, only once have I received all nine tests. These tests are essential to ensure that diabetes is controlled. If left unchecked, diabetes can, as we heard, lead to blindness and kidney failure, and can increase the risk of developing cardiovascular problems, such as heart attacks and stroke. The National Diabetes Audit found that young people are the least likely of any group to access these nine treatments.
We have also heard that type 1 diabetes is a chronic, life-threatening condition that has a lifelong impact on those diagnosed with it and their families. It affects about 400,000 people in the UK, including 29,000 children, which is equivalent to more than 600 people in each constituency. Type 1 diabetes is not caused by lifestyle factors, such as obesity, poor diet or lack of exercise—I should know; I have just run the London marathon on behalf of the Juvenile Diabetes Research Foundation—and there is currently no way to prevent the condition.
People with type 1 diabetes rely on multiple insulin injections or pump infusions every day, just to stay alive; we know this. In 2014, a person with type 1 diabetes will on average undertake more than 2,000 finger-prick blood tests, have 1,500 insulin injections and count the carbohydrates in more than 1,000 meals.
A child diagnosed with type 1 diabetes aged five faces 19,000 injections by the time they are 18 years old. Since my diagnosis, I have been fortunate enough to meet many young people with the condition and each and every one of them inspires me. I am incredibly grateful for the work that they do through the Juvenile Diabetes Research Foundation and through Diabetes UK. Their advocacy is superb and their voice is becoming louder, but I say to them that it needs to become much louder still.
Good blood glucose control is hard to achieve. Type 1 diabetes reduces life expectancy by approximately 12.5 years in people with the condition aged 20 to 24 years old, compared with similarly aged adults without the condition. High blood glucose can cause very serious long-term damage to the body. On average, complications of type 1 diabetes set in 20 years after diagnosis, meaning that a child diagnosed at age five may begin to show signs of damage that can lead to sight loss, kidney disease, limb amputation, heart attacks and stroke by the age of only 25.
Just 6.7% of children with diabetes in England and Wales, 96% of whom have type 1 diabetes, are receiving their full set of annual recommended checks. That is a national scandal and it should shame these Houses of Parliament. Type 1 diabetes in young children presents more than a health burden. In 2011, members of the parent group, Children with Diabetes, reported that 60% of families had to change their working arrangements and almost half—48%—had seen a significant drop in their family income. Shockingly, as we have heard, more than half felt that their child had been bullied as a result of having type 1 diabetes.
Type 1 also brings with it an increased risk of depression, with 32% of people with type 1 diabetes showing signs of depression, compared with 16% in the general public.
In addition, type 1 diabetes leads to huge costs for the health service and the wider economy. The lifetime cost to the UK economy of everyone living with type 1 diabetes today is more than £55 billion. This figure is only going one way, and that is up. In 2014, conservative estimates suggest that type 1 diabetes will cost the NHS £1 billion directly and a further £1 billion to the wider economy more generally, excluding a number of treatment costs.
In 2008-09, the Medical Research Council invested £6.6 million in type 1 diabetes research, but unfortunately that fell to £3.9 million in 2010-11 and £4 million in 2011-12. In short, we are spending less than half the per capita figure spent in Australia—the hon. Member for Cities of London and Westminster (Mark Field) made this point earlier—and less than a third of the United States per capita figure, and the Canadians spend almost three times as much per capita as we do. Will the Minister explain why?
Incidence of type 1 diabetes is growing at a rate of about 4% each year. The recent report “Impact Diabetes” estimates that 650,000 people in the UK will live with the condition by 2035, if incidence continues at the same rate. That report also estimates that by 2035-36 the direct cost to the NHS of treating type 1 diabetes will be £1.7 billion and the indirect cost to the UK more generally will be an additional £3 billion.
The UK has the fifth highest incidence of type 1 diabetes in the world and it is increasing at an alarming rate. Research is the key to addressing this growing problem, but UK Government funding for type 1 research has fallen significantly. Let us be honest; this reduction is jeopardising our position as Europe’s number one place for type 1 diabetes research and investigation and I passionately believe that this is letting people with type 1 diabetes down.
The truth is that we are failing people with type 1 diabetes. As a nation we need a war effort—I am not ashamed to say it—in our work to improve treatments and services for people, particularly young people living with type 1 diabetes. We must ensure that every young person with type 1 diabetes receives the nine annual tests. Will the Minister explain how he thinks this can be done and what he will do about it?
Too often I hear from type 1 diabetics and their families that they cannot access insulin pumps, that blood glucose monitoring strips are being rationed and that it is getting harder to access primary care to get the help they need to manage their condition. Will the Minister take a close interest and deal with these issues where they arise around the country? There is huge, clear geographical disparity and it needs some close Government attention.
I will write in detail to the Minister about what needs to happen to improve the lives of people with type 1 diabetes. What is needed is more attention and understanding and more research and resource, to ensure that people with type 1 diabetes receive the care that they deserve. I look forward to the Minister’s reply.
It is a pleasure to serve under your chairmanship for the second time this week, the first time being during the Defence Committee sitting yesterday.
I pay tribute to the right hon. Member for Knowsley (Mr Howarth) for securing the debate and for his articulate and reasoned contribution to it, and for his passionate advocacy of the needs of people with type 1 diabetes. He has family experience of these issues that will have strongly informed his understanding of them. The balanced, perceptive way that he approached the debate, raising important issues, particularly about tariff-setting, which is in my view the strongest and best way to drive up the quality of care available for patients with type 1 diabetes, is of great credit to him and helped set the tone for a consensual debate. It is also a pleasure to respond to the right hon. Gentleman formally, because he responded to my maiden speech when I was first accepted into the House. He was kind to me then and I hope that my response will do this debate justice and will bring some comfort to hon. Members who have raised concerns.
I also pay tribute to hon. Members’ contributions to the debate. As always, the hon. Member for Strangford (Jim Shannon) makes important points about how, although we have devolved health systems, we need to learn lessons from best practice throughout England and Northern Ireland. It is important, even in a devolved health system, that we work collaboratively together to improve standards of care. I will try to deal with points raised in the contributions from the right hon. Member for Tynemouth (Mr Campbell) and the hon. Member for Brighton, Pavilion (Caroline Lucas).
My hon. Friend the Member for Cities of London and Westminster (Mark Field) eloquently outlined for all of us what this means on a day-to-day basis for a young person with type 1 diabetes. In many respects, that sets out the challenge for our health service: working together with the education sector and with other parts of our health and care system, it needs to help improve the day-to-day quality of life for people with type 1 diabetes. My hon. Friend the Member for Torbay (Mr Sanders) made a similar point. My hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) raised the importance of research funding. I will address those points later in my remarks.
As we have heard, type 1 diabetes has a potentially devastating effect on children’s health. Poor diabetic control for children increases their risk of developing long-term complications over the course of their lives—we have heard about renal complications, diabetic retinopathy and the consequences of diabetes-related peripheral neuropathy. Such consequences are potentially life changing, and so it is important that we do all that we can to address them and to support people with type 1 diabetes. It is a question not just of early diagnosis but of the right care and support in the secondary care setting, in primary care and in the community, to give better support to people with the condition so that they can stay well and be properly looked after. That is a challenge that we face in all aspects of the care that we provide to young people.
The children and young people’s health outcomes forum, which was set up by my right hon. Friend the Member for South Cambridgeshire (Mr Lansley), highlighted a number of challenges faced by children with long-term conditions such as diabetes and by their families. It is worth highlighting two or three. The first was that there are poor arrangements for transition to adulthood—that has been highlighted throughout our debate. Secondly, there is a need for better integration of care, with co-ordination around the patient—the child or young person. We need a comprehensive, multidisciplinary team approach to care, with a much greater emphasis on better support for young people in the community and in their own homes. There also needs to be much speedier diagnosis of long-term conditions in young people, including asthma, diabetes and epilepsy.
The NHS atlas of variation has identified an unacceptable variation between different areas, a point raised by the shadow Minister. That is clearly unacceptable to us all. There is variation in the quality of management of children’s diabetes, and in the number of children with previously diagnosed diabetes admitted to hospital for diabetic ketoacidosis. We all know, then, that we have some way to go on improving the care of children and young people with diabetes. I hope my remarks will be able to give some reassurance that we are now firmly on the right track, particularly with our best practice tariff.
In my contribution I outlined the diabetes strategy that was in place for the 10 years up to 2013. I have asked Ministers about that issue a number of times and am keen to see a continuing initiative for a UK-wide strategy. Will the Minister give us an idea of his intentions in that regard? That strategy could address regional variations.
As I mentioned earlier, it is important that we learn from good practice, not just in the UK but elsewhere. A key driver of improving practice is clinical audit of the quality of services delivered. Outcomes for people with diabetes in England will also be assessed by the national diabetes audit, which includes a core audit, the national in-patient diabetes audit, a diabetes pregnancy audit, the national patient experience of diabetes services survey and the national diabetes foot audit, which is due to be launched this summer. Having that high quality comparative data, gathered through clinical audit from different care settings across the UK, will help us to understand where services are and are not delivered well. Audits in particular care settings always make recommendations for improvement, and the following year there is another audit. Exposing where care is good or not so good and putting in place plans for improvement on the ground will be a big step forward. At a national level, we can then look at which improvement plans have worked and which have been less successful. That learning is a good way of driving up standards and can be shared with Northern Ireland and other devolved parts of the United Kingdom, and indeed on an international basis. I believe that in this country we are historically good at collecting data. The purpose of national audits is to drive up standards of care, which is why NHS England is putting many more national audits in place throughout the health service. We will be able to compare what is done in different care settings, learn where care needs to be better and drive up standards throughout our health service.
We all understand the importance of the integration of mental health care and diabetes care for the young people who have serious health issues resulting from that combination of issues, which puts them at high risk of complications and premature death. The Government are investing £54 million over four years to enhance the children and young people’s improving access to psychological therapies—CYP IAPT—programme. That programme is helping to transform services through training in evidence-based therapies to support children and young people with a range of mental health issues. I am sure we all support that programme and want to see it expanded further.
I am glad to say that investment in type 1 diabetes research by the Medical Research Council and the National Institute for Health Research has risen from more than £5.8 million in 2011-12 to more than £6.5 million in 2012-13. The National Institute for Health Research is funding a £1.5 million trial focusing on children and young people with type 1 diabetes, which is comparing outcomes for patients treated with multiple daily insulin injections to outcomes for those using pumps, one year and five years after diagnosis. The report of the trial is due to be published in a few months. When we are looking at how best to support people with type 1 diabetes in leading as normal a life as possible, whether that be in education or in the workplace, it is important that we understand which interventions and methods of support work best. I am sure that that research will put us in a much better place on that.
Is the Minister aware of the JDRF’s “#CountMeIn” campaign? It is calling for an investment of £12 million per annum by the MRC and NIHR to bring the UK in line with recent per capita spending by Governments internationally. Has he given any thought to that and if so will he comment on it?
With research funding there is often a bidding process, and it is up to organisations to bid for funding. I am pleased that the amount of money going into diabetes research is improving and that there is a now a project specifically on type 1 diabetes that is looking at the impact of different interventions and support—such as the use of pumps—on young people’s lives to see which methods work better. The emphasis is not just on clinical outcomes but on how young people’s experience and quality of life is affected, so that that is taken into account in how we look at diabetes. Health care research funding is moving in the right direction, and not just for diabetes—research funding has increased considerably over the past few years in a number of areas of health care, something that we should welcome.
As we know, NICE has national standards, but in the few minutes left I want to discuss the best practice tariff. The way that we set up commissioning arrangements and the best practice tariff will help us make a difference in the future. The tariff ensures that payment is linked to the quality of care provided, an important driver of how services are delivered to patients.
I will briefly set out aspects of the diabetes best practice tariff. A young person’s diagnosis is to be discussed with a senior member of paediatric diabetes team within 24 hours of presentation, to get early specialist support in place. All new patients are to be seen by a member of the specialist paediatric diabetes team on the same or the next working day, and each patient is to have a structured education programme, tailored to their needs and the needs of their family, to support them and help them understand how they can better cope with their condition and manage it themselves as best as they can. The tariff places a strong emphasis on multidisciplinary team work, including support from dieticians—we have heard about issues connected to eating disorders, and dieticians will have a key role on that. Many other aspects of the tariff focus on multidisciplinary working to put things on a better basis for young people with diabetes.
The right hon. Member for Knowsley raised a number of other issues in the debate; I will write to him about those matters. The issue is complex and important, but I hope that I have been able to offer some reassurance. The tariff and the increased spending on research mean that we are moving to a better place with our support for people with type 1 diabetes.
It is a pleasure, Mr Havard, to serve under your chairmanship. I sought this debate on behalf of bowlers—crown and flat green alike—who are facing a growing crisis that is emerging not only in the game’s traditional heartlands, such as my constituency of Barrow and Furness in the north-west of England, but wherever the cry of “jack high” is heard.
Bowling is part of the fabric of these islands. Its precise origins are obscured by the mists of time, but a form of the sport that we know today was certainly flourishing on Plymouth Hoe as far back as 1588. On the Hoe, as elsewhere in the country, the game in under threat. The reassuring click of kissing wood is gradually being replaced by the unsettling clank of mechanical diggers ripping up greens in every corner of Britain.
Local bowlers, led by green keeper Keith Mills, first alerted me to this problem soon after I became MP for Barrow and Furness at the previous election. Seven Furness greens had been redeveloped since the mid-1990s, and there were fears that more could follow. The “Hands off our Bowling Greens” campaign was born on College Green just across the way. With a bit of mowing and rolling, it would make a surprisingly good bowling green.
My ten-minute rule Bill, the Protection of Bowling Greens (Development Control) Bill, was presented to the House in March 2011. The combined pressure resulted in a promise of action from the Government. On August bank holiday three years ago, the Minister’s Department for Communities and Local Government announced that bowling greens would receive greater protection under the national planning policy framework. That move was, of course, welcome, but since then it has all gone very quiet and greens continue to disappear. In written answers, Ministers have not been able to tell me how many greens have been designated as local green spaces under the new powers. The Minister may have the figures at his fingertips now in his reply.
Our greens continue to be trapped in a vicious pincer movement. Council-owned greens are falling victim to spending cuts—as in the case of the one I recently visited at Hove at the invitation of superb local parliamentary candidate, Peter Kyle. The local Green party-run council, no less, is threatening the future of well-used greens. It is hard to believe that it is using one of them as a dumping ground for refuse.
Many privately owned lawns are tempting prospects for development, especially if the pub or social club to which they are attached is struggling financially. As greens shut down in an area, players drift away. It is estimated that around 40% of bowlers where a green closes leave the game altogether, even if there is another green half a mile or so down the road.
These bowling greens are at the heart of their local communities, providing social interaction as well as physical activity. Too often, we see underhand tactics from the owners of greens to make them appear unused and thereby smooth the path to selling them off, right down to some examples, including one in my constituency that I will go into in a more detail in a moment, of bowlers finding the locks on the gates to the greens super-glued shut.
Only last month, another story emerged. I am grateful to Mel Evans, a friend, a bowls commentator and keeper of the flame in Staffordshire, who was recently deservedly awarded an MBE for services to the sport. He provided me with fresh information that McKechnie’s club in Aldridge in the west midlands has become one of the latest community clubs to come under threat. That bowling green was attached to a once-booming factory that has closed down. The bowls team played in a number of local leagues and its members were told just a few weeks ago that they must vacate their premises and find another home. Such short notice has caused a crisis for members that they are still grappling with. That is another example of how economic woes in apparently unrelated sectors are threatening the game of bowls.
Some people might ask why that matters. Bowling helps form the sinews that make this country great, obviously, but there is even more to it than that. The health costs alone of seeing greens closed could be enormous. Think of the savings to social care and the NHS from keeping older people active—physically, mentally and socially—longer into retirement.
Bowling is for all ages. I am a retired crown green bowler, having played in the junior leagues in Sheffield in my youth. It is obviously particularly popular among older people. It is a top 10 sport in this country, although it receives nothing like top 10 billing around the country and on the nation’s media. It is a vital antidote to the sedentary lifestyle that some older players might otherwise lead. For the price of keeping open a bowling green—under £10,000 a year—the potential is there to save far more in reduced health care costs.
There are groups valiantly taking action. Bowls England and the British Crown Green Bowling Association do a sterling job on behalf of bowlers across the country. Organisations such as Fields in Trust offer support with recreational land protection to communities. Sport England, according to figures it gave me yesterday, has so far offered support to 54 clubs from the inspired facilities fund, totalling nearly £2 million. However, we need to do so much more.
To mark the start of the new bowling season, last month I was proud to launch, alongside Peter Kyle, the Labour Bowlers’ Charter at the Hove and Kingsway Bowling Club on the south coast. We and local bowlers became the charter’s first signatories at a club that has lost three greens owing to cuts. Although that is a Labour initiative, I think the point of the charter can command cross-party support and would certainly do so much in offering greater protection to the sport and to the conservative estimate of 400,000 people who regularly enjoy it.
The charter calls first for an end to active bowling greens being designated as surplus to requirements by local planning authorities, thereby allowing the redevelopment of the greens—building over them—to go ahead. Secondly, it calls a halt to the practice of locking bowlers out of their greens. I am sorry to tell the Minister, but it was at Dalton’s Conservative club in my constituency where bowlers turned up for practice one September morning in 2009 and found that the electricity and the water at the club house had been turned off and the gates to the green had had the locks changed. Those appalling tactics were designed to put the green out of use forcibly and soften it up for redevelopment. That is the fate that has befallen too many bowling organisations that were attached to pubs and clubs.
Thirdly, the charter calls for the creation of a community right to buy for any green where disposal is agreed to by the planning authority. Where a club is prepared to commit to keeping the green in use, bowlers would be given the opportunity to buy it on the basis of its market value as—this is really important—a sporting facility, which is often much more affordable than the amount developers are prepared to pay.
Fourthly, the charter calls for extra support for bowlers who want to form co-operatives to run threatened greens. We should help clubs that are willing to form such co-ops to preserve their prized assets. This is a field in which Supporters Direct has blazed a trail for other sports. The Co-op club in Barrow has flourished since taking that route to protect its green. When its members were offered the green and clubhouse by the Co-op, people living in the vicinity even gave extra money towards the cost to prevent the land from being built on.
So how about it? Does the Minister want to sign up to our charter today? I have a copy right here if he wishes, but if he wants a bit of time to mull it over, will he at least answer the following questions?
Have the Government made any assessment of whether the local green spaces designation powers announced in 2011 are effective in protecting bowling greens? How many greens have been protected through that process? Are communities finding the rules and regulations too bureaucratic, as we fear?
Will the Government consider a community right-to-buy scheme specifically for bowling greens, where they are in active use and threatened by development, with the right of a vote by the bowlers themselves—the people who actively take part in the sport and not the wider club, where sometimes, financial fears can overtake the poor, embattled team members?
Will the Minister agree to raise the protection of bowling greens linked to pubs with major pub chains, which may be able to make a difference? Will he join the Department of Health in commissioning a study to quantify what I hope we both agree are the undoubted health benefits and savings to the NHS and social care budgets from people continuing to bowl?
Finally, will the Minister agree to join the House of Commons team in the first annual House of Lords versus House of Commons bowling match in July, adding his no doubt great skills to the elected side and showing his support for Britain’s bowlers?
It is a pleasure to serve under your chairmanship, Mr Havard, and to discuss a matter that is close to my heart, to my name and to lots of other things.
I congratulate the hon. Member for Barrow and Furness (John Woodcock) on securing a debate on a matter that not only concerns his constituency, but many constituencies, including one he mentioned where I previously stood as the parliamentary candidate—Hove and Portslade. I was very familiar with the bowling greens and bowling clubs there and with the important role that they play in providing recreation, fresh air and social contact for many people, and particularly retired people in that community.
I also welcome the debate because we heard a poetic speech from the hon. Gentleman about the virtues and history of bowling. Conservative Members have a great affection for the great Englishman who was found playing bowls in Plymouth when the Spanish decided to come knocking. It is perhaps a little unfair of me, but I always thought that as a buccaneer in an early version of the global race, Sir Francis was clearly a Conservative supporter.
On protections for bowling greens, I understand entirely the hon. Gentleman’s concerns. In time, when he is serving as a Minister in a Department of State—in 10 or 20 years—he will discover one of the features of Government, which is that people legislate, and create new powers and possibilities, and it is often a very long time before those to whom powers and possibilities have been given take them up with the enthusiasm and gusto that the Government had originally intended. In the Localism Act 2011, as he mentioned, we created powers that had never existed before on the statute book to designate places as local green spaces—in a sense, as a planning matter, to say that a particular piece of ground that is open and green has a value to the community, and people want it to be recognised as that, and then any planning decision needs to take that into account as a material consideration in considering any proposal to build on a local green space.
We also created the concept of an asset of community value and the ability to register various kinds of community assets as assets of community value, with particular protections stemming from that. The asset of community value provision gives a community the ability to say that a particular asset can only be put up for sale—and for sale with a view to convert it into some other use—after the community has been given an opportunity to bid for that asset. They have to register their interest in bidding, and then they have a six-month moratorium in which no transaction or sale can take place in order to be able to put together a bid for an asset that is designated in that way. That provision has great potential power, if only authorities would use it.
It was really useful to take through that provision. Will the Minister say what the definition of a community is in that regard? The concern to which I alluded was that sometimes the bowling club forms a minority in the community, but nevertheless, its needs and the bowling green’s value should not be ignored and overruled by a larger group.
That is a very good question. I shall ask for support—for a definition of a community interest group. Meanwhile, I will go on to explain how it works, then come back to that point.
Ultimately, the point of the Localism Act was to do what it said on the tin, which was to further localism. Localism takes place, as it were, on many different levels. There is the level of individual community groups, neighbourhood groups and the like, and there are the democratically elected authorities that represent them, such as district councils, county councils and metropolitan councils. Ultimately, the decision making about whether to list an asset as an asset of community value, with the protections, therefore, that flow out of that, has to rest with a democratically accountable body, which is the local authority. Therefore, a community interest group needs to persuade its local authority—the only authority that has a democratic mandate to make such decisions on behalf of the public—to accept the proposal to designate something as an asset of community value.
I am fortunately now informed that a community interest group can be just 21 local people on the electoral register in the area in which the asset is located, so hopefully, even if, as the hon. Gentleman says, they are just a subset of the membership of a broader club, finding 21 people to form such a community interest group is within the reach of most existing bowling greens.
I thought that the hon. Gentleman had possibly applied for this debate, in part, to celebrate a decision that was made very recently—indeed, only a week ago. It was one of the very first appeals that we are aware of against a decision by a district council to register a bowls club as an asset of community value. I will spend a little time explaining that decision.
Rother district council decided on 16 September 2013 to include the site of Gullivers bowls club at Bexhill-on-Sea on its list of community assets, and there was an appeal against that decision. The owner of a bowls club, or some other party, quite properly has the right to appeal against a decision in which they have an interest. I am delighted to report that the first-tier tribunal general regulatory chamber, which for some reason hears such appeals rather than the Planning Inspectorate, found that it was entirely proper for Rother district council to register Gullivers bowls club on its list of community assets.
Such decisions include a test of whether the criteria for an asset of community value have been met by a bowls club. An important criterion is that the bowling green is still sustainable in its current use and, as the hon. Gentleman points out, has not become neglected. I was truly shocked to hear of the case he mentioned in which a bowls club’s locks were superglued shut. I have no doubt that if such evidence were presented to any appeal or tribunal, it would dramatically undermine any claims that a bowling green is no longer in use and therefore no longer sustainable. It is clearly not fair if people who want to play bowls cannot access a bowling green.
I hope the hon. Gentleman and those who are keen on the sport of bowls will take encouragement from this debate that powers and provisions already exist. The local green space power is important but, if anything, the asset of community value power is more important. Within that power—he talked about the right to buy—there is a community right to bid. A community can say, “This is an asset that we want to preserve in its current use, and we want to have a bit of time to raise money through a local appeal, or whatever it is, to acquire that asset and retain it in its existing use.”
I thank the Minister for giving way again. This is all helpful. He mentioned at the beginning of his speech the difficulties found between setting out the Government’s intentions, putting in place the needed legislative changes and the time it takes for those changes to reach fruition. I am sure he has a sense of the difficulty of translating those intentions on the ground, even once the changes have been made. How will he monitor how the changes actually work on the ground and address our fear that the powers are either not known or seen as too bureaucratic?
The hon. Gentleman asks a reasonable question, and to some extent I throw it back at him. I am happy to work with him, and with any associations that exist in the sport, to write to every bowling green and bowling club in the country to make them aware of the powers under the Localism Act to register as an asset of community value and as a local green space, to draw their attention to the two bowling greens of which we are aware—there is not only the Rother case that we have just discussed but a bowling green in Camden, too—that have been registered as assets of community value and to make them aware that the bowling green in Rother was able to sustain that position against a challenge. The designation was upheld on appeal. Hopefully, we will be able to encourage other bowling greens to take up that right, because it may be the case that, first, they are not aware of the right and that, secondly, even local authorities are not necessarily completely up to speed on how the right works and how other people are using it. I am happy to ensure that bowling greens and bowling clubs across the country are aware of those rights, but I might need to work with him and through him to do so.
Finally, the hon. Gentleman invited me to join a match. I hope he understands, as he would if he had ever witnessed me take part in any athletic activity, and certainly any activity involving a moving ball, that I decided long ago at the start of my political career that I would say no to any invitation to partake in a sport. If it satisfies him, however, I would be pleased to attend and cheer on the more able participants.
Catholic Schools (Admissions)
[Jim Dobbin in the Chair]
It is a great pleasure to serve under your chairmanship, Mr Dobbin. As we gather today to discuss matters of education and those who dedicate their lives to it, all our thoughts and prayers are naturally with the family of Ann Maguire and all the children and staff at Corpus Christi Catholic college in Leeds.
This debate was originally in the name of my hon. Friend the Member for Canterbury (Mr Brazier). He secured the debate, but he sends his apologies for being unable to attend owing to a long-standing engagement at the Ministry of Defence in Glasgow for his work on reserves. I am grateful to him for the opportunity to speak in his place and to Mr Speaker for allowing the transfer.
The Catholic Church is this country’s largest provider of secondary education, and it is the second biggest name in primary education. Altogether, the Catholic Church educates more than 800,000 children in more than 2,000 schools. The Catholic Church has always seen education as vital to the formation and development of the whole person, and historically it has prioritised the building of schools in England, even over building churches.
At their heart, Catholic schools always have a mission to provide for underprivileged children and serve a Catholic population that has primarily been made up of many waves of immigrants from France, Ireland, south Asia, the Philippines, Africa, eastern Europe and elsewhere. Under the Education Act 1944 —the Butler Act—Catholic schools became voluntary-aided schools, part of the state system but with a distinct Catholic ethos guaranteed through various legal protections. Unlike the Church of England, which is the established Church in this country, the Catholic Church has always established its schools primarily to educate Catholic children and puts substantial resources into that effort. These days, the figure is some £20 million a year.
Catholic schools today are high performers in the state sector. On average, they get higher Ofsted ratings for overall effectiveness, pastoral care and various other criteria. Their results are above average at the ages of seven, 11 and 16, and they perform strongly on value-added measures. Such schools are also plugged into their local communities. At secondary level, two in five Catholic schools are judged by Ofsted to be making an outstanding contribution to their local community, which compares with one in four schools overall. A key question is whether all that is just a coincidence and, if not, what the driving factors are behind that performance.
I congratulate the hon. Gentleman on standing in for the hon. Member for Canterbury (Mr Brazier), who secured this debate. I often hear from a small number of constituents that they feel Catholic schools must be selecting only the cream of pupils. Would the hon. Member for East Hampshire (Damian Hinds) like to put on record his observations on that point?
I will happily do so: I contend that the ethos and character of Catholic schools, although they are not the only factors, are key contributors to the performance of such schools in all senses. It is categorically not the case that Catholic schools get better results by being some sort of middle-class filtering service.
I, too, congratulate the hon. Gentleman on introducing this debate. I associate myself with his remarks on the tragedy in Leeds, which is close to my constituency. It is an awful thing to happen.
I press the hon. Gentleman on the point raised by my hon. Friend the Member for Stoke-on-Trent South (Robert Flello). When I chaired the Select Committee on Education, we found real evidence that many Christian schools, both Catholic and Anglican—I am an active Christian myself—manage to get far fewer people from poorer backgrounds than one would expect from any interpretation of the population both inside and outside the Catholic community. There is evidence, and surely the hon. Member for East Hampshire (Damian Hinds) must worry about that.
That would be a worry. I never had the privilege of serving under the hon. Gentleman’s distinguished chairmanship of the Education Committee, although when I subsequently served on the Committee, we had a session on similar matters, and we did not find that to be the case. Depending on our point of view and the point that one is trying to make, we can draw boundaries around schools in different ways. We can draw an immediate boundary or a wider boundary. A little later, I will go through some of the actual statistics on the intake of Catholic schools.
The hon. Gentleman is being kind in giving way again. The Education Committee’s report—I am looking at the hon. Member for Isle of Wight (Mr Turner), who was a member of the Committee at the time—recommended a mandatory code for admissions, which made a difference. Under the mandatory code, schools have to obey a fair admissions policy. That is why, when the Education Committee returned to the matter, many of the problems had been resolved.
I am grateful for my hon. Friend’s unique geographical perspective. This comes up time and again, and I will shortly address some of those instances, but on the key point of whether Catholic schools are some sort of filtering device for middle-class, wealthy and bright kids, the answer is no. That would be a fundamental misunderstanding of the demographic profile of this country’s Catholic population, the location of those schools and the communities that they serve.
There is a school about a mile from here across the river that may be a contender for England’s most diverse school: St Anne’s Catholic primary school in SE11. The school’s pupils come from a wide variety of ethnic backgrounds. Half of key stage 2 pupils are classed as disadvantaged, with most coming from the immediate wards, which are among the poorest in London. The school’s deprivation indicator is in the top 10%, but there are also families from higher income brackets. Altogether, pupils speak 32 different mother tongues, and 99% of pupils have English as an additional language, which is what we used to call English as a foreign language. The one thing that almost all pupils have in common is their faith, with more than 95% being baptised Catholics.
That is a striking example—that is why we politicians use such examples—but overall the profile of Catholic schools is more diverse than schools in the maintained sector in general. At primary level, the proportion of schools at which more than 5% of pupils do not speak English as their mother tongue is 57% for Catholic schools and 38% for schools overall. Some 34.5% of Catholic primary school pupils are from ethnic minority backgrounds, compared with 28.5% in the maintained sector as a whole; at secondary level, the figures are 30% for Catholic schools and 24% for other schools.
The proportion of children on free school meals at Catholic schools is somewhat lower on average than at other schools, and there are various explanations for that, but I do not think we know the answer conclusively. One thing that we do know conclusively is that pupils at Catholic schools tend to come from poorer places than children at schools in general. At secondary level, 17% of children at Catholic schools are from the most deprived wards, compared with 12% for schools overall. At both primary and secondary, Catholic schools over-index in the bottom four deciles and under-index in the top six deciles.
The diversity of Catholic schools, notwithstanding the water boundaries of some places, is partly due to the potential for much larger catchment areas. Typically, a Catholic school may have a catchment area 10 times the size of a typical community school’s catchment area. I saw a bit of that in my own schooling. The school that I went to in south Manchester had kids from leafy north Cheshire, but it also had kids from Stretford, Old Trafford, Stockport and Warrington. It really had a very wide intake.
Schools must comply with the schools admissions code, and over-subscription policies mean that Catholic schools typically give priority to Catholic children over the wider area and welcome others where there is remaining capacity. That system enables more parents who desire a Catholic education for their children to get one, bearing in mind that it is a minority religion in this country, so the population is likely to be more sparsely spread.
As has been mentioned, the admissions criteria of faith schools make regular media space-fillers. Headlines have included, “Faith schools ‘biased towards middle classes’”, “Faith schools ‘skewing admissions rules’” and, “Faith school admissions ‘unfair to immigrants’”. Those came respectively from the Daily Mail, The Daily Telegraph and The Guardian after the publication of the schools adjudicator report in 2010. As was alluded to, we had the chief adjudicator into the Education Committee to discuss that report, which was extremely fair and balanced and made hardly any reference to faith schools. Somehow, between the publication of that report, the press conference and journalists filing their copy, the story became about bell ringing, schools insisting that parents clean churches and giving priority to white middle-class families. I do not know about you, Mr Dobbin, but I struggle to think of many Catholic churches that even have a bell tower. Anyone saying that people who clean churches having priority somehow advantages white middle-class families has a poor understanding of the demographics of those who clean churches.
I will tell the hon. Gentleman what I acknowledge: there are 2,000 Catholic schools in this country, and one of them is the London Oratory school. When these stories come up, they always centre on literally a handful of schools, virtually all of which are in west or south-west London. They are in no way representative of Catholic education as a whole, whether in location, resident population or type of school and so on.
We all know why London Oratory became so well known: Tony Blair, the former Prime Minister, sent his children there. I always defended that, because he was, as I understand it, the first Prime Minister ever to send his children to a state school. To put the record straight for anyone reading the report of this debate, before the reforms, when I was Chair of the Education Committee, the crucial thing was not just the number of children on free school meals, but the numbers of looked-after children and children with special educational needs. Things have not much improved, but I have to put on record, as a lay canon at Wakefield cathedral, that we often found that Anglican schools were worse than Catholic schools.
I say gently to the shadow Minister that that was represented as faith schools plural, not as one school where it was the case. The figures speak for themselves. In 2010, 337 Catholic secondary schools made 54,830 offers of a place to year 7 pupils. The number of complaints to the Office of the Schools Adjudicator about the application of the admissions code in Catholic schools was nine. In fact, there were proportionally fewer complaints about Catholic schools than there were for schools of no denomination.
There is a view that no admissions procedure or criteria should include a religious element and that if these are high-quality, sought-after schools, they should be made available equally to all, so that more people, or at least people living closer to the school, would benefit. I contend that that misses the point of what makes Catholic schools distinctive and sought after. If they were open to all, they would lose their distinctive character—not immediately, but over time.
Schools can withstand some variety, which is a good thing, in admissions. The proportion of non-Catholic children at Catholic schools today is 30%, which is probably higher than most people realise. A 50% cap on admissions would gradually erode that character in two ways. It would not only erode it directly by diluting the religious nature of the school’s population, but indirectly, because Catholic parents would cease to see a distinction between those schools and entirely non-denominational schools, as my hon. Friend the Member for Fareham (Mr Hoban) effectively argued in a recent debate in this place. Put simply, a half-Catholic school is not the same thing as a Catholic school.
The 50% cap is not in the coalition agreement, but is an interpretation of some of its wording. We would probably all agree that it was well-intentioned, because there is concern about diversity, inclusiveness and mixing in schools, and I understand the sensitivities around those topics. As I hope that I have demonstrated, Catholic schools are more diverse than the average, with mixing beyond that available in the average school. The cap is inhibiting the creation of new quality schools that will be just as sought after. It is clear that the 50% cap directly precludes the creation of Catholic free schools, because the Catholic Church feels unable to support, with all the implications of commitment that that brings, new so-called Catholic schools that would in the end have to turn away some families seeking a Catholic education for their children in favour of others who happen to live a little closer to the school.
There is an alternative, which is to create a new voluntary-aided school that can subsequently convert to an academy, and the same result could be had that way. That is not an impossible route to pursue, but there are two problems with it. First, it is a somewhat convoluted approach to reach that end, inevitably carrying additional inefficiencies and costs. Secondly, it is not as straightforward as a free school application, because voluntary-aided applications do not have the same priority as free school applications. The applicants for the new voluntary-aided school at Richmond experienced a legal challenge from the British Humanist Association, which claimed that the Government had to look first at free school applications that would have the 50% cap. That legal challenge failed, but it is inevitable that parents will feel some uncertainty about what will happen with future openings. That could affect the number of applications and the viability of such a new school.
The hon. Gentleman is a man of letters, and he will understand that I can answer the question only in the sense of why I said that, which is because it is my understanding. It is for the Minister to talk about how these things work in practice, and he might want to contend that point.
I have some questions for the Minister. First, has the Department made projections of demand for Catholic places at schools, the growth or otherwise in the Catholic population and the propensity of parents of those children to seek a Catholic school? Secondly, has the effect of the 50% cap on applications for faith-based schools been assessed? Thirdly, would the Department consider a pilot of a Catholic free school without the 50% cap? Fourthly, is it possible to construct a new fast-track, voluntary-aided through to converter academy route that would effectively be a single process?
In conclusion, Catholic schools are a key part of the education landscape in this country, and have been for a long time. They are diverse—more diverse, in fact, than the average—and that diversity includes already having a substantial proportion of non-Catholic children. They also have something special about them, and that specialness comes at least partly as a direct result of their religious nature.
The hon. Gentleman is being extremely generous with his time. On that point, it is the special nature of Catholic schools that appeals to many people of other religions. For example, in Stoke-on-Trent, a large proportion of the Muslim community want their children to go to the local Catholic school because of its Catholic nature. That might seem a little bizarre at first, but that is the reality.
I agree with the hon. Gentleman entirely. Many Catholic schools have large numbers of children of other faiths. As I came to my close, the point I was making was that the specialness of Catholic schools comes at least partly as a direct result of their religious nature. I suggest that that helps to promote cohesion and community spirit, rather than detract from it. That specialness would inevitably be eroded over time by enforcing a lower cap on admissions made on the basis of faith.
As Cardinal Vincent Nichols—as he is now—said in 2006, when faced with a not entirely similar proposal,
“Catholic schools make a positive and clear contribution, and do so in an open and proven manner. They are part of the solution. They should not be undermined.”
I thank the hon. Member for East Hampshire (Damian Hinds) for introducing this significant and important debate. The backdrop to debates on education is often the London scenario. Frankly, I fail to recognise the landscape spoken about in such debates: the fierce competition for places; sharp elbows; tiger mums; socially-segregated intakes; and back-door selection via baptism and church attendance. I come from an area where half the schools are denominational, with the bulk of them being Roman Catholic. Unlike the Minister, I did not go to a Roman Catholic school, but in the ’70s and early ’80s I taught at a Catholic comprehensive in Bootle, where the situation was very different from London: St Kevin’s in Kirkby was not the Oratory.
My school was run by the Salesians, a religious order that originally set out to look after the poor of Milan. When I taught there, that spirit prevailed, although over time as an order they had migrated into selective and boarding schools, as is often the way. However, some of the original fervour was certainly there: the headmaster taught remedial maths and, even after he resigned as headmaster, continued to do so.
When I joined, the school had just amalgamated with another Catholic denominational school, St Joan of Arc, which was again far from being like the Oratory. That was a school that, throughout its history, had had a proud reputation of never having entered a pupil for a public exam. It was a dockland school and the only qualification that pupils left with was the—slightly discounted now—Bootle school leaving certificate. In fact, to get a job in that area, one needed only to befriend the local shop steward to be assured a job; one did not need to be particularly good at maths or anything like that. The comedian, Tom O’Connor, honed his act in such a school.
I was latterly a governor and a parent. My children went to Christ the King school in Southport, which was a community school with a tradition of caring for pupils; it did not expel them even when they had appreciable problems. When I reflect on that, I must say that the system that we have got is not a planned system, but one that has evolved. The state took responsibility for education only after the churches had spent many decades doing so in the 19th century. It funded what was there, but, at that time, there was political sensitivity that we might now find difficult to understand about Rome on the rates, or, in fact, any church on the rates, particularly in my party. The solution was the funding of religious autonomy but only in return for a capital contribution: the Butler settlement. Congregations did indeed partly fund the schools and, as a result, got certain privileges.
That deal has now been superseded by the Blair Government and the coalition Government with a new deal that I do not claim to understand perfectly: it does not have the same funding snags, but there certainly is a protracted debate about admissions and admission policy. That policy has been developed by the coalition, but I do not claim to understand the rationale perfectly. Perhaps the Minister can help me with that.
However, insofar as the Government make the offer to religious bodies to promote schools, it is almost certainly not because they want to promote a religious ethos or because they believe that, because those schools have a religious ethos, they are good per se. The promoters certainly believe that, but secular Governments in a secular, pluralistic society cannot usually claim that. The argument appears to be that there is a demand and will to provide these schools in many parts of the country, that educational standards are good—I think that that is recognised widely—and that no social objectives are being significantly impaired.
That is a point on which most Members party to this debate are probably on a different side from, say, the British Humanist Association, which regards serious social objectives as being compromised by the sheer existence of faith schools: it talks about the promotion of sectarianism and the like. That claim is contentious, but that is not the issue of this debate. The issue today is whether schools set up for an avowedly religious purpose function in a way that separates pupils by class or ability, because that, surely, is what the Government are against and the real question is whether there is a case for saying that.
There seem to be three bits of evidence to look at. One is the disparity that occasionally exists between a school’s social mix and the neighbourhood. It must be acknowledged that that exists. Secondly, frequently cited is parents affecting religious affiliation or enthusiasm to get their children into faith schools and that schools overtly collude in that. Thirdly, which I think is the point made by the former Chair of the Education Committee, the hon. Member for Huddersfield (Mr Sheerman), there is some evidence that, in faith schools, there are relatively lower numbers of pupils on free school meals compared with other schools.
None of that strikes me as conclusive. As the hon. Member for East Hampshire pointed out, a disparity between neighbourhood and social mix should sometimes be expected. In an area where Catholics are very much a minority population, such as Salisbury, where there is only the one Catholic church, there will be a difference between the families immediately adjacent to the Catholic school and those who send their children to that school, but that would equally apply to other faith schools. A good example is in Liverpool, where one of the most popular and successful schools is King David high school, which is a Jewish school that does not necessarily reflect the wider social area in which it sits. I do not think, therefore, that that argument is conclusive.
Equally, I do not think that it is conclusive to point out what we probably all know: sometimes, parents affect a degree of religiosity to get their children into a school that they might not otherwise succeed in doing. That argument is hard to address, because it is not possible for schools—or churches, for that matter—to have proper insight into the fervour or motives of the people who turn up en masse on a Sunday. We surely cannot ask the Government to do that either.
Therefore, we come to the crucial point, which is the most difficult point for faith schools to address: a lower proportion of children receive free school meals in faith schools than in state schools in comparable areas. It cannot be supposed that Catholics, or those of any other faith, are innately prosperous and unlikely to be on benefits. That is a dilemma for Catholic schools, but also for the Government. If there is a remedy to that, that would be for the faith schools to be more rigorous in applying the faith criterion rather than any of their others, and I am not sure that the Government could advocate that.
None of the solutions would satisfy the critics of faith schools. I regard the Government’s policy as a muddle to some extent, though not a pernicious or problematic muddle. I do not see how what we have in the way of faith schools at the moment can concern a Government who are seeking to address the joint objectives of promoting educational achievement and ensuring that all pupils have fair access to it.
I commend my hon. Friend the Member for East Hampshire (Damian Hinds) for opening the debate in such a thorough way. I will not speak for long, having aired the issues in an earlier debate, to which the Under-Secretary of State for Education, my hon. Friend the Member for South West Norfolk (Elizabeth Truss), responded. I am pleased to see the Minister for Schools, my right hon. Friend the Member for Yeovil (Mr Laws), in the Chamber, because he might be able to shed some light on some of the discussions that his colleague and I had in the previous debate.
It is important that we recognise the role of the Catholic Church in providing education. I, too, am a product of a Catholic education. The role of Catholic schools has been widely praised, with the most recent example I have coming from the Deputy Prime Minister. He praised faith schools, rightly highlighting:
“In my own view the crucial thing for faith schools, and I think all the best faith schools do this, is to make sure they act as engines of integration and not silos of segregation.”
He made that comment on visiting a Catholic school in east London, which perhaps provides an antidote to the slightly obsessive nature of the discussion about faith schools elsewhere in London.
The Church has a long tradition of providing education, in particular in urban areas, initially to meet the needs of migrants from Ireland, not only during the great famine, but in subsequent waves of migration as well. The view of the Catholic hierarchy, the bishops, when they established schools in England and Wales, was that this was a good way to enable migrants to integrate into the wider community, by providing them with the opportunities for education that would enable them to progress in different careers. Certainly in my own family, coming from the north-east, some found such opportunities to progress in particular through education. That is highly valued, and the role in integration is still played now with subsequent waves of migration, especially with migrants from eastern Europe. Also, in many communities throughout the country, large numbers of people from the Philippines can be seen at mass; they are in this country to work in the health service. Again, we are helping to integrate people into the wider community.
Integration is reflected in the demographics of Catholic schools. They are ethnically and socially diverse, reflecting the Church itself. To use my own experience, the Catholic school that I attended in Durham attracted pupils from a wide area, not only from leafy, middle-class housing estates in the centre of Durham, but from the former pit villages around Durham. It was a socially diverse school, different from the nearest school, which predominantly served leafy, middle-class housing estates. There is something about the catchment area of Catholic schools, and their coverage, which means that they have a much wider range.
The hon. Gentleman’s comments put me in mind of my constituency and of my city of Stoke-on-Trent. If we compare Stoke-on-Trent with Kensington, Chelsea or Westminster, they are in almost completely different worlds, let alone different cities. Stoke-on-Trent could hardly be described as incredibly affluent, but the Catholic and indeed Church of England schools do a good job of educating people in the area.
Indeed. That diversity of social class is important, although I would counsel a note of caution. It is not only about what happens in Stoke-on-Trent; churches and Church schools in central London are socially diverse, and we should not get away with thinking that Westminster and Kensington and Chelsea are predominantly or exclusively upper middle-class areas.
The Oratory is socially diverse, because it allows in the children of both Prime Ministers and Deputy Prime Ministers these days. We should not forget that diversity.
The catchment areas mean that Catholic schools, rather than serving a narrow cross-section of the population, tend to serve broader communities. They are not aimed exclusively at either the children who live in pit villages or those who live in middle-class housing estates.
Free school meals have been mentioned by a number of hon. Members and the issue is a cause for concern, which is why the Catholic Education Service has looked at it carefully to understand some of the barriers. The service highlighted cultural aversion, immigration status and language as potential barriers to people claiming free school meals. We need to understand that a bit more: is there a factor here that we need to take more action on?
I have a concern about Government policy in the area—I do not have many concerns about Government policy, because I am by nature loyal.
I paused before intervening, because I thought the hon. Gentleman was going to move on to talk about the figures. It is worth putting on record that in 2012 the difference in the number of those receiving free school meals nationally and of those receiving them in Catholic schools was about 0.7%; in 2013, the figure might have risen to about 2%. It is worth putting the scale of the difference into the context.
Indeed. The hon. Gentleman is absolutely right, although that closer difference is between secondary schools; the gap is slightly wider for primary schools. Nevertheless, we need to get to the bottom of the issue and to understand it.
Since Catholic schools are so diverse and so inclusive, I have a problem in understanding the nature of Government policy in the area. Why is the admissions cap in place? Why has faith been singled out for such treatment? No other cap is in place and there is no cap for ethnicity or social class; the focus appears to be entirely on faith, and yet we can see from the track record of Catholic schools that they are more representative of the population and more diverse in ethnicity and social class than schools as a whole. I find it hard to understand why the barrier is in place.
When my hon. Friend the Member for South West Norfolk responded as the Minister in the previous debate, she talked about the need to demonstrate broad support in the community for such schools and the need for access. I could understand that if it applied to all new free schools and academies and if there were similar constraints in place on other aspects of diversity, but there are not. The cap applies only to faith schools. In a situation in which a faith school is oversubscribed, that oversubscription demonstrates that a school is popular and that people want to send their children to it, so it is more likely to have a broader range of applicants. My concern, if we are concerned about exclusivity and segregationism, is with schools of a particular faith that are undersubscribed. What message of ethos or approach is therefore being sent to other people in the community who are not of that faith? We need to be clear about why things are happening and why the cap is in place.
I hope that my right hon. Friend the Minister will provide the logic, because I cannot see it the moment. If I look at other factors involved in setting up free schools, one such school might be in the middle of a middle-class housing estate where there is a lack of capacity, and yet there is no requirement to ship pupils in from other areas. Such a school could serve exclusively children from that middle-class area. There is no constraint on that or any cap to require pupils coming from elsewhere. I am not sure what mischief the Government are seeking to address by such a narrow approach to one aspect of admissions policy.
My right hon. Friend the Minister might be able to shed some light on one aspect of the issue, because he was there at the birth of the coalition. The cap flows from language in the coalition agreement, but I am not clear whose ask that was. Was it an ask of my party or of his? I suspect that I know the answer, because the Liberal Democrat manifesto for which the Minister stood in 2010 pledged to prevent faith schools selecting on the basis of their religion. I suspect that the policy flows from that manifesto commitment. Since he and others have now had experience of Catholic schools, he might feel that that manifesto commitment is no longer appropriate. The Liberal Democrats might seek to change that. I will be interested to see if that is their policy.
I do not see where that commitment sits logically in an admissions policy. Why have the Government decided on that one demographic characteristic, above all others, in determining admissions policy? I do not think it is logical. It is perceived to be unfair and discriminatory, and is certainly preventing the establishment of new Catholic free schools and academies that could support the demand for places and want to be able to offer a Catholic education but do not want to be in the position, as would be the case under this policy, of having to turn away Catholic parents. That is the barrier—those schools would have to turn Catholics away under the policy.
I would like my right hon. Friend to explain the logic behind the policy—why it is faith that has been singled out, and no other demographic characteristic.
It is a pleasure to contribute to the debate. I congratulate my hon. Friend the Member for Canterbury (Mr Brazier) on securing it and—more amazingly—my hon. Friend the Member for East Hampshire (Damian Hinds) on starting the debate with such aplomb. I am slightly disappointed that the hon. Member for Huddersfield (Mr Sheerman) has left the Chamber; frankly, I did not understand what he was going on about and would have enjoyed a debate with him.
One concern for people and particularly for Catholics who send their children to Catholic school is that when topics such as this are debated in Parliament, the debate seems to become an assault on the values of those parents and on the fact that they choose to send their children to a school that selects by faith. They are often attacked by various campaigning organisations for trying to be separatist and for not wanting to be part of a wider society. Frankly, such attacks are so ridiculous as to be untrue.
Although it is not quite an interest, I should declare that I only ever attended Catholic schools, so I have that narrow vision, as it were. My parents taught principally in Catholic schools, although they taught in other types of state school as well.
I am glad to see the Minister in his place today. I hope that he is not overly influenced by Liberal Youth—a Liberal Democrat group of students and young people in education that has joined the British Humanist Association in a coalition against faith schools—particularly on the admissions code. I am pleased that he was part of a Government that resisted amendments trying to remove any selection based on faith during the passage of the Academies Act 2010 in the early days of this Parliament. It was important that we took that step at the time. I share the views already put forward by hon. Members on the impact of the 50% cap on admissions to free schools.
I know that this debate is going out to the world, but let us talk openly: was the issue that small minority faiths would set up particular kinds of schools and the Government were concerned that that would lead to extremism of one kind or another being taught in our schools and being paid for by the taxpayer? If that was the case, it was an overreaction. As we know, the setting up of a free school is subject to stringent tests, which apply to some elements of the curriculum. Although certain things are not banned for academies or free schools, those schools still have to satisfy the Department for Education and Ofsted that they are providing a suitable education that covers a broad spectrum—albeit that the minutiae of the curriculum are not mandated in the same way as for other state-maintained schools.
We need to set the right tone. We must allow new schools to develop where they are needed. My hon. Friend the Member for East Hampshire has already referred to the extended process in Richmond, which led to considerable opposition both politically and from other groups that deliberately tried to stop the school being set up.
Sitting suspended for a Division in the House.
I have been reflecting while away from the Chamber. I did not mean to give the impression that I thought the hon. Member for Huddersfield did not know what he was talking about; I just did not understand what he was referring to. I normally enjoy debates with him, and I wish he was here so that we could have further discussion and dialogue.
To return to the meat of the discussion—the reason for the 50% cap—I could understand if the Government’s intention was to prevent the establishment of pockets of extremist teaching in schools. However, there are other ways to achieve that. Indeed, the current inspections by Ofsted, the Department for Education and Birmingham city council show that there are other ways to proceed when concerns are raised about the possibility of manipulation. I am not convinced that the hurdle of a 50% cap is necessary to stop such alleged activity.
On whether people are excluded, I do not like the attitude that claims that Catholic schools try to cream off the top, or that people are deliberately excluded because they are poor. That is very far from my experience of the Church and of my time as a governor of Bishop Challoner Catholic secondary school in Basingstoke. I have been a governor of other schools as well. It costs absolutely nothing to be a Catholic. If anyone has the desire, ignited by a sense of mission and the faith of the Church, that is all that is required. It is irrelevant in our Church whether someone earns as much as another person. Long may that continue. People do not have to worry about whether their name is on the wall on a plaque, for having given something, or whether their family has their own pew, paid for in times past. That is all irrelevant. People try to smear the whole idea of faith schools, using data that consist of such red herrings, rather than entering into serious debate.
A comparison can be made with membership of a political party. We can go anywhere in the country, and we know we will find our local Conservative association, Labour club or Liberal Democrat association, which we can hook up to, and where we can be with like-minded people. We may not agree with the other members on everything, but we can come together in the cause of a common interest. The same can be true of any Church or religion.
I have only just learned, from reading The Independent during the debate, that my old school, St Mary’s college, Crosby, is trying to become a free school, but the archdiocese of Liverpool is blocking that on the grounds that more than two thirds of children who go there are Catholic. I agree with the archdiocese that it would be extraordinary to allow a school designated as Catholic to turn away pupils because they are Catholic, as a result of the arbitrary 50% cap. It is important to remove those arbitrary measures. Distinguished former pupils of the school are Cardinal Vincent Nichols and Roger McGough. I could add the noble Lord Birt and myself, but that would be boasting and probably a sin.
It is completely false to try to compare Roman Catholic schools with Church of England schools. The Church of England is the established Church in England, and anyone may attend a Church of England school—such schools have been set up in almost every parish—just as anyone may be buried in a Church of England churchyard. Under our constitution, anyone may have access to the rights of the Church of England. The Government had to go to extraordinary lengths with the Marriage (Same Sex Couples) Act 2013 to legislate specifically for the Church of England on the grounds that anyone may marry in a Church of England church if they have not previously been married. The analogies are completely false.
What can we do about it? I would like a change of Government policy, but I would also encourage Catholic schools and priests, and the Catholic Education Service, to keep the pressure up. I remember that when there was a proposal to change schools’ admission codes to prioritise siblings over children of the Catholic faith, I and other governors, particularly parent and faith governors, fought against that on the grounds that when people move to a new area, it is not unreasonable for them to want to join the school attached to their Church and where they make new friendships. I would encourage Catholic schools to consider that rather than automatically going down the usual local education authority model of prioritising siblings.
I think it was Pope St Pius X who, when asked to prioritise among a church, school or seminary, always went for a school, recognising that passing on the faith and giving children a good education so that they go on to become pillars of society was an important role of the Church. St Ignatius of Loyola famously said:
“Give me the boy at seven and I will show you the man.”
Many religious orders were established solely to teach children. It is right that we continue to keep up the concept of faith schools; it is right that dioceses tend to pay for schools, the land and so on; and it is right that we in the House continue to uphold the right of parents to send their children to the school of their choice, which is often motivated by faith.
It is a pleasure, Mr Dobbin, to participate in this debate under your chairmanship. I congratulate the hon. Member for East Hampshire (Damian Hinds) on his charity in taking on this debate when the hon. Member for Canterbury (Mr Brazier) was unable to. As ever, he led the debate ably and elucidated the issues very well.
The hon. Member for East Hampshire mentioned that free schools—this may come up in the Minister’s response—are given priority over the setting-up of a new voluntary-aided school. If a new Catholic school is needed because there is demand from a sufficient number of Catholics in an area, why should free schools or any other schools be given priority over voluntary-aided schools? The Minister could solve the problem here and now, and perhaps he will pick that up in his response. I do not see why that should not be possible.
The hon. Member for Southport (John Pugh) told us that he taught at St Kevin’s school in Kirkby.
I understand that school could squeeze the pupils into very small spaces.
We also had contributions from the hon. Member for Fareham (Mr Hoban), who referred to free schools, and the hon. Member for Suffolk Coastal (Dr Coffey), who thought that some critics of Catholic admissions and education were sneering. I congratulate all hon. Members on their contributions and interventions.
Like other hon. Members here, I attended a Catholic school and I am a Roman Catholic. I attended St David’s Roman Catholic school in Cwmbran and St Alban’s Roman Catholic comprehensive school in Pontypool, which, as was said earlier, drew from a wide catchment area in that part of what was first Monmouthshire and then Gwent. It included my home town, Cwmbran, and Pontypool, Blaenavon, Abertillery, Ebbw Vale and other areas of the Gwent valleys.
Given my name, which is Irish, hon. Members may not be surprised that I had a Catholic education, and the names on the school register were diverse. I shared classes with people such as Michael Sczymanski, Endonio Cordero, Maria Bracchi and the usual mixture of people with names such as Mario Evans and so on. There were many Italians, Irish and Poles mingling with the Welsh, and they were a diverse and interesting group of colleagues.
I should put on the record the fact that although I have not yet had the opportunity of contributing to the debate, I am here as someone who also attended Catholic schools: St Mary’s in Hexham and Sacred Heart in Newcastle. I agree with much of what has been said today and will be interested to hear my hon. Friend’s response to some of the concerns that seem to arise from the complexities of the free schools policy.
I thank my hon. Friend. I will say a little about that and about the Labour party’s policy on Catholic education and faith schools more generally.
Labour strongly supports faith schools in our state education system. I quote from a recent speech made in the midlands by my hon. Friend the Member for Stoke-on-Trent Central (Tristram Hunt), the shadow Secretary of State:
“Across the country, we can all point to many successful, collaborative, pluralist faith schools working with children of particular denominations and of no faith at all.”
However, he also said:
“But we also need to be clear about the duties which a state-funded school is expected to fulfil.”
In that context, he was obviously talking about some of the current issues in the city of Birmingham, which the hon. Member for Suffolk Coastal mentioned. It is right that there are also duties on faith schools when they are funded by taxpayers: they are to participate positively in the family of schools in their area and to ensure that they have a fair admissions policy.
I recognise and commend the work by the Catholic Education Service to look into the whole issue of admissions, in response to some of the criticisms aired in the press about admissions to Catholic schools, which hon. Members have highlighted. I commend that work because it has gone to trouble to look into why it seems that Catholic schools admit a lower proportion of pupils claiming free school meals than there are in the general school population.
The service is as baffled as some of us that that seems to be the case despite the fact that the areas that many pupils come from are deprived and despite the great diversity of children attending Catholic schools. It has made a great effort to look into the issue and I commend it; it is important not to be complacent. Whether we are Catholics, Anglicans or have no faith, we should not be unwilling to shine a light on admissions to taxpayer-funded schools. There is a duty for those admissions to be fair. The Catholic Education Service has done us all a great service by undertaking the work and by taking the issue seriously, rather than simply trying to fend off any criticism. It has met it head on, demonstrating—as it has done very well in its research—that Catholic schools are extremely diverse and take pupils from all sorts of backgrounds and areas.
As the Catholic Education Service pointed out in some documents—in its briefing papers on the issue and in its cultural diversity and free schools document, which I have read, explaining the low take-up of free school meals in Catholic schools—Catholic schools are extremely diverse, often with large numbers of people from immigrant backgrounds. In a sense, that is the history of Catholic schools in the United Kingdom. I am conscious of the fact that in my own case, my father came from the west of Ireland. He married a Welsh girl and was an immigrant into the UK.
As I said, I commend the Catholic Education Service for its work, for taking the criticism seriously and for being prepared to put the work in to explain its case. That is important because if the values and ethos of a faith school are to mean anything, it should be that they take very seriously the need to engage with, educate, and have a mission to the poorest in our society. That should be at the heart of any faith school based on a Christian and Catholic ethos.
I shall quote from Pope Francis’s Twitter feed. He said this week—rather controversially for some, although I do not know why:
“Inequality is the root of social evil.”
That was Pope Francis on his Twitter page—“@Pontifex”. Of course, he is absolutely right. The Pontiff’s statement should be at the heart of the ethos of all faith schools, and particularly Catholic schools. I believe that it is at the heart of those schools, but it is important to point out the limited examples of schools that are not following admissions procedures that meet the test of being fair. Those institutions should be held to account, whatever kind of school they are. However, it seems particularly important that a mission to educate the poorest in our society should be at the heart of a faith school’s ethos.
Yes, indeed. I have looked at all the statistics in the report, some of which my hon. Friend mentioned earlier, and I have commended the Catholic Education Service for the serious effort it has made to look into the issue. If people look at the statistics, they could say that the problem, if there is one, might be elsewhere, rather than necessarily in Catholic schools. I will not pursue that any further, however, because it is not the subject of today’s debate.
When a system is in place to adjudicate on the fairness of schools admissions, and when a body is in place against which those admissions should be tested, schools should take them seriously and not try to evade them. I thought it was disappointing earlier in the Parliament when the role of schools adjudicator was weakened and watered down by the Government. I put on the record the fact that we intend to strengthen the role, should we be elected at the next general election.
Given that the hon. Gentleman is talking about policy and going back to the Opposition’s position prior to this Government’s being elected, I should say that his right hon. Friend the Member for Kingston upon Hull West and Hessle (Alan Johnson), when Secretary of State for Education, flirted with the idea of imposing quotas on faith schools of those who were not of the relevant faith—I think it was about 25%. Is that a policy he intends to go back to?
No, it is not, and it will not be Labour policy. For the very reasons I have outlined, I do not think that is in any way necessary—but it is necessary that there should be fair admissions, which is the point that I am making. All schools, when they are criticised by the schools adjudicator, should not try to evade the issue. They should take it seriously and ensure that their admissions policies are meeting the criteria.
Yesterday, the former Secretary of State for Education, my right hon. Friend the Member for Sheffield, Brightside and Hillsborough (Mr Blunkett), issued a report for the Labour Front-Bench team. I will read a short bit from it, to put it on the record—although it is a consultation, it is essentially an outline of the position that Labour are taking regarding admissions. We said that
“whilst the Office of the Schools Adjudicator…annual report noted that only 10% of Local Authorities objected to the arrangements of other admission authorities in their area, the OSA has separate evidence of much more widespread non-compliance. This review recommends that the School Admissions Code is strengthened by removing the possibility of individual schools ‘opting-out’ of the locally agreed admissions framework. This would not prevent changes to arrangements locally or agreed experimentation by Admissions Authorities, but would avoid the detrimental impact of rogue action with one school damaging the admissions of other schools in the locality. This recommendation does not interfere with the role of diocesan authorities, academies or schools as their own ‘Admissions Authority’, but reinforces the necessity of agreed and coherent arrangements within the relevant local area.”
It is important to put that statement on the record, because there are concerns about the watering down of the role of the schools adjudicator by the current Government and about the continuing disintegration and fragmentation of the school system as a result of the Government’s academisation and free school policy. I commend the document to hon. Members, if they would like to read it further.
Yes, I can. It means that Labour will, as we previously pledged, strengthen the role of the schools adjudicator to make sure not only that admissions arrangements are fair, but that when the schools adjudicator makes a ruling, the changes are put in place—if necessary, by the schools adjudicator. I will explain that with a further quote from the document:
“It will be necessary to strengthen the OSA and re-instate its power to change admission arrangements directly on upholding an objection (rather than merely issue a ruling).”
That was a source of great contention earlier in this Parliament, when the Government removed the power of the adjudicator and effectively made it extremely difficult for parents, when they have objections to admissions arrangements, to get those changed.
To be clear, does that mean that in the case of faith schools, in the Labour party’s outline plans, the definition of practising a religion—or an element, I suppose, of practising a religion—would fall further towards the Office of the Schools Adjudicator and away from diocesan authorities?
It need not affect in any way the essence of practising a religion, but where there are requirements—as in the case discussed earlier—for people, for example, to undertake cleaning, the Office of the Schools Adjudicator could rule that that was an unfair part of an admissions policy.
Forget bell ringing and cleaning—let us talk about late baptism for a moment. As a practical example, could the Office of the Schools Adjudicator decide that children having had a late baptism should not count, in a sense, as being Catholic in the same way as those who had infant baptisms?
I am sufficiently well versed in Catholic theology to know that there is no distinction between Catholics, regardless of when they were baptised. Of course that would not be applicable; it would be ludicrous if that were the case.
This has been a very good debate. It is extremely important that we have an opportunity to air these subjects. I want to place on the record my support and praise for the work of Catholic schools throughout the country and to commend, as I said, the Catholic Education Service for the serious engagement that it has had with the issue in relation to admissions. I ask the Minister to respond to the questions that hon. Members have raised about the 50% rule with regard to free schools and to give an answer about why voluntary aided schools cannot be set up as quickly and easily as free schools under this Government’s policy.
The hon. Gentleman wants to find out what the Government’s policy is. Will he elaborate on what his policy is in connection with the Labour party’s replacement for free schools? Will those schools be subject to the same cap as applies to free schools at the moment?
It is a pleasure to serve under your chairmanship, Mr Dobbin. I join other hon. Members in congratulating my hon. Friend the Member for Canterbury (Mr Brazier) on securing the debate and my hon. Friend the Member for East Hampshire (Damian Hinds) on taking on the mantle so well and setting out his concerns so clearly. I also join him in the comments that he made at the beginning of his speech about the tragedy that has occurred in Leeds. It is on the minds of all hon. Members. Our condolences are very much with the relatives of the teacher who died, and our thoughts are with the governors, teachers and pupils at that school.
We have had an extensive debate, with good participation from a number of hon. Members. I thank my hon. Friend the Member for Southport (John Pugh) and the hon. Members for Suffolk Coastal (Dr Coffey), for Huddersfield (Mr Sheerman), for Stoke-on-Trent South (Robert Flello), for Fareham (Mr Hoban), for Isle of Wight (Mr Turner) and for Cardiff West (Kevin Brennan) for their contributions. We have had good representation from those of the Catholic faith here today. They even seem to have got through to the Front Benches, because I also have to declare an interest, having been educated only at Catholic schools—at a Catholic state primary school and an independent Catholic secondary school. I think that I can therefore speak with a bit of knowledge and some sympathy for the points made by hon. Members.
I want to place on record the fact that the Government recognise the important contribution that the Churches and faith schools—schools of all faiths—make to our education system. About one third of the schools in England are Church or faith schools and, as my hon. Friend the Member for East Hampshire said, about 10% of all schools are Roman Catholic. These schools are usually popular with parents and include some of the highest-performing schools in the country. Catholic schools in particular generally outperform other types of state school. Last year, at primary level, 81% of pupils in Catholic schools achieved level 4 and above in reading, writing and maths at key stage 2, compared with 75% of pupils at all state schools. At secondary level, 67% of students secured five good GCSEs, including English and maths, in contrast to 61% of students at all state schools in 2013.
A number of hon. Members have commented on the composition by deprivation of pupils in Catholic schools compared with other schools. Obviously, that is a complicated issue, because the fact that there are differences between schools in their disadvantaged cohorts does not necessarily prove that there has been an attempt by schools to skew their intake in one way or the other. The underlying demographics of the area and the people who want to access the faith schools may mean that they are represented in different ways from the national average in terms of their deprivation characteristics. It is worth noting that the proportions of pupils eligible for free school meals in Roman Catholic schools are not notably different from the percentages of all pupils who come from disadvantaged backgrounds.
The Minister has just profiled the difference between Catholic schools and other kinds of school in terms of educational achievement, but to the credit of a lot of Catholic schools, they also have very good pastoral arrangements. Has the Department any data showing, for example, the number of exclusions from Catholic schools as opposed to other sorts of school? My instinct is that they are rather better at catering for pupils who have problematic histories than normal state schools.
My hon. Friend raises an interesting issue. I do not have those data to hand, but I am happy to look into the statistics that the Department has. I suspect that we probably do or could access such statistics, and I will write to my hon. Friend to let him know whether his hunch is supported by the data.
I know that the Catholic Church feels a strong sense of mission to provide a high-quality education through its schools. That stretches right back to before the Reformation, but was confirmed and strengthened more recently, following the reintroduction of Catholic bishops in 1850. Catholic schools do extend opportunities to pupils from disadvantaged backgrounds. As I said, it is true that Catholic schools have slightly lower proportions of pupils on free school meals, who are eligible for pupil premium funding, but at both primary and secondary levels, poorer pupils in Catholic schools are doing better than their peers nationally, resulting in smaller attainment gaps.
In 2013, 49% of pupil premium pupils in Catholic schools secured five or more A* to C grade GCSEs, including English and maths, compared with 41 % of their peers nationally. That is a healthy advantage in favour of Catholic schools. It equates to an attainment gap of 24 percentage points in Catholic schools. That is lower than the national average of 27 percentage points.
Catholic schools continue to serve high numbers of children from immigrant families—as my hon. Friend the Member for East Hampshire said—both old and new, and from deprived communities. According to the Catholic Education Service, with which we meet and engage regularly, 30% of pupils in Catholic maintained secondary schools are from ethnic minorities, compared with 24% nationally, and 17% live in the most deprived areas, compared with 12% nationally.
My hon. Friend asked whether we had made an assessment of some of the trends in demand for Catholic schools recently. We have not made such an assessment. Obviously, there is an issue about active participation in religion, which is declining in our society, but he is right to point out that we have had an influx of immigrants from communities with strong Catholic representation abroad. That has put pressure on Catholic school places in some communities in the country.
The Education Act 1944 brought many Church schools, including from the Catholic sector, into the state education system, and we continue to benefit from that settlement today. There are nearly 2,000 Catholic schools in England, serving more than 700,000 children—more than 400,000 primary school children and about 300,000 in secondary schools. The notable involvement of the Catholic sector also extends into higher education, particularly through the teacher training colleges, such as St Mary’s.
There is a lot more for us to do, however, and a lot of scope for Catholic schools to play a big role in the education system. Many parents want to see more school places, particularly in parts of the country where there has been that bulge in the primary population since the increase in the birth rate in 2004. That is why the Department has allocated a total of £5 billion for local authorities between 2011 and 2015 to meet basic need.
To support the expansion of schools across the country, we have also allocated large amounts of basic-need capital beyond the existing Parliament, which will help to fund those school expansions. I urge Catholic schools to play a full part in expanding, to help us in those areas with a shortage of school places to meet basic need. I think that that will provide some of the opportunities that my hon. Friend has been seeking, but it is also, in many communities, a responsibility that those who are engaged in state education should want to meet.
Our free schools programme is also helping to meet parental demand for good local school places. Once they are full, the 173 open free schools will provide a total of around 82,000 additional places, with around 23,000 of those places at primary school level. There are two open Catholic free schools. One of those cases was not uncontroversial with the Church, and I will say something later in my speech about the potential involvement of Catholic schools in the free schools programme.
The free schools programme offers new opportunities to groups of all faiths and none to set up new schools in their community. However, faith free schools and new provision academies must be open and welcoming to the communities around them. Where the Government fund new Church or faith school provision, it is right that such new schools cater for local demand in the faith, but the needs of children in the broader local community must not be overlooked. We want all local children to have the same opportunity to access high-quality state-funded education. The fact that it is state funded is the point.
One of the fundamental principles of our education system is the idea of parental choice, something that is important not only to Liberals but to Conservatives and members of other parties. Parental choice is particularly important in the context of new Church and other faith provision. Creating new Church and faith schools gives parents who want their children to have a Church or faith education the opportunity to choose to seek a place at a Church or faith school. However, the Government and I are clear that parental choice also means that all parents should be able to exercise choice and apply to suitable state-funded schools. That includes parents of another faith or not of the faith who may choose to seek a place in their local faith school. It is vital, when we establish new academies and free schools, that we balance those two elements of parental choice. The schools must be set up to serve the needs of the wider community, not simply the faith need. That is why we pledged in the coalition agreement to ensure that all new academies follow an inclusive admissions policy. We followed that up by saying that we wanted to ensure that at least 50% of places in new provision free schools and academies with a religious designation are not allocated on the basis of faith but are accessible by the local community to children who are of the faith, of a different faith or of none.
I apologise for being delayed because of other commitments. I had two sons at the London Oratory school, and I never knew why Tony Blair drew up the ladder after him and stopped the school interviewing. The school made every effort to make its intake very socially diverse, and it was. The Minister says that he went to an independent Catholic school. Why can we not simply let independent schools do what independent schools do, and give them freedom of admission? Of course they will try to create a socially diverse system. They will admit who they want. Why do we have to tie their hands?
I am coming directly to that point. I think that there is a significant difference between schools funded by taxpayers, who have the right to access schools that are, in many cases, their local schools; and schools chosen by parents who seek paid-for private education. I will go on to explain how the 50% works in practice, because it is not quite as some hon. Members have described. The Government are taking forward the principle that was in place under the academy provision created by the previous Government, so there is consistency between the 50% approach that we have taken and the previous situation. The 50% cap represents a balance between providing places for parents who want their children to be educated in line with their faith, and preserving the inclusive, broad local community focus of the school so that local parents, who may not be of that faith, can exercise their choice over state-funded schooling.
We have no reason to believe that the balance is not working effectively. Proposer groups, representing many different faiths and none, still come forward and are keen to set up free schools. Those schools are proving popular with parents. The 50% limit on faith admissions does not mean that Catholic children must be turned away once the school has reached the 50% threshold. A faith free school may end up recruiting more than 50% of pupils who share its faith as long as no more than half the places were allocated on the basis of faith. Other Catholic children have the same opportunity as all other applicants to access the remaining 50% of places, which are allocated according to the other over-subscription criteria.
We do not believe that a 50% limit on faith admissions is incompatible with the provision of high-quality faith education. Church and other faith free schools have the freedom to deliver religious education and collective worship according to the tenets of their faith and to appoint teaching staff and leaders by reference to faith. Not all Church and faith schools, even those with a faith priority in their admission arrangements, admit only children of their faith. If a faith school is under-subscribed, the school must admit all children who apply, regardless of their faith.
Many Church and faith schools choose not to adopt faith-based admission arrangements. The Catholic Education Service’s data show that the average proportion of Catholic pupils in its maintained schools is 70%, and its independent schools have an even larger proportion of non-Catholic pupils. I have been looking during the debate at the percentage of Catholic pupils in Catholic schools, which ranges from 72.8% of Catholic pupils in Catholic primary schools to 42.6% of Catholic pupils in Catholic sixth-form colleges. In the independent sector, only 36.4% of pupils in Catholic schools are Catholic. Only 5% of maintained Catholic schools and colleges—100 institutions—have entirely Catholic pupils, and 20% of Catholic schools, or 401, are already operating with half of their student body composed of non-Catholic children.
I do not believe, however—I am sure that my hon. Friend the Member for East Hampshire agrees—that the 95% of schools that do not have a fully Catholic population are not providing a high-quality Catholic education for all their pupils. Indeed, the attainment levels of Catholic schools bear that out. Many of us who have been in Catholic schools know that a school can have a large proportion of non-Catholic pupils and still maintain its faith principles. The Government and I are clear that that is one of the conditions under which non-Catholic or non-faith pupils enter Catholic or faith schools.
Does not what the Minister sets out raise an obvious question? If such diversity already exists, and if large numbers—30%—of pupils at Catholic schools are non-Catholic, why is there a need to impose a cap? Such a cap would come into play in places where there is a large Catholic population over a slightly wider area. Children would not be turned away for being Catholic but, inevitably, other children who happened to live a little closer to the school would be preferred in their place.
There are two separate points. I sought to make the first point by addressing the question that my hon. Friend raised in his speech about whether it was possible to have a Catholic ethos and education in a school in which a large number of pupils were not Catholic. If he agrees that it is possible to retain that ethos, I welcome that. I come back to the issue of there being two competing rights in a state-funded school system: people’s right to choose to have their children educated in the way that they wish, and the right of taxpayers who live near state-funded schools to have some ability to access them despite the over-representation of people from the faith that the system allows.
I am coming to that, and I hope I will be able to get to it before the end of my speech. As a Catholic—this is a personal comment and not one that I make on behalf of the Government—I think that our faith is at its best when it reaches out to people beyond the faith, and I urge the Catholic faith in this country not to think of itself as providing schools to serve only people of the Catholic faith. Surely, in a society where all religions seem to be struggling to keep people engaged, faiths such as Catholicism should welcome the fact that many parents want their children to attend those schools even if they are not of the faith. I acknowledge that that is an issue for Catholic schools and the Catholic faith; it is not for me, but I think it should be considered.
Although I recognise that the Catholic sector has aspirations whereby it continues to have objections to our policy on admissions in faith free schools, I am keen that that the Catholic Education Service should continue to engage with us in discussing the matter. We remain committed to continuing our engagement with the Catholic Education Service on this issue, and we would welcome innovative ideas from it. For example, a free school that, in response to local demand, met the anticipated faith demand but had a capacity greater than that demand and thus did not exceed the 50% limit would still be eligible for funding. Such a school would help to provide additional school places where they are most needed and extend school choice to parents who might not be Catholic but nevertheless want a Church education for their children. I must be clear, however, that we currently have no plans to change the 50% limit. Given the fact that we have a very small number of Catholic free schools, I hope that Catholic schools will consider engaging further in that programme.
In understanding the importance of the 50% limit in ensuring that new provision Church and faith schools are also accessible to their local community, it is vital that we recognise the wider pressures on the schools system. Making sure there are enough high-quality school places for the growing population will remain one of the Government’s top priorities. The Department has allocated a total of £5 billion of basic-need money to local authorities between 2011-12 and 2014-15. That is considerably in excess of the amount for the previous Parliament. Local authorities and other schools in those areas have already created about a third of a million additional school places, and must continue to create such places in future.
The Department provides funding to enable local authorities to meet the demand for new places based on authorities’ forecasts of pupil numbers in their areas. The Government welcome Church and faith schools as part of the diverse and autonomous pattern of education provision in this country. We therefore provide for faith designation of both maintained schools and academies. A voluntary-aided school can seek to convert to academy status, just like any other maintained school, but a voluntary-aided school converting to academy status would convert under existing arrangements—
Prison Education and Welfare Services
It is a pleasure to serve under your chairmanship, Mr Dobbin. I am pleased to have secured this debate on education and welfare services in prisons—an important subject that affects the lives of thousands of prisoners throughout the United Kingdom, where 85,000 people are in prison. According to the Government’s figures, 81,000 are men and just under 4,000 are women. More than half of the UK’s prison population are in their 20s and 30s and therefore likely to have many years of freedom ahead of them upon their release.
In the first instance, prison must be seen as a punishment: a restriction of an individual’s freedom in response to their behaviour. However, it should not be a place that permanently reduces their life chances upon release. Offenders who are ex-offenders should be regarded as ex-offenders; they should be given the chance to move on with their lives and given a second chance. However, for some offenders, whole-of-life prison terms are more than appropriate; others, such as paedophiles and those who cannot be reformed, in my view deserve longer sentences than is currently the case. I hope that the Government will look at that in detail. I also think that tariffs for breaching the Official Secrets Act and acts of treason are far too lenient and might not deter those who would seek to undermine our nation’s national security.
For some offenders, however, prison can be an opportunity for them to change and turn their lives around—there is an opportunity, through education and welfare services, statutory or otherwise, to rehabilitate prisoners and provide them with the knowledge and skills to help them to lead successful and productive lives in their communities upon release. Through education courses, prisoners will be better equipped to find and sustain employment on release, becoming an asset to local communities and the wider economy. Education is still very much an escalator to opportunity and should be a key focus of the Government’s prisons policy. It has been estimated that up to 80% of prisoners have a reading age lower than that of an 11-year-old. That does not bode well for their employment on release or their successful reintegration into local communities.
A large proportion of prison education services are provided by the Government through the offenders’ learning and skills service, as well as through a number of Government-contracted providers. Although welcome, such statutory services tend to focus only on key basic skills such as maths and literacy. Those are of course important, but the training does not usually go beyond level 2, which is equivalent to a GCSE. The courses are highly valuable for prisoners, particularly those from poor educational backgrounds, and the Government deserve credit for increasing prisoner participation in them.
One of the key providers of such courses is A4E, which does some excellent work in helping former prisoners into employment, often bringing potential employers into prisons and giving offenders the chance to demonstrate their skills in a work-like environment. However, there are still areas in which the Government can improve the provision of educational services and make further progress. In particular, the focus on processes and outputs alone, where pressure is put on providers to get prisoners on to and through courses, risks missing those prisoners who require more focused, specialised, bespoke and, in some cases, higher-level teaching experience than the current system provides.
It is also difficult for education providers to draw down funding for courses beyond level 2, which results in a distinct lack of progress for prisoners who come from a stronger educational background. Furthermore, the comparative lack of more engaged learning, including more practical and vocational courses—such as gym courses, as well as workshops and other creative activities—risks alienating individuals who may not be academically minded but nevertheless have other practical skills that could equip them for the outside workplace. That is why the role of charities is important, because it often falls to charities and other external organisations to provide educational services in areas not currently covered by the offenders’ learning and skills service, or OLASS.
I congratulate my hon. Friend on securing this debate, and make my usual declaration about my publication on prison reform two years ago. Does he agree that we should be looking into the idea of an academy prison, whereby the whole prison is run by a charity or altruistic institution? The current model is either state or private, whereas in schools we have transformed education by the provision of academies that are outwith the state or private institutions. Surely, the next step for public sector reform of prisons should be the charity not just providing the education within a small segment of a prison, but taking over the whole prison itself.
My hon. Friend makes an important point. We must have a mixed economy for education provision in the prison estate. He makes an innovative point on the potential for an academy—either an individual academy within an individual prison or an academy with a capital A across the whole of the prison estate. He is of course well versed and experienced on this subject, having written a book entitled “Doing Time: Prisons in the 21st Century”, which looked at the subject of literacy, numeracy and education. I applaud his continued commitment to improved education in the prison estate.
I was talking about charities, and the Prisoners Education Trust, for example, funds around 2,000 people each year to study a wide range of courses in subjects and at levels not provided by statutory education services, including Open university degrees and diplomas as well as more practical and vocational courses. The trust does an excellent job in helping thousands of prisoners across the estate, and I pay tribute to its work. Over the past quarter of a century, it has led many prisoners back into successful lives in the community. The Ministry of Justice’s research confirms that prisoners who study are less likely to reoffend, so everyone wins. Other charities involved in such work include the Shannon Trust, the No Way Trust and the Henry Smith Charity—I do not believe that the latter relates to our colleague, the hon. Member for Crawley (Henry Smith), but I know that he is interested in this subject. They all deserve credit for supplementing other education services within the estate.
Welfare services available to prisoners, whether counselling, faith-based or pastoral services, such as the work of the prison chaplaincy, all make for better prisons and help reduce reoffending rates on release. Once again, the role of charities makes an invaluable impact on the lives and welfare of prisoners. In particular, the Prison Fellowship does excellent work in support of prisoners to navigate their way through a host of different programmes and initiatives. It also supports those who have little or no social or family network to support them in or out of prison. Through its excellent victim awareness programme, the Prison Fellowship teaches the principles of restorative justice, by giving prisoners the opportunity to explore the effects of crimes on victims, offenders and the community, as well as to take responsibility for their own actions and crimes.
On restorative justice, the Government should look again at the moneys provided to the police and crime commissioners for that type of justice work. I do not think that the majority of PCCs are best placed to spend those justice funds. My view is that organisations such as the Prison Fellowship and others should be able to apply for direct funding from the Ministry of Justice. I hope that the Minister will consider that again and will respond when winding up.
Other charities, such as Time for Families, also do good work, including running relationship courses in prisons. The staff and volunteers, like those of so many other charities, do so much for so many, and I pay tribute to all those who do such work. I also pay tribute to all prison officer staff and volunteers who work within the prison estate, most with professionalism and commitment, in both the public and private sectors and—who knows in the future?—in some third-way academy; I hope so.
The prison chaplaincy is the backbone of the prison welfare and pastoral services provided, with that care playing a vital role in the rehabilitation process, and helping prisoners with many of the challenges that they face.
Mr Dobbin, with your permission, I would like to be reminded when there is one minute left for me to speak. That would be very helpful.
For those prisoners of faith, the prison chaplaincy provides solace, confidentiality and somewhere for them to go to practise their religion. I pay tribute to all those who offer spiritual and pastoral counselling to prisoners and staff. None the less, some recent concerns have been expressed about accessibility to chaplaincy services. In a recent submission to the Select Committee on Justice, the Caritas Social Action Network in collaboration with the Catholic Bishops Conference of England and Wales raised a number of concerns about access to religious services for prisoners. Some of that has resulted from changes in the organisation of the prison day, with the bishops citing the shortening of the prison day. I am interested to hear the Minister’s response to that claim, given the vital role, which I know he and the Government recognise, of the work chaplains do in the prison service.
I highlight the excellent Listener scheme established within prisons by the Samaritans. I recently tabled a written parliamentary question on the subject. The scheme helps to support hundreds of prisoners and can help reduce self-harming. Prisoners are trained by the Samaritans and other prisoners come to that prisoner for help, support and guidance. I hope that the Minister will ensure that all prison governors and staff are made fully aware of the Government’s support for this scheme, since, again, everyone benefits.
I turn briefly to maternity services and women in prison. My view is that women with very young children should be jailed only for serious offences. I think that pregnant prisoners as far as practicable should always give birth in NHS hospitals and stay in hospital for as long as possible wherever needed. The Government need to publish annual official figures on the number of pregnant women in prisons and the number of mothers and babies passing through the prisons estate each year. Those figures are currently not published. Bespoke policies cannot surely be made without sufficient detail and empirical data and evidence.
There are estimates that more than 600 women receive antenatal care in prisons each year, with more than 100 women actually giving birth during their sentences. Can the Minister confirm that the female prison population is likely to rise? If he thinks that is the case on projections, will the 80 mother-and-baby places in units in England—and other places—spread between seven establishments be sufficient to meet future demand? Does he think that such units are the right environment for babies to be born?
I am aware that in 2000 the prison service and the NHS entered into a formal contract to provide prisoners with the same standard of midwifery care as that provided elsewhere in the community, and rightly so. Is the Minister content that that contract is providing the health care that mothers and babies require?
Can the Minister confirm on the record that, though the practice was outlawed since 1996, mothers are no longer in every case shackled while in labour or giving birth? The Government need to do more to ensure that standards of antenatal care are far more uniform across the prison estate—high levels of care, not a lowering of standards of care.
I am grateful, Mr Dobbin. I would like to thank the Maternity Alliance for the work that it does in relation to mothers and babies in prison.
The Government are doing some excellent things to ensure that education and welfare services are available in prisons, and that work is admirably supplemented by the excellent work of numerous charities, some of which I have referred to today. However, I hope that more progress can be made, particularly in relation to uniformity of access and standards.
Changes of policy or process within individual prisons or across the whole prison estate should not lead to a lowest-common-denominator approach. Those who occupy prisons are individuals who have done wrong to society. However, that does not mean that they should be written off. Yes, prison should be a place of punishment, but also a place of rehabilitation, a weaning off dependency and a place of restorative justice for those who have open minds and hearts. The prison service should be a helping hand in that process, not a deterrent or an unwitting roadblock. The prison service works best in a collaborative process.
Most prisoners will return to the outside world and it is in large part the responsibility of this Government to ensure that policies are advanced that help equip prisoners for a fresh start and a new life on their release, going on to lead productive and fruitful lives for themselves and for wider society.
It is a pleasure to serve under your chairmanship. Mr Dobbin. I start by congratulating my hon. Friend the Member for The Wrekin (Mark Pritchard) on securing the debate and on the way he has set out his case. I agree with a great deal of what he has said. He is entirely right that the first thing the public expect is that sentencing is carried out in a robust and proper manner and that, where tough sentences are appropriate, they are handed out.
My hon. Friend will know that the Government are acting on that expectation in relation to legislation currently passing through Parliament. We will, for example, no longer have automatic release for terrorists and those who have committed child rape offences. I think that he and many others will welcome that.
My hon. Friend is right that prison should not simply be a place of punishment, but also an opportunity to turn lives around. He will recognise the Government’s clear focus on reducing reoffending. A large part of that relies on rehabilitation that takes places during custody as well as that which may take place later.
My hon. Friend talked about education and skills, and again he is right that that is hugely important. We recognise the important role that skills and employment can have in reducing reoffending. We are committed to creating a more effective system for helping prisoners develop the skills required for sustainable employment. I am especially concerned, as I know that my hon. Friend will be, about the number of prisoners who have poor literacy and numeracy. We know that such skills are essential for life and work and without them any individual is disadvantaged in the job market. For that reason, from August this year we are introducing mandatory assessment of learning needs for all prisoners on reception. This will help to ensure that those with the greatest need do not slip through the net. Of course, education is not mandatory for anyone over 18. However, we hope that our revised incentives and earned privileges scheme and more innovative and engaging approaches will secure the involvement of those adult prisoners.
My hon. Friend may know that we have piloted the use of the Army’s approach to intensive maths and English and have found that to be effective with prisoners. We intend to roll this out further, particularly for those serving short sentences.
The assessment should apply to all prisoners, so that we understand what someone’s learning needs might be. As I have said, it is difficult to compel anyone above the age of 18 to engage in any education courses, but it is important that we understand what a prisoner’s learning needs are when they arrive in custody. If someone has significant learning needs, it is right to give them every incentive and encouragement to address those needs, so that they can start to make their way in the world in a legitimate way, just as my hon. Friend described, when they leave custody.
My hon. Friend mentioned a number of charities that have an important part to play in this regard. He is right about that. He mentioned the Prisoners Education Trust, and I support what he said about it. He is right to mention the Shannon Trust in particular, given that we are discussing literacy among prisoners; it does good work, as he knows, through the “Toe by Toe” programme, which enables prisoners to learn to read outside a classroom setting.
My hon. Friend is also right to say that we have to focus on vocational training. Our offender learning strategy concentrates on preparation for employment, as we know that having a job when leaving prison can reduce reoffending. Vocational training, based on labour market intelligence, particularly in the year before release, will remain a priority especially in the new resettlement prisons. More broadly, I want to ensure that a core of employers is in place to offer employment opportunities to offenders and ex-offenders, in particular through the Employers Forum for Reducing Re-offending, chaired by James Timpson.
I am fully aware, as my hon. Friend is, that many prisoners have experienced a lifetime of social deprivation and face more significant barriers to obtaining employment than the average jobseeker and that prison leavers spend longer on benefits than other new jobseeker’s allowance claimants. For this reason, from March 2012 we introduced a change so that all prison leavers are immediately mandated to the Work programme if they make a claim for jobseeker’s allowance in prison or within 13 weeks of release. This is intended to ensure that newly released offenders have the support that they need to find and stay in work.
Of course, work after prison is an important factor, but work in prison is important, too. Work in prison can prepare prisoners to take up opportunities outside. Too many prisoners are able to pass their time in prison in a state of enforced idleness, with little or no constructive activity. We want prisons in England and Wales to become places of meaningful work and training, where many more prisoners work for up to 40 hours a week, and possibly beyond. We have had considerable success in increasing the number of hours worked in our prisons since 2010.
We want more prisoners to undertake challenging work, within the discipline of regular working hours, which will also help them develop the skills that they need to gain employment, to reform and, ultimately, to turn away from crime.
I visited HMP Northumberland with the Secretary of State for Justice this month and spoke to the highly successful providers of education in prison there. Does the Minister accept the potential for alternative providers for an individual prison? Does he agree with his predecessor, the hon. Member for Reigate (Crispin Blunt), who indicated on 13 March 2014, as reported in Hansard, that such organisations would be genuinely welcomed by the Ministry of Justice, provided that they satisfy the financial and safeguarding criteria?
It is not so much who provides the prison accommodation that matters, but what they provide and the support that goes with it. My hon. Friend will recognise that neither this Government nor the previous one have excluded the possibility of prisons being run by people other than the state. It is important that we look at every potential provider of prisons, to ensure that they can provide for us not just a secure environment, but one in which rehabilitation can be achieved. I recognise his enthusiasm for this cause. We think that it is more important that what is provided is good, rather than who provides it.
Let me move on to restorative justice, which my hon. Friend the Member for The Wrekin mentioned. I am an enthusiast for restorative justice, which has a significant part to play, not just outside custody but inside, too. He will know that restorative justice principles are sometimes used inside our prisons. The Government have, in this sense, put their money where their mouth is and made some £30 million available over the next few years for restorative justice to be carried out. He is right to say that, at the moment, the bulk of that money goes to police and crime commissioners. It is right that people who are in a position to determine local need have that money available to them, but that is not the only resource available for restorative justice. I will consider carefully what my hon. Friend has said, to see whether there are other ways in which we can achieve the objective that he has set out.
I am, like my hon. Friend, an enthusiast for chaplaincy, which does a good job. He knows that chaplaincy teams in prisons are available to provide pastoral support to prisoners of all faiths and to those of no faith. All prisons have multi-faith chaplaincy teams to both provide this support and to enable religious provision. All new prisoners are seen by a chaplain, from whom they hear about the support and services provided. In addition, prisoners who are segregated or in health care—both particularly stressful times—are visited daily by a chaplain to offer support. Chaplains can also be alongside prisoners at times of crisis in their lives, such as bereavement, when they may be particularly vulnerable. Our chaplaincy teams also deliver a wide range of group activities and classes that are not just faith-based but look at issues such as loss, victim empathy and developing life skills. Chaplaincy teams are well placed to both provide this support and to challenge behaviours and to provide positive role models.
My hon. Friend mentioned the care that may be on offer from other prisoners, aside from the care offered by the authorities. Again, he is right about this. Often, we find that prisoners respond and relate more easily to their peers. A good example of this is the Samaritan-trained Listener scheme, which he mentioned, whereby carefully selected and trained prisoners act as listeners inside the prison. They listen in confidence to their fellow prisoners who may be in crisis, feel suicidal or need a sympathetic ear. The listeners assist in preventing suicide, reducing self-harm and generally help alleviate the feelings of those in distress. In addition, selected prisoners act as what we call insiders, helping with the induction process by telling new prisoners all they need to know about life in prison, what is available and where to find help.
My hon. Friend asked about maternity and childbirth provision. He knows that, under the Health and Social Care Act 2012, since 1 April 2013, NHS England has a legal duty to commission health services or facilities for all people who are detained in prison. Women prisoners and their babies should have access to the same range and quality of health services and treatments from the NHS as everyone else. This will include antenatal and post-natal care through attendance at hospital or in-reach midwifery. The six mother-and-baby units in England and Wales provide an overall capacity of 64 places for mothers. In fact, there is a total of 70 places for babies, to allow for twins.
My hon. Friend asked about population projections. Of course, we keep this matter under review, but we will always look to ensure that we have sufficient capacity to accommodate those who we believe will find themselves in the custodial system. He is right to say that the custodial system is not the best place for mothers and babies to be. He will know that courts will always think twice before incarcerating someone who is in that condition, but sometimes that is necessary. The decision to provide a place in a mother-and-baby unit is taken by a board consisting of representatives from the local authority, the prison, other interested parties and an independent chair. The overall age limit for most of these units is 18 months, although that may vary depending on the circumstances. He will appreciate that, when considering applications for admission to mother-and-baby units, the best interests of the child are paramount.
My hon. Friend asked me one other question, which was on handcuffing. Handcuffing is profoundly undesirable, and the general policy is not to handcuff women, but as he will understand, an individual risk assessment has to be made in each and every case.
I hope that my response assists my hon. Friend, and I welcome his interest in what happens inside prisons. I am also grateful for the intervention of my hon. Friend the Member for Hexham (Guy Opperman) who, as my hon. Friend the Member for The Wrekin has said, takes a consistent interest in such matters. There is a good deal more to do, but as my hon. Friend the Member for The Wrekin and I entirely agree, prisons must be both places of punishment and places where we seek to turn around the lives of those who would otherwise go on to reoffend.
Garment Industry (Working Conditions)
It is a pleasure to serve under your chairmanship, Mr Dobbin. I am grateful for the opportunity to debate matters related to the Rana Plaza disaster in Bangladesh, the anniversary of which was a few days ago. I am grateful to be joined by colleagues who have a long-standing interest in Bangladesh and who have spoken a great deal about the Rana Plaza disaster and what it means for the ready-made garment industry in Bangladesh. Our time is limited, so I am grateful for their support. I know they will also want to make relatively short contributions in the limited time available.
I was privileged to visit Bangladesh last September with fellow members of the all-party group on Bangladesh. We planned the visit specifically to feed into our subsequent report, “After Rana Plaza,” which focused on the ready-made garment industry in Bangladesh. We made recommendations on what we think is needed to get the ready-made garment sector in Bangladesh into the right place so that we can ensure that we do not see another Rana Plaza.
The disaster at Rana Plaza claimed some 1,100 lives, with 2,500 people injured, and it came only a few months after the Tazreen Fashions fire in Dhaka, which killed 112 workers. There is a pattern of industrial incidents that have claimed lives in one of the world’s poorest countries, and it is a stark reminder to the rest of the world that our cheap, fast fashion has a human cost that is often hidden. Those two disasters in Bangladesh have particularly helped to bring home the human cost to consumers in Britain, Europe and elsewhere in a way that had not necessarily happened previously.
I will address the recommendations made in the all-party group’s report, but I will first talk about our visit to Bangladesh. I am pleased that my hon. Friend the Member for Bethnal Green and Bow (Rushanara Ali) is here, because we went out to Bangladesh together, and she was with me when I visited one factory in particular. The Department for International Development, which was working with the all-party group during our visit, encouraged us to go to the factory. The incongruous image that comes to mind when I think of that time is of seven Bangladeshi women in shalwar kameez sewing zips on to bright pink skinny jeans that were destined for sale in Russia.
My hon. Friend and I were in the factory for our work on the all-party group’s report. We had been sent there by DFID because it was one of the better factories and had much better standards on health and safety, fire risk and work force engagement than many other factories in Dhaka. DFID was rightly keen for us to see what a good factory in Dhaka’s ready-made garment industry looks like. When I went into the factory, even though it was one of the better factories—I took that point on board—the first thing that hit home was the unbearable heat. The factory was not hot just because of the lovely weather in Bangladesh, because I am not a wimp when it comes to general heat and nice weather. Going into that factory, the first thing I felt was a blast of heat that was unlike anything I had ever experienced. When I stood near those women who were sewing zips on to the pink skinny jeans, it was all I could do to maintain for 10 minutes a reasonable conversation in broken Urdu that the women could just about understand before I thought, “I have to wrap this up and get over to the other side of the factory, because I cannot physically stand here for very much longer.”
I also remember clearly that the women were supposed to be wearing face masks because there was a lot of cloth fibre and dust in the air, which is damaging for people to breathe in every day at work, but because it was so hot they had to take off their masks. Even in a good factory that was doing its bit to meet some minimum standards, particularly after the Rana Plaza disaster, there were still issues that I, as a British woman, felt to be serious as I was standing in the factory.
On the side of the building, again in relation to health and safety standards, there was what we were told was decent fire escape provision. There was a door at the side of the building that led out to a stairwell that went down into the outside courtyard. Again, unlike what sometimes happens in other factories, access was clear and there were no boxes of garments in front of the door. The access was not blocked, unlike pictures we had seen of other, less good factories. When I saw that stairwell, which was the fire exit for hundreds of workers in the factory, I thought to myself, “God help me if I ever find myself working in a factory like this and having to run out into that stairwell, which feels pretty rickety to me.” That might be because of the British experience and the good safety standards that we expect for ourselves, but it was a stark reminder that even what passes for good standards, and what outside organisations such as DFID and others say are good standards for Bangladeshi workers, are things that I do not think many British workers would ever accept for themselves—I certainly would not accept them.
Before the hon. Lady intervenes, I clarify that interventions are acceptable with the agreement of the hon. Member for Birmingham, Ladywood (Shabana Mahmood) but speeches are not acceptable unless the hon. Lady and the Minister have agreed. The Chairman should also be informed.
Thank you, Mr Dobbin. I will make an intervention.
My hon. Friend the Member for Birmingham, Ladywood (Shabana Mahmood) mentioned our visit to Bangladesh, and it is clear from that visit that, across the board in the garment industry, people face a threat to their life every day in such places. That was highlighted by the most appalling tragedy last year in the Rana Plaza accident.
My question is both to my hon. Friend and to the Minister. I seek progress and pressure from our Government to ensure that the issues with labour standards and building regulations that we found in our report are addressed quickly so that we see no further tragedies. Does my hon. Friend agree that the Government should put more pressure on companies that have not paid compensation? Only $15 million of the $40 million has been paid. Will the Minister support the “No more fashion victims” campaign led by Labour Behind the Label and Katharine Hamnett, which seeks to apply such pressure?
I thank my hon. Friend for that intervention, which highlighted a number of important issues. I will come to building standards a little later.
As I was saying, I did not feel that even what I accepted was a good factory represented a safe environment in which I would happily rock up for work, do my shift and go home without thinking that I had taken my life in my hands. That is a stark reminder, if one were needed, that even with minimum standards in place—there has been a lot of good work on getting standards in place for the sector in Bangladesh post-Rana Plaza—there is a long way to go, first to meet those standards in the first place and then to get the kind of working conditions in that part of the world that workers in many other parts of the world, particularly in this country, enjoy.
I apologise to all Members; I will not be able to stay until the end of the debate. Briefly, does my hon. Friend agree that the standards issues she describes make it all the more important that we support and back up the work of the International Labour Organisation, which does this work around the world on all our behalves?
I spoke on this issue on 25 April, two days after the disaster, in the Council of Europe; what happened was in breach of article 4 of the European convention on human rights. On standards, my hon. Friend visited a factory where she was shown that everything was fabulous, but that was because she was visiting. The reality is that in October 2013, 112 women died at the Tazreen factory in Dhaka because they were locked in the factory when it caught fire. On 11 September 2012, 289 workers died at the Ali Enterprises factory in Karachi because they were locked in the factory when it caught fire. How much confidence can we have that we are not just being shown the best on the day? All the reports say that such factories do not represent the standards when interested parties, such as my hon. Friends, are not there observing.
That is an important point. When we visited that factory in Dhaka, I had the benefit of having my hon. Friend the Member for Bethnal Green and Bow with me. She was able to engage with the workers in Bengali and Sylheti. She had a conversation with them that probed whether what we were seeing was for the benefit of visitors, rather than what happens on a day-to-day basis. I left confident that what we had seen was a true picture. DFID put in place arrangements to work with grass-roots organisations to ensure that those standards are not just what someone sees when they visit on any given day, but what happens every day for those workers.
I am afraid that I will not, because I have so little time left.
Post-Rana Plaza, there has been a lot of action to try to get better safety standards in Bangladesh. A number of companies have signed up to the accord on fire and building safety there. It covers just less than 2,000 factories, which still leaves many thousands of factories not within the scope of the accord. That is a concern, although the fact that some 1,800 or so factories are covered by the accord is a good thing.
When we were in the country with the all-party group, we had a number of conversations with Rajdhani Unnayan Kartripakkha, the Bangladesh university of engineering and technology and other stakeholders in Bangladesh on regulations and building codes and their enforcement. Their point was not that the building regulations do not exist, because there is a strong and relatively robust system of regulations and codes; their point was more on the level of enforcement and capacity—having enough trained surveyors, architects and engineers to implement the regulations.
I am the daughter of a civil engineer. My dad is an expert in water and waste management systems, so I have grown up looking at maps, regulations and things like that. I was struck that the experiences of those experts was not that different from those of my dad as a civil engineer in Britain. They had similar relationships with colleagues and brought similar professionalism to bear. The problem is that there are not enough of them in Bangladesh and they are not organised into professional bodies, such as those we are privileged to have in this country with—for example, the Institution of Civil Engineers and the Royal Institution of Chartered Surveyors. That is the missing link, almost, in getting Bangladesh to a place where the regulations are properly implemented and enforced when buildings are being put up.
I am pleased that DFID has decided to focus its energies on fire and safety regulations, capacity and so on. That is an important step. I am a big believer that our activities through DFID in other parts of the world should not be seen as just giving money. We should help countries to build up the infrastructure and systems that they need to deal with these issues themselves.
One thing that remains a concern is that, although many organisations are carrying out inspections and reports into building safety in Bangladesh are being prepared, I am not clear or confident that the information captured will go quickly to a place where it can be implemented. For example, Tesco wrote to me in advance of this debate to say that it had ceased to work with one of its suppliers in Bangladesh because it does not believe that the building that the supplier works out of is safe enough. It is worried about that, but once it has ceased to work with that factory I am not clear what will happen to ensure that the factory ceases to operate or that it takes remedial action to ensure that it is a safe working environment.
There are so many assessments of building safety covering such a wide geographic area; I remain worried that the Bangladeshi Government will not end up with the data they need to take remedial action in situations where remedial action has not been enforced because the big clothing companies have ceased their relationship and walked away.
Issues remain on workers’ rights and the organisation of the labour force in Bangladesh. Trade unions in this country have been active in trying to support Bangladeshi workers to be in a position where they can organise. There is a lot of discussion on labour law amendments in Bangladesh—whether they go far enough and whether workers will soon be able to organise and to negotiate with company owners on wages and their safety at work.
Regardless of the politics of the trade union movement in this House, we are privileged to have such things in this country. I would very much like to see Bangladeshi workers and poorer workers across the world in a similarly strong position when it comes to negotiating rights at work. I would be very grateful if the Minister said a little more about what DFID is doing to support labour law and rights in Bangladesh. There has been a lot of discussion about whether to take the United States route, which is to deny trade privileges, or whether to try to work with the Bangladeshi Government in a slightly different way, which is what the UK and the European Union have decided to do.
There remains, as my hon. Friend the Member for Bethnal Green and Bow (Rushanara Ali) said, a big issue on the Rana Plaza compensation fund, which does not have half the money that it aimed to have. It was said to need £24 million, but only £9 million has been raised. I find that disgraceful and shocking. For the big companies that are involved in this industry, which is worth billions and billions of dollars, £24 million is small change. It is a tiny sum.
I remain shocked and deeply upset that that fund has still not got the money that it needs. I pay tribute to the companies that have paid into it. Primark, which has a base in my constituency, wrote to me recently to inform that it has paid in and taken the action that it feels that it can, but we need to continue to press other British companies to do the right thing and ensure that that fund has all the money that it needs.
On compensation for workers, in this country we are privileged that we have a body of personal injury law that makes it easy for lawyers to argue on behalf of victims for compensation that truly and accurately reflects lifelong loss of earnings or amenity. We have formulae in our legal system that enable us to provide adequate compensation to victims of injury at work and elsewhere, but I am worried that the robustness that we expect in Britain or elsewhere in Europe or in the States through such legal formulae for deciding rates of compensation, especially in the cases of injuries that prevent someone from being able to work fully for the rest of their life, will not necessarily translate into what will be received by the victims of the Rana Plaza disaster and their families.
I would be grateful if the Minister could say a little about the British Government’s view on compensation, as that is important. We must ensure that the families of those who lost their lives are adequately compensated, as well as the 2,500 people who were injured. Some of them, who are desperately poor, will never be able to work again and, as each day passes, they are getting into more desperate circumstances.
Terrible things happen in faraway parts of the world, but sometimes good can come out of those disasters and it is our duty to try to find that good. One such good is that, for consumers in wealthier parts of the world who enjoy fast and cheap fashion, this is a reminder of the human cost of our £10 dress from a British high street chain. We have responsibility as consumers to think more about that when we are buying and brands need to think not just about the moral and right thing to do, but their reputational risk when they find that they may have contributed in some way to the problems that caused disasters such as Rana Plaza.
I congratulate the hon. Member for Birmingham, Ladywood (Shabana Mahmood)on securing this very important debate and I thank her for doing so. I acknowledge and admire her conviction and concern on this issue and agree in particular about what she said about the enforcement regime.
The ready-made garment sector is in many ways a huge success story for Bangladesh: it is worth over £13 billion and it provides jobs for more than four million people, of whom over 70% are women. The garment industry supports a further 25 million people across the country. The problem, however, is that the growth in this sector has outpaced the development of the standards that underpin it. Like others around the world, we were all shocked by the appalling loss of life in the tragedy at Savar last year, where more than 1,100 people were killed and a further 2,500 were injured.
In the immediate aftermath, the Department for International Development helped to provide trained volunteers and equipment to help rescue those who were trapped. Many of the injured were taken to the DFID-funded centre for the rehabilitation of the paralysed, which is just 1 km down the road, for treatment and rehabilitation. The collapse was a wake-up call, not only for the garment industry, but for all of us who buy clothes that may be made in Bangladesh. It threw the spotlight on building and fire safety and on the wider working conditions and rights of Bangladeshi garment workers.
I visited Bangladesh at the beginning of April, which was my second visit since the collapse, and I met survivors who have received help from the UK to recover from their injuries and retrain for new jobs. It was moving and inspiring to hear how the survivors have sought to maintain their dignity and re-establish their livelihoods despite receiving such severe injuries and psychological trauma.
We can all learn from their stories. The two that most stuck in my mind were first that of someone called Yusuf, who was paralysed after he ran into the building to help others to escape. The compensation that he has received means that his family has a secure future. I also met Amzad for the second time. He is a double amputee who is being trained at the centre to use prosthetic legs.
I also met the Government, factory owners and the Accord on Fire and Building Safety. I am pleased to say that, one year on from the Rana Plaza tragedy, genuine progress has been made in addressing the many challenges facing the industry, through commitments made by manufacturers, brands, development partners and, as is essential, the Government of Bangladesh. A new labour law has been introduced that allows for greater freedom of association and increased occupational health and safety for workers. Encouragingly—this goes to the nub of what the hon. Lady was referring to—more than one thousand structural, fire and electrical safety inspections have been carried out in the last year. However, a further 2,500 registered garment factories need to have structural, fire and safety inspections and those factories that are not registered need to be identified.
Let me outline the action that the UK Government have taken during the past year to help improve standards in the garment sector. Along with Canada and the Netherlands, the UK is providing £4.8 million to an International Labour Organisation programme to improve working conditions in the sector, which will conduct about 1,500 structural, fire and electrical safety inspections. We have also supported the development of a website and an inspection database for the new Department of Inspection for Factories and Establishments. That is exactly the sort of objective that the hon. Lady outlined: to get a common standard across the whole sector so that the good do not pass on lower standards to the bad. We are supporting the development of an efficient, credible and transparent cadre of labour inspectors through training and technical support. The inspectors will ensure compliance with the new labour law and include occupational health and safety and working conditions in their remit. Training for the inspectors begins next month.
When I was in Bangladesh earlier this month, I launched three new projects that will help staff at all levels in garment factories to work together to improve the working environment by addressing issues such as fire safety, absenteeism and working hours. The projects will provide training for middle managers in labour standards and, critically, improve the health care provided to factory workers—in essence, by having a nurse in every factory. DFID is also helping to launch a new programme that will focus on building industrial relations inside factories—on the spot—so that management and workers are better able to prevent, identify and solve problems in the work place.
On compensation, as the hon. Lady said, Primark—which first of all got attacked in the press—has in fact been an absolute market leader and exemplar in how it has paid out long-term compensation to workers and their families. I am aware that some other companies have made smaller additional contributions. I use this opportunity today to ask other UK companies to step up and contribute to help the Rana Plaza workers.
At the heart of the issue is the idea that companies must take responsibility for all the workers in their supply chain. The best brands do the best things, and British companies can be a force for good by enforcing improvements in their supply chain. I urge all brands, companies and retailers to think about their sourcing practices and to introduce more transparency into supply chains. Those standards have to go all the way from the till at which a garment is sold right back to the sewing machine where it is made.
The garment industry is having a positive impact on social change and women’s empowerment, by providing women with opportunities to work outside the home, to earn their own money, to help support their family and to have an alternative to early marriage. The empowerment of women must be allowed to continue and flourish within the garment sector. We want to see continued growth, rather than boycotting or abandonment, so that the sector can continue to flourish as an important part of the economy, thus increasing the number of safer and better jobs for women in particular.
The UK will continue to support work towards the goal of building a healthy, safe and sustainable garment sector in Bangladesh that benefits everyone. The priority now, assisted by today’s debate, which was initiated by the hon. Lady, is to maintain momentum and use this first-year anniversary to push for continuing further progress.
Question put and agreed to.