Wednesday 29 March 2017
[Mr David Hanson in the Chair]
School Funding (London)
I beg to move,
That this House has considered schools funding in London.
It is a pleasure to serve under your chairmanship, Mr Hanson. I am pleased to have secured this debate so that Members can highlight the specific impacts that the proposed national funding formula will have on London schools. I am grateful to the Minister for meeting me last week, together with my hon. Friend the Member for Bermondsey and Old Southwark (Neil Coyle), my right hon. and learned Friend the Member for Camberwell and Peckham (Ms Harman) and the leader of Southwark Council, to discuss the challenges that schools in Southwark and Lambeth will face as a consequence of the national funding formula proposals.
Since I was elected almost two years ago, there have been only a handful of issues on which my constituents feel as strongly as they do about the schools funding formula, and few issues around which people have mobilised on such a large scale. In the past few weeks, I have attended meetings in Lambeth and Southwark with a total of more than 500 parents. A further 100 parents and children joined a protest in Dulwich last week, and hundreds more have been in touch with me by email and letter and on social media. I want to speak about the impact the Government’s proposals will have, what exactly is at stake and why it matters so much. I have some specific asks to make of the Minister.
The new national funding formula will see 70% of London’s schools receiving cuts to funding. The proposal comes at a time of unprecedented budget pressures in our schools as a consequence of a series of unfunded costs: the national minimum wage increase; employers’ pension contributions; employers’ national insurance contributions; inflation; and, for local authority schools only, the apprenticeship levy. In that context, the additional cuts introduced by the schools funding formula will be unsustainable for many schools in London. London Councils calculates that the combined impact of introducing the national funding formula at a time of wider budgetary pressure means that collectively, London schools will lose £360 million in 2018-19.
The Conservative manifesto pledged that the funding accompanying every pupil into school would be protected, but the National Audit Office is clear that per-pupil funding has not been protected in real terms. In London, the proposed national funding formula will clearly break that pledge further. The cuts will not fall evenly but will fall disproportionately on areas of London with the highest levels of deprivation. Therefore, while Croydon Central will gain £4.4 million for its schools, West Ham stands to lose £4.4 million, East Ham loses £3.6 million and Bethnal Green and Bow loses £3.5 million.
I am grateful to my hon. Friend for highlighting the scale of the cuts in my constituency and the scale of the concern among my constituents about that. I have had letters from lots of teachers at Central Park Primary School about the £710,208 being taken out of its budget. Does she agree that that is quite wrong?
I agree with my right hon. Friend entirely. The level of pressure our schools are being asked to bear would be unacceptable in any circumstances, but in order to understand exactly how damaging the proposals are, and why parents in my constituency and across London feel so strongly about them, the Government must understand the journey that London schools have travelled in the 14 years since the Labour Government introduced the London challenge programme of improvement for London schools in 2003.
I moved to London in 1996. At that time, parents in the same situation as I am in now, with their oldest child approaching secondary school age, were often trying to do one of three things: move close to a high-performing state or church school; move out of London to a part of the country where schools were better; or educate their children privately. Children whose parents were unable to make any of those choices often attended local schools, which despite the best efforts of their teachers substantially failed generations of children. In my constituency at that time, we had William Penn boys’ school and Kingsdale school, both of which were failing schools that became notorious. William Penn subsequently closed and successfully re-opened as the co-educational Charter School, and Kingsdale was completely remodelled under a change of leadership. Those are now outstanding and good schools respectively.
I have spoken with many parents in my constituency who attended failing schools as children. They remember the crumbling buildings, leaky roofs, shortages of books and materials, very large class sizes and poor discipline. They tell me that any success in their educational outcomes was due to the hard work that they and their teachers put in and happened despite, not because of, the funding and policy environment in which the schools were operating.
The situation could not be more different across London now: 94% of London schools have been judged to be good or outstanding by Ofsted. While London schools were the worst in the country in the 1980s and 1990s, they are now the best. That transformation was achieved through a combination of political leadership, appropriate resourcing, stringent accountability and—most importantly—the hard work of teachers, governors, support staff and parents. I think I speak for all London MPs from across the House when I say that we are deeply proud of our schools and everything they deliver for London children.
Our schools in London deliver for every child. They are not reliant on selection, and as a consequence London children also benefit from being educated in a diverse environment, which helps to build understanding and community cohesion. My children are receiving an excellent education alongside children from every possible walk of life, and their lives are enriched as a consequence. It is that approach, not grammar schools, that delivers the social mobility the Government say they want to see.
London schools are the best in the country, despite having the most complexity among their intake. They have the highest levels of students with English as an additional language, special educational needs and children from deprived households, and they have very high levels of churn, in part due to the large numbers of families now living in the private rented sector, who often have to move when short-term tenancies come to an end.
London schools are able to deliver in that context when they have the teaching and support staff to provide the help and support that every child needs, so that those who need extra help in the classroom can receive it, those who need to be stretched more to fulfil their potential can thrive, and a rich, imaginative curriculum can be offered to all students. The headteachers in my constituency increasingly talk about the new challenges their students face. Chief among them are mental health issues, which are growing in part as a consequence of the pressures children face on social media. They feel the need for additional support in school that students can access, but they are already unable to afford that.
I wrote to every headteacher in my constituency to ask about the impact that they anticipate the national funding formula will have on their school. I want to share just two examples of their feedback today. A primary head wrote to me and said,
“in order to balance the budget this year we had to lose six members of staff. Prior to this academic year we employed one Teaching Assistant per class. This year we have a Teaching Assistant per year group. I can see a time when schools will not be able to afford Teaching Assistants at all. Our building is shabby because we cannot spare the funds to redecorate and carry out minor repairs. Cuts in funding will mean that Headteachers will become more and more reluctant to accept pupils that put a strain on the budget.”
I am listening carefully to the hon. Lady and, as I did at the meeting with her and her colleagues, I have paid careful attention to what she is arguing. Is she interested in knowing that in Lambeth, under the new national funding formula, the funding per pupil is £6,199 and in Southwark it is £6,271, whereas in Waltham Forest it is £5,129 and in Surrey it is £4,329? It is that discrepancy that the national funding formula tries to go some way to dealing with.
I thank the Minister for his intervention. If he bears with me a little longer, he will hear that I am not arguing that schools elsewhere in the country—or indeed in outer London—should lose out as a consequence of the funding formula; what I am interested in is a funding formula that is fair for all schools.
A secondary headteacher wrote to me and said:
“Effectively our budgeting will be reduced by £500,000 in real terms in the next three years...it will make it very difficult for us to continue to provide a high quality education for our students, and will undoubtedly affect our ability to support student achievement and wellbeing. It will also have a negative impact on the workload of our staff who already work incredibly hard day in day out to support our students.”
Those are experienced headteachers, looking at a spreadsheet in the cold light of day and working out the choices they will have to make to accommodate the Government’s funding cuts.
To clarify, are not many of the pressures the hon. Lady talks about, which I certainly do not dismiss, the associated costs, rather than necessarily to do with the funding formula itself?
My argument is about the cumulative impact of unfunded cost pressures in recent years, and some still to come because of the apprenticeship levy, in addition to the impact that the new funding formula will have.
Seventy per cent. of schools’ budgets are spent on staff, so it will be teaching assistants, speech and language therapists, learning mentors, family support workers, school trips, sports clubs, music specialists and teachers that will have to be cut. Heads across my constituency say that the formula does not work. London schools also face a recruitment crisis, fuelled by the high cost of housing and childcare in the capital, as well as the Government’s failure to meet teacher training targets. More than 50% of London heads are over the age of 50, and the current budgetary pressures, combined with the new inspection regime and changes in the curriculum, are making it harder and harder to recruit. Further reductions in funding will only exacerbate the situation, making it harder for schools to retain experienced teachers and creating a level of pressure in the profession that will cause many hard-working teachers to look elsewhere.
The Government’s stated aim in revising the schools funding formula is fairness. I agree with that aim. There are problems with the current formula in some parts of the country, because of the embedding of resourcing decisions made by local authorities many years ago and their use as the basis for calculating future increases. However, there is nothing fair about a proposal under which funding will be cut from high-performing schools in deprived areas. A fair approach would take the best-performing areas in the country and apply the lessons from those schools everywhere. It would look objectively at the level of funding required to deliver in the best-performing schools, particularly in areas of high deprivation, and use that as the basis for a formula to be applied across the whole country.
London schools should be the blueprint for education across the whole UK, but school leaders in London are absolutely clear that quality will inevitably suffer as a consequence of the funding changes that the Government are implementing. It is simply irresponsible for the Government to put the quality of education in London at risk. Children are growing up in a time of great global change and uncertainty. We feel that today perhaps more than ever, as article 50 is triggered. They need to be equipped with the knowledge, skills and confidence to navigate and compete in a post-Brexit economy. Our schools are essential to that, and to ensuring that children make the maximum possible contribution to the economy and public services in the future.
I ask the Minister this morning to think again and, as he reviews the 20,000 consultation responses that have been submitted, to consider the impact that the changes will have on London schools. I have two specific asks. When I met the Minister last week, it was not clear from what he said that he had recently visited high-performing London schools, so I invite him to visit a primary school and secondary school in my constituency to see at first hand the great work that our local schools do and to understand the current financial pressures that they face.
I visit high-performing London schools all the time. Most recently I have visited Michaela Community School in Wembley and St Michael’s Church of England School just south of the river in Battersea.
I thank the Minister; I would dearly love to welcome him to high-performing schools in my constituency, so that he can hear at first hand about the pressures that headteachers are talking about.
Secondly, I ask the Minister to go back to the Treasury and to negotiate again. Spending on schools is an investment that the Government make in the future of our economy. It would take just 1% of the education budget to ensure that no school loses out through the introduction of the national funding formula. I ask him please to think again and not to put the success of London schools and their ability to deliver for future generations of London children at risk.
As Members can see, a number of right hon. and hon. Members want to participate in the debate. I intend to call the Front-Bench spokesmen at 10.35. I hope that Members will show self-restraint so that everybody is able to take part.
It is a pleasure to serve under your chairmanship, Mr Hanson. I shall be brief in making a few points about how the costs—and the associated cost pressures that I mentioned in my intervention—affect schools in Sutton.
All hon. Members welcome the opportunity to get fairer school funding. It has been debated at great length in the House over the past few months, with good reason. It is not fair that pupils with similar needs do not benefit from the same funding, and that that depends on where they live. It is right and proper to look at the issue, but that has not happened for a long time because it has been politically difficult. I welcome the fact that it is happening now. The consultation has just finished, and I am sure the Minister will look at the representations made in the responses and present any changes that he feels are appropriate for us to debate further.
Secondary schools in Sutton receive greater funding from the formula, by about 1.4%. Primary schools lose by 0.5%. However, as was mentioned before, many of the issues that headteachers are dealing with at the moment and that they will face going forward are associated cost pressures. With all the changes being made, now is an apt time to consider them.
There is a lot of concern among headteachers—all the headteachers in the area have written to me and the right hon. Member for Carshalton and Wallington (Tom Brake). Some headteachers from the London Borough of Sutton have already met the Minister for discussions. They are concerned about such things as the apprenticeship levy, which affects only some secondary schools and is comparatively low when set against the effects of some of the other changes and pressures. However, I find it strange and puzzling when any public sector institution’s money is churned around, as happens when we give a school funding and then claw some back through levies, rates and such things. I would find it easier if we cut through the bureaucracy and paid schools the money they needed to spend on their pupils.
Schools are not really well placed, especially at the moment, to take on apprentices because they are already training centres—they already train newly qualified teachers, Teach First teachers and other student teachers. Where they might be able to take on apprentices, such as in administration, things have already been cut to the bone, because those are in many ways the first places where cuts can be sought. It then becomes difficult to send anyone out on day release. I have a lot of sympathy with headteachers about the apprenticeship levy.
Many headteachers have talked to me about the 1% salary increase for public sector workers. They say that they want to be able to pay teachers more but, without the requisite funding, doing so would effectively mean an extra 1% cut in their budgets. They are not attracting more funding from the centre to pay for it. Again, I understand their concern. A signal is being sent, and it is pushed on to the headteachers to say, “Sorry. I can’t pay you any extra this year because of budget constraints”—despite the mood music in the media about pressure to pay people the extra 1%.
Another headteacher mentioned the cost of recruitment. It is difficult to get teachers, and especially senior teachers. I have been a governor for many years. When I was the chairman of governors at a primary school, we were looking for a headteacher and put many adverts in The Times Educational Supplement. It cost thousands of pounds each time and the response was woeful. I am interested in whether the Minister would consider a centralised recruitment system that everyone could tap into—one source that teachers can use—which would be a great cost saving for schools. The Department has talked about being able to make savings in schools through such things as procurement. It would be great if the Department could help schools by taking that approach.
I talked about the fact that secondary schools are a net gainer and primary schools a net loser. One reason they are all losing is the local authority formula. The local authority in Sutton has caused two issues. First, it had built up a surplus in the part of the grant it left behind, which has been used over the last few years to cushion some of the pressures. The surplus has now been used up and has finally come to an end. That has not been communicated particularly well to the schools, so there is a little bit of a cliff edge this year. On top of that, the local authority has effectively made a 0.5% cut for many schools to the amount it is keeping back, rejigging and then handing out to them.
Whereas the national formula helps us out a lot, the local formula means that Sutton loses out. It is important that parents and headteachers know exactly where the blockages are. In these times of greater devolution, it is important that the right people are accountable for formulae. I ask parents and headteachers to ensure that they question the local education authority and hold their councillors to account, including the council leader in Sutton, on why that money is being held back.
There is a disparity in Sutton between some of our secondary schools of about £1,000 per pupil—some get £4,500 while others get £5,500 per pupil. We have a number of grammar schools, with six fully and partially selective schools in Sutton. I question the argument about a lack of social mobility. There is a good amount of social mobility in those schools, primarily for Asian communities. We have a big Tamil community and a Bangladeshi community.
The issue with grammar schools is not what they deliver for the children who are able to access a place there. The evidence across the country shows that children from deprived backgrounds who do not go to grammar schools in areas that have them do demonstrably worse in their education. That is the issue of fairness I was referring to.
That is an interesting intervention, but I can only use the Sutton example. All our schools are excellent, including the ones that are not selective. Indeed, Stanley Park High School in Carshalton and Wallington won The Times Educational Supplement secondary school of the year award last year. All the schools are being brought up in Sutton. A lot of Tamil and Indian families are moving around to be able to access Sutton’s schools. The problem in Sutton is ensuring that white working-class people can get that social mobility. We need to work harder on that.
My final point is that the funding pressures on the grammar schools are such that they are getting considerably less pupil premium per pupil than those in other areas, despite some of them being in average deprivation, because they are in more affluent areas. They are being disadvantaged because of the fixed costs—buildings cost a lot to heat and light, and there are staffing costs. They are losing out to other schools, which are getting pupil premium on top.
I make a special plea to the Minister to consider some of the work being done by grammar schools. Essentially, the funding formula is fair. It is good we are addressing this issue. I would like the Minister to have a look at some of the associated cost pressures and to answer some of the questions that headteachers have raised with me.
It is a pleasure to see you presiding over us this morning, Mr Hanson. I am not sure I have had the privilege of serving under your chairmanship before. I congratulate my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes) on securing this debate and commend her for her excellent speech, which detailed the problems we all face.
I do not have a long record of speaking in education debates over the years. As the Minister knows, my main engagement with his Department has been about fire sprinklers in schools and trying to improve the guidance on their installation. We have not cracked that yet. However, I have been contacted by a number of primary school heads in my constituency. Their comments need to be registered not only with me but by me in this debate. I will do so briefly, in line with your request, Mr Hanson. I have also written to the Secretary of State.
Heads from Cubitt Town Junior School, Mayflower Primary School, Cyril Jackson Primary School, Lansbury Lawrence Primary School, Arnhem Wharf Primary and St Peter’s London Docks Primary School, as well as constituents, have contacted me on this issue. One letter said:
“the national funding formula has the potential to make school funding fairer, but it will fall short unless it is given sufficient resources to succeed. School budgets are being pushed beyond breaking point.”
That brief quote says a lot. Given the pressures faced by schools, the writer of the letter is still able to see the positives in the funding formula, but refers to how it is let down by the sheer lack of resources. In her letter to me, the headteacher of Cyril Jackson Primary School listed 12 ways in which the school was forced to act to reduce overheads in 2015-16, meaning reduced staff numbers, less guidance, less encouragement and fewer opportunities to see new things, and experience other environments and be inspired by them.
My hon. Friend the Member for Dulwich and West Norwood has previously said, and may have said again this morning:
“The government is putting our excellent local schools at risk, with a change in the funding formula which will see money taken away from our local schools to give to schools in other parts of the country.”
Neither I nor any other colleague, I am sure, would wish to see schools in other parts of the UK short-changed, but giving them what they need to deliver a great education service should not be at the expense of London schools. Children everywhere should have and must enjoy an equally high standard of education. Whether they live in Dulwich, Docklands, Dudley or Droitwich, children deserve well-funded schools that enable them to reach their potential. It is as simple as that.
Those on the ground are telling me that school budgets are being pushed beyond breaking point. One of our local representatives in Tower Hamlets, Councillor Danny Hassell, recently tweeted that he had just seconded a Labour motion at the council against Government plans to cut funding in our schools that will mean a staggering loss of £511 per pupil in Tower Hamlets. Children such as those at Cubitt Town Junior School cannot afford the Government’s proposals. Their headteacher tells me it is calculated that Cubitt Town pupils will lose up to £746 per pupil.
I am listening carefully to the hon. Gentleman. Does he acknowledge that Tower Hamlets was the highest funded local authority in the country on a per-pupil basis before the national funding formula and remains so, even after the national funding formula is implemented, with funding of £6,718 per pupil, compared with £4,329 in Surrey and £5,129 in Waltham Forest?
I am grateful to the Minister for citing those statistics. I was citing one myself from the headteacher of Cubitt Town Junior School, who said that Cubitt Town pupils will lose up to £746 per pupil. I do not doubt that Tower Hamlets’ schools are well resourced and well funded by the Government, but the cuts being introduced will be unsustainable. The headteacher says that it could mean the school losing up to six teachers. How will that Isle of Dogs school withstand such a reduction without significant negative consequences for the quality of education it can give to local children?
Along with parliamentary colleagues, I urge the Government to acknowledge that their funding plans do not work for Cubitt Town, for the other schools I have mentioned or for all those left unmentioned. They certainly do not work for Tower Hamlets.
It is a pleasure to take part in this vital debate. I congratulate the hon. Member for Dulwich and West Norwood (Helen Hayes) on securing it. Members from both sides of the House are present. That is important, because this is a cross-party issue that cannot be monopolised by any one party. It matters to us all because it matters to children in our constituencies and their life chances.
I am grateful to the Minister. He is one of the most patient Ministers and, indeed, one of the longest-standing Education Ministers. No one can preach to him about schools. He has been out there visiting schools across the country. He may be patient, but he is intolerant in the sense that he does not tolerate educational failure, wherever it comes from, particularly for disadvantaged pupils. He has been a Minister on a mission, both in the Department and on his sabbatical—we could not do without him, so he came back. The Minister’s mission, which is shared by the Department for Education, is:
“to deliver educational excellence everywhere, so that every child and young person can access world class provision, achieving to the best of his or her ability regardless of location, prior attainment and background.”
We all want to achieve that aim. That is what the debate about the national funding formula and schools’ overall budgets is about. That is what we want to achieve. Like other hon. Members, I am a governor, at two schools. I am also a parent and I care passionately about the Government achieving what is very much this Minister’s mission.
London is a success story as a result of that mission. The Government should be proud, along with the previous Government in terms of funding, of what they have achieved. They have ensured that 92% of schools across London are good or outstanding. We pay tribute to the teachers, governors, parents and pupils for being very much part of that success story. Particularly relevant is the fact that disadvantaged pupils are progressing better in London than elsewhere in the country. We want to ensure that others are lifted up to that standard. That means being lifted up in funding as well, and that is what the national funding formula is about.
I recognise that the Government have a position. We can spend our time—I do not want to spend too much time, Mr Hanson—defending manifesto commitments, and we can dance on the head of a pin about how much extra money there is per pupil, or we can make the point, as I am sure the Minister will, that more is being spent than ever before, in cash terms. The figure is £40 billion a year. We also have to recognise the context, which is our national debt; interestingly, that is £40 billion a year as well. That is important context for the restraint that all public services are facing.
I have been ready to defend the reality that the Department for Education budget and the schools budgets are not immune from that restraint. They have already had to make significant decisions and cuts in school budgets. However, we are in a position in which schools have already been vulnerable. Before the national funding formula, we could have had a debate about school funding and cuts in my local schools and others. However, we now have the national funding formula. Many of us, particularly in outer London, were hopeful that that would lead to a significant rebalancing of funding. For those of us in outer London, there has been an impact not just in relation to school funding. Local government has historically been underfunded. There is a need to recognise the demographics—the population increases—in outer London. Mental health funding is also relevant. The right hon. Member for Tottenham (Mr Lammy) will join me in making this point. There has been 25% less funding in parts of London such as Camden. All of that impacts on schools, so we were looking to the national funding formula in particular to see us through these difficult and challenging times.
I recognise that the Government are right on the principle. This is perhaps where this funding formula debate will differ from others to which the Minister has patiently listened. We need to retain recognition of deprivation. That needs to be reflected, and it is: 18.1% of the schools budget is for additional needs, based on low attainment, deprivation and English as an additional language. That is so important and it must stay. It must not in any way be diluted or reduced; in fact, some of us say that it should be increased. It should be good news for Enfield and other parts of London that are particularly impacted by those additional costs. It is also right there is flexibility; that is good news as well.
There is an issue about deprivation. I ask the Minister to reflect on the concerns in that regard. I am thinking of free school meals and the income deprivation affecting children index. Is what is happening truly reflective of the challenges facing children in families who may well be on universal credit and who may be in work, but who could well still be in poverty and in challenging situations? There is concern that the drop-off in free school meals is impacted by the benefit changes and that that is not leading to a proper settlement, a proper reflection of people’s needs.
Enfield does better than other parts of London, and it should do, but it does not do well enough—the Minister may have been expecting me to say that. My constituency may get £400,000 more in cash terms, but the reality is that 15 out of 22 schools will lose out. The reality as far as budgets and the real costs are concerned is that there will be £3 million of cuts in Enfield, Southgate by 2018-19. There is also an impact from the apprenticeship levy, national insurance contributions, pensions and pay.
That matters greatly to schools such as West Gove Primary School, which have significant additional needs. Just over the weekend, I got another 280 petition letters, all of which I have here. Never before has there been such interest and concern among parents. At West Grove, they are concerned about a cut of £276,572 over the next four years. Hazelwood Infant and Junior School faces a cut of £150,000 over that period. It says that that equates to eight teachers. We have dealt with challenging budgets before, but there is now an impact on the budgets for teachers. That is affecting particularly primary schools. A particular issue is the high cost of recruitment and retention.
The principle behind the national funding formula is sound. I do not want us to go backwards. We need to be bold and continue with that, but we need to recognise that eventually it has to mean adequate provision, proper provision, for additional costs. I will defend the principle, but I will not defend the reality of the cuts that will come through for the budgets of my local schools. In fact, I join the Minister in this intolerance: I will not tolerate that, because it will impact particularly on disadvantaged pupils. When we get to the autumn Budget, I will want to see, to help the Minister, a bigger pot so that we can help schools in other areas and ensure that there is fairer funding, and ensure that London continues to be the success that it deserves to be and is not a victim of its success.
Order. We have 30 minutes before the winding-up speeches, and six Members. That means five minutes each, if people can exercise self-restraint.
I congratulate my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes) on her brilliant exposition of the issues currently facing London schools.
In May, I will have been the MP for Mitcham and Morden—the place of my birth—for 20 years. One of the biggest and most satisfying things during those 20 years has been seeing the blooming of our schools. Schools that were universally performing so poorly have been transformed into schools that, in the main, although not exclusively, are doing really well. School buildings are now places that people would want to enter, rather than fearing to enter. I want to see that continue, and I want to see that mostly for those who have least. What concerns me is the number of teachers who come and see me at my Friday advice surgery from schools where children are in temporary accommodation and finding it difficult to get to school. As has been mentioned, more children than ever suffer from mental health problems and are self-harming. These demands on schools at this time make it difficult for them to cope from where they are, let alone if they lose any funds at all.
Let me gently point out to the hon. Lady that 96.2% of the schools in her constituency, Mitcham and Morden, gain funding under the new national funding formula. That amounts to a 6.6% increase once the formula is fully implemented, and that is £3.5 million. Schools should not be coming to the hon. Lady to talk about cuts in funding, because 96% of her local schools will see an increase in funding under this formula.
I invite the Minister to come to William Morris Primary School, in Pollards Hill, which is going to lose £487 per pupil, which is the equivalent of four teachers, or to Singlegate Primary School, which will lose £424 per pupil; or perhaps he would like to go to Morden.
Again, the hon. Lady takes the misleading figures from the National Union of Teachers, which is conflating the cost pressures that all of the public sector is incurring over this year and the next three years—amounting to 8% in total—with the national funding formula. The national funding formula is good for schools in the hon. Lady’s constituency. I hope very much that her local headteachers and she herself will support the new national funding formula, because it is fairer, and fairer for her schools.
Order. I call Siobhain McDonagh.
I am sure that, when a bill has to be paid, the headteacher is not looking for the reason why it is becoming more difficult for them to do that. Certainly—
I am sorry to interrupt my hon. Friend, who is making a fantastic speech. The Minister has interrupted hon. Members a number of times. The figures that he talks about, from the Association of Teachers and Lecturers, the NUT and the National Association of Head Teachers websites, come from the figures from the Department and the National Audit Office, so the figures are as accurate as they can be from Government statistics. The Minister should stop interrupting Members who are standing up for schools in their constituency.
I thank my hon. Friend for his intervention, but I am delighted that the Minister is intervening on us, because he needs to understand what schools are finding and experiencing. I know from my long awareness of his work that this cannot be a pleasant thing for him to be doing. He needs to understand—I am sure he does—the effect on the schools that are the most vulnerable and hang on to their improvement with all their might.
That brings me to a school that we both appreciate—Harris Academy Merton. It has had a 70% pass rate for five A to C GCSEs in the last year and will lose £298 per student. St Mark’s Academy will lose £291 per student. These schools cannot afford to lose money. They need the Government’s help, not the Government’s debate.
It is a pleasure to serve under your chairmanship, Mr Hanson, and to follow the hon. Member for Mitcham and Morden (Siobhain McDonagh). I congratulate the hon. Member for Dulwich and West Norwood (Helen Hayes) on securing this excellent debate.
My parents are teachers, and I have had the pleasure of visiting every school in my constituency at least once. We have the best schools in the UK in terms of the proportion of good or outstanding schools and GCSE and A-level results, and we also have grammar schools. They suffer the same pressures as schools do everywhere else in London. I want to speak briefly about the funding formula and other funding pressures that schools face, but I will say at the outset that I would be an advocate for more funding for schools—that should be a priority. As a Parliamentary Private Secretary for the Department of Health, I sit here in countless debates asking for more funding for the NHS—indeed I sit in debates asking for more funding for all other areas of public spending, and see colleagues ask for more funding across the board—but what I would focus on is more funding for education. We cannot just demand more funding for everything; we have to identify where we would raise the additional revenue or what we would cut.
The funding formula came about after a cross-party campaign that was premised on an agreement that the funding for schools was not fair, in the sense that it was not equitably distributed and that different parts of the country with similar demographic profiles were seeing different funding for their schools. The campaign was never based on levelling up to the level of schools funding in the highest funded area—Tower Hamlets. That would have added billions of pounds to the cost of the funding that is required for schools, and no party committed to that in their manifesto. In any new funding formula there are going to be winners and losers. I expected that, as the third worst funded borough in London, we would be a winner, although I had hoped that it would have been by more than 0.9%, with some schools’ funding going down.
Having followed this and other debates on the funding formula carefully, I have not actually heard any coherent criticisms of the general approach to the funding formula in terms of the per pupil funding and the additional factors. No one seems to disagree that those are the right factors. What they disagree with is that, as a result, some schools’ funding is going down. Personally, I would like to have seen a more radical approach, because that would have ended the unfair and inequitable situation that schools in Tower Hamlets, 14 miles away from my constituency, receive £2,406 per pupil more than schools in Kingston, on top of the pupil premium, which is not counted in those figures.
The hon. Gentleman is nodding. Before I am intervened on by an MP from Tower Hamlets, I completely accept the political consensus that we should address social deprivation through funding for education. I completely accept that schools in Kingston are always going to get less than schools in Tower Hamlets, where there is a higher index of social deprivation. However, if we take into account the pupil premium figures and the differential in the same city of £2,400 per pupil, that is simply not fair. In my stage 2 response to the fairer funding consultation, I asked that the per pupil funding element should not be reduced to a weighting below the current 76%, unless significant additional funding is identified for the additional factors.
I want to touch on the other pressures beyond the fairer funding formula. I have spoken to many of my headteachers in Kingston, and frankly their concern is not with the fairer funding formula primarily, but with the other pressures on their budgets. Some of those have been mentioned. They include increased employers’ national insurance contributions, increased pension contributions, increased national living wage, the apprenticeship levy, the equalisation of sixth-form and further education funding, the reduction in the education services grant and a general increase in costs.
Another factor that I imagine affects other hon. Members as well, and certainly has a profound effect in Kingston, is the huge overspend in high-needs funding. It has resulted, as in other boroughs, in Kingston having to top-slice the dedicated schools grant to the level of the minimum funding guarantee. It is a demand that Kingston’s schools and Kingston Council are not really in a position to regulate, because a lot of the high-cost, private school, out-of-borough placements—sometimes of more than £200,000 per pupil—are made by the first-tier tribunal for special educational needs. Kingston Council is trying hard to address the issue by supporting applications for two new free schools—two special schools, one in Kingston and one in the constituency of my hon. Friend the Member for Twickenham (Dr Mathias)—so that we can better deal with high-needs children in borough, but this matter needs to be addressed. We need more funding for high-needs provision in particular.
I absolutely agree with everything my hon. Friend says about the pressures regarding special educational needs. These are unpredictable, six-figure sums—he is absolutely right about that. Does he agree that there is a case for there being a separate pot, perhaps of central funding, because those costs are unpredictable year on year and are increasing?
In addition to the funding formula, those additional costs need to be addressed. I will close by rebutting the ridiculous suggestion that has been made, although not in this Chamber today, that we should cut funding for new schools and use it for existing ones. In London we know that there is an acute pressure for school places, and that the cost of buying the sites for them is very significant. Some 750,000 new places are needed by 2025. Yes, we need more funding for schools now, but we will create a terrible situation for pupils if we take away the funding that has been put aside for the schools we need to build and that I very much welcomed in the Budget.
I congratulate my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes) on securing this debate. I think that the tone has been very measured, but I say to the Minister that back in communities across London there is tremendous fury, frankly, at what the Government are proposing. I really want to warn him. I went to school in the 1970s in London; I have seen schools in the 1980s in London, and I am deeply worried that we will be returning to that story in this city. When London slips back, as night follows day, the nation slips back on education. London’s contribution to our GDP is bigger than at any time since 1911. In the Brexit environment that we are now going into, this is a very dangerous move. The Government simply cannot talk about social mobility and about families that are just getting by, and see the sorts of devastating cuts that we are hearing about right across the city.
Will the right hon. Gentleman give way?
No, I will not give way. I think of the Willow Primary School on the Broadwater Farm estate—no one at that school is well off—and of the six teachers and all the learning mentors that it might have to lose. I ask the Minister, with all sincerity, how he can stand by the cuts. When he says to my hon. Friend the Member for Poplar and Limehouse (Jim Fitzpatrick) that Tower Hamlets is the best-funded local authority in the country, has he knocked on doors in Tower Hamlets? Has he seen the deprivation that exists in Tower Hamlets?
The Minister knows, as we all do, that the education debate in this country is not between state schools in deprived areas of the country, but between the state schools and private schools. That is the big gap, and that is what any Government with any ambition to raise the standards of children across the country should be seeking to match, not cut. Let us not have this fake debate about redistribution across already deprived constituencies, when the real debate is how we level up to the standard of private schools. When he says, “Look, you are getting just under £7,000 in Tower Hamlets,” let him remember that a child that goes to Eton means £33,000 a year. That is the debate. If he is sincere about social mobility, he will go back to his friends in the Treasury and ask for more.
I have been asked by this Government to do a review into the disproportionate number of black and ethnic minority young people and adults in our criminal justice system. I have to warn the Minister that this situation will lead to more young people in our pupil referral units, and more young people in our young offenders institutions and prisons as a direct result. That is because teaching assistants help to keep the peace and order in our schools, and help with kids with special needs, and they will have to go. It is because a class size of 30 or 32 kids is hard on one teacher. I commend all teachers committed to teaching in deprived constituencies; it is a vocation that none of us should forget about in this debate.
I say to the Minister, do not just interrupt Members and quote the figures blindly at us. We know what this is about. This is a direct cut of the education budget. The Government are turning their back on a commitment they made when they first came into office, and we must and will hold them to account.
It is a pleasure to serve under your chairmanship, Mr Hanson. I will try to be brief, as I agree with most of my colleagues’ points. I, too, have had meetings with hundreds of parents and with smaller groups of parents, and I have met many headteachers.
I have received many letters from children and I will highlight one of those, because thankfully the children are celebrating, rather than being fearful of the changes to their schools’ budgets. Serine Zahr of Hampton Hill Junior School told me that her school is precious because of its values. She noted that in Hampton Hill Junior School, they are “collaborative like a bee” and “reflective like a swan”. As I am sure the Minister knows, most of the schools in my area are good or outstanding, as evidenced by Serine.
There is concern among teachers and parents. In particular, parents who help in schools—the schools appreciate them giving up their time—are rightly concerned that although they are giving their time in the classroom, they are now being asked to contribute money because of the fear of losing teachers and, even in one school, for repairs to the toilet blocks. That shows that although there is less argument about the funding formula—headteachers agree that the formula needs to change—the issue is the overall real-terms cost per pupil. I note the pertinent comparison made by my hon. Friend the Member for Enfield, Southgate (Mr Burrowes) with the amount we are spending on debt interest. I agree with other colleagues that education must be a priority.
I agree with some of my colleagues’ points about small wins. I know that the apprenticeship levy is less than 1% of the budget, but does it have to apply to schools? Although I appreciate the point made by my hon. Friend the Member for Kingston and Surbiton (James Berry) about no party asking for a levelling up, we need some levelling up per pupil.
In the longer term, there could be a review of governors. I have been a primary school governor. Now that we need good financial health in our schools, there is an argument over the longer-term duty and training of governors in that respect.
Will the Minister please look at special educational needs funding? The trajectory that it is on cannot be predicted. It is great that children get extra help for milder forms of, for example, dyslexia and dyspraxia, but as my hon. Friend the Member for Kingston and Surbiton said, we need to spend £200,000 a year on some children to ensure that children have, as we say, educational excellence everywhere.
I thank the Minister for being here and I really appreciate his interrupting hon. Members. He did not interrupt me, probably because we have a very small increase in our area. The issue is not the formula in particular, but the overall grant and the per-pupil protection.
It is a pleasure to serve under your chairmanship for what I think is the first time, Mr Hanson. I also congratulate my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes) who set out her case admirably, allowing me to do what I should do, which is to concentrate on the situation in Hammersmith.
I had a conflict of interest a couple of weeks before the consultation closed. As well as needing to be here, I was being asked almost every day to be at the school gates at 3.30 pm, which is not the best time to persuade the Whips that I should not be here. I managed to play truant on at least three occasions and go to meetings at Wendell Park, Brackenbury and Kenmont schools in my constituency. I say meetings, but they ranged from sober affairs, with speakers from the local authority, the headteacher and myself explaining the not-always-entirely-clear 75-page document that people had to fill in, to rather more exuberant demonstrations, with a lot of visual aids prepared by the children in playgrounds to express their views on what was happening. I am also grateful to the local authority in Hammersmith; Sue Macmillan, the cabinet member for children’s services, who came back from maternity leave to organise that; and Sue Fennimore, the cabinet member for social exclusion, who organised a meeting for some 400 parents and governors at Hammersmith town hall before the consultation ended.
I mention all that because I have never seen such unity of purpose on an issue before. Irrespective of political allegiance or indeed any other factors—we have extremely mixed communities in Hammersmith—the whole school community, including governors, parents, teachers, pupils and headteachers, all came together, which is perhaps not surprising, given that Hammersmith faces the largest cuts possible in formula funding. Forty-seven headteachers from the 48 schools have written to the Government expressing their concern—I do not know about the one headteacher who did not, but I am told he does not look at his emails too much. All 48 schools in Hammersmith will lose almost 3%. However, this debate is not just about the national funding formula; it is about school funding, and I echo what Government Members, as well as Opposition Members—
Will the hon. Gentleman give way?
If the hon. Gentleman does not mind, I will not, given the time. Government and Opposition Members have said that this is about the overall picture. It seems extraordinary that substantial sums of money should be taken away from schools in deprived areas through the formula funding when other cuts are being imposed.
I agree with what my hon. Friend the Member for Wythenshawe and Sale East (Mike Kane) said from the Opposition Front Bench. The figures from the NUT and other unions should not be rubbished by the Government, but looked at, because they give an overall picture of the cuts that there have been over a number of years, starting as long ago as 2013 and going through to 2020, and possibly beyond.
Let us look, for example, at Ark Burlington Danes Academy, which is a very successful academy with 67% of pupils on free school meals. By 2020, it will have lost 18% of its budget. Hammersmith Academy, which is a new-build academy with 61% of pupils on free school meals, will have lost 25% of its budget. Wormholt Park Primary School, which has 59% of its pupils on free school meals, will have lost 16% of its budget. As the Minister can readily tell, those schools have very deprived intakes and they are losing unsustainable amounts of money.
In addition to the cost pressures, which cannot be separated out as the Minister would like, what will happen if we have the misfortune of the Government continuing this after 2020? The NUT has pointed out that, according to the Government, several schools will still be overfunded. Will they be restricted by not having inflation increases thereafter? What are the plans? In my constituency a number of schools will still be said to have, once the floor is imposed, funding that is 10% above what they should have, and in one case, 31% above. How are those figures in any way realistic or sustainable for schools to cope with?
Given the amount of time that the Minister has been in the job, he ought to appreciate the absolute sapping of morale, particularly among teaching staff in these areas. It is absolutely right that London schools are a huge success story, but like the rest of the country, we have been through a lot of trauma, with the loss of Building Schools for the Future. Without going into the politics of it, there has also been the way in which academies and free schools have been introduced, and the imbalance of resourcing going to those schools rather than to community schools.
My hon. Friend the Member for Dulwich and West Norwood mentioned English as an additional language, special educational needs, deprivation and turnover. In particular, the effects of the Government’s housing policies mean that not only has there been this extraordinary churn, but families are regularly being thrown out of London and they then have to commute hours back with their children every day. Schools are seeing a huge turnover of pupils. Those things cannot be coped with easily. Schools need additional resources and we do not need this destabilisation.
I will continue doing the school gate meetings, even though the consultation has closed, because what has happened has awakened an appreciation of the overall attack on school budgets under this Government. It is unprecedented—it has not happened for at least 20 years or perhaps longer—so I echo what Members on both sides of the Chamber have said. Nobody wants the funding not to increase or the funding gaps not to be addressed in schools that may have been historically underfunded for a number of reasons. That is certainly not the fault of London education authorities, which have always—going back to the days of the Inner London Education Authority—prioritised funding for inner-city schools. However, the problem will not be addressed by substantially reducing the funding and resources of schools in London, which have done a fantastic job over the last 10 to 20 years in changing the mood and the climate. The Minister should wish to emulate that around the country, not drag London down.
I call Wes Streeting. I ask him to finish his speech by 10.35 am.
It is a pleasure to serve under your chairmanship again, Mr Hanson. I will be mindful of the clock.
The Minister will be able to cross out huge sections of his speech because of the number of interventions he has made. I am sure that when he came here this morning, he would have been delighted to have a debate about the education funding formula, but let me save him from intervening on me. He would tell me that in my constituency there are 24 winners and five losers from the formula, generating an additional £2.8 million, but even by the conservative estimate of London Councils, which uses National Audit Office figures to look at cost pressures, my constituency’s schools will lose £3.6 million.
The Minister has great attention to detail, so he knows as well as anyone that the principle of the education funding formula and the rebalancing of budgets is not contested. The real problem is the real-terms cuts to all schools throughout the country, alongside serious inflationary pressures and rising costs. In fact, the Institute for Fiscal Studies has said that school funding per pupil has been frozen in cash terms until 2019-20, resulting in a real-terms cut of 6.5%, which it describes as
“the largest cut in school spending per pupil over a 4 year period since at least the early 1980s”.
It is not even a case of robbing St Peter’s school to pay St Paul’s. The whole system is losing money and pupils will suffer as a result.
Take my own borough, the London Borough of Redbridge, of which I should declare that I am still a councillor. Taking into account cost pressures, funding cuts and the education funding formula, more than £15 million will be taken out of its schools by 2020—about £338 per pupil per year, which is equivalent to losing 411 teachers. Redbridge Primary School, which I know the Minister has visited—I went there to play the recorder with him—will lose £396 per pupil per year, which is equivalent to losing seven teachers.
The worst-affected primary schools include Ilford Jewish Primary School, which will lose £575 per pupil per year, and Ray Lodge Primary School, which will lose £554 per pupil per year—equivalent to nine teachers. Beal High School, one of our largest secondary schools and a great, successful academy school, will lose more than £500,000—£357 per pupil per year, or 15 members of staff. Even my local grammar school, Ilford County High School, will lose just shy of £300,000 because of cost pressures—£498 per pupil per year. That is partly a reflection of the terrible funding settlement that the Minister has received from the Treasury, but it is also a reflection of the terrible priorities of the Government under the new Prime Minister.
Brett Wigdortz, who as founder and chief executive of Teach First has done more to tackle educational disadvantage in this country than most, said:
“Some of the most depressing things I’ve seen in England were going to East London and seeing outstanding schools where kids from low income backgrounds were getting a world class education… And then you travel 20 miles to the south-east into Kent, which has a grammar school system and visit schools there, and they’re very depressing places I would say.”
It is a scandal that the majority of schools in this country are losing money to fund ideological pet projects such as the expansion of grammar schools, when there is no evidence that they will tackle educational disadvantage—quite the opposite.
I conclude by reflecting on my own experience as a child of the 1980s who went to primary school in east London and secondary school in central London—I have lived in London for my entire life. My old primary school, St Peter’s London Docks, which my hon. Friend the Member for Poplar and Limehouse (Jim Fitzpatrick) referred to, will lose £732 per pupil per year—£144,982 by the end of the decade. My old secondary school, Westminster City School, which is just down the road, is losing more than £500,000—£831 per pupil per year or the equivalent of 12 teachers. From visiting the school, I know the impact that that is having on the curriculum and on the wide provision of choice at a secondary school that still serves a majority deprived population with a high free school meal intake.
Through its educational provision, that school took a council estate boy from Stepney in east London and gave him opportunities that he would never otherwise have had. Without those opportunities, I would never have been elected to Parliament. It also took a Peckham boy from a south London council estate, John Boyega, gave him great drama teaching and sent him to Hollywood as one of the stars of “Star Wars”. The school no longer has curricular or extracurricular drama provision. That should rest on the Government’s conscience. It is to their shame, because those are the chances that take kids from council estates and give them a world of opportunities enjoyed by those from the most wealthy and privileged backgrounds.
It is a pleasure to serve under your chairmanship, Mr Hanson. I congratulate my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes) on securing this debate and on her impassioned speech.
As my hon. Friend the Member for Ilford North (Wes Streeting) said, under this Government we are seeing the largest real-term cuts for 20 years. The schools budget will not be protected in real terms and will not rise during the Parliament, and funding will be protected only in cash terms. No planning for budgets has been put in place by the Department for Education to cover the cost pressures that have been articulately pointed out by hon. Members today, such as inflation, the living wage, pension provision and the apprenticeship levy, which the hon. Member for Sutton and Cheam (Paul Scully) mentioned. There has already been a sharp rise in the proportion of secondary schools in deficit, which has risen to nearly 60% in 2014-15, according to the National Audit Office. The NAO has also confirmed that there will be a real-terms reduction in funding per pupil because of a failure to increase funding in line with inflation. That, I am afraid, is a clear breach of the Conservative party’s manifesto commitment.
Does my hon. Friend agree that this is, in essence, an attack on all young people, regardless of whether they live in London or anywhere else in the country? This is an attack on the future generations of this country.
My hon. Friend the Member for Dulwich and West Norwood pointed out that it would take 1% of the education budget to level up in London—about £500 million. Some £380 million was clawed back from the Department for Education for its failure to convert enough schools to multi-academy trusts. This can be done—it can be achieved—but, as with their U-turn last night to downgrade GCSE passes to grade 4, we can only hope that the Government will see the light on the key issue of the £3 billion of funding cuts that we face between now and 2020. The funding formula amounts only to redistributing a small sum of money while we face cuts across the board. Instead of moving an inadequate sum of money around, what is required is investment in all our schools, for every child.
The Library briefing states that
“inner London constituencies are expected to see the biggest fall in funding under the consultation proposals.”
There are particular pressures on London from the fair funding formula, as has been pointed out. The number of children on free school meals has declined in London, partly because of gentrification in particular areas, but also because of benefit changes, which mean that fewer children are eligible. That is having a disproportionate impact on school budgets in London.
The Secretary of State has said that no school should lose more than 1.5% of its funding as a result of changes to the funding formula. However, it has already been shown by the IFS and the NAO that, given the budget cuts, cuts to schools will be far more severe. Those are the figures on the union’s website.
I come from a part of the country with £2,000 per pupil less than the London average. Will the hon. Gentleman confirm that he believes that there should be fairness in how we distribute funds between schools? That is what the NFF is about, and it is welcomed very broadly around the country.
There should be fairness in the funding formula. There are good things in it, such as an emphasis on high needs, a deprivation index, a focus on prior attainment—why would we not welcome those things?—but we have seen many U-turns from the Department. I would bet my bottom dollar that, with the pressure that is coming from all hon. Members, we will see another one. I am worried that we will also see a U-turn on some of the good things about this funding formula.
The financial challenges of providing London school places is huge, because of the cost pressures and land values. That is why we have seen the Government U-turn on the 50% faith school cap. The Catholic Church needs to build at least 40 new schools in London and the Government have had to U-turn on their policy from 2010.
The free school programme in London is not subject to any spatial planning whatsoever. There was a school in Bermondsey that recently closed down after £3.5 million was spent in two years on educating 60 pupils. That was £60,000 per pupil. As my right hon. Friend the Member for Tottenham (Mr Lammy) said, we could have sent those pupils to Eton for half the price. That is what happens when there is a free school programme that is not subject to spatial planning.
Will the hon. Gentleman give way?
I will not give way, if the hon. Gentleman will forgive me. I really am up against the clock.
The Education Funding Agency is paying inflated prices for land, particularly in London. Funding issues are hitting teacher recruitment, as has been articulately pointed out. Pay in real terms for teachers has fallen by 10% since 2010. The jobs market is beginning to pick up, no wonder we are failing to meet our graduate targets for teacher training, which adds to the pressures. The cost of living, as has also been pointed out, and the cost of childcare are exacerbating the problems, as is inflation. My hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh) has been articulate for weeks and months in the Chamber on the effect of London’s housing crisis, which means that teachers are priced out of the market.
As I have said, the Opposition would love to support elements of the funding formula. I remember the joke by Peter Kaye, who is a Bolton comedian. When his children were trying to get to sleep but could not do so because of the “wardrobe monsters”, he rang them up and said, “Don’t worry about the wardrobe monsters. It’s the burglars coming in through the roof!” This issue is not about the funding formula, a high needs index, a deprivation index or the focus on prior attainment; it is to do with cost inflation. The Minister should stop confusing the matter for his own Back Benchers and for Parliament. The national funding formula will not touch the sides of what needs to be done to avert a massive crisis in our schools.
We need change. The Minister should not bang on about the funding formula. He needs to address the cost pressures that all schools face. He needs to tell them, which he has not done so far, how they are to make the savings required. More importantly, however, he needs to tell us how he will change his mind in the weeks and months to come.
It is a pleasure to serve under your chairmanship, Mr Hanson.
I congratulate the hon. Member for Dulwich and West Norwood (Helen Hayes) on securing this important debate. I trust that she would agree that we share the ambition to have a country that works for everyone, where all children have the opportunities for an excellent education that unlocks talent and creates opportunity. That should be regardless of their background or where they live, which is why today 1.8 million more pupils are in good or outstanding schools than was the case in 2010, and why 147,000 more six-year-olds are now reading more effectively this year compared with 2012 as a result of our reforms.
The Government are prioritising spending on education and have protected the core schools budget in real terms so that, as pupil numbers increase, so will the amount of money for our schools. School funding today is at its highest level on record at more than £40 billion in 2016-17, and is set to rise to £42 billion by 2019-20. However, the current funding system is preventing us from ensuring that the money is allocated fairly. In the current system, similar schools and similar local authority areas receive very different levels of funding with little or no justification. For example, a secondary school in Wandsworth that is teaching a key stage 3 pupil with English as a second language and low prior attainment would receive £7,699, but if that same pupil were in a school in the neighbouring Borough of Lambeth, the school would receive £10,263, which is a difference of more than £2,500. There is no reason why moving just a single mile should lead to such a change in funding.
Opposition Members complained about the debate. They do not like their figures being challenged, but I am afraid that I am going to do so, because they repeatedly cite misleading campaign data from the National Union of Teachers. First of all, let us take the hon. Member for Nottingham—
It is Tottenham.
Haringey is the 11th best-funded local authority in the country at the moment and it will remain—
I will not give way. Haringey will remain the 11th highest-funded authority.
Allocations are based on 10-year-old data—2005 data—but during that 10-year period deprivation in London has been reduced. In 2005, 27% of pupils in London were eligible for free school meals; today, that figure is 18%. By ensuring that we allocate funding on the basis of up-to-date data and fairly, we can allocate £5 million more to boroughs such as Merton, the funding of which will rise from £114 million a year to £119 million a year, reflecting the fact that Merton has been underfunded in the past. It was disappointing—
I will not give way to either of the hon. Gentlemen. It was disappointing that the hon. Member for Mitcham and Morden (Siobhain McDonagh) did not acknowledge that, directly as a consequence of this fairer way of allocating funding—this new funding formula—her schools are receiving £3.5 million more.
The hon. Member for Ilford North (Wes Streeting), who is itching for me to give way, said that his borough of Redbridge was seeing a reduction in funding. I am afraid that that is simply not the case. Redbridge’s school funding will increase from £201,600,000 to £209,859,000, a 4.1% increase, as a direct consequence of the introduction of a national funding formula.
Will the Minister give way?
I will not give way.
These anomalies will be ended once we have a national funding formula in place, which is why introducing fair funding was a key manifesto commitment for this Government. Fair funding will mean that the same child with the same needs will attract the same funding, regardless of where they happen to live.
We launched the first stage of our consultation on reforming the schools and high needs funding systems in March last year. We set out our principles—
On a point of order, Mr Hanson.
I hope it is a point of order, Mr Kane.
Mr Hanson, it should be noted that Members from all parties, including myself, were generous in giving way to the Minister. The Minister has not been generous in return.
I am afraid, Mr Kane, that that is not a point of order for the Chair. The Minister is entitled to give way or not give way according to his own preference.
Thank you, Mr Hanson; I want to respond to all the points that were made in the debate.
We launched the first stage of our consultation on reforming the schools and high needs funding systems in March last year. We set out the principles for reform and proposals for the overall design of the funding system. More than 6,000 people responded to that first stage of our consultation, with wide support for those proposals. I acknowledge the support that the hon. Member for Wythenshawe and Sale East (Mike Kane) has given to the principles of this formula.
We have just concluded a 14-week second stage consultation, covering the detailed proposals for the design of both the schools formula and the high needs formula. Our proposals will target money towards pupils who face the greatest barriers to a successful education. In particular, our proposals will boost the support for those from disadvantaged backgrounds, and for those who live in areas of deprivation but who are not eligible for free school meals—those ordinary working families who are too often overlooked. We are also putting more money towards supporting those pupils in both primary and secondary schools who have fallen behind in their education to ensure that they have the support they need to catch up.
Overall, 10,740 schools would gain funding under our proposals, and the formula will allow those schools to see those gains quickly, with increases of up to 3% per pupil in 2018-19 and of 2.5% in 2019-20. Seventy-two local authority areas will quickly see an increase in their high needs funding, and no local authority will see a fall in its funding.
As well as providing those increases, we have listened to those who highlighted in our first stage consultation the risks of major budget changes for schools. That is why we have proposed to include significant protections in both formulae. No school would face a reduction of more than 1.5% per year or of 3% overall per pupil and, as I have said, no local authority will lose funding for high needs. The proposals will limit the otherwise quite large reductions that some schools, including many in London, would see as the funding system is brought up to date.
The real-terms protection of the core schools budget underpins these proposals. As a result, we are able to allocate some £200 million to schools in both 2018-19 and 2019-20, over and above flat cash per pupil funding. That will combine significant protection for those facing reductions with more rapid increases for those set to gain under the fairer funding formula. High needs funding will see an equivalent real-terms protection.
London will remain the highest-funded part of the country under our proposals. Schools in inner London will attract 30% more funding per pupil than the national average, which is right. Despite the city’s increasing affluence, London schools still have the highest proportion of children from a deprived background and the highest labour market costs, as has been acknowledged in the debate.
We are using a broad definition of disadvantage to target additional funding to schools, comprising of pupil and area level deprivation data, prior attainment data and data on English as an additional language. No individual measure is enough on its own. Each factor reflects different aspects of the challenges that schools face, and they work in combination to target funding. Where a child qualifies for more than one of those factors, the school receives funding for each qualifying factor. For example, if a child comes from a more disadvantaged household and they live in an area of socioeconomic deprivation, their school will attract funding through the free school meals factor and the area-level deprivation factor—the income deprivation affecting children index.
The additional needs factors in the formula are proxies for the level of need in the school. We are not suggesting that the funding attracted by an individual pupil must all be spent on that pupil, but that schools with high numbers of pupils with additional needs are more likely to need additional resources. Using the proxy factors helps us target funding on schools that are more likely to face the most acute challenges. I will give way to the hon. Member for Dulwich and West Norwood (Helen Hayes), who introduced the debate, if she wants to come in on that point. If not, I will press on.
I will come in at the end.
Very good. In addition to the formula, schools will continue to receive additional funding through the pupil premium to help them improve the attainment of the most disadvantaged pupils. We have also included a mobility factor in our formula to recognise the additional costs faced by schools, many of which are in London, where a high proportion of pupils arrive at different points through the year. We were influenced by the right hon. Member for East Ham (Stephen Timms) in making that change. London schools will receive additional funding to reflect the higher cost base they face from being in London, which is particularly important given that so much of schools’ spending goes on staffing costs. The higher funding for London schools will support them to continue their success in recent years, particularly for children from disadvantaged backgrounds.
I understand the reactions of those Members who are disappointed by our formula’s impact on their constituencies. The formula is not simply designed to direct more money to historically lower-funded areas or areas with the highest levels of deprivation. It is designed to ensure that funding is properly matched to need using up-to-date data, so that children who face entrenched barriers to their education receive the support they need. That includes pupils who do not necessarily benefit from the pupil premium but whose families may be only just about managing.
The debate is about schools funding in London and the Minister is almost exclusively talking about the formula. Does he not understand that the additional cost pressures talked about by my headteachers in the letter they sent to the Secretary of State are having an effect on all schools in addition to the funding formula? It is that combination that is causing these difficulties.
I recognise that schools are facing cost pressures, including salary increases, the introduction of the national living wage, increases to employers’ national insurance and pension scheme contributions, and general inflation. We have estimated, as has been acknowledged in the debate, that national pressures will add about 8% per pupil between the start of 2016-17 and 2019-20, but it is important to note that some of those cost pressures have already been absorbed, and 8% is not an estimate of pressures to come. Over the next three years, per pupil cost pressures will on average be between 1.5% and 1.6% each year.
The current unfair funding system makes those pressures harder to manage. We felt very strongly that introducing a national funding formula will direct funding where it is most needed. That will help schools that have historically been underfunded to tackle those cost pressures more easily. We will continue to provide advice and support to schools to help them use their funding in cost-effective ways and improve the way they buy goods and services so that they get the best possible value for their pupils. We have published a wide range of tools and support, which are available in one place on the gov.uk website and include tools to help schools assess their level of efficiency and find opportunities for savings, guidance on best practice, including on strategic financial planning and collaborative buying, and case studies from schools. We have launched the school buying strategy to support schools to save more than £1 billion a year by 2019-20 on their non-staff expenditure.
In addition to those pressures, I appreciate that schools will be paying the apprenticeship levy. As my hon. Friend the Member for Sutton and Cheam (Paul Scully) pointed out, the apprenticeship levy comes with real benefits for schools. It will support schools to train and develop new and existing staff. It is an integral part of the Government’s wider plan to improve productivity and provide opportunities for people of all backgrounds and all ages to enter the workplace.
In conclusion, I am grateful for this opportunity to debate school funding in London. I hope Members are reassured to some extent that the Government are committed to reforming school funding and delivering a fair system for children in London and across the whole country—a system where funding reflects the true level of need of pupils in schools.
I thank all hon. and right hon. Members who have participated in the debate this morning, and I thank the Minister and my Front-Bench colleague for responding to it. It has been a high-quality debate. The strength of feeling and the passion are clear, and Members have represented the interests of schools in the constituencies very powerfully indeed. There is no disagreement on the principle of fairness for school funding. The concerns that have been expressed this morning are about the impact of a funding formula that will see schools in London losing funding on top of the existing severe cost pressures they are suffering.
The Minister continually refers to total sums of money and the ranking of schools according to their allocation, but that is not the concern. No Member in this Chamber is concerned about where their local authority sits in the ranking of authorities across the country. We are concerned that our schools have the funding they need to deliver the excellent outcomes for our children that they deliver at present. Higher levels of funding are good value when they deliver for children in deprived areas.
The point we are making is that the Government’s approach is putting the quality of education in London schools at risk. That is of grave concern. It is simply disingenuous of the Minister to dismiss the concerns of headteachers in London as a response to inaccurate campaign data. They are looking at their spreadsheets and telling us that the Government’s approach is not working. There is nothing fair about a formula that cuts funding for high-performing schools in deprived areas.
I conclude the debate by reiterating the powerful words of my right hon. Friend the Member for Tottenham (Mr Lammy):
“When London slips back…the nation slips back”.
I urge the Minister to reflect on those words and to think again about the impact that the funding formula will have on the quality and performance of London schools.
Question put and agreed to.
That this House has considered schools funding in London.
Homeopathy and the NHS
I beg to move,
That this House has considered homeopathy and the NHS.
Mr Hanson, it is always a pleasure to serve under your chairmanship, particularly when before we have even started the match, you have given us extra time. It is not often that we are able to start a debate earlier than expected.
This debate has come about for two reasons. The first is the attacks on the long-established national health service homeopathic service. Secondly, we are approaching a very happy moment, Homeopathy Awareness Week, when the homeopathic community comes together to tell people about what it can offer in providing support to doctors and alternatives where other treatments have not worked.
Homeopathy Awareness Week takes place from 10 to 16 April in a celebration of homeopathy: a safe, gentle, natural system of medicine that I have used for 30 years to great effect. In the UK, it might surprise people to hear that 15% of our population already use homeopathy and a further 80% have heard about it. Many people are not sure what makes it different from other medical systems. The week aims to get people to have a better understanding. A lot of events have been organised, including the film première of “Just One Drop”.
To put things in a global perspective, some 450 million people use homeopathy each year. If homeopathy did not work, why would so many people choose to use it and carry on using it? It is a global medical system, the second largest medical system in the world, and is used particularly in very poor communities, which I will come on to.
On British practitioners, a survey recently showed that 72% of homeopathic patients rated their practitioners either very good or excellent. The 4Homeopathy group recent study showed that practitioners are treating all kinds of things, from irritable bowel syndrome—30%—to depression—20%. More than three quarters of teenagers and 41% of adults receive homeopathic treatments for skin disorders. About a third of adults and 40% of teenagers go to homeopaths for anxiety and stress. It is a service that delivers both in and out.
I congratulate the hon. Gentleman on securing this debate. I certainly would not dispute the testimony of those who have benefited from homeopathic treatment, but does he not agree that scientific evidence of its effectiveness would help in a decision on whether to use it?
The right hon. Gentleman, who has been in the House as long as I have, has made a good point. There is scientific evidence out there, although we could use more. One of the problems is that, when scientific evidence is produced, it is pooh-poohed. However, that does not stop people using, for example, arnica cream when they get wounds. It is a standard preparation and it is a homeopathic medicine. So there is a degree of need for more studies, but there are studies out there that are ignored.
I have said homeopathy is the second biggest medical system in the world. Some would say it is the most prestigious. It has always been held in very high regard by people who are widely respected. It is no secret that the royal family and many celebrities have used homeopathic medicine over the years. It has become increasingly important in an age when drug dependency is epidemic and when there are serious worries about the effectiveness of antibiotics.
The homeopathic private sector is growing fast not only in this country, Europe and America, but everywhere. However, in the NHS, we are under attack from people in the medical establishment. This goes back to 2005, when a letter was put out attacking homeopathic services in the health service. It was actually a bogus letter on NHS letterhead. The Countess of Mar and Lord Palmer asked a question about it and the reply acknowledged that
“this document was not issued with the knowledge or approval of the Department of Health and that the use of the National Health Service logo was inappropriate in this instance. The document does not represent any central policy on the commissioning of homoeopathy”.
Anti-homeopathy groups such as the so-called Good Thinking Society, which is a front for one individual, a sceptic called Simon Singh, are threatening clinical commissioning groups with legal action for commissioning homeopathy. People such as Simon Singh are anti-patient, anti-choice and closed-minded individuals who have never studied or used homeopathy. In the UK, we have a robust system of homeopathic regulation. We have the Faculty of Homeopathy, which was formed in the 1950s for doctors. Doctors are, of course, regulated by the General Medical Council as well. In 2015, the Professional Standards Authority took on oversight of the regulation of the 2,000 members of the Society of Homeopaths. Such enhanced regulation is important and is a good reason why homeopathy should be more greatly available in the health service.
Will the hon. Gentleman give way?
I will give way to my hon. Friend from Northern Ireland.
It is always good to have debates on anything to do with health, but particularly with homeopathy. There have been several reviews of the scientific evidence on the effectiveness of homeopathy. Indeed, this House had a report in 2010, which the Minister will be aware of, from the Science and Technology Committee. In my constituency of Strangford is a major shop in Newtownards that deals in nothing else but homeopathy medicine, which clearly shows a demand. Does the hon. Gentleman feel it is perhaps now time for the Government to look at homeopathy in a new light because of the demand that there is, and also to see what homeopathy can offer?
My hon. Friend makes a powerful point. There is insanity about this subject. The amount of money spent on homeopathic prescriptions in the health service is about £110,000 per annum. So why are those who are against it so fanatically against it? What is it that gives them the swivel-eyed look? Why do they take so much trouble to rub out an alternative at a time when the mantra of the Government is patient choice? It is quite bemusing. Many of the patients that go to homeopaths have contraindications to pharmaceutical drugs, or chronic illnesses that have not been helped by conventional medicines. I say to the Minister that there are no cost savings to be made by banning homeopathic prescriptions, as patients will still need other interventions instead. The Government should assess how much money the health service has spent on other interventions for these patients before the successful use of homeopathic medicine.
If we look around the world, we see a much more developed landscape. In France, 70% of pregnant women use homeopathy. You can go to any chemist in France and find homeopathic preparations and chemists who are qualified to talk about them. If we go further afield, I particularly like the example of India where there is a Ministry for complementary medicine called the Ministry of AYUSH—the “H” in AYUSH stands for homeopathic medicine. I will say a little about that later.
We have already discussed evidence and there is always a need for good studies. There was a study in France, which I sent to the Secretary of State a long time ago for consideration by the chief medical officer. I have not had a reply yet, although I accosted him about it in the Division Lobby this week. A bullet-proof study named EPI3, which looks at the integration of homeopathy into general practice in France, showed positive outcomes, as does a randomised double-blind, double-dummy, multi-centre, non-inferiority clinical trial, which covers everything possible to follow the protocol, looking at the effect of an echinacea-based hot drink versus oseltamivir in influenza treatment. There are also promising indications that homeopathy could be helpful in combating the increasing problem of antimicrobial resistance. That is an example of a good study. I will come back to the EPI3 study.
The attacks on homoeopathy in the NHS come pretty much from one person. They come from an organisation called the Good Thinking Society, a charity that is not supposed to campaign for changes in the health service, but its website states that it wants to raise money because it
“Helps us campaign against the funding of homeopathy”.
According to the website, its leader, the Good Thinking Society’s chairman, largely funds the whole operation and another charity. It launched an attack on the Liverpool homeopathic service to shut it down, and eventually it was shut down. It worked like this. There was a consultation for local people at the end of 2015, at which I had a representative. Some 90% of those present were in favour of retaining or extending the service. Voting was by secret ballot, using hand-held remote controls, and 90% were in favour. One lady present, who suffered from a range of chronic conditions that conventional medicine had been unable to treat, was close to tears. She said that the only thing that had allowed her to live a relatively normal life was homeopathy. She pleaded with the clinical commissioning group not to cut the homeopathy service.
The next stage was a formal consultation open to everybody, with no restriction by area and no checking of who was contributing. That consultation found 73% against keeping the homeopathic service. It is my belief that that consultation was hijacked by the Good Thinking Society—that it got people to call in and distort the result. The right hon. Member for Oxford East (Mr Andrew Smith) and I have been here for a long time—nearly 30 years—and I think we can smell electoral fraud when we feel it. I cannot see how the results can go from 90% in favour to 73% against.
Patients who relied on that service have nowhere to go now, except for being a charge on the health service. That decision caused immense pain. One patient, Mr T, aged 58 from Liverpool, said in an interview from October 2015:
“After 3 years of trying everything my doctor gave me homeopathy, and within 4 months my stomach problems were better. 18 months later I can lead a normal life again.”
A London patient with arthritis said:
“It is the only thing that has helped me find remission from a disease that previously left me wheelchair-bound.”
The core of this debate is the most recent, and most serious, attack on NHS homeopathy—the attack on the Royal London Hospital for Integrated Medicine, the largest public sector provider of integrated medicine in Europe, formerly known as the Royal London Homeopathic Hospital. It offers an innovative patient-centred service, integrating the best of conventional and complementary treatments for a wide range of conditions. All clinics are led by consultants, doctors and other registered healthcare professionals, who received additional training in complementary medicine. This is a flagship hospital that is admired around the world. Instead of threatening it with closure, it should be hailed as an example of best practice and used to develop integrated medicine and to spread understanding of its benefits to the public and the health community.
For greater accuracy, I spoke to the director, Peter Fisher, and I have a briefing note from him. Apart from being a director of the hospital, he happens to be—as he described himself when he came before the Select Committee on Health in the last Parliament, during an inquiry into long-term care and conditions when I was acting Chair of the Committee—physician to Her Majesty the Queen. This is not somebody with a little training; he is a highly proficient, highly trained doctor—so much so that he is a doctor at that level.
Dr Fisher says:
“The Good Thinking Society is harassing the Royal London Hospital for Integrated Medicine by threatening legal action against its host clinical commissioning group, Camden. The RLHIM has an agreement with the north London cluster of clinical commissioning groups, led by Camden, for clinical care pathways for 13 conditions. Patients who do not have these conditions can be treated if normal treatments have failed or have caused serious adverse effects, and in certain other circumstances. The GTS is attempting to close the latter pathway. This would cripple the hospital, preventing it from providing homeopathy, herbal and other treatments and from treating cancer patients. The GTS has harassed the RLHIM and other complementary medicine providers with legal action, reporting to the ASA”—
the Advertising Standards Authority—
“and the Charity Commission.”
I will say more on that if we have time. He continues:
“The RLHIM is the largest public sector centre for integrated medicine in Europe with a strong record of provision, innovation and research. A large scale study in France comparing conventional and homeopathic GPs showed that homeopathic GPs prescribe far fewer drugs, with the same or better clinical results, at 20% less cost.”
So there is an economic argument here, which I will say a word about in a moment.
In the year ending March 2016, the Good Thinking Society had an income of about £100,000. It gave £25,000 to something called the Nightingale Collaboration, which is not a charity, so that it could use the money more freely. That organisation has attacked osteopaths, who are regulated by an Act of Parliament—I was on the Bill Committee for that—and homeopaths, and has waged a campaign against complementary therapies with the Advertising Standards Authority.
The individual, Simon Singh, is a strange and inconsistent individual. He sent me an email before Christmas explaining why he could not send me a Christmas card. I am not sure I would have expected one, as I absolutely despise him. In 2015, it was reported that the charity made claims that processed sugars are not deadly and do not feed cancer, but he did not reveal that the charity was receiving funds from a very large soft drinks manufacturer. I think it is accepted that large amounts of sugar are not necessarily a good diet for cancer patients. I think that is why he got his nickname, “Sugar Drinks Simon”.
Mr Singh also criticised the lyrics of the Katie Melua song “Nine Million Bicycles” for inaccuracy, referring to the size of the observable universe. He proposed correcting the lyrics, saying that the value of 13.7 billion light years would be correct. I looked into that and found that the correct figure is 46.5 billion light years from home. Even on that subject, on which Mr Singh professes to have knowledge, he was wrong—so there is no surprise that he is wrong about homeopathy, about which he has absolutely no knowledge.
To recap, we have what my daughter would call the absolutely bonkers situation where an individual, Singh, who is a physicist, not a physician, with no understanding or experience of homeopathy, is trying to cripple our leading academic medical centre, part of the University College London Hospitals NHS Foundation Trust, whose director—the man running it—is the Queen’s doctor. How mad can you get?
The core problem is not about whether or not homeopathy is effective. There have long been arguments about evidence-based medicine. Professor Sackett, who was responsible for the phrase, did not say it is about whether medicines work or not. He said it is about integrating individual clinical experience and the best external evidence; it is not just about external evidence. It is not just about the medicine—it is about the patient’s and the clinician’s experience. The nub of it is that complementary medicine can reduce the costs on the health service. I have quoted the French EPI3 study, which said that French GPs who integrate homeopathy in their practice use about a third of the antibiotics and psychotropic drugs and half the analgesics, with very similar results, at 20% less cost. That is not taking into account antimicrobial resistance or the adverse effects of analgesics, sleeping tablets or whatever.
There is a turf war here between two sides of the medical establishment, which is actually about resources. We have to resist that. The Secretary of State said, very sensibly, on LBC on 10 September 2014:
“There are some bits of the NHS where it”—
“is sanctioned by GPs, but it wouldn’t be done without a doctor saying they thought that that was the right thing to do. And what doctors say is the right thing.”
He signed early-day motion 1240, which was about supporting homeopathic hospitals, in the 2006-07 Session of Parliament. It was signed by more than 200 Members—nearly a third of the Members of the House of Commons.
Today of all days—Brexit day—when the Prime Minister will be writing to the European Commission, I found this written answer in the Scottish Parliament from 23 February 2011. The then Health spokesman—no less an individual than the current First Minister, Nicola Sturgeon—replied. This is what she said in reply to a question about the effectiveness of homeopathy in relation to the Scottish Government’s integrative approach to patient care:
“In primary care, costs will relate to the cost of the remedy, which can be cheaper than the cost of orthodox drugs. Practitioners have also noted a reduction in side effects and dependency risks in some cases. In secondary care in Scotland, homoeopathy is only employed within a broader integrative care approach, with surveys showing both enhanced wellbeing and symptom reduction across a broad range of long term conditions, and a resultant reduction in NHS costs through reduced GP and hospital visits and repeat prescriptions.”
Well, there we are. That is what the First Minister in the devolved Administration thinks.
Homeopathy is a wonderful system of medicine. It has been part of the national health service for a long time, and I look forward to hearing from the Minister about the Government’s position.
It is a pleasure to serve under your chairmanship, Mr Hanson. I congratulate my hon. Friend the Member for Bosworth (David Tredinnick) on yet again leading the charge—we have debated this issue in various parts of Parliament—and on securing this debate in close proximity to Homeopathy Awareness Week, which starts on 10 April. He normally corresponds with my colleague, the Minister for Public Health and Innovation. I apologise that he has to put up with me today, but I will do my best to address the points he raised and set out as specifically as possible the Government’s and the NHS’s position on homeopathic remedies.
The Government have no particular position on the efficacy or not of any type of treatment, but we have a position on evidence-based medicine, and I will come on to talk about how we expect an evidence base to determine how we spend public money. There is an acceptance that there is great popularity for some parts of this medicine across the world, as my hon. Friend said. The Government have no particular control over how people spend their money in terms of these treatments. He was involved in the Walker report and review, which put in place a regulatory environment involving the Professional Standards Authority system and the voluntary lists for that.
As well as that popularity-led issue, there is the issue of how we spend public money in the NHS. I will come on to that process, but it is about the evidence base. It is right that there is a method of evaluating competing drugs, technologies and treatments. I will come on to talk about that and what it means in this context. We have no overall position on this issue. My hon. Friend made a good point about the over-prescription of antibiotics. He said that, in certain areas, homeopathic remedies may be an alternative.
I used the phrase “evidence-based medicine”, which means that the medicine is clinically cost-effective. Typically, the drugs that are used across the NHS are subject to trials—possibly lasting many, many years and involving large populations, statistically clear correlation and all that goes with it. A requirement of those drug trials is that their results are not anecdotal, but clearly repeatable. The drugs must demonstrate efficacy. When the National Institute for Health and Care Excellence evaluates them, it uses a threshold to measure their cost versus the quality of life and the years that are obtained by their use. Precisely the same criteria would be applied to any homeopathic or alternative remedy; they would be evaluated in that way. The Department’s position is that medicine must be evidence-based. Within that constraint, we use what the evidence tells us to use. For non-NHS expenditure, it is up to the public to buy what they wish, provided it is safe. There are some controls, and if I have time I will talk a little about the Walker review and what the controls are.
The NHS’s commissioning power is set locally by CCGs, which are GP-led. They set out their policies, in terms of what the CCG uses, but as they do that we expect them to be advised and informed by best practice and, where they are available, by NICE guidelines. Within that, GPs have considerable discretion. As my hon. Friend knows, some GPs still prescribe such remedies, where that is permitted by the CCG. That is not something that the Government have chosen to interfere with, although the drive towards evidence-based medicine means that over the past decade the amount of prescribing has decreased considerably. Last year, something like 9,000 separate prescriptions were made in primary medicine at a cost of about £100,000. A decade ago, the figure was nearer £150,000. That decline has been driven not by a Government diktat, but by our requirement that all CCGs use an evidence base for their decisions.
My hon. Friend gave various views about the evidence base. In 2010, the House of Lords Science and Technology Committee said:
“There has been enough testing of homeopathy and plenty of evidence showing that it is not efficacious.”
More recently, NICE said that it is not aware of any evidence that demonstrates therapeutic effectiveness, and it does not currently recommend that homeopathy should be used as a treatment for any health condition. As a consequence, there has been a tail-off in the use of such remedies.
I accept that, in certain circumstances, patients may feel that they have tried many other things, and a physician working with them might say, “Let’s have a go at one of these things. What have we got to lose?” As I say, it is not the Government’s job to stop a GP taking that position in that situation. Very often, that will be done in conjunction with a patient who, as my hon. Friend said, feels as though they have tried everything else, and will have a go at it as a last resort. It may well be that, anecdotally, it works, whether that is through a placebo effect or for whatever other reason. It is not the Government’s job to stop that.
In the last minute that I have, I want to talk about the Walker review, of which I think my hon. Friend was the vice-chairman—he certainly helped to inform it. A system of regulation was brought in. We have been talking about the potential need for statutory regulation of the use of such remedies outside the health service. The Walker review looked at a variety of issues with respect to such medicines and concluded that we should put in place a voluntary system of regulation accredited by the PSA—something of a middle way.
The Society of Homeopaths is now regulated by the Professional Standards Authority, and will be looking to the health service to make better use of its services.
The Society of Homeopaths is accredited by the PSA, as my hon. Friend says. When somebody gets accredited, that is an endorsement that that practitioner is committed to safety and to work of good practice. It is not necessarily an endorsement of the technique that is being used, but it is accreditation that it is a safe technique. We accept that, and we would like more professionals working in that area to go down that route. I will finish on that note. I hope that I have been successful in setting out the Government’s position.
Motion lapsed (Standing Order No. 10(6)).
[Mrs Anne Main in the Chair]
Before I call Mike Freer to move the motion, I want to say that our thoughts are with the victims of last Wednesday’s atrocities. I do not think that the House is pausing in its proceedings, but our thoughts are with them today.
I beg to move,
That this House has considered the all-party parliamentary group report Impact of Health and Social Care Act on HIV treatment.
I associate myself with your comments, Mrs Main, which are exactly right, and it is a pleasure to serve under your chairmanship. I also put on the record my appreciation of the Minister and other colleagues, but especially the Minister, who has been extremely supportive of the all-party parliamentary group on HIV and AIDS and who has always been helpful when I have raised issues to do with HIV/AIDS. I am grateful, too, to other Members on what is a busy day, with other demands on their time. Their attendance at this debate is much appreciated.
Since 2015, when I was elected chair of the all-party parliamentary group on HIV and AIDS, our main objective has been to draw on evidence from clinicians, patients, HIV charities and research groups concerned about the potential impact of the Health and Social Care Act 2012 on HIV treatment in England. In December 2015, therefore, we started to collect written evidence so that we could investigate whether such concerns were based on reality.
Our inquiry took about a year to conclude. We heard from clinicians, local authorities, public health officials, people living with HIV, and the charity sector. We took both written and oral evidence. After a year of gathering evidence, it is fair to say that we concluded that fragmentation has occurred, creating a degree of uncertainty and presenting opportunities for aspects of HIV care to fall through the gaps between the commissioning bodies. I will outline that later.
The purpose of our report, “The HIV puzzle: Piecing together HIV care since the Health and Social Care Act”, was not to turn back the clock, but to reach out to the sector for evidence and recommendations so that we may make tangible improvements to the commissioning of HIV services. We need to work together to make such changes to ensure that people continue to maximise the benefits of the world-class treatment and clinical care service available in the UK.
I emphasise that the majority of the report recommendations focus on the need for clarity and accountability in all parts of the HIV care pathway, because the lack of clarity in the 2012 Act is what came into sharp focus. It was exemplified by the debate surrounding the provision of PrEP—pre-exposure prophylaxis—and the uncertain future of HIV support services. I and my APPG colleagues who advocate central funding for PrEP welcome NHS England’s announcement of a new PrEP trial to reach 10,000 people.
Our report concluded that the Health and Social Care Act increased fragmentation to many aspects of the care pathway, from prevention to long-term condition management. For example, fragmentation has created risks for HIV support services. The separation of sexual health and HIV is another example. There are new potential barriers to testing and prevention. Most importantly, there is confusion over the commissioning of new prevention techniques. I will highlight some of our key findings and offer suggestions as to how the APPG believes the report’s recommendations can help address them.
HIV support services—non-clinical services—have long been considered a vital part of the care pathway for people living with HIV. The British HIV Association, BHIVA, which is accredited by the National Institute for Health and Care Excellence, provides official guidance on HIV treatment and care. BHIVA states that the following are necessary for effective long-term condition management: peer support; support from other trained professionals; and information about HIV treatment, healthy living with HIV, diet and lifestyle, and optimisation of general health issues. People living with HIV also need support to access general health services, financial advice, and housing and employment support.
That view is endorsed by NHS England:
“The effectiveness of specialised HIV services depends on other elements of the HIV care pathway being in place and effectively coordinated”,
Those elements include:
“Third sector HIV care and support services for treatment adherence, peer support and self management…Social care, mental health and community services for rehabilitation, personal care or housing”.
Not everyone living with HIV requires support, and most will only need to use those services periodically, such as when they are newly diagnosed, experiencing employment issues, pregnant or considering disclosing their status to others, and if they are experiencing discrimination. The UK stigma survey identified that 28% of people diagnosed within the previous 12 months reported suicidal thoughts. Sadly, the suicide rate for HIV-positive men in the first year after diagnosis is more than five times higher than for men in the general population.
Similarly, while the side effects of treatment have improved in recent years, many people still have real difficulty in managing them, especially when starting medication or transferring regimens. People who are long-term diagnosed may experience ongoing and irreversible side effects of older HIV treatments, such as neuropathy and lipodystrophy. Most recently, there is emerging evidence on diabetes.
Support services in those instances not only ensure that people have access to a trained professional or volunteer at the point of crisis, but reduce the pressure on healthcare professionals. The National AIDS Trust reported that 50% of attendees at expert patient groups subsequently reported fewer GP visits. For an investment of £400 per attendee, the average net saving to the NHS for each patient with a long-term condition was £1,800. In addition, Positively UK reports that 88% of people reported that peer support has helped them to adhere better to their treatment plans.
Unfortunately, however, we have heard from the National AIDS Trust and other local support organisations that HIV support services are vulnerable under the 2012 Act, because commissioning responsibility has not been clearly defined. Therefore, the clearly mandated service provision has instead taken priority, in particular where there have been reductions to public health grants for local authorities. Last year, for example, HIV services in Berkshire and Oxfordshire were reduced by more than £100,000. In Berkshire, that equates to a loss of a third of the funding, which will directly affect 300 people living with HIV in Slough and Bracknell.
In Public Health England’s guidance to commissioners, “Making it work”, HIV support services are the only part of the care pathway left “to be determined locally”. That means that either the clinical commissioning group or the local authority can provide such services, but in a number of cases it appears that no one is commissioning services such as community-based HIV clinical nurse specialists.
The value of support services in other disease areas is well recognised. CCGs already commission cancer care, peer support for mental health services and the DESMOND —diabetes education and self-management for ongoing and newly diagnosed—programme for diabetes. The APPG has therefore recommended that the responsibility for providing HIV support services is met by NHS England and CCGs as part of the patient care pathway provided for long-term condition management.
Local authorities have a responsibility to provide public health and social care services, but the ambiguity in the 2012 Act and reduced funding mean that the responsibility has been deprioritised. Support services sit comfortably within the mandate that CCGs and NHS England already have to provide HIV treatment and care. Importantly, what we are asking is that the Department of Health reiterate the need for a mandated whole-treatment plan, from start to finish.
My hon. Friend is making some good points, and I commend him for bringing forward this important debate. Does he agree that one of the fundamental challenges thrown up by the Health and Social Care Act 2012 is the fragmentation of services? As a clinician, it is strange to me—I made this point when I was on the Health Committee—that sexual health services are now commissioned by local authorities and a lot of HIV diagnoses are first discovered by contact with sexual health services.
My hon. Friend makes a good point. I will go on to identify what is almost a lottery or a roulette, where people can access testing only if the parts of the health service or social care services that they come into contact with know what to do. I will also comment on the problem that some services—particularly GP services—feel that they are under so much pressure that they do not always know how to refer people for testing. One of the implications of the rationalisation of genito-urinary medicine clinics—GUM clinics—is that people risk falling through the cracks. My hon. Friend makes a good point that because services are provided in a number of places by a number of parts of the health service and it is not clear who is responsible for doing what, there is a great danger that people will think, “Someone else is doing it,” or, “Someone else is paying for it,” and we end up with no one doing it or no one having the funds to do it.
Civil society groups have highlighted that, under the Health and Social Care Act, some HIV services have been separated from sexual health services, which seems to have had the unintended consequence of creating different commissioning responsibilities for different aspects of caring for people living with HIV. HIV clinical services are commissioned by NHS England. HIV clinics traditionally sit in or next to sexual health or GUM clinics. That is the logical place for them to be; it helps with referrals and the continuation of care. Most HIV diagnoses are picked up during routine sexual health check-ups.
For example, the team at the Marlborough clinic at the Royal Free hospital, which serves my constituency, offer HIV testing and treatment alongside sexual health advice, testing and treatment for sexually transmitted infections, and contraception services. Where an HIV-positive diagnosis is made, staff can quickly link the newly diagnosed person into care at the adjacent Ian Charleson day centre, almost by walking them from one part of the building to the next, to ensure that there is continuation of care and no gap between someone being diagnosed and referred. In every part of the health service, whatever the illness or condition, if there is a gap between diagnosis and referral to a specialist service, some patients simply do not turn up. The collocation of services improves the continuation of care. The threatened merging of GUM clinics, which might take them away from HIV clinics, is therefore a cause for concern. I fear that it will make fragmentation worse.
Although local authorities are entirely responsible for providing sexual health services, they are not responsible for the entire HIV care pathway. That has resulted in sexual health services being put out to tender without a plan for the HIV service. That disruption of care presents a real problem for keeping track of patients and ensuring that they remain in the care pathway.
One of the other practical problems that was not thought through very well in the run-up to 2012 is communication between services, which my hon. Friend rightly mentioned. IT systems in the NHS often do not talk to one another very well, and they certainly do not communicate well with local authority databases or those of private sector providers, which may store information about the same person. That is at the core of the problem, and I wonder whether he might look at that issue when he makes recommendations to the Minister in the future.
My hon. Friend makes a good point. The APPG is currently considering an informal report about the future of social care. Because HIV is no longer a death sentence but a manageable condition, people are living to ages by which they expected to be dead, or by which the health service expected them to be dead. We have early indications that the social care sector simply is not geared up for handling admissions or placements of HIV-positive people into care homes and nursing homes. Some care workers are simply uneducated about how to provide support. My hon. Friend is right: as people are moved into private placements, whether they are funded by the local authority or self-funded, we will have the problem of a lack of joined-up support—not just in IT, but between social care, which is a local authority responsibility, and care for health conditions, which is the responsibility of HIV clinics with NHS support. He makes a very good point.
The disruption caused by dislocating HIV and sexual health clinics presents a real problem in keeping track of patients. As I said, collocation ensures that patients stay in the care pathway. Integrated HIV and sexual health services support young people living with HIV as they transition from paediatric care into adult services. Navigating adult HIV services for the first time can be challenging for young people. Including those services alongside sexual health services ensures that they have a one-stop shop for their HIV care and other tools for ensuring good sexual health.
The reality is that, in many cases, sexual health has become fragmented from HIV. Sexual health is the more profitable aspect of tenders, so some providers have purchased only the sexual health service, leaving no provision for HIV. In oral evidence to the APPG last year, the British Association for Sexual Health and HIV—BASHH—said that it believed that that had been a genuine oversight in the tendering process. Its president said:
“I don’t think the connection of what would happen if, particularly in a small service, the sexual health element of the tender was won by another provider. I don’t think anybody thought what would happen to the HIV service that was there. I think they thought it would just continue to be provided…and of course that may well be the case if it’s a large HIV unit, but in many cases it isn’t and it’s financially not viable, and that’s where the problem lies”.
Others report that when sexual health tenders were purchased without the HIV service, HIV clinics were left understaffed and with little certainty about the commissioning of the service. That means that people living with HIV have been required to access services elsewhere, which has led to small but significant numbers being lost to care. In its written evidence to the APPG’s inquiry, BASHH also noted:
“In a sexual health service that went out to tender a few years ago the contract was awarded to a community NHS provider. The outreach HIV clinic that had been well established was not sustainable and the service was discontinued. The majority of the service users transferred their care to other HIV providers some miles away but 9% were presumed to have disengaged in care.”
With that in mind, the APPG’s report, “The HIV puzzle”, recommends co-commissioning of HIV and sexual health services by local authorities and NHS England. Those two commissioning bodies should work collaboratively to ensure that a service assessment is in place so that the new provider, whoever it is, has a responsibility to ensure that the HIV service is maintained and not lost. The Department of Health needs to ensure that there is mandatory guidance for sexual health service bidders to undertake risk assessments and produce action plans detailing how the HIV treatment service will be transitioned and implemented.
The separation of HIV clinics from sexual health clinics is an unintended consequence of the Health and Social Care Act that needs to be addressed. The split of responsibility for different aspects of HIV care between local authorities and NHS England is leading to confusion in commissioning, and as I mentioned, early indications are that a small but significant proportion of HIV patients have fallen out of the care pathway as a result. Previously, sexual health services were all commissioned by primary care trusts and the separation of HIV services from sexual health services was unheard of.
The inquiry also identified that there remains no whole service specification for HIV and sexual health, which we believe is causing health professionals to deprioritise the service. The service specifications that do exist relate to either sexual health or HIV services through “Integrated sexual health services: national service specification” and the NHS England service specification for adult HIV services, and it is the same for paediatric HIV. Those guidelines are useful, but what is really lacking is a comprehensive service specification for HIV and sexual health that encompasses all aspects of the HIV care pathway.
That is why we recommended that the Government develop a whole service specification for HIV and sexual health, bringing together the various existing strands of clinical guidance to ensure clear and consistent advice is available to all local authorities, CCGs and NHS England. A clear service specification for HIV and sexual health would mean that there is a one-stop shop for local authorities or CCGs, which would help to remove the sense of fragmentation experienced by both patients and health professionals.
We recognise that public health is a devolved issue, but the Secretary of State must ensure that local authorities have enough guidance to ensure that there is a minimum service requirement that they must provide. At the moment, the 2012 Act does not provide enough clarity or accountability to any one commissioning body. The nature of HIV as an infectious disease means that HIV services do not start at the point of diagnosis.
Let me turn to testing and prevention, which are a critical part of encouraging safe sex. The APPG is extremely pleased with the Government’s recent announcement that relationships and sexuality education will be made compulsory in all secondary schools. Properly informed and sensitively taught, that will go a long way to ensuring that young people are able to make informed decisions about safe sex and preventing the transmission of sexually transmitted infections and HIV.
None the less, testing and prevention are subject to similar fragmentation of commissioning responsibility, so confusion over commissioning responsibilities remains. As an example, HIV testing can be paid for by any of three commissioning arms—local authorities, NHS England and CCGs—depending on the setting and context in which the test is offered. HIV testing—including community outreach—for most-affected groups and routine population screening in areas of high prevalence is the responsibility of local authorities. HIV testing clinically indicated in a hospital—and termination of pregnancy services—is paid for by CCGs. Testing and treatment for STIs, including HIV testing, provided in general practice when clinically indicated or requested by individual patients, is covered by NHS England as an essential service under the GP contract. Different settings, different funding, total confusion.
In short, if someone is offered an HIV test by a hospital doctor because they arrive in A&E with shingles, it is paid for by the CCG. If they are offered the same test for the same reason by their GP, it is paid for by the NHS primary services contract. If they are offered a test by the same GP simply because they live in an area of high prevalence, as NICE recommends, it is paid for by local authority.
The evidence for prevention and early diagnosis is overwhelming. People living with HIV can expect a near-normal lifespan if they are diagnosed early, but people diagnosed late continue to have a tenfold increased risk of death in the year following diagnosis. NICE also estimates that the costs of HIV care remain 50% higher for each year after diagnosis if the diagnosis is late. Likewise, preventing onward transmission is crucial not only for individual and public health but in terms of the sizeable lifetime costs of treatment. In 2011, PHE estimated that each infection prevented would save between £280,000 and £360,000 in lifetime treatment costs. NICE estimates that, if national testing guidance is implemented fully, 3,500 cases of onward transmission could be prevented in the next five years, saving the NHS more than £18 million a year in treatment costs.
I mentioned that GPs say they are under time pressure, and for a number of health issues that is widely reported as a barrier to proper intervention. The availability of education for GPs on offering HIV tests remains a problem. GPs feel they do not have enough information about the most appropriate time at which to intervene on HIV testing. As the Royal College of General Practitioners notes,
“There is...the issue of effective implementation—including training and support for practices to adopt these schemes...GPs and our teams are already under immense resource and workforce pressures making it incredibly difficult to implement any new programme”.
Many in primary care will therefore refer patients to GUM services for testing. However, that has the potential to entrench existing inequalities in late diagnosis rates, given that high-risk communities—particularly black African communities—are far less likely to access sexual health clinics and much more likely to access primary care.
Although healthcare professionals’ knowledge of when to offer an HIV test is not directly related to the Health and Social Care Act, the expectations from patients and the NHS England to mandate commission testing based on clinical indicators mean that educating healthcare professionals on the subject in line with NICE public health guidance must be a priority. The APPG has also called for protection of local authority public health grants from further funding reductions, in line with the Government’s commitment to ring-fencing the NHS budget. I would be grateful if the Minister could outline what plans she has to ensure that public health investment is not lost under further changes to local authority funding.
Finally, arguments over commissioning responsibilities have led to a stalemate on the introduction of innovation in HIV prevention. In 2015, studies from the UK, France and the US reported that, when taken regularly, PrEP can reduce the risk of HIV transmission by up to 86%. As the National AIDS Trust notes:
“PrEP is exciting, new, and currently, unique. It is not a vaccine, although it has a similar impact. We can draw comparisons to statins, in terms of preventing illness, or contraception, in terms of preventing unwanted consequences of sex. But actually, there is nothing quite like it. It is the definition of healthcare innovation.”
I do not wish to repeat the arguments made for and against the centralised commissioning of PrEP, but it does serve as an important case study in highlighting how the fragmentation outlined already risks HIV services that are focused on both lifelong condition management and preventing onward transmission.
As I mentioned at the beginning of my comments, I am enormously grateful to the Minister and NHS England for the announcement of an expanded clinical trial phase, including at least 10,000 participants, which will be launched early in 2017-18. I hope she will be able to update us on that trial in her response. I thank everyone who participated in the inquiry, particularly those who travelled across the country to attend our oral evidence sessions, and all the members of the APPG who took enormous time out of their diaries to support the inquiry.
It is a pleasure, as always, to serve under your chairmanship, Mrs Main. It was a particular pleasure to hear the hon. Member for Finchley and Golders Green (Mike Freer) set the scene for us on a subject that is close to his heart and one that he has become a champion for in this House. I congratulate him on that. I have always been here to support him in his endeavours, and I am pleased to do likewise again.
When we think of HIV, as we are doing in this debate on the report, our thoughts automatically go to African nations. They do in my case, and Swaziland in particular, as my parliamentary aide visits and supports an orphanage there. One in every two people there has AIDS, so there is naturally a massive need for care and support of orphans. My heart has long been touched by the needs of the people in that country who have been ravaged by the spread of AIDS, and by the work of the World Health Organisation and other charities such as Teen Challenge and Elim Missions, which are active in my constituency.
However, this debate is about the report, which makes it clear that this is an issue much closer to home as well as one in Africa. We can relate it to our own constituencies. I understand that health is devolved to Northern Ireland—at least it is now; we will see how these talks go. The Minister might be the person making the decisions. We will have to see what happens in relation to that. With great respect, I hope she will not be making those decisions; I hope we will be making them back home, but that is by the by.
In Northern Ireland in 2015 there were 103 new diagnoses of HIV, bringing the total to almost three times what it was in 2006. Some of these figures are shocking and worrying. That is the highest number of HIV diagnoses to ever be recorded in a single year in Northern Ireland. From 2000 to 2014, a total of 557,000 HIV tests were carried out in Northern Ireland.
In Northern Ireland a total of 126 people diagnosed with HIV have died. That includes AIDS and non-AIDS-related deaths. Data obtained from the Public Health Agency showed that 114 pregnancies were affected by HIV from 2005 to 2016. Encouragingly—there is always a good message to be told—the pregnancies were managed to prevent the infection being transmitted from mother to child. That is certainly a bonus and highlights the importance of knowing about infection and managing the birth of babies correctly. We have come forward with medicine and medication over the years in an innovative and very effective way.
In 2015, there were some 6,095 new cases and 88,769 people being treated for HIV across the UK. This is not an African infection; it is a problem in the UK that we must address. In setting the scene for us, the hon. Member for Finchley and Golders Green focused attention on where it should be in this debate: where we are in the United Kingdom. Some 101,200 people were estimated to be living with HIV in the UK by the end of 2015.
As with many illnesses, many people are living with the disease without knowing it. I would like to hear the Minister’s thoughts on how we can reach people out there who are carriers and perhaps do not know it. The clear fact is that, if people are not diagnosed, there is a much greater danger of them unwittingly spreading the infection.
It is estimated that 87% of people are diagnosed; 96% of those diagnosed are accessing treatment; and 94% of those accessing treatment are virally suppressed or “undetectable”—the virus will not show up on tests; it is unable to be transmitted to others. Those are some of the facts. That means that around 13% are undiagnosed and unaware of their infection—they are not able to access care to protect their wellbeing and prevent the onward transmission of HIV to others.
It has been estimated that each new infection costs the NHS between £250,000 and £360,000 in direct lifetime treatment costs. That is something we need to address, and the Minister must at least consider it. The number of new diagnoses in 2015 was slightly lower than in 2014, but new infections have remained roughly static since 2010. The fact that there are new infections each year is something we cannot ignore and needs to be addressed. I am keen to know the Minister’s thoughts on the best way of doing that.
Some 39% of people are diagnosed late, which has a potential impact on their immediate health and therefore the cost of treatment at the point of diagnosis and beyond. The fact that people are diagnosed late indicates that there was a possibility of diagnosis earlier. If that is the case and it has not been done, why? There must be a proactive approach to encourage screening and to reinforce education and learning about the prevention and spread of HIV and sexual health in general.
I tabled a question some time ago, to which the Minister responded, on the increase in sexual infection among those in the 50-to-70 age bracket. The figures indicate a rise in HIV infection among that group as well. I ask this question because it is important to do so. When people get to a certain age in life, they may not be involved in those activities as much as they may have been in the past, but there has been a rise in sexual diseases in that age bracket. I know the Minister responded to that question last year, but I would like to hear an update on her thoughts.
Some of the recommendations in the 2016 report from the all-party parliamentary group on HIV and AIDS on the impact of the Health and Social Care Act on HIV services bear highlighting. The first one that I want to mention states:
“While public health has been devolved, the Secretary of State must ensure that local authorities have enough guidance to ensure there is a minimum service requirement, which they must provide.”
The hon. Gentleman mentioned that in his introduction and clearly outlined the issue. With respect, at the moment the Act is not providing enough clarity or accountability, and it is the Department of Health’s responsibility to ensure that it does.
I look to the Minister, as I always do—she is a very responsive Minister—and ask what co-operation there has been with the regional devolved Assembly in Northern Ireland and the Health Minister there. What plans are in place for such engagement, involving the Secretary of State or Minister of State for Northern Ireland, should we return to direct rule? We cannot afford for health to suffer due to the reluctance of Sinn Féin to enter into government with the party with the largest mandate—the Democratic Unionist party. It is the responsibility of Ministers in this place to step in and step up if necessary and ensure that the people of Northern Ireland have the right strategies in place.
I was quite encouraged by the Library briefing on this debate, which has been extremely helpful. It mentions the pre-exposure prophylaxis drug Truvada, to which the hon. Gentleman referred. There are some excellent medications today, and that is one of them. It is a brilliant, new, innovative drug that can make a difference. It can save lives, stop or at least control HIV infection and give a longer life. We must welcome some of the things that are happening out there and that the NHS is providing, because it is tremendous news.
Lastly, it is clear that the Department of Health needs to ensure there is mandatory guidance for sexual health service bidders to undertake risk assessments and produce action plans, detailing how the HIV treatment service will be transitioned and implemented. We need to have that in place. It is not enough to put a couple of adverts in the media. Although that is good and should be done, it is not enough. We must have a strategy to deal with the prevention of this disease. We must also remember that it is not something that affects only one nation; it affects us all in this nation of the United Kingdom of Great Britain and Northern Ireland, and we must deal with it effectively. I look to the Minister for an indication of how she intends that to be done.
I congratulate the hon. Member for Finchley and Golders Green (Mike Freer) on securing this debate, on his all-party group’s excellent report and, indeed, on all the work he does on HIV and AIDS. I draw attention to my entry in the Register of Members’ Financial Interests and declare an interest: I am a trustee of the Terrence Higgins Trust.
The hon. Member for Finchley and Golders Green is absolutely right, as is his report, on the impact of the Health and Social Care Act 2012 passed in the previous Parliament. I am sure the Minister has read not only his APPG’s report but the Health Committee report that we published last year on public health in general and the impact of that 2012 legislation on the delivery of public health, and particularly the delivery of sexual health and HIV services across the country.
The hon. Gentleman is right that, in our report, we identified a number of problems and challenges with the new landscape and commissioning structure. We heard from people up and down the country in evidence—HIV/AIDS organisations, those who work in sexual health, consultants and virtually everyone else—that the area that has been hit most negatively by the Health and Social Care Act and the changes in commissioning arrangements are HIV services and sexual health services more generally. We all have our own ideas of why that might be the case. Although the jury is still out about the decision to pass the responsibility for public health to local authorities, there were concerns expressed at the time of the Health and Social Care Act—some of us warned the then Health Secretary, Andrew Lansley—about the potential impact of giving local authorities the responsibility for HIV support and other sexual health services, but I am afraid those concerns were not listened to. I hope the Minister will explain to hon. Members and to the country at large what monitoring the Government have been doing on the impact of the Act on services and what measures or action the Government will take as a result of anything they find.
I agree with the right hon. Gentleman. Does he agree that one challenge is the fact that local authorities are now commissioning the provision of health services in complete isolation from many of the other HIV and associated services? That is very different from our general understanding of public health at the core of the Act—it is a fault.
I completely agree with that point. The different commissioning responsibilities for different bits of sexual health and HIV and AIDS are all over the place. On top of that, although the Government can, with some justification, claim to have protected NHS spending in cash terms if not in real terms, they cannot claim to have done that when it comes to public health, which has taken significant cuts and will continue to take significant cuts over the next few years. Of course, those cuts are being imposed on local government. As the hon. Gentleman and other hon. Members know, local government faces huge financial challenges across the piece. There is also the threat of the withdrawal of the ring fence on public health funding in the next two or three years. In our report we made it clear that we thought that was a risky move indeed.
I do not want to repeat a lot of what was said by the hon. Member for Finchley and Golders Green, who made a comprehensive and excellent speech, but I hope the Minister will explain to us what monitoring the Government are doing on the impact. What will they do in response both to the concerns raised and the recommendations of the all-party group report and our Select Committee report to address the problems? We have known about them for some time—our report is now more than a year old.
The news about PrEP is very welcome, but will the Minster clarify the timing of the commencement of the trial? While we are on the subject, another potentially welcome development is the big fall-off in HIV presentations or positive tests at some of the London clinics in the past few months, which some people suggest may be to do with the availability of PrEP. Can the Minister tell us whether she has made an assessment as to whether that is the case, in which case it is a promising development indeed?
Finally, one of the things that concerns me is the plight of older people living with HIV and AIDS. Around a third of the people in Britain now living with HIV and AIDS are over 50. About 60% of them live at or below the poverty line. When many of them were originally diagnosed, they did not expect to have a long life expectancy, but they are still here thanks to the fantastic treatment and care that has been invented and developed, which has not only helped to keep people alive but enabled them to lead lives of reasonable quality. Back when they were diagnosed, they may have been less cautious about spending their money to get by at that time, and now they find themselves hopefully with many years stretching ahead and no more means at their disposal, so there is a particular challenge when it comes to older people living with HIV and AIDS. That will require the Department of Health to work more closely with the Department for Work and Pensions. Some of the people that my charity—the Terrence Higgins Trust—deals with face problems when it comes to benefits and benefits sanctions. Those sorts of things add extra pressure and misery to the challenges that people living with HIV already face.
I apologise for arriving late and missing the start of the debate, Mrs Main, but I was waiting to speak in the Prime Minister’s statement. It is a pleasure to serve under your chairmanship again. I long for the day when I can get called as quickly as my right hon. Friend the Member for Exeter (Mr Bradshaw), who gets called with such speed and alacrity.
You have to be here for 20 years.
I long for that day as well, but that is in the lap of the electorate. I also thank the hon. Member for Finchley and Golders Green (Mike Freer). He heads up some incredible work by the all-party group, which has provided remarkable and concise information that is usable not only within the sector, but by a great number of people, to advocate for the challenges of people living with HIV and AIDS and to help to explain the broader issues people face. The reports are read by a great many individuals, and not only by experts in the subject, which is a credit to him. His wide-ranging speech—the last three quarters that I caught—was exceptional, and I am grateful to have been here for it.
I represent the city of Brighton and Hove, which has more than four times the national average HIV contraction rates and people living with HIV. That places an additional onus on me to give voice to both the sector and the individuals who live with this long-term condition. I am a representative for that city and for the gay community. When I was on the board of Pride, I spent a lot of time trying to understand the fabric of the support services going to people living with HIV, and I have done so with even more enthusiasm and dedication since being elected as an MP.
I am proud that we have incredible preventive work in Brighton and Hove. THT, Stonewall and local groups, co-ordinated through the LGBT Forum, have done remarkable work on prevention. It is a sadness that they do not have all of the tools that they call for, including PrEP, at their disposal. I know that the issue has been aired by other Members today, so I will not go into any more detail on that, but the grassroots and the people working on the frontline in Brighton and Hove are absolutely enthusiastically calling for that.
I, too, wish to add my thanks to the hon. Member for Finchley and Golders Green (Mike Freer). Does my hon. Friend agree that having such a confusing and complex mix of commissioners and authors of standards for prescribing does not help to establish the consistent commissioning of drugs such as PrEP, which he has mentioned and which would help so many people not only in his own constituency, but in Bristol West?
Bristol and Brighton share many of the same characteristics in terms of demography and the numbers of people living with the long-term condition of HIV/AIDS. I agree with my hon. Friend wholeheartedly. The hon. Member for Finchley and Golders Green made the point very well about the split that was created in the Health and Social Care Act. It is having an impact on communities and I hope Ministers will finally realise that that needs to be prioritised.
In the work I have been doing with the people who deliver frontline services, I have learnt that the people who live with HIV/AIDS often have complex needs. The landscape for provision is also complex and moves from prevention to treatment. As my right hon. Friend the Member for Exeter mentioned, people are living into old age with HIV—that is not entirely new, but it is a fairly recent development. We should celebrate the fact that people now live into old age with HIV, but it presents us and our health service with very complex challenges.
I too have met people living into their 70s and 80s with HIV, who, when they were first diagnosed pre-1996, were given just weeks to live. There is an additional challenge for such people, as hinted at by my right hon. Friend. Many of those people are not only vulnerable because of the comorbidities and complex health challenges that they may have, both physical and emotional, but many of them spent all of their money when they thought they had a very short time to live, so they are additionally vulnerable because of their financial position. That means those individuals need the holistic care that they deserve.
The hon. Member for Finchley and Golders Green spoke well about the split created by the Health and Social Care Act 2012. I have seen its direct impact on support for people living with HIV. Some people are failing to get the comprehensive care that they need. That is leading, first, to individuals with complex needs not getting the comprehensive care they need, and, secondly, to providers of comprehensive care not getting the funding they need to provide the services. That is causing a terrible ruction in the provider landscape for HIV. Specifically with regard to Brighton and Hove, I am referring to the Sussex Beacon—I shall talk more about that in case the Minister is not aware of its fantastic work.
First, it is important to describe the general health landscape in the city of Brighton and Hove, which is in crisis. We have a hospital, a clinical commissioning group and an ambulance trust in special measures, as well as patient transport services whose privatisation was botched, and which were then renationalised, all within six months. On top of it all seven GP surgeries have closed in the past 12 months. The service is comprehensively in crisis. However, there is one jewel in the crown—the Sussex Beacon, which was established as a hospice in 1992, to provide end-of-life care for people who were dying because of HIV and AIDS. It has flourished and evolved as the needs of the client group have changed and evolved over time. It is a remarkable organisation, providing preventive, outpatient and inpatient services, and more than 2,000 bed nights a year.
Last year the Care Quality Commission said that the Sussex Beacon is outstanding. It is one of the true beacons of health in the community, and I am proud that it exists to provide comprehensive, holistic and tailored care for individuals living with HIV. It is incredibly important to the community. Because of the split, however, no one agency is taking overall responsibility for funding the Sussex Beacon any more—not the local authority, and not any of the funding agencies designated to do so by central Government. As a result, its statutory funding has fallen by £400,000 a year. That funding gap is bringing an extraordinary organisation to its knees.
In Brighton and Hove politics there is a rainbow coalition. The three MPs are each from different parties, but last year we united in writing, along with the leader of the council, to the Health Secretary, to point out how extraordinary the work of the Sussex Beacon is, and what the dangers are. We pointed out what would happen if all its client group—people with extremely complex needs who were used to and are deserving of specialist care for the special challenges they face—were to be transferred from somewhere rated outstanding to somewhere in special measures, such as a hospital struggling to cope with the patients it has at the moment. Before the general election, the Health Secretary took time to come to Brighton and visit the Sussex Beacon for a photoshoot, as did the Prime Minister when she was Home Secretary on another occasion. Sadly, neither had time to respond to the letter about the dangers that the service will face in future. It was passed on to another agency in the Department of Health for a response.
Perhaps people felt that we were crying wolf, but we were not. The trustees of the Sussex Beacon have issued a warning that they will start to shut services from June this year unless the funding gap is closed. Staff have been put on notice of redundancy. We are in the last chance saloon for that fantastic organisation, which is celebrated beyond Brighton for the services it provides. I urge Ministers to consider the specific challenges it faces. The Minister will know what an achievement it is in today’s health environment to get an outstanding rating for something so complex, meeting such complex needs. Because of the nature of the debate, she will know that the people who use the services count on them in a heartfelt, emotional and dependent way. It is an extraordinary service and I urge her to look directly at the challenge and see what the Government can do. Once the service is lost it will be gone forever, and will not be coming back.
I labour the point for two reasons: because I am a Member of Parliament for the area that the Sussex Beacon serves and one of its patrons, but also because it speaks to the challenges that comprehensive providers face in an environment in which funding has become very specialised and very narrow. Comprehensive providers are struggling to find their feet in the new environment. What is happening to the Sussex Beacon is relevant to the broader challenges faced by the sector, in the broader health environment.
It is a pleasure to serve under your chairmanship, Mrs Main, and to take part in today’s debate. I am grateful to the hon. Member for Finchley and Golders Green (Mike Freer) for securing the debate, and for his detailed and informative speech, as well as for the work of the all-party group on HIV and AIDS in producing an excellent report, “The HIV puzzle”. The report notes, on the basis of evidence from charities, civil society groups and the pharmaceutical industry, significant upheaval to HIV and sexual health services since the Health and Social Care Act 2012 was implemented.
The findings of the report are very worrying. A joined up, multi-sector approach to support and care for those at risk of or living with HIV is crucial to its prevention. The UK Government should reflect seriously on how they can improve HIV services in the light of that body of evidence. The report is concerned with HIV services in England, but its findings will be of interest throughout the UK. Communicable diseases do not, after all, recognise administrative or national borders. The report recognises:
“In Scotland sexual health sits under Blood Borne Viruses in the health system, which Dr Gordon Scott argues makes it easier to set priorities.”
In that spirit, and given that the issue is devolved, I hope that the comments of a Scottish Member about HIV in Scotland will also be of interest to Members from other parts of the UK.
There were 6,095 new diagnoses of HIV across the UK in 2015, and 300 of those were in Scotland. The latest figures for NHS Lothian, which covers the West Lothian part of my constituency, tell us that there are 1,589 people diagnosed and living with HIV, and that 70 of those were diagnosed in the past year. At the other side of the country, Glasgow has experienced its biggest rise in HIV infection for three decades. The issue will affect every community in the country. We all have our challenges, especially when we consider that it is estimated that about 13% of people may be undiagnosed, with all the consequent risks of onward transmission, as well as the impact on those people of being unable to get access to care and treatment.
Lifetime treatment costs the NHS between £280,000 and £360,000 per patient—a not insignificant amount. Prevention of HIV infection remains a priority for the Scottish Government. There is no room for complacency on communicable diseases such as HIV. We continue to provide funding to NHS boards for HIV prevention, as well as supporting organisations such as HIV Scotland, with £270,000 in funding this year. There is of course no one-size-fits-all approach to HIV prevention. That is why in Scotland we are providing Waverley Care with £45,000 in funding this year for its HIV prevention and support work with African communities.
A joined-up approach to HIV care is vital to ensuring that infected people can get the care they need to live life as independently as possible. The Scottish Government’s sexual health and blood-borne virus framework 2015 to 2020 is continuing to build on achievements made under the original framework document of 2011. The HIV Testing Kits and Services Revocation (Scotland) Regulations 2014 lifted the ban on the sale of instant-result testing kits in Scotland. In the light of that change, and following leadership on the issue by HIV Scotland, a subgroup of the executive leads group published a questions and good practice document on instant-result self-testing in March 2014. The good practice document was the first of its kind in the world and has since been recognised internationally as an example of good practice by the World Health Organisation.
All NHS boards in Scotland have protocols in place in relation to HIV post-exposure prophylaxis—PrEP—for sexual and non-sexual exposures. The framework makes clear the importance of a multi-agency approach to sexual health and blood-borne viruses. Truly delivering on the framework outcomes in the long term will require the involvement of patients and service users, NHS boards, local authorities, the third sector, academics, the media and, indeed, the general public. The integration of health and social care in Scotland is one of the most significant reforms since the establishment of the NHS. We are the only UK nation to have legislated to put NHS boards and local authorities under statutory duties to work together. That is helping to tackle priorities in the framework to work towards as joined-up an approach as possible to caring for people with long-term conditions and disabilities, such as HIV.
Evidence generated in late 2014 and early 2015 indicates that the HIV infection is being transmitted among a small population of highly chaotic, vulnerable and often homeless people who inject drugs. These transmissions reinforce the importance of prevention work with such populations. The Scottish Government are working with health boards, schools and the police service to ensure that vulnerable groups can get the right support to prevent and treat infection. The framework update includes commitments on development of care services with local authorities; tackling social stigma through education; encouraging HIV testing to be regarded as routine; and NHS boards and partners offering testing to vulnerable groups using innovative approaches such as delivering testing in the communities themselves.
The Scottish Government are also considering the recommendations of an independent review of PrEP. The European Medicines Agency has granted a licence for Truvada as PrEP for HIV in adults at high risk. The Scottish Government’s chief pharmaceutical officer has written to its manufacturer to ask it to make a submission to the Scottish Medicines Consortium. The Scottish Government’s position is that all medicines must be licensed before they can be made routinely available on the NHS, but we recognise that some people are already buying PrEP drugs privately in Scotland. It is important that people who are doing so receive appropriate advice from and are monitored by clinicians. The executive leads network for the sexual health and blood-borne virus framework is considering the findings of the PrEP short life working group, which considered a range of issues associated with the use of PrEP. I look forward to hearing about the outcomes.
In conclusion, I commend the work of the APPG and its report on this issue. There are undoubtedly lessons for us all within it.
It is a pleasure to serve under your chairmanship, Mrs Main. I thank the hon. Member for Finchley and Golders Green (Mike Freer) for his excellent chairmanship of the all-party parliamentary group on HIV and AIDS, for securing this important debate and for his comprehensive opening speech. It was a tour de force.
I also thank the other hon. Members who have contributed to the debate. I thank the hon. Members for Strangford (Jim Shannon) and for Linlithgow and East Falkirk (Martyn Day), my right hon. Friend the Member for Exeter (Mr Bradshaw) and my hon. Friends the Members for Hove (Peter Kyle) and for Bristol West (Thangam Debbonaire) for their excellent and knowledgeable speeches and interventions. They will all have given the Minister much to think about.
We have come a long way since the height of the HIV/AIDS epidemic of the 1980s, but that does not mean that we should be complacent in our approach to the disease now. Across the UK, an estimated 101,200 people were living with HIV by the end of 2015; 87% of them had a diagnosis, and 96% of those diagnosed were accessing treatment. Although they are a minority of people in the wider population, they are a significant minority that we cannot let down when it comes to their care and treatment.
The number of people receiving HIV care in 2015 in England was just over 81,000. That is a 73% increase in the number of people accessing HIV care since 2006. In part, that is welcome, as it means that more people are accessing care that can improve their lives, but it also provides us with reasons to ensure the future quality of care provided, and that is the crux of why we are here today to debate this issue.
As the APPG highlighted, it is understood that since the passing and implementation of the Health and Social Care Act 2012, there have been growing complications with the commissioning and provision of HIV services across the healthcare system. In the rest of my contribution, I will touch on the Health and Social Care Act’s impact on HIV services, but I will also expand into other areas, such as the cuts to public health budgets and the worrying trend of decommissioning of HIV services, and finally I will touch on issues regarding PrEP.
Since the passing of the Health and Social Care Act, there has been a significant fragmentation of our NHS and wider health services. During the passage of the Act, Opposition Members felt that it was an unnecessary top-down reorganisation. The case of HIV services proves exactly how that fragmentation is causing consequences for the future of vital services. The creation of CCGs and the devolution of public health to local authorities have fragmented HIV services across various bodies, with no coherent commissioning and oversight. Currently, services are failing to maintain the standard that patients expect. That is down to commissioning responsibility not being clearly defined under the Health and Social Care Act. Although the coalition Government argued that the Act would ensure the streamlining of services, the opposite has clearly been the case for HIV services.
I therefore want to push the Minister on what she is doing to look into the APPG’s recommendations, especially about joint commissioning for support services by NHS England and CCGs, along with co-commissioning of HIV and sexual health services by local authorities and NHS England. Another issue that the Minister must look at—I raise this repeatedly with her—is public health funding. The cuts to services further exacerbate the problems that HIV services face because of commissioning responsibilities being unclear, which is pushing services to walk away from their responsibilities.
I know that the Minister will reference the funding going into regular HIV testing and the promotion of safe sex, along with the HIV innovation fund, but the impact on funding cannot be ignored. Last week, the National AIDS Trust published a report showing that in England, there has been a 28% decrease in the expenditure between 2015-16 and 2016-17. That is on top of the cuts to HIV support services, or decommissioning of said services, in Lambeth, Southwark, Oxfordshire, Portsmouth and Bexley. Although public health budgets are only one part of the funding streams for HIV support, treatment and care, they are nevertheless an important part of the pathway, as cuts to sexual health services more broadly are detrimental to HIV care. The £200 million in-year cut and 3.9% cut year on year will only have a negative impact on the future of all sexual health services, including those for HIV. The Minister must seriously address that false economy, or risk seeing a public health crisis that could easily have been avoided.
I thank my hon. Friend for the excellent speech that she is making. I want to add my support for what she has just said, and perhaps go a bit further. Does she agree that the Minister needs to address the fact that the failure to address preventive services will only store up costs and problems further down the line, and that when there are cuts to public health grants, those services need to be ring-fenced or protected in some other way so that we are not storing up problems for the future?
I thank my hon. Friend for that helpful intervention. I agree with her absolutely. The whole point of preventive services—HIV and sexual health services are preventive—is to save money, and lives, further down the line. We regularly debate preventive measures for other health issues with the Minister in this Chamber.
There is still a question mark over the future of HIV services, not only because of the cuts that we are seeing now, but because the future of public health budgets after 2018 is not guaranteed. There are also issues with the devolution to local authorities of business rates, which will be used to fund public health spending. The Government have still not published details of how they aim to ensure that public health will continue to be prioritised when that comes into effect. I hope that the Minister will be able to offer clarity today.
PrEP is a highly effective way of protecting someone who does not have HIV from contracting it. As the UK PROUD study showed, it was 86% effective in preventing HIV transmission and, if taken correctly, it has closer to a 100% success rate. That is why it is important that this drug treatment is supported as much as possible. While the announcement on the feasibility study is welcome, questions remain that the Minister must answer. Nearly four months since the trial was announced, we are still none the wiser as to when it will begin, other than that it will begin early in the 2017-18 financial year. I welcome that in her letter to the APPG yesterday the Minister said that the trial would begin in the summer, but I hope she will offer further clarity on when we will know more. There remains an issue with the drug Truvada, which is used in PrEP. For the trial to reach the 10,000 people that it plans to, a generic version of Truvada will need to be used. I am interested to know what conversations the Minister has had with Gilead, and how co-operative it has been to ensure the success of the trial.
Finally, I want to ask the Minister about the concerns that many PROUD participants will run out of their supply of PrEP this week, and that between 350 and 4,000 individuals at the highest risk of HIV will run out of supplies. That is a matter of urgency, and the Minister must address it as a matter of priority. We cannot allow the people who take this drug treatment to be put at risk. Therefore, I hope the Minister will go away today and look at the matter immediately.
These issues are highly important to many people who live with HIV or within those communities where infection rates are more common than in others, as we heard from my hon. Friends the Members for Hove and for Bristol West. I was shocked and surprised to hear that there is four times the normal rate of those people in the community of my hon. Friend the Member for Hove. I am well aware why he is here today to speak for his constituents.
The Government’s mismanaged approach to the NHS’s structures and to wider health services is seeing services fall through the gaps and people’s lives affected, which is exacerbated by short-sighted cuts. It is important that we recognise the work that has already gone into addressing HIV in our society, but accept that we still have a long way to go. We cannot squander these opportunities, as we could see yet another public health crisis due to complacency and failure to step up and address this issue. I hope the Minister has listened carefully to all the contributions to the debate and the seriousness of it, and will go away and do the right thing by the tens of thousands of people living with HIV or at those risk of contracting it, and support them. They should not be let down.
It is a pleasure to serve under your chairmanship, Mrs Main. I congratulate my hon. Friend the Member for Finchley and Golders Green (Mike Freer) on securing this important debate, and all Members who have contributed to what has been a highly informed discussion. I welcome the opportunity to discuss the findings from the recent and interesting report “The HIV puzzle”, which was produced by the all-party parliamentary group on HIV and AIDS. I pay tribute to my hon. Friend for his work on HIV innovation, and to all the members of the APPG for the work they do to champion HIV within Parliament.
Preventing the spread of HIV and supporting those who already have the disease remains a Government priority. As colleagues present will have heard me say before, and as the shadow Minister, the hon. Member for Washington and Sunderland West (Mrs Hodgson), also said, when we look back at the HIV epidemic in this country we can be proud of our achievements so far. In particular, we have made considerable progress in recent years towards meeting the UN 90-90-90 ambitions to eliminate HIV-related mortality and transmission by 2020. We have already met two of the ambitions, with 96% of people diagnosed with HIV receiving antiretroviral treatments and 95% of those treated virally suppressed. We have made significant progress on the third goal—to reduce undiagnosed HIV so that diagnosis is over 90%. The proportion of undiagnosed cases was 13% in 2015, which means we have seen a fall of almost half, from 25%, in just five years. However, that is still too high and we need to redouble our efforts to ensure that those who are positive receive a timely diagnosis.
The right hon. Member for Exeter (Mr Bradshaw) was right that we must have robust monitoring to ensure that we understand what is happening. He identified some particularly encouraging reports from London; there were some encouraging reports during 2016 from London clinics, particularly Dean Street. Those trends are welcome. Public Health England is actively investigating the trends, and whether the reduction has also been seen in other parts of the country and in other risk groups. It will report on that when the 2016 HIV data are published later this year, and I shall be happy to notify him if he would find that helpful.
Many Members today have reported concerns about how public health funding in the future might affect the provision of HIV prevention and support services. In line with recommendation 6 in the report, we have decided, in relation to this aspect and wider public health funding, to retain the ring fence on the public health grant for a further year, until 2019, as we move towards the implementation of local business rates retention. This is a step on the way to a more locally owned system, but that will help to smooth the transition by providing certainty for the next two financial years. It means that grant conditions will continue to apply and Public Health England will have a clear assurance role in relation to grant spend. I recognise that local authority funding remains tight and that councils have tough decisions to make to ensure that vital public services remain sustainable. Returns from local authorities have identified that more than £82 million was spent on sexual health.
I thank my hon. Friend the Minister for the constructive approach that she is taking in replying to this debate, as indeed she does in all debates on health matters. Does she recognise that there are areas with very high demographic change, that some of them have high rates of people living with HIV and that the funding formula is beginning to be out of date and needs to be reviewed? There are some parts of the country that need more money than that funding formula makes available for public health purposes.
I am going to come to what we are going to do in the future. The current situation will remain in place for one year, but we have identified the public health spend. A significant proportion of the funding will be allocated to HIV testing and prevention activities. We also recognise that there are reasonable concerns about the practicalities as we move towards business rates retention, and how it will work in practice, in particular in relation to health. The fact is that the only way we are going to get the scale right is if we continue to engage closely with Members. One thing we are looking at is how we manage the move towards mandation and how we look at transparency and accountability in public health spending. We will be doing that in a very consultative way—
I am sorry to interrupt the Minister. I think she mentioned a minute ago something about protecting public health funding for two years until the change to business rates. I am so sorry, but I missed that point. Could she clarify it? Does she mean that this is a new announcement of new protections?
The public health ring fence will remain in place until 2019.
We also recognise, as recommendation 1 makes clear, that HIV support services are an important part of the overall care that people diagnosed with HIV receive to support their health and wellbeing. I have heard hon. Members’ concerns today about such services being decommissioned because of budget pressures. We are increasing our focus on supporting and improving place-based commissioning, and will work to provide the right opportunities for all commissioners and providers involved in a care pathway to work together to secure the right service response for the needs of the local population, taking into account each partner’s responsibilities.
In line with a number of the recommendations, we also need to ensure that we make the most effective and efficient use of the resources available. We are already seeing some really effective examples of that in the Public Health England HIV innovation fund, which supports voluntary sector-led projects across the country that are focusing, as my hon. Friend the Member for Finchley and Golders Green knows only too well, on HIV prevention and testing. That includes the OutREACH project in Cumbria, which is using community pharmacists to provide HIV testing in a rural area with very high rates of late HIV diagnosis, and the MESMAC project in Yorkshire, which is providing HIV awareness training and testing at a hostel housing migrants who are claiming refugee status in the UK. We are also encouraging innovations such as home testing. Our aim this year is to see 50,000 tests for HIV carried out at home. They are already starting to make a difference. The introduction of compulsory relationships and sexuality education will, as my hon. Friend says, have an important role to play in prevention.
I was very sorry to hear the comments made by the hon. Member for Hove (Peter Kyle) about the Sussex Beacon. I am sure that, given his account of the clear local need and the quality of the service, he is holding local commissioners to account for their decision making. I am afraid that my recollection is that I had responded to him on that matter, and not an arm’s-length body. I am very sorry if there has been confusion, but I am happy to continue the discussion following this debate, so that we can clear it up and ensure that we make progress on it. I would not like him to think that we do not take it very seriously indeed.
As we all know, delivering high-quality HIV services is about not just funding, but getting the commissioning right. As the report highlights, a lot of work still needs to be done to ensure that the commissioning landscape for the services supports effective collaboration and co-operation, so that we can continue to see improvements in these and other outcomes. That is exactly why Public Health England commissioned a sexual health commissioning survey, which very much supports the findings of both the Health Committee and APPG reports.
I recognise that commissioning sexual health and HIV services is complex, given the range of services and the different population needs that are covered under the broad umbrella of sexual and reproductive health and HIV. We are very alive to and are working to address the risk of fragmentation damaging the progress that we have made, so I am particularly pleased to announce that, shortly, Public Health England will launch an action plan to support commissioners and ensure that they can provide the sexual health and HIV services that their populations need.
As its first priority, Public Health England will look for ways in which to reduce the fragmentation of commissioning and address the barriers that stop effective collaboration and co-operation between commissioners. That will include encouraging the development of a model of lead integrated commissioning in each locality, including developing models for out-of-area tariffs and other issues that can slow down contracts and increase costs. PHE will also identify system leaders across the country to lead local sexual health, reproductive health and HIV commissioning in an agreed locality and form a national network of commissioning leads to promote the effective national development of commissioning.
To test out how that might work in practice, PHE will pilot local delivery models working with local authorities and CCGs to help to build on effective models of commissioning. We will announce the names of the pilot sites shortly—the work is still in the early stages of implementation—but I take this opportunity to urge any areas that are interested in working with us to get in touch with PHE and to take part in developing the work as it takes shape.
I warmly welcome what the Minister has just announced. When the pilots are up and running and have delivered results, if it is necessary to revisit some of the structural and commissioning changes that were made under the Health and Social Care Act and which caused the problems in the first place, would she be open to doing so? On the ring fence, if she is going to delay its removal by a year, she might as well have a proper review of that, given the concerns out there about the impact of removing it on public health funding and spending in general.
I think the right hon. Gentleman slightly misunderstood me on the ring fence. We have kept it because we believe that transparency and accountability measures need to be put in place, so that when local authorities move to business rates retention, their decisions can be made in an appropriately accountable way that can be scrutinised properly. We do not feel as though we have that yet, so we have moved the date back a bit. We want to do that effectively and to have proper consultation on the mandate. On his other point, I think it is a bit early in the process to start discussing that.
Given the time, let me move on to service specifications. During the debate we have heard examples of contracts for sexual health services becoming divorced from the provision of HIV services. A key recommendation from the APPG report was to create a joint service specification for sexual health and HIV services. We recognise that the existing service specification for sexual health needs strengthening, which is why it is now being updated. PHE has committed to building on existing commissioning guidance to provide more focused advice and examples of locally designed systems to support the commissioning of HIV and sexual health services.
NHS England is responsible for the service specification for HIV treatment and care, and we think that that remains a sensible division. However, the development of a new integrated service specification for sexual health services will allow us the opportunity to join up our advice to produce a more integrated offer.
I want to recognise the continuing priority of PrEP, which many colleagues mentioned, and the trial that was announced last year by PHE and NHS England. Up to £10 million has been set aside to fund the trial, which is anticipated to include at least 10,000 participants over the next three years. We expect the trial to be under way this summer. It has the potential to change the lives of thousands of people who are at risk of contracting HIV.
I asked about where the older generation featured in things, as did the right hon. Member for Exeter (Mr Bradshaw), but the Minister has not touched on that yet. If she is not able to do so now, perhaps she can come back to us in writing.
The whole point of developing a much more systematic process and having a commissioning programme that does not allow the fragmentation of services, but instead is much more integrated, is that it will take into account more ageing people living with HIV. We believe that that will deal with the issue.
The hon. Gentleman also asked how we will tackle the issue of undiagnosed people living with HIV in the community. We believe that the strategy of increasing education and introducing compulsory sex and relationships education will be part of that, as will improving our performance, testing and early diagnosis. The work being done through the innovation fund is a key plank of that. Having clear specifications in commissioning guidelines so that we have coherent services for all who seek them is the strategy. We think that is a coherent response.
Could the Minister write to hon. Members to clarify what will happen to those who are currently on the PROUD trial? What will happen while there is a gap between the drug stopping and the new trial starting? That would be appreciated.
I shall be happy to provide that very important clarification.
We should not underestimate our progress on testing and diagnosing HIV. That is down to the campaigning and the very hard work of many people in this Chamber, and by the many campaign groups out in the community that are the bedrock of the service in this country and provide world-class services for people who live in the UK with HIV. However, as today’s debate shows, our way forward is not free of challenges, and we must continue to reflect on how we can best deal with and meet those challenges. I hope that the commitments I have announced today go some way towards reassuring Members that the Government take these issues very seriously. However, the Government cannot do it alone. I am sure that we can continue to rely on the wisdom and support of all those in this room and the incredible work of voluntary organisations, so that we can finally achieve our goal, which we have all been working towards for so many years: a world free from HIV/AIDS.
I thank right hon. and hon. Members for their time this afternoon. This has been a constructive debate, and I thank the Minister specifically for the commitments on extending the ring fence, for recognising that work needs to be done on the commissioning model and with regard to the work that PHE will be doing on a new action plan to support the pilots in addressing fragmentation and specification. Those announcements were all very welcome.
We have come a long way from HIV/AIDS being a death sentence. It is now a manageable condition. That is largely to do with drug breakthroughs but, importantly, it has been delivered through a co-ordinated response both from Public Health England and the NHS. I hope that this debate will help to avoid undoing the progress that we have made.
Question put and agreed to.
That this House has considered the all-party parliamentary group report Impact of Health and Social Care Act on HIV treatment.
Joint Spatial Plan (Thornbury and Yate)
[Mr Andrew Turner in the Chair]
I beg to move,
That this House has considered the West of England’s joint spatial plan and green space in Thornbury and Yate.
It is a pleasure to serve under your chairmanship today, Mr Turner. I requested this debate because of the unprecedented levels of concern in my constituency about the West of England’s joint spatial plan, especially in the communities of Thornbury, Charfield and Coalpit Heath.
I completely support the Government’s plan to deliver 1 million more homes by 2020. I welcome the recent housing White Paper, which is clearly an ambitious plan to fix a broken housing market and build the homes that we need in this country. The four West of England councils—Bath and North East Somerset Council, Bristol City Council, North Somerset Council and South Gloucestershire Council—are working together to produce a West of England joint spatial plan and joint transport study, which is supposed to be setting out a prospectus for sustainable growth, to help the region to meet its housing and transport needs until 2036.
I support a thought-through, locally led, long-term plan for development in the West of England. I thank the leader of my local authority, Councillor Matthew Riddle, for his work so far. I also thank local town and parish councils and community groups such as TRAPPD—Thornbury Residents against Poorly Planned Development—and VALID, or Villagers against Local Intended Development, for their tireless work on behalf of our community.
I want to outline a number of serious concerns about the joint spatial plan. First, it is clear that the currently proposed infrastructure will not be sufficient to alleviate the proposed developments or to link the areas being developed to areas of employment. The second serious concern is about relying on satellite locations in the West of England when the demand is so clearly in Bristol and Bath. The third is about the lack of affordable housing, the fourth is about the difficulties surrounding the deliverability of the plan, the fifth is the proposed development on the green belt, and the sixth is the complete lack of local support.
The joint spatial plan should focus on integrating workplaces in the region with homes and transport, because the economic growth areas will provide jobs for the additional residents who will be living in the new homes. Unfortunately, it is clear that the joint spatial plan focuses on providing more housing, not on integrating that housing with employment and businesses. The developments proposed in rural areas simply lack the employment opportunities that will be necessary for local people. There appears to be an emphasis on developing the economy and jobs in south Bristol but promoting house building north of Bristol. Like other local people, I understand that that may be because of a desire to protect the green belts, but it will have huge consequences for other aspects of the environment. It will eat into the countryside that is not designated as green belt and create the prospect of inadequate and highly polluted transport corridors. That view was reinforced by the joint spatial plan consultation, which concluded that
“the majority of responses…did not agree that the strategy makes adequate provision to address economic and employment needs”.
If building is not concentrated nearer to large employment areas in more sustainable locations closer to Bristol, Bath or Weston-super-Mare, we will see a dramatic increase in congestion, with more and more people commuting into Bristol and Bath from satellite locations such as Buckover. The Institute of Directors South West stated that
“there is a lack of a proper consideration of future employment needs”.
Business West pointed out the
“imbalance between employment and housing provision.”
A representation from the development industry highlighted that
“creating a new settlement in a location away from any sort of urban area may induce further levels of out-commuting.”
The University of Bristol noted an
“obvious lack of connection with the wider housing spatial strategy and JTS”—
the joint transport study—and a
“clear disjoint between the housing and economic development strategies which cannot reasonably endure.”
My second point is about one of the elements of the joint spatial plan that has caused most concern: relying on satellite locations or strategic development locations in the West of England when the demand is so clearly in Bristol and Bath. The proposal to build a garden village at Buckover of up to 3,000 houses, divided straight down the middle by the A38 and less than 600 metres from Thornbury, is a prime example of the flaws in plans to prioritise satellite developments coming together to form a completely unsupportable development. It is clear that there is no serious proposal to deal with the extra traffic that would be directly funnelled onto the A38, a road that already has more than 22,000 daily car movements on to the nearby motorway junction. There is next to no local support for the expansion of Buckover: more than 92% of the more than 10,000 residents whom I surveyed in Thornbury and Alveston were opposed to it. The Government rightly rejected South Gloucestershire Council’s application for support for a garden village at Buckover earlier this year, because it was clear that Buckover did not meet a number of the criteria. I thank the Minister and his Department for that extremely wise decision.
The consultation report readily admits that there is significant concern in the development industry that
“there is no clear evidence as to how the Joint Authorities have adopted the methodology, assessed the range of potential development locations and chosen the Strategic Development Locations”.
Business West said:
“The implications of sustainable development have failed to guide key decisions on spatial location”.
Highways England expressed concerns about
“the location of these developments and their impact on the SRN”—
the strategic road network—
“particularly the M5.”
The University of Bristol stated the need for
“a thorough assessment of the environmental impacts of all the SDLs”.
Satellite developments are one of the core planks of the plan. That extremely brief overview of some of the problems associated with the proposal to build a garden village at Buckover, despite its having been rejected for Government support, is a good example of why the joint spatial plan needs to be fundamentally reconsidered.
There are problems associated with the deliverability and sustainability of the West of England joint spatial plan. There are serious concerns that the JSP is not deliverable, primarily because of the pressure that it would put on the transport infrastructure. The infrastructure that would be needed is simply undeliverable—that is clearly the case in Charfield, Coalpit Heath and Buckover. The JSP would also put too much pressure on other local infrastructure, such as schools, recreational facilities and medical services. Further concerns have been raised that it would not meet the tests of environmental, economic or social sustainability.
I have mentioned the significant concern in the development industry that
“there is no clear evidence as to how the Joint Authorities have…chosen the Strategic Development Locations”.
Wessex Water has now raised serious concerns about deliverability, especially around Thornbury, Charfield and Buckover, particularly in respect of drainage and erosion prevention. Highways England has also raised concerns about the deliverability of the strategic site locations, including the sites at Charfield and Buckover, and has suggested that
“their identification should be revisited to identify sites which would have less adverse impact.”
Business West states:
“The process undertaken by the West of England Authorities in producing this Plan has failed to take into account the overriding principle of achieving sustainable development. The implications of sustainable development have failed to guide key decisions on spatial location”.
Those are damning words on the joint spatial plan.
The community does not believe that the plan is deliverable. Only 3.7% of respondents to the consultation report believed that the strategy could be delivered; over 96% stated that it could not. The most common reasons given included pressure on transport and associated infrastructure and the fact that strategy
“would not meet the tests of environmental, and/or economic and/or social sustainability.”
There are also problems associated with the deliverability of affordable housing. The consultation report noted:
“The National Housing Federation and several others were concerned that the plan does not meet objectively assessed housing need and would fail to meet the tests set out in national planning policy. The Federation stated that they did not agree with the approach that has been taken to set the target at a significantly lower level than the number identified through the objectively assessed needs exercise...The Home Builders Federation…considered that the calculation of affordable housing needs has been under estimated and that the actual affordable housing need is considered to be significantly above 32,500 dwellings”.
There is concern in the development industry that the affordable housing target should be higher. A number of local residents and some local parish and town councils also believe there is a need for more affordable housing. Mendip District Council is concerned that the current approach to affordable housing is
“likely to have an impact upon housing demand in Mendip as the district generally offers lower cost housing than many areas in the West of England.”
The proposals to build in the green belt in Coalpit Heath are also misguided. South Gloucestershire Council’s strategic green belt assessment designated Coalpit Heath’s green belt as serving all five of the policy objectives for inclusion in green belt, and the southern part as serving four out of the five. Why the joint spatial plan considers that there are exceptional circumstances or why the location is of strategic importance are not demonstrated.
On local support, I have surveyed more than 14,000 residents, asking for their views on this plan. More than 92% of them are opposed to the expansion at Buckover, more than 93% are opposed to the development in Charfield and almost 96% are opposed to the development on the green belt in Coalpit Heath. When we compare those figures to the results of the 2016 British social attitudes survey, in which only 45% of people opposed more homes being built in their area, it becomes easier to understand the scale of local concern about the plans in south Gloucestershire.
In summary, the need for housing in our area is predominantly in Bristol and Bath, but the joint spatial plan is prioritising satellite town growth far from where the need for housing actually is. There is too much of a focus on providing housing and not enough on integrating those houses with employment, which will result in more commuting from the north of our area and increased congestion.
That is echoed by voices in business, academia and the development industry. The development industry, the local town and parish councils, the business community and more than 96% of consultation respondents believe that the plan is not deliverable. The National Housing Federation, the Home Builders Federation, parish and town councils, local residents and Mendip District Council have all raised concerns about affordable housing. The business community, Highways England and the local academic community have all raised serious concerns about the strategic development locations, and there is no clear evidence as to why they were chosen. It is also clear that the proposed Buckover garden village, which is still being advocated internally within the local authorities despite being rejected by the Government, would put immense pressure on the surrounding infrastructure. As for public support, there simply is none.
I have written today to the Minister asking him to use the powers under section 21A of the Planning and Compulsory Purchase Act 2004 to issue a holding direction on the West of England joint spatial plan. I would be grateful if he could give me the following assurances today: first, that he will consider putting a holding direction on the West of England joint spatial plan; and secondly that he will agree to meet me to discuss these issues in more detail, and especially to ensure that the Government do not support any future applications for financial support to develop Buckover. Considering the glaring and obvious flaws in this joint spatial plan, and the level of concern about it in the community, I urge the Minister to reassure the residents of Thornbury, Charfield, Coalpit Heath and south Gloucestershire, and intervene over this unsustainable, undeliverable and unsupportable plan.
It is a pleasure to serve under your chairmanship, Mr Turner.
I congratulate my hon. Friend the Member for Thornbury and Yate (Luke Hall), both on securing this debate on a subject that is clearly very important to him and, more importantly, to his constituents, and on the eloquence with which he set out his case. I have listened carefully to his concerns about the adequacy of infrastructure, the location of some of the proposed development, the provision of affordable housing and deliverability.
My hon. Friend asked me to consider and discuss with the Secretary of State whether to issue a holding direction on the emerging West of England joint spatial plan. I should say at this stage, as he probably anticipates, that propriety considerations prevent me from commenting on the detail of the plan. My quasi-judicial role in the planning system means that I have to remain impartial. The plan could—certainly if he has his way—at some point come across my desk or that of the Secretary of State. Likewise, I cannot comment on individual planning applications, in case they are ultimately appealed or a request to call them in comes across my desk or that of the Secretary of State.
I welcome my hon. Friend’s support for the Government’s plans to deliver 1 million homes in total by 2020 and for our recent housing White Paper, which sets out how we aim to fix the broken housing market and to build the homes that we so desperately need. In addition, I welcome his support for a locally led, long-term plan for development in the West of England. However, I recognise that, although he may support that principle, along with other people, he has serious concerns about the nature of that plan in its current form.
In the recent housing White Paper, the Government reiterated our strong encouragement for local planning authorities to get plans in place and to keep them up to date. We have been very clear that local planning authorities are best placed to prepare plans that address the strategic priorities of their area, in consultation with their local communities. Up-to-date plans are really important because they provide clarity both to communities and developers about where homes should be built, where employment uses should go, where community facilities should be located, and where not. That means that development is planned, rather than the result of speculative application by developers.
Planning is a very democratic process and rightly so. Local people should be involved at the heart of decisions on how their areas are developed, particularly in respect to some of the issues that my hon. Friend referred to. The national planning policy framework, which is the master document for Government planning policy, sets out that early and meaningful engagement and collaboration with neighbourhoods, local organisations and businesses is essential. In addition, there is a statutory right for any person to make representations about a plan that the local planning authority proposes to submit for examination. A wide section of the community should be proactively engaged, so that local plans, as far as possible, reflect a collective vision and a set of agreed priorities for the sustainable development of the area, including those contained in any neighbourhood plans that have been made.
As well as the statutory duty to co-operate, we are keen to encourage collaboration between planning authorities, so that strategic priorities, particularly for housing, across local boundaries are properly co-ordinated and clearly reflected in individual local plans. A joined-up plan-making process, whereby local planning authorities work together and key decisions are taken together, will provide communities with certainty, clarity and a plan for delivering the housing and other development and infrastructure that they need.
From the Government’s point of view, I welcome the fact that the four West of England councils—Bath and North East Somerset, Bristol City, North Somerset and South Gloucestershire—have been consulting on the emerging joint spatial plan and joint transport study. More recently, there was a public consultation on that plan and study, which set out a prospectus for sustainable growth to help the area to meet its housing and transport needs for the next 20 years. I understand that that consultation ran from 7 November until 19 December 2016, and that nearly 1,600 responses to the consultation were received.
How many homes are needed in a particular area is a matter for local decision, based on comprehensive evidence, and to simplify that process we will shortly consult on a standard methodology to help local planning authorities to assess housing need. However, my hon. Friend is right to say that we need to ensure that we maximise the contribution of land for new housing from brownfield and surplus public sector land, and that local planning authorities should have a strategy to maximise the use of such land, for example, through minimum densities. As he argued so powerfully, that is vital to ensure that the development we get is sustainable and is as close as possible to where the employment opportunities are. I thought that he made powerful points in that regard.
My hon. Friend was also right to say that councils need to ensure that there is sufficient infrastructure, such as roads, schools and surgeries, available to accommodate the proposals that they bring forward in their plans. That is an integral part of the evidence base behind a plan and I assure him that it is one of the things that will be thoroughly tested at examination.
I understand that the four councils will now take the next few months to consider and evaluate the responses that they have received and, as appropriate—clearly, my hon. Friend believes that it is highly appropriate—to revise their draft proposals. That will include potential schemes to tackle existing issues on roads and other infrastructure to help to meet the increased demands that will come with growth in population and economic activity.
I believe that, after that, the councils aim to publish an updated draft in the summer of 2017, ready for a further round of public consultation in the autumn of 2017. The feedback from that consultation will be considered and incorporated into a final draft joint spatial plan, and then a further consultation will be held before the submission of the plan to the Secretary of State in 2018. Therefore, further opportunities— indeed, I might say extensive further opportunities—for representation on the detail of these plans can be requested during the examination process and during the hearings that will be held by an independent inspector.
Therefore, my hon. Friend should take some comfort that the planning system allows ample further opportunity for his voice, and the voice of the constituents he so ably represents, to be heard on this plan, before it comes anywhere near being adopted by each authority. If it is adopted, the joint strategic plan will become part of the development plan, in accordance with which planning applications must be determined, unless material considerations indicate otherwise. It is intended to guide the four councils in the development of their local plans. I understand that the individual councils will keep control over how development is permitted in their areas, but the demand and approach to meeting that demand will have been decided collectively and with extensive consultation.
My hon. Friend raised the proposal for a garden village known as Buckover in his constituency, at Thornbury. I am pleased to be supporting 14 locally led garden villages from Cornwall to Carlisle with exciting proposals to deliver new communities with up to 48,000 homes. As he made clear, Buckover is not one of the schemes we have accepted on to the programme. Community support was one of the criteria we took into account in assessing the expressions of interest we received, and I recognise that there is a strong sense locally that Buckover is a proposal that does not have that support. I reassure him that that will remain an important criterion in assessing future decisions about further garden towns and villages that we may want to add to the programme.
I welcome the fact that four areas in South Gloucestershire are pursuing neighbourhood plans, and I understand that includes Thornbury, which was designated earlier this month. Neighbourhood plans mean communities can have a real say over the detailed location of development, and its design, phasing, mix and appearance. Communities can also use their plan to help to provide for local employment, to protect important local green spaces and to engage in the area’s wider planning strategy. We strongly encourage communities to consider the benefits of neighbourhood planning, which is why the recent housing White Paper announced further funding for neighbourhood planning groups for 2018 to 2020 and gives communities a greater role in housing design.
The framework expects local authorities to recognise the character and beauty of the countryside and the benefits of the best and most versatile agricultural land. Local plans should include strategic policies for the conservation and enhancement of our natural environment, including landscape, whether that is designated landscapes or the wider countryside. The framework empowers communities to use their local plan or neighbourhood plan to designate smaller areas as local green space. Designation rules out new development there, other than in very special circumstances.
In conclusion, as we move towards greater flexibility in plan making, it is as important as ever that local communities are given the opportunity to participate in the process and to make their views known to their local authority. I hope that my hon. Friend and his constituents will take every opportunity to participate in consultation on the West of England joint strategic plan as it moves forward, and I hope the authorities will listen to the views expressed as they develop their plans. Nevertheless, subject to the propriety considerations that prevent me from commenting on the detail, I am more than happy to meet with my hon. Friend to discuss his and his constituents’ concerns.
I will of course discuss with the Secretary of State my hon. Friend’s specific request that I issue a holding direction. There are issues around timing, because the plan is still at a relatively early stage in the process and the inspector appointed by the Secretary of State to assess whether the plan meets national policy has not had the chance to do that work yet. However, I would be more than delighted to meet my hon. Friend. I commend him for securing the debate and for raising with passion and eloquence the concerns his constituents have expressed over the plan. I look forward to discussing the matter with him further.
Question put and agreed to.
Breathing Space Scheme
I beg to move,
That this House has considered the Breathing Space scheme to help families in debt.
It is a pleasure to serve under your chairmanship this afternoon, Mr Turner. I am grateful to have secured my first Westminster Hall debate since my election to the House and I am thankful that so many Members have turned up to support me.
As many Members will know, issues of fairness are close to my heart, and in particular, fairness for children and young people. Personal debt problems can have profound consequences on those groups, yet the system we have means that creditors are again and again hassling and hounding families and young people for debts in an aggressive and harmful way. The breathing space scheme would deliver respite from those threats in two ways: through introducing a breathing space so that people in financial difficulties get the help they need to stop their debts from spiralling, and through achieving a safer way for families to make agreed debt repayments with creditors. The scheme is about ensuring that families doing the right thing about their debts are properly protected.
I am delighted that the Government are actively considering whether a breathing space scheme, such as I have proposed in my private Member’s Bill, should be introduced. I want to ensure that families who are repaying their debts have a legal guarantee against poor practices, ultimately protecting the children in those households. People often have debts with multiple creditors. Unfortunately, at the moment, what we see so often is councils reaching for bailiffs instead of looking to work on affordable payment plans, or a bank adding punitive charges to a family’s account, sending their debts out of control.
I am sure my hon. Friend is aware that the Children’s Society data show that 20% of families in council tax debt are visited by bailiffs, and that more than 30% of those families have to cut back on essentials such as food. Does she agree that a breathing space would give those families an opportunity to work with charities such as Fair for You to have planned expenditure for household items, and that Christians Against Poverty offer training courses in budgeting, which would help prevent debt spiralling?
I agree with my right hon. Friend. My Bill and this campaign seek to give people exactly those opportunities to work with charities to come up with a structured payment plan and to give them safety in that period—I completely agree.
I congratulate the hon. Lady on securing this debate and on her private Member’s Bill. In my constituency alone, 3,348 children are living in families with problem debt. Those children are five times more likely to have low wellbeing than those in families who are not in such debt difficulties. Does the hon. Lady hope, like me, that the Minister will take into consideration that family debt problems can have a significant impact on children’s mental health and wellbeing?
I agree. As I outlined at the beginning of my speech, one of the reasons I am behind the campaign is that I have an interest in the wellbeing of children and families. Debt can have a major impact on the young people in those families.
People working on a plan with an independent debt adviser should not be forced into an ever-worsening situation when they are doing their best to recover. The Government have a proud record on moving people into work, and the latest employment figures show that we now have the highest levels of employment that have been recorded. In my constituency of Rochester and Strood, hard-working families are sometimes bringing up their children and getting on with life, paying mortgages or rents on low incomes, sometimes with insecure jobs. However, while we have good news on employment, it is worrying that Bank of England figures show that household debt is at its highest since the financial crash in 2008.
Problem debt is when that debt gets out of control. Sometimes, it is small sums of money that push families into that situation. Credit can be a good thing, helping people smooth their finances and make purchases today to be repaid out of future income. When things are good, that can be managed and provide benefits, yet the rise in personal borrowing has led to mounting concern that households who get into debt need safer ways to manage when they get into difficulties.
According to figures from the Children’s Society, an estimated 2.4 million children live in families in problem debt in England and Wales. In my constituency of Rochester and Strood, more than 2,700 children are living in more than 1,500 families who are suffering with problem debt.
Problem debt often strikes when people experience a sudden change in circumstances, or, more usually, an unexpected income change. For example, if a boiler breaks down or hours are cut at work, parents, and particularly those on low incomes, sometimes find themselves forced to rely on credit to make ends meet. That is the reality for many families in the UK, and we often do not hear about the struggles that working families face. Sometimes the debt is not through any fault of their own. That is backed up by the fact that the vast majority of people seeking help from charities such as StepChange or Citizens Advice have fallen into debt as a result of a job loss, a reduction in income, illness or a relationship breakdown that affects their income and ability to cope.
When problem debt grows, keeping up with repayments can demand ever increasing proportions of monthly income. Families in problem debt are spending, on average, 18% of their income on repayments, and more than 600,000 families are spending more on debt repayments every month than they are on food for themselves and their children. I would argue that, in many cases, that is a temporary financial difficulty that could be resolved with the right help and support, given time.
We know too well the devastating impact that debt can have on people’s lives. Debt makes people ill. Half of the clients seeking debt advice from independent debt charities such as StepChange said that debt-related mental health problems or physical health problems were so bad they needed to get treatment from hospital or from a GP. Debt can also cause families to break up. It can stop people from working and make them much less productive at work.
The hon. Lady is rightly talking about the consequences of debt. In Sheffield this week, there has been a crackdown on the growth in illegal money lending. It has revealed a world in which physical violence and rape is used to intimidate those who are not paying back money. Does she agree that there is a depth and unpleasantness to the options that are available to people who do not have the opportunities that an initiative such as breathing space would provide?
It was truly terrible to hear of those practices in Sheffield this week. I completely agree: an opportunity to implement a breathing space will allow a regulated, clear way to enable people to go to legal credit agencies and deal with charities, so that they can borrow and deal with debt in a managed way, without having to seek help from organisations such as the hon. Gentleman refers to.
I join others in commending the hon. Lady for securing this debate, for her Bill and for her leadership. The Liberal Democrats are delighted to work with and support her. I also commend the volunteers in my constituency and others who have raised this very important campaign. I am sure the Minister will be very sympathetic, but as a society we need to understand that the costs of debt can be far bigger than we realise. The hon. Lady has mentioned the health costs. When it affects children, holding them back at school and meaning they do not get the qualifications they might otherwise do—that is quite common—it can have a lifelong impact on their earning potential, so the economic costs of debt of this nature are really devastating.
The hon. Gentleman is absolutely right. We can look at these things in silos, but this is actually about the whole of society. Debt is just one factor, and if we look only at debt we sometimes do not recognise or take account of its effects. I completely agree with his point.
As hon. Members said, debt has a profound effect on children. Children in households that are struggling with debt problems are twice as likely to say at school that they are being bullied. Adding up all the social impacts that are endured—the loss of health, the broken families, the loss of production and the hardship—there could be an £8 billion cost to the state and society, which would fall on all of us. Those unthought-of issues have an impact on families. My Bill would enable us to look at those issues further.
I want to dwell for a moment on the damage that problem debt does to families and children living in such households. Unfortunately, the presence of children in households corresponds with a rise in debts. One in five parents said that they have faced problem debts in the past year, compared with one in 10 adults without children. Geographically, families and children are more likely to have debt problems in the north-west, the midlands and Wales, where at least a quarter of households have struggled in the past year. That compares with Scotland, which has a form of breathing space scheme, and where only 10.9% families with children suffer debt problems.
Research from the Children’s Society shows that families trapped in problem debt are also more than twice as likely to argue about money problems, leading to stress on family relationships and causing emotional distress for children. It found that children living in families with problem debt are five times more likely to be at risk of having low wellbeing than those without debt difficulties. More than half of parents in council tax debt polled for research carried out by the charity said that they thought their children suffered anxiety, stress or depression as a result of that debt. The Children’s Society research shows that is not the amount owed by households that directly impacts on children’s wellbeing but the number of creditors to whom they owe money.
StepChange Debt Charity clients typically take between six and 12 months to stabilise their finances. It estimates that, in just six months, a typical StepChange Debt Charity client would have an extra £2,300 added to their debts if creditors applied default interest and charges to all their accounts. John Kirkby, the founder and international director of Christians Against Poverty, said that even three months could be a sufficient period to enable a stabilisation of finances.
The debt trap and the direct impact it has on children in the household brings me to why this scheme is needed. There are two main problems with the current system. First, this House has given people who need to go bankrupt legal protection against spiralling debt problems, but we have simply failed to deliver for people repaying their debts more manageably over time. Our laws have focused on people with the most intractable problems, who need debts written off and the chance of a fresh start. However, there is a cost for families who go down that route—bankruptcy is not free. It is the right solution for many people and undoubtedly meets an important need, but fewer than one in 10 people seeking debt advice enter into an insolvency option. For the majority of families who are likely to recover from a temporary setback and repay their debts in an orderly way, there is no equivalent protection. We all know about the issues associated with bankruptcy. They are often a step too far for those families.
Secondly, the voluntary approach to breathing space fails far too often. We know that creditors agree with the general principle, because it is in industry and Government codes, yet sadly there is a widespread failure to abide by those codes. According to StepChange, between a third and a half of people who contacted creditors for help said they were not given any kind of temporary breathing space. Without such protection, pressure to repay debts at an unaffordable rate and threats of enforcement can leave households cutting back on everyday essentials, or falling even further behind on other bills. The benefits of a breathing space scheme go across the board. Indeed, Martin Lewis of MoneySavingExpert, who spoke at the launch event for my Bill, called it a
“win, win, win—for the creditor, the state, and the individual.”
The evidence is clear: 60% of StepChange clients said that their finances stabilised once further interest, charges and collection actions on their debts were frozen voluntarily. However, not one client who received no such help reported that their finances had got back on a steady footing. That is not all. Many firms that provide that sort of support when their customers have a temporary financial difficulty say that the repayments they receive are higher in the long term.
We need a scheme on a statutory footing that enables families to recover. That is what breathing space sets out. It will help more families to recover and repay their debts. It will reduce the social cost of debt, which affects us all. Ultimately, breathing space will benefit the wider economy. I want to propose the introduction of such a scheme, with two key protections. The first would provide a guaranteed period of time—breathing space—without additional interest, charges, collections and enforcement action. First, that would stop the spiral of worsening debt while people gain control of their financial situation, for example by moving into new employment or recovering from ill health. Secondly, it would give people who need more time to repay their debts through an agreed affordable payment plan the same statutory protection from further interest, charges, collection and enforcement action that the law currently gives to people who need an insolvency option.
I am delighted that a breathing space scheme has had support from across this House, including from the Work and Pensions Committee, the all-party parliamentary group on debt and personal finance and the many Members who have supported my Bill. It is important to stress that we are not starting on this endeavour from scratch. A comparable scheme—one we seek to improve on—is already in place in Scotland. The debt arrangement scheme has been in place in Scotland since 2004, and in 2015-16 £38 million was repaid through it. Over time, the number of people using the debt arrangement scheme has increased. Crucially, its use has increased as a proportion of the available debt options. At the start of available data in 2009-10, over half—57%—of debt options were bankruptcies. That number has now shifted significantly down to 36% bankruptcies and 22% for the debt arrangement scheme. That means that more people are paying back their debts and are being supported to do so, rather than having their debts written off.
The scheme works for all. It works for creditors, which get back the money owed to them rather than seeing it written off through bankruptcy. It works for the state and services who support families. Most importantly, it works for families and children, who can repay their debts free from enforcement action, rising fees and charges and spiralling interest repayments.
I welcome the Prime Minister’s announcement in January that she will review the unfair practice of charging people with mental health problems up to £150 to fill in crucial debt help forms. I pay tribute to the Money and Mental Health Policy Institute and MPs across the House for campaigning to end that unfair practice, which prevents people with mental health problems from getting the help they so desperately need, but we need to tackle the causes, drivers and consequences of mental ill health in all services.
Addressing the impact of debt on children’s mental health is central to the breathing space scheme. This week, we launched the all-party parliamentary group for young people’s health, which seeks to look at ways in which we can improve the health, and particularly the mental health, of young people, and seek to understand all the reasons for the increase in mental health issues that we see in our young people. Working with families and helping families thrive is a way of improving the health of our young people. As I have outlined, debt is a factor. We now have the ideal opportunity to introduce a comprehensive breathing space scheme to give people in debt a guarantee of protection from the escalating pressure that blights families’ lives and affects the wellbeing of children and families who are trying hard to do their best and work their way through life. I hope we do not miss this opportunity, and I hope the Minister will agree that this is a sensible way forward in improving outcomes for families who are just managing.
Order. Three Back Benchers have caught my eye. I will call the Scottish National party Front Bencher at 5.10 pm, the official Opposition at 5.15 pm and the Minister at 5.20 pm.
It is a pleasure to serve under your chairmanship, Mr Turner. I congratulate the hon. Member for Rochester and Strood (Kelly Tolhurst) on obtaining the debate.
I will not go over the figures, because we have heard many times about the problems and the numbers of people in debt. Most of us have taken out credit and it is not a problem until it becomes debt—unaffordable debt. As I know from my previous role at Citizens Advice, that often happens because of a bump in the road, whether it is a reduction in hours of work, illness or a relationship breakdown. The problems are often temporary, but people need time to recover. Moreover, they need space to recover from the illnesses, mental health issues and stress that can be caused, and which are contributed to by threats from creditors and pressure to repay debt at unaffordable rates. I therefore support a statutory breathing space.
I will not go into all the reasons for such a scheme or for the debt payment programme in Scotland, but I will stress that a breathing space is a temporary measure. A breathing space is not permanent and it is only available when people are working to get back in control of their debt, with assistance, and as long as they engage with a provider of regulated debt advice. I will, however, spend some time on how long the breathing space should be.
R3, the Association of Business Recovery Professionals, has said that 28 days is sufficient for a breathing space. Frankly, when I worked on debt problems I never even got a response from a creditor within 28 days. People would come in; I would write to their creditors, who would then respond to me with how much they owed; I would get people back in and they would give me their income and expenditure; and I would write to the creditors again with an offer—28 days is a completely unacceptable amount of time for all that.
Twelve months is a reasonable period, and six months would be a minimum. Often I got a letter within six months, but people’s incomes and circumstances change and so we had to write back. The Financial Conduct Authority’s rules already guarantee 30 days from the lending firms it regulates, and that period is extendable by another 30 days. The R3 proposal would extend that to other creditors, but 28 days is simply not enough.
The R3 proposal is the exact opposite of giving people the space and time they need to get back on their feet. It does not even give time for the necessary paperwork, let alone give people in difficulties the time they need to concentrate on their debt and to take in the fact that they are getting to grips with it and a solution is in sight. For those recovering from illness—if they have had a cancer diagnosis, for example—going through a relationship problem or trying to find a new job, things do not happen within 28 days, I am afraid. The R3 proposal is diametrically opposed to what debt advice agencies say is necessary. People need a chance to recover. Twelve months is reasonable.
The breathing space is not for everyone. It is not a catch-all or a get-out for people in debt. It needs to be conditional on a full assessment of their circumstances and needs by a regulated debt advice provider. I cannot stress the word “regulated” enough. Continued engagement with the process is necessary by the individual in debt.
The breathing space is not simply a way of putting off paying, and it needs continued engagement. Were the debt advice provider immediately able to recommend another statutory debt remedy such as bankruptcy, an individual voluntary arrangement or a debt relief order as the best option, people would not be advised to enter the breathing space scheme, other than for temporary protection while an application was going through. It is not a way for people to get out of paying.
In 2015, the Government accepted the recommendation of an independent review of the future of the Money Advice Service. They said that they would look at introducing a breathing space. The consultation was expected to be opened and completed before Christmas 2015, but I am still waiting for the consultation document and the terms of reference. I ask the Minister when that consultation will come through. I have my response ready—it is there and ready to go.
Can we have the statutory consultation? Can we help people who are in debt and have had a bump in the road? Let us help them to smooth it out a bit. Let us help the creditors get their money, let us help people in debt to pay off their debt and let us help the state as well as the families, because the state is dealing with the mental health problems and paying for the prescriptions of people with depression. Let us help those people deal with the root cause of their problems, which is being in debt.
It is a pleasure to serve under your chairmanship, Mr Turner.
I congratulate my hon. Friend the Member for Rochester and Strood (Kelly Tolhurst) on securing this important debate, in which I am able to speak on behalf of the heartbreaking number of children in families who have fallen into problem debt in Eastbourne and Willingdon, which is estimated to be about 4,000. I am also thinking about the national picture, in which 2 million or more children are caught in the same situation.
There is no statutory scheme to support families in temporary difficulty who are seeking to repay their debts. The Children’s Society and StepChange have called for the breathing space so ably championed by my hon. Friend, and they have identified in it a practical and pragmatic way forward to help such families.
Debt reaches far into every aspect of life. More than half of the 500,000 people who sought help with debt last year were also seeking mental health support from their GP. StepChange estimated that the cost of problem debt to the state and to society, on top of the personal and human costs, is about £8 billion.
Speaking as a teacher, I would simply add that no matter how contemporary the curriculum, how handsome the funding or how stellar the school building, children who live under stress simply struggle to learn, recall and fulfil their potential. Debt reaches right into the heart of everything we want to see for our children in their education. With 2 million children involved, that is hugely concerning.
A breathing space would protect those vulnerable children living in families in problem debt by giving the families the time and space to come to an affordable and safe repayment plan. Between a third and half of those who contacted their creditors for help said that creditors had not given them any kind of temporary space. Without such protection, households trying to deal with their debts are often thrown into worse and cumulatively more damaging financial difficulties.
My hon. Friend’s words still ring true for me—“win, win, win”—because her Bill ultimately would be just that for all parties, because they all stand to benefit, including creditors. A breathing space scheme is not about writing off debt; it is simply about allowing people the time to pay back the money owed. The credit companies get their money back, families get out of the debt trap and children can have their childhood back. The Minister understands those concerns, and good work is already going on in the area, so I look forward to his comments and to learning more about some of that work, because the Government share the value of wanting to support those who find themselves in problem debt.
It is an honour to serve under your chairmanship, Mr Turner.
I, too, thank the hon. Member for Rochester and Strood (Kelly Tolhurst) for securing this important debate on a serious issue. I can see the devastating effects of debt simply from my constituency casework. Blackburn, unfortunately, has more than 5,000 children living in families with debt problems. I have seen cases where a relatively small debt of a couple of hundred pounds has escalated to well over £1,000 in a very short time through court costs and bailiff costs, and I have seen sad cases where people have actually lost their homes.
Although I welcome the options that have been put forward and hope the Minister will support them, I am concerned that they do not go far enough. A wider approach is required. The proposals are a good starting point, but there needs to be a recognition that, in the last few years, the price of food has escalated and council tax precepts for police and adult social care have added to the burden for very poor families. In addition to implementing the scheme and providing respite for families suffering from debt problems, the Government must do more to offer security for people, both in and out of work, who suffer from poverty. Families on low incomes need far more certainty. Current policies attack low-income families and just add to their huge burden.
As I said, I agree wholeheartedly with the proposals, and I share the concerns of the Children’s Society about the long-term effects of growing up with problem debt. My hon. Friend the Member for Newcastle upon Tyne North (Catherine McKinnell) mentioned young people’s mental health. Debt stigmatises and isolates families and can reduce young people’s chances of developing into confident human beings who can contribute. It is devastating. I have worked with many families whose children’s confidence has gone because the family has ended up in debt—often, as several hon. Members said, through no fault of their own. If someone suddenly loses their job or is taken ill—there are terrible diseases that can render people totally unable to work—a happy family that has had a secure life for 10 years can suddenly be faced with the devastating need to deal not only with the illness that has hit the family but with the impact of losing their income. Often, those families just do not know where to turn. It is important they have support and breathing space to help them try to get their lives back on track.
We must also recognise the high level of insolvency, particularly among small businesses, which can leave people with debt from money that they invested in their business. People can suddenly be left with no business but a huge debt.
I back the scheme but, as I said, I do not believe it goes far enough. I welcome it as a starting point, but I would like some reassurance from the Minister that he will consider the wider impact of political decisions on low-income families, particularly in places such as Blackburn.
I commend my hon. Friend the Member for Rochester and Strood (Kelly Tolhurst) for her initiative in bringing forward these proposals. She is clearly at the forefront of this worthwhile campaign, and she is ably supported by hon. Members from across the House, in particular by my hon. Friend the Member for Eastbourne (Caroline Ansell), who made a powerful speech.
Debt is a terrible problem among households. Like the hon. Member for Makerfield (Yvonne Fovargue), I was a debt adviser in a citizens advice bureau some years ago. Far too many families in Kettering have their lives blighted by taking on too much household debt.
Part of the problem is the language we use to describe these issues. At its most fundamental, it comes down to the word “credit”. Everyone thinks that credit is a good thing, and creditors like to use that word because it attracts people to take out their products, but let us call it what it is—it is not credit; it is debt. They are not credit cards; they are indebtedness cards, or debt cards. People love to have a credit card but, for hundreds of thousands of our fellow citizens, a credit card is a passport to a life of misery. They get themselves completely out of their depth when it comes to managing financial products and, as hon. Members so ably described, their lives and the lives of their children are blighted in so many ways as a result.
R3, which was mentioned, did a survey in February and found that just over two fifths—41%—of British adults are worried about their current debt and that 40% say that they often or sometimes struggle to get to payday. Those figures are true for people in the Kettering constituency, and the proposals of my hon. Friend the Member for Rochester and Strood would really help to address that.
There is also a woeful lack of financial education at school. If we are struggling now to manage household budgets, things will be even worse for future generations.
I would like to encourage my hon. Friend with the information that the Church of England’s schools—even the primary schools—have rolled out a programme of teaching financial literacy so that the next generation of children will be better equipped to cope with money and the pressure that is put on them at a tender age to borrow money.
Thank God for the Church of England—that’s all I can say. I hope that that scheme, which my right hon. Friend is right to highlight, is rolled out across the country into non-Church schools, too. We need to take advantage of best practice, and it sounds to me like the Church of England is doing that. There must be lenders out there that are examples of best practice and already give their customers breathing space, but we have not heard mention of them today. I would like to see their names up in lights as examples for others to follow. I close by commending my hon. Friend the Member for Rochester and Strood for her sterling efforts on the issue.
The first two Front-Bench speakers may now have an extra minute each. I call Kirsty Blackman.
It is a pleasure to serve under your chairmanship, Mr Turner. I do not imagine that I will take six minutes, but we will see—I sometimes wander off track.
I really appreciate the hon. Member for Rochester and Strood (Kelly Tolhurst) securing this important debate. It is key that we continue to discuss this issue and keep the pressure on until solid action is taken, so I appreciate being able to talk about it.
Several Members mentioned the percentages involved and the effects of debt on families. We do not talk enough in this House about the low savings that many families have. A quarter of families have less than £95 in savings because they are just not able or do not have the financial knowledge to save. If someone has only £95 in savings and their washing machine breaks down or their children need new shoes, their only option is to go into debt to fix those things, which are necessary. A lot of families just do not have an option; they have to rely on debt. It is not something that people get into intentionally to get nice shiny new sofas; it is a way that people finance their daily lives. I would like us to get out of that cycle, but that is where we are, and we need to help people whose debt becomes unmanageable.
The increased price of food was mentioned, and I think that that will come more to bear. We have seen rather high food inflation, particularly in the first part of this year, and that will really impact family budgets. The other thing about families is that children really are pretty expensive. On top of everything else—clothing and things like that—childcare costs are massive, especially when children are young. When you are having to work less because you have just had children, it is a very difficult time for families to manage their finances. For me, that is key point at which families should get the most support, rather than the little support they seem to get in some of these situations.
The hon. Lady mentioned the debt arrangement scheme in Scotland. As was said, that has been in place since 2004 and we have seen really big benefits from it. Scotland now has the lowest proportion of over-indebted individuals in the UK, which is probably a good measure to judge the scheme on. In advance of the debate, I looked up debt arrangement schemes. It struck me that a huge number of people who provide advice said, “If you are really struggling with debt, it’s very likely that a debt arrangement scheme will be the best type of scheme for you if you live in Scotland.” It seems to be held up as the go-to one. The quote from Martin Lewis about it being a “win-win-win” was mentioned by a number of Members. The people who are owed money get their money, which is key. That is why we have managed to get them on board and to bring in that regulated scheme.
In relation to the point made by the hon. Member for Makerfield (Yvonne Fovargue) on the length of time, in Scotland, it is six weeks, rather than 28 days. She might not think that is long enough, but that is what we use. If she were to be looking at the Scottish scheme and thinking about importing it to England and Wales, it might be good to look at whether six weeks has worked.
The debt arrangement scheme we have in Scotland has provided protection from enforcement by creditors across the time the money is being paid. People pay back the money over four or five years, instead of the one or two years in which they would have been expected to pay it back. It has also provided them with protection from bankruptcy; they do not have to go bankrupt. Yes, their names are placed on a register and stay on there for six years, but that does not have all the issues associated with bankruptcy. For us it has been hugely positive to have that scheme. I am sure the Minister will look at what has been done in Scotland and the effect that it has had. I am not saying in any way that it is perfect, but it has had a positive impact and changed the lives of families in Scotland.
I congratulate the hon. Member for Rochester and Strood (Kelly Tolhurst) on securing this debate, which is critical to many individuals and families. I also recognise her commendable work in initiating and progressing the Families with Children and Young People in Debt (Respite) Bill, which has the potential to form part of a much needed solution to the escalating levels of personal debt.
As several hon. Members have already outlined, we face a growing crisis with the levels of unsecured household debt. In January, the TUC released analysis that showed that it reached record levels in 2016, according to data provided directly by the Office for National Statistics. Total unsecured debt, which does not include mortgages, reached a record level of £349 billion during the third quarter of 2016. Unsecured debt per household increased to an average of nearly £13,000 in that quarter, which was an increase of more than £1,000 on the previous year and according to the TUC was the largest annual increase since 1997. As a share of household income, that represents an average of 27.5%, the highest figure for eight years.
It is clear to Opposition Members that the Government’s policies have created a perfect storm for those conditions to worsen. Weak wage growth has left many households struggling to get by as the cost of living continues to increase and the poorest continue to bear the brunt of Government cuts. It is therefore hardly surprising that personal borrowing has increased to fill the gap. As we have heard, sometimes people have no other option as a means of putting food on the table.
As we have said previously, the Government need to reassess their policy programme urgently, with specific consideration for the impact it has on the most vulnerable in society. However, in the interim, some sort of remedial approach is needed to give a helping hand to people who find themselves in a vicious circle of debt.
There is currently too great a gap between struggling with debt repayments and formal bankruptcy proceedings. Insolvency proceedings are typically suitable for only a small number of unmanageable personal debt cases. In particular, as my hon. Friends the Members for Makerfield (Yvonne Fovargue) and for Blackburn (Kate Hollern) said, a single event can often serve as the trigger for a spiral into debt problems. That is typically a change in circumstances such as family breakdown, redundancy or bereavement. The individual suffering from such problems can often be back in employment or have support from the welfare system arranged in a period of six months to a year, but at present the challenge of having to deal with the initial personal problems alongside that mounting debt can have an adverse effect on getting back into employment and cause serious mental health issues, which slows the process down. Those factors combined demonstrate that a breathing space scheme would help to alleviate the pressure on individuals while they get back on their feet.
Does the hon. Gentleman agree that schemes such as the debt arrangement scheme that my hon. Friend the Member for Aberdeen North (Kirsty Blackman) spoke of are hugely important in alleviating the stresses and strains that impact on not only the family members who are dealing with the debt but the children themselves? If we do not put steps in place to try to deal with that, the impact on the children could be long standing; it could have a lasting effect on their life chances.
I endorse those remarks in terms of what the objectives of such a scheme should be. We believe that, for it to be as effective as possible, the Government must undertake some further exploration of the technical details. In current versions of the scheme under way elsewhere, I understand that public sector debts such as council tax debt are excluded as well as self-assessment fines, benefit overpayments and so on. Those debts can often cause the most serious stress to individuals, so it is important to include those obligations alongside consumer credit.
Does my hon. Friend agree that, as recent research from StepChange has shown, local authorities and Government agencies are worse than payday lenders in how they enforce debts?
I am afraid that is my experience. I want to stress that that has been a serious problem for my constituents. In preparing for the debate I recalled that in recent months in my surgeries there have been three individuals who have all been pushed into dire financial situations specifically by the recovery of benefit overpayments, including one situation in which someone had to borrow money from family to feed their children. I have also found one of the fastest growing problems is council tax arrears, which affected 36% of the clients helped by the charity StepChange in my constituency in 2015, up from 20% of its client base in 2012.
As per previous announcements confirmed in the spring 2017 Budget, the Government intend to shift collection of certain overpaid tax credits from Her Majesty’s Revenue and Customs to the Department for Work and Pensions, with its enhanced collection programme projected to collect £520 million by 2022. The recovery of that sum is likely to have a substantial impact on the individuals concerned in the next few years, so a breathing space scheme that includes that type of debt would be enormously helpful in alleviating some of that pressure.
I wonder whether my hon. Friend would echo the concerns raised by my hon. Friend the Member for Makerfield (Yvonne Fovargue) that the Government have indicated some sympathy for the proposals but seem to be kicking the issue into the long grass. If the Minister says nothing else in his response, will my hon. Friend share my hope that he will give a commitment of a date for when a review could be undertaken and completed?
I agree entirely with my hon. Friend, and in my closing remarks I will ask for exactly that commitment.
There needs to be clarity over how participation in a debt arrangement scheme will impact on an individual’s credit rating. The rationale behind avoiding bankruptcy is partly down to the future impact of that on an individual’s borrowing capacity and financial position, particularly when their financial affairs may stabilise in a matter of months. Individuals struggling with debt in the short term may be hesitant to enter into a scheme if they feel that would damage their long-term ability to secure finance or if it would serve as a black mark on their credit history, should they wish to obtain a mortgage in future.
The key priority now is to see some progress and movement. The Government initially promised to put forward the review of the scheme—[Interruption]
Order. I understand that there may be more than one consecutive Division in the House. Please could all Members return here as soon as possible after the final Division so that we can conclude the sitting? If there is only one Division, Members should return immediately after that.
Sitting suspended for Divisions in the House.
The sitting will conclude no later than 6.7 pm.
Before the sitting was suspended, I had begun to reach my conclusion. The key priority now is to see progress and movement on this issue. The Government initially promised to have a review of the scheme by December 2015, as we have heard today, but we are still waiting for that. Since then, according to the debt charity, StepChange, 1.3 million people have sought debt advice from the major debt advice charities. That shows the urgency of the situation and the real need for the scheme.
In a December 2015 report, StepChange also estimated that problem debt was costing the economy £8.3 billion, through knock-on effects such as lost productivity and the strain on health services. I ask the Minister to agree about the importance of minimising the harm caused by personal problem debt, the costs of which evidently affect all parts of the country. Will he also commit to a timeline for producing a detailed proposal for a breathing space scheme?
The issue of growing personal debt will not go away. Indeed, evidence shows that it is getting worse. The Government need to respond to this debate by promising clear and comprehensive action on how that can be tackled. Opposition Members believe that, although the scheme would not be a total solution for the public, it would be an excellent starting point.
It is a pleasure to serve under your chairmanship this afternoon, Mr Turner. I congratulate my hon. Friend the Member for Rochester and Strood (Kelly Tolhurst) on securing this important debate. There have been many thoughtful contributions and I am particularly pleased that they are on the record.
We all share an interest in helping people who have fallen into serious debt. We have heard some very distressing stories from hon. Members today. Debt can have a devastating impact on the lives of people in our communities, and people can fall into debt at really hard times in their life. Whether it follows the death of a loved one, a separation, or being made redundant, they are difficult times, so we must do what we can to help people who are in that situation to get back on their feet. That is all part and parcel of making a society and an economy that works for everyone. It is important that financial services work for everyone, too.
We have done some really good things to help, particularly on the role of the consumer credit market. The Financial Conduct Authority, which we set up in 2013, now regulates the market to give people much more protection. For instance, firms must provide forbearance—a period of respite—if their customers are unable to make their repayments. They must treat customers fairly and lend money responsibly. Crucially, they must lend money only to those whose affordability checks have proved that they can afford to repay it.
Those measures have had a real effect. Since the introduction of the payday loan price cap, the number of payday loans has fallen by more than 50%, from 4.2 million in 2014 to 1.8 million just a year later. Regulation alone is not the answer, so we are taking direct action to support people who are struggling with their debts, such as through the Money Advice Service, which last year funded more than 380,000 free advice sessions for people in debt. We have also been resourcing our illegal money lending teams to tackle those who seek to exploit and abuse vulnerable people. We are helping to ensure that there is a genuine alternative to ruthless illegal lenders with our support for the credit union sector, which includes £38 million of funding for the credit union expansion project.
We have been exploring carefully whether we could introduce a breathing space scheme to give people time to find a way to deal with their debts. I thank all those debt advice charities and creditors that have given their time and expertise to help us to look into this. It is clear that such a scheme has the potential to help people to get their finances back on track. We are looking at it carefully. I am pleased to say that we entirely support its principles of better debt management and lower problem debt.
However, we have also found that introducing such a scheme could mean costs to the public purse and could have an impact on local authority finances. With the national debt nearing 90% of GDP over the next few years, and while we are still forecast to borrow more than £50 billion this year, we have to assess any new spending proposals carefully. That is why we will continue to look into the various options for implementing a scheme such as this, and will consider closely its costs and benefits.
The Government are committed to tackling illegal money lending, which the hon. Member for Sheffield Central (Paul Blomfield) mentioned. In last year’s autumn statement, we announced that all funds from convicted loan sharks would be used to scale up credit union incentives.
My right hon. Friend the Member for Meriden (Dame Caroline Spelman) mentioned council tax debt. It is important that councils, which are best placed to make judgments about collecting council tax, act proportionately and fairly, and take into account the impact of non-collection on the broader population.
My hon. Friend the Member for Rochester and Strood made a number of very important points during her speech. The Government agree that it is important to ensure that people in financial debt get the help they need. That is why, for example, we are creating a new single financial guidance body. We are keen to address the impacts of debt, including on mental health, and we are working closely with the Money and Mental Health Policy Institute to review practices.
I thank the hon. Member for Makerfield (Yvonne Fovargue). Clearly, she has personal experience of this important area. My hon. Friends the Members for Eastbourne (Caroline Ansell) and for Kettering (Mr Hollobone), and the hon. Members for Blackburn (Kate Hollern), for Aberdeen North (Kirsty Blackman) and for Stalybridge and Hyde (Jonathan Reynolds), made thoughtful contributions. I thank them for being strong voices not only for their constituents, but for the vulnerable people we are discussing.
As I said, we have been carefully exploring the option of introducing a breathing space scheme, working closely with the debt advice and credit sectors. So far, the work has demonstrated that a period of statutory protection from creditors has the potential to give indebted customers the chance to get their finances back on track by giving them time to seek debt advice and move into existing debt solutions. Officials have found that a breathing space could stop consumer paralysis in the face of multiple creditor letters and enforcement action. It could encourage more people to come forward for debt advice earlier.
We will continue to look into the various options for implementing such a scheme and will consider closely its costs and benefits. We are looking carefully at what is happening in Scotland. When we are in a position to consult further, we will do so. I understand that many people, including those struggling with debt, would like to see such a scheme sooner rather than later.
In short, we have to do all we can to ensure we are helping people to get out of debt. We have done a lot already. My hon Friend the Member for Kettering mentioned financial education. He may be pleased when reading Hansard to learn that I had a meeting last week with the all-party parliamentary group on financial education for young people—indeed, I am in the process of writing to the Secretary of State for Education on this matter. The hon. Member for Blackburn (Kate Hollern) mentioned financial shocks. We are providing £45 million of levy funding a year via the Money Advice Service to fund, for example, the 380,000 free-to-client debt advice sessions that I mentioned had taken place last year. We are also working with the Financial Conduct Authority to ensure that the lending sector is better regulated.
We have been looking closely at the idea of a breathing space and will continue to explore its potential. I will do my best to work with my hon. Friend the Member for Rochester and Strood, and indeed anyone and everyone else who has an interest, because this is important and I would like as many people as possible to be involved as we move forward.
We will keep examining all the ways in which people in serious debt can be protected and supported as they get their finances under control. We want them to build happier, more secure futures for themselves and their families. I understand that the costs of debt are bigger than just the financial costs—for some, they have a lifelong impact. I want an economy that works for everyone, and will be doing all I can to move this forward.
I thank all Members for their contributions and for supporting my debate today, and thank the Minister for his positive comments.
Motion lapsed, and sitting adjourned without Question put (Standing Order No. 10(14)).