Tuesday 15 December 2020
[Sir Christopher Chope in the Chair]
Healthcare Support Services: Conception to Age Two
I beg to move,
That this House has considered provision of healthcare support services in the period between conception and age two.
It is a pleasure to serve under your chairmanship, Sir Christopher. Today’s debate takes place against the backdrop of such a disruptive and damaging year. This year, as ever, it is the very youngest, the very oldest and the most vulnerable in our society who suffer when times are tough. It is timely that we are having the debate today, as the early years healthy development review, which my right hon. Friend the Prime Minister asked me to chair, is now gathering together its phase 1 recommendations.
Personally, I am grateful for the chance to highlight what has been my real passion in politics for more than 20 years. The first chapter in my early years story begins with OXPIP—the Oxford Parent-Infant Project—a charity in Oxford providing psychotherapeutic support for families struggling to cope with their new baby. I got involved as a banker, writing a business plan and successfully applying for a substantial lottery grant. I very soon found myself chairing the charity, and that was when I learned the vital importance of the period from conception to the age of two.
I was introduced to OXPIP by my mum, who was a midwife and a trauma therapist and had seen at first hand how so many new parents have unspoken and appalling birth experiences or traumas in their personal lives that leave them unable to focus on their baby and that precious early bond. Having had my own brief experience of post-natal depression in 1995, with my first born, I could empathise with how hopeless and helpless someone can feel as a new mum. Even with a loving partner and family around, those first few weeks can be frightening, sleep-deprived and, in many ways, overwhelming. Statistics show that up to one in seven women has that sort of experience after having a baby, so it really is an invisible epidemic.
Therefore, when I became the parliamentary candidate for South Northamptonshire in 2006, my family moved to the constituency and I set up NorPIP, the Northamptonshire Parent Infant Partnership, which is the Northamptonshire sister charity to OXPIP. I then established PIP UK, Parent Infant Partnership UK, a national charity that would lobby for better support in the early years and oversee a programme of building new PIPs around the country. I chaired PIP UK until I became a Minister in 2014 and had to leave the role overnight, whereupon my very old friend, my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton), picked up that work. I want today to pay tribute to him for all that he has done for the PIP movement and on the first 1,001 critical days.
During my early years as a Back Bencher, from 2010, I became chairman of the all-party parliamentary group on Sure Start Children’s Centres and set up the APPG for conception to age two—first 1,001 days. With cross-party support from colleagues such as Lord Field and the hon. Member for Brighton, Pavilion (Caroline Lucas), I launched the first “The 1001 Critical Days” manifesto in 2013.
Under the leadership of my hon. Friend the Member for East Worthing and Shoreham, PIP UK has become the Parent-Infant Foundation and the “The 1001 Critical Days” manifesto has become a movement with the support of more than 160 charities and professional organisations. There is no doubt that there is overwhelming support from the early years sector for significant Government action, and the opportunity for that is now, as we build back better. This has personal backing from the Prime Minister himself.
How do the first 1,001 days shape a baby’s lifelong potential? From conception to the age of two, a secure and loving relationship between baby and carer literally shapes the way the baby’s brain develops. It is where the building blocks for lifelong physical and emotional health are laid out and, like a sponge, the developing brain will soak up the sense that the world is a good place and that problems can be solved. Humans are unique in the animal kingdom in the extent of their underdevelopment at birth. What other animal cannot walk until it is a year old and cannot fend for itself in any other way until it is at least two years old? The physical underdevelopment is only a small part of the story. The human brain is only partially formed when we are born, with billions of undifferentiated neurons, and parts of the brain that are yet to exist. At birth and in the precious months that follow, a baby has no cognitive skills; it can only cry, sleep or look around. Its neural connections are stimulated by the loving attention of its carer and the world around it, which makes those things so important for the baby’s future development and secure attachment.
Those people who have children will all remember walking up and down the landing in the middle of the night with baby in their arms, saying, “Go to sleep, go to sleep”. We wind them, we change them and we feed them, all of which comes naturally to most parents. The baby whose basic needs are met learns that the world is a good place and they retain that instinct throughout their life. The baby who develops secure attachment will grow up able to cope with life’s ups and downs. They will develop speech skills and they will be able to pay attention in school, make friends, hold down a job and then go on to become a good enough parent themselves.
On the other hand, a baby who is ignored, neglected or abused will find life much harder, and in the most extreme cases of abuse there will be a severe impact on the developing brain. A baby cannot regulate his or her own feelings. If their needs are not being met, they will cry, and that cry will get more and more persistent. If no help comes, that baby will eventually take refuge in sleep.
We know that a baby left to scream continually for days and weeks on end will experience raised levels of the stress hormone cortisol. We also know that excessive amounts of that hormone can damage the baby’s immune system, with lifelong implications for their physical and emotional health. Such damage can happen in the womb itself and there is strong evidence to suggest that high-risk behaviours evidenced in adults have a link to a high tolerance to raised stress levels that started in the earliest years.
We know that a pregnant woman who suffers from stress produces more cortisol, and the more stressed the mother, the more the foetus is exposed to higher levels of that chemical. This exposure can lead to modifications in gene expressions while the child’s brain is still developing. A baby’s brain development has deep implications for society, and we know that a human being without a properly developed social brain will find it difficult to empathise with others and to regulate his or her emotions, which will make it harder to cope with life’s stresses, as well as with building and keeping relationships in later life.
We have seen the lack of human connection at its most extreme, particularly in the case of the Romanian orphans under Ceauescu’s regime. Their minimal physical and emotional contact left them profoundly and permanently damaged. Sadly, we know that long-term violence, self-harm, poor mental health and substance misuse have roots stemming back to the earliest experiences in childhood.
What we do with a baby from conception to the age of two is about building the human and emotional capacity of that infant, and what we do after the age of two will be about trying to reverse damage that has already been done. In the words of the Royal Foundation, the early years are the most important time of life to set out the building blocks for a human being’s future development and success, and I truly applaud the Duchess of Cambridge for her passion to ensure that every baby gets the best start in life.
It is utterly indisputable that the first 1,001 days is the most crucial period of human development, and I want to set out where we are now. Between 2018 and 2019, I chaired an inter-ministerial group on the early years, under the premiership of my right hon. Friend the Member for Maidenhead (Mrs May). That group made some key recommendations, the main one being that the Government should set out and identify a vision for the critical first 1,001 days.
Our current Prime Minister has always been a supporter of greater help for new families. During many Cabinet meetings and conversations over several years, his commitment has always been clear, so I was delighted earlier this year when he asked me to chair the early years healthy development review on behalf of the Government. The review has three advisory groups—parliamentary, practitioners and academics—using the knowledge, experience and passion of colleagues across both Houses and across the early years sector. Lockdown has prevented any physical visits, so instead our group has taken part in a series of virtual visits, meeting parents, health professionals and service providers in Camden, Devon, Stoke, Leeds, Essex, Newcastle and other places. We had a series of deep dives looking into and hearing from professionals and stakeholders on everything from breastfeeding to parenting apps to parental mental health. We have engaged with parents and carers through a questionnaire that has gathered over 3,500 responses. A personal favourite has been the Mumsnet thread that I have logged into every week to chat with new mums.
We are now at the point of bringing together the review’s recommendations with a view to communicating them at the end of January. I do not want to spoil that by talking about them now, but I want to raise a few key learning points today, because, I am sorry to say, during the lockdown there has been much suffering that has come to the review’s attention. We have heard troubling stories of isolation with partners unable to be at health checks and even unable to stay with mum and baby after the delivery. Parents have experienced limited face time with health visitors and disastrously there has been a rise in cases of domestic violence.
Half a million babies were born during the first lockdown alone, with 1,800 babies born every day in England. Far too many have entered a world of isolation and limited social contact. There have been few cuddles with granny and grandad, much less support for mums and dads, and barely any time spent with other babies. If a baby’s potential for good life-long health and wellbeing is derived from their earliest experiences, surely we need to make sure that every new family is now getting the best possible support. That is why it is vital that once the vaccine is rolled out and we start to get our lives back to a sense of normality, we improve and increase the care given to new families who have had such a tough year.
Despite the troubling stories, there are some silver linings. We should not lose sight of them. I would particularly like to highlight the use of digital and remote support. Many parents have said that during lockdown they really valued being able to text or have a Zoom call with their GP or health visitor on a much faster timescale than an in-person appointment. Some mums told the review that they preferred remote breast-feeding support to a physical group setting. Those who have taken advantage of mental health therapies online have felt it has been a positive step forward. This rapid adaptation to change has pushed open the door for the possibilities of technology in backing up good face-to-face support for new parents.
Another silver lining is the better joining up of services. From family centre workers to health visitors, from midwives to mental health therapists, professionals have found getting together on a Zoom call to discuss how better to support a family has been a vast improvement to their working practice and one that they do not want to lose.
Although the pandemic is not yet over and therefore until the vaccine has been rolled out sufficiently there will still be the need to remember hands, face, space, I call on the Minister to think about what more can be done for those 1,800 babies born every day. One in seven women and up to one in 10 new dads suffer post-natal depression. That was even before lockdown. We can only begin to imagine how many more families are struggling today. I urge the Minister to consider allowing new families at least two other supporting family members to bubble with them, or two other individuals if they are a lone parent. I also encourage her to make sure that health visitors and early years health services remain available and accessible face-to-face for everybody.
The strength of feeling of those here today, of sector stakeholders and, importantly, of parents, gives me the confidence that we can create real change in the early years and make sure that every baby gets the best start in life. For me it has been a long journey—more than 20 years—to reach this point, and I thank colleagues in both Houses who have committed themselves to this agenda. I also want to thank the hundreds of thousands of people across this country who, through their professional careers or through volunteering, are supporting the next generation day in, day out.
Finally, I want to end my remarks with a thought from Nelson Mandela, who is a bit of a hero of mine. He said,
“Our children are our greatest treasure. They are our future.”
The actions that we take in the present will help to shape not only the future of the youngest in society, but the outcomes of generations to come.
It is a pleasure to see you in the Chair, Sir Christopher. I thank the right hon. Member for South Northamptonshire (Andrea Leadsom) for securing this debate and for the work that she has done on this agenda. I chair the all-party parliamentary group on infant feeding and inequalities. We have worked on many of the things that she has been working on, but in a very focused way around the importance and significance of infant feeding for babies between conception and age two.
Breastfeeding is a really important part of babies’ health as they grow up, but that has not been matched by breastfeeding support services and investment in them across the UK. Breastfeeding support services have been very much a Cinderella service. They are run by dedicated volunteers who are often unpaid and the first to go when budget cuts are made. They are often treated as a “nice to have” rather than as the essential support service that they are for many families. We know and all the evidence suggests that women want to breastfeed, but they are being failed and let down time and again because the services that they need when things get tough are simply not there.
On the Breastfeeding Cuts UK Facebook page, Ayala Ochert has documented cuts in recent years in Sunderland, Stoke-on-Trent, Peterborough, Wigan, Dudley, Luton, Kent and Reading among many others. Services have been cut without any thought being given to the impact on the women and babies. There is a real postcode lottery in these services. Some local authorities value breastfeeding and invest in services, but some do not even consider it. Since lockdown, breastfeeding support services have been forced to close due to social distancing requirements. We understand why that is, but it has been a huge blow to the many who use those services and who might struggle to go online. In many cases, it is difficult to get that support online because of the need to have somebody there by their side to show them exactly what needs to be done. Not having that makes it incredibly difficult.
Emma Pickett, a fantastic breastfeeding counsellor, has mentioned the ongoing issue of the shortage of venues as they have closed because of lockdown. She has asked whether other health providers plead with café owners and vicars to set up clinics. I do not think so, Sir Christopher. It is important that the venues are there for people when they need them.
On the issue of the postcode lottery, I should like to mention the issue of tongue-tie treatment. Getting tongue-tie assessed and treated in new-born babies is incredibly important for people trying to make sure that their babies latch on properly, but this again is a postcode lottery. Many places do not think it is important, and many parents are forced, if they can afford it, to pay for private treatment for tongue-tie division, which is not acceptable. It is an important service, it ensures that breastfeeding can continue, and the Government need to see it as such.
I want to thank all of the volunteers at the National Breastfeeding Helpline who have had to do an incredible job to support families through lockdown. Their volunteers saw 124% more calls between April and September than this time last year. That is an awful lot to ask of volunteers. They have had to ramp up their training and make sure that the calls are answered, because they know that the people at the other end of the phone are absolutely dependent on their expertise and advice. It is important for the Government to look at more funding for services at the National Breastfeeding Helpline because they need to be seen as an essential service and funded properly.
Women and babies have been left out of the conversations around lockdown. Very little consideration has been given to the impact on women who were on maternity leave or about to be on maternity leave, who lost out on provision and were often forced to either take their maternity leave early and lose out on that provision or were told that they were not eligible for furlough. Many have lost out. I pay credit to Bethany Power and all her colleagues, who have pushed so hard on behalf of those excluded groups who have experienced gaps in support and have not had the maternity experience they wanted. That has been compounded by the Government’s failure to provide the financial support they needed at such a vital time, which has in turn compounded their isolation.
The spending review provided no specific funding for public health services such as breastfeeding support, which, as I have said, is absolutely essential. Breastfeeding has been overlooked by the Government’s obesity strategy and online harms strategy, even though we know that online advertising can have a huge impact on how women choose to feed their babies.
A significant number of people have raised concerns about babies and mothers being separated in hospital, despite all the evidence showing that it is desperately important for mums and babies to stay together in those early months, and that breast milk is a protective factor due to the antibodies present in it. Mums and babies should be kept together unless it is impossible to do so; in many cases, it is possible to do so. Advice should be given by Public Health England as well as other health authorities to make sure that can happen. If we separate mums from babies unnecessarily, it upsets the rhythms of breast milk and leads to complications for mothers, such as mastitis, if they are not able to breastfeed when they need to.
Issues have also been raised by Dr Wendy Jones, who runs the Breastfeeding Network’s drugs in breastmilk helpline. She has concerns about the advice on vaccination for lactating mothers. I fully appreciate that there are ethics involved in the drug and vaccine trials and that generally we would not test on pregnant and breastfeeding mothers, but her concerns are about the advice in the PHE Green Book, which changed in just a matter of days. Initially, it said:
“There is no known risk associated with giving inactivated, recombinant viral or bacterial vaccines or toxoids during pregnancy or whilst breast-feeding”.
Two days later, however, that changed to say:
“Until more information is available, it is also recommended that women who are breastfeeding should not be vaccinated until they have finished breastfeeding.”
I would like some clarity from the Minister as to precisely why that advice changed. There will be many people working on the frontline of health and social care who are breastfeeding, which can continue for much longer than the recommended six months. It can last for up to two years and beyond, so we need to be giving proper advice, with evidence behind it, to those mums on the frontline who might be breastfeeding. They need to know what the advice is and what it is based on, so that they can make the best possible choice. They should not be told just to cease breastfeeding, because, as I have said, the impact on babies is considerable, and the antibodies passed through breast milk are very helpful. Interesting research has been done on mums who have had coronavirus, and on the antibodies passed through to babies. The Government should pay attention to the incredibly interesting research that is emerging.
There is a lot more that the UK Government can do to support breastfeeding. I could talk about this for quite some time, but I want to make sure that other colleagues are able to speak. I urge the Minister and the right hon. Member for South Northamptonshire, who secured the debate, to meet the all-party parliamentary group on infant feeding and inequalities at the next possible opportunity. We have been having meetings online, which has been great in encouraging people to come together, but I urge the Minister to put some funding towards this—not just warm words—and make sure that breastfeeding is protected in everything that the UK Government do.
It is a pleasure to serve under your chairmanship, Sir Christopher, and a great pleasure to be speaking in a debate secured by my very old, wise and aged colleague, my right hon. Friend the Member for South Northamptonshire (Andrea Leadsom)—the high priestess of early years. As she said, I speak as the chair of the all-party parliamentary group on the first 1,001 days. I also recently stood down as chair of the Parent-Infant Foundation, the charity that she founded and that is having such an important effect on the whole movement for 1,001 days. I have been very proud to chair that charity for the past six years.
It is great to see this subject coming into the mainstream. We have had a number of Westminster Hall debates, including on the impact of covid on maternity, families and children in lockdown. Before the general election, I held a debate on health visitors. Since “The 1001 Critical Days” manifesto, the important document produced about eight years ago by my right hon. Friend, we have had various reports, including “Babies in Lockdown”, “Rare Jewels” by the Parent-Infant Foundation, “Building Great Britons”, and several Select Committee reports, including by the Health and Social Care Committee and the Science and Technology Committee, all of which were serious, heavyweight studies of the first 1,001 days.
This is, at last, not a new subject. I come to this debate much in the mode of Elizabeth Taylor’s sixth husband: knowing what was expected of him, but struggling to make it new and fresh. But we will give it a go.
Children, particularly very young children, have been the forgotten element in the whole pandemic lockdown; so too have parents of very young children. The lockdown, the regulations, and the alienation from or unavailability of family member support networks—which many of us, as early parents, took for granted—have had mental health impacts on new parents and single parents in particular. We should not underestimate that. It will be a long time before we can get back to a degree of normality and start to see the impact that missing out on those important contacts and support mechanisms in those crucial early months has had and will have for many years to come.
Early years has for too long been forgotten when it comes to Government spending. Many of us have been going on about that for a long time, and it is worth repeating. Work done a few years ago estimated that the cost of perinatal mental illness is £8.1 billion each and every year. The cost of child neglect in this country is £15 billion each and every year. That means that we are spending more than £23 billion on getting it wrong for parents and very young children in those crucial early years. If we were to spend a fraction of that amount on greater preventative intervention measures for those who most need it in those crucial early years from conception to age two, that bill would be reduced significantly and it is a false economy not to be doing that.
It was disappointing to see just £300 million in additional funds being given to the social care sector—that is, the adult and children’s social care sector—in the spending review, even though there is a shortfall of some £3 billion in local authority children’s social care alone, not to mention all the problems with public health and the shrinking numbers of health visitors, which I will come back to in a moment.
Why is that important? My right hon. Friend the Member for South Northamptonshire has given us some of the figures. Up to 20% of women experience mental health problems in pregnancy or the first 12 months after birth, and 50% of all maltreatment is related to children under the age of one. It has been estimated that 122,000 babies under the age of one live with a parent who has a mental health problem. One third of domestic violence begins during pregnancy—a figure I could not believe when I first came across it. The Government are doing good work with domestic abuse legislation, but we need to be addressing the problem at source. If domestic violence is happening in a household, what sort of physical and psychological message is that sending to the newborn child? The same applies to even before it is born as well: there are signs that communication within the womb itself is a factor. Suicide is one of the leading causes of death during the period of pregnancy to one year after the birth of a child. That is a deeply tragic figure, but it preventable if proper systems and checks are in in place.
About 40% of children in the UK have an insecure attachment to a parent or carer by the age of 12 months. The figure that I have always used—this is, I think, the killer point—is that for a child at the age of 15 or 16 who is suffering from some form of depression or low-level mental illness while at school, there is a 99% likelihood that his or her mother suffered from some form of depression or mental illness during or after pregnancy. It is as direct a correlation as that. If we do not do something within those first 1,001 days, we will reap the consequences, as will children, not just during childhood but into adulthood as well.
Child obesity rates are all connected to what happens in the first 1,001 days. Last year we also had worrying figures—this is particularly topical now—about the dwindling vaccination rates in England. In particular, only 86.5% of children had received the full dose of the measles, mumps and rubella vaccine. We have effectively lost our immunity status, because the World Health Organisation target to protect a population from a disease is 95%. One hopes that parents in particular will take up the covid vaccination as it is rolled out, because we have seen the effects on the children’s population of not having vaccinations in recent years.
The Children’s Commissioner estimates that 2.3 million children are living with risk because of a vulnerable family background and that more than one third within that group are invisible—they are not known to services and are therefore not getting any support. That is why it is crucial, particularly before those children present at school and come on the radar, that health professionals at various levels are having contact with those children and families to ensure that everything is all right. They can give that help and support and that tender affection and empathy, but they are also an early warning system for when things are going wrong, right up to safeguarding issues. The one thing that all those ailments have in common—there are a lot more that I have not mentioned—is that they come under the remit of the health visitor to a varying extent. I will come back to the importance of health visitors.
The impact of covid is great, as I have said, and I will not go over that again, but more families with babies and young children under five have been tipped into vulnerability due to the secondary impacts of the lockdown. At a time when families, and particularly families from deprived communities and single-parent families, need face-to-face contact with people like health visitors the most—I also refer to health visitors as the trusted uniform services who are usually welcomed over the threshold, whereas with social workers and others a barrier goes up instantly—more than 70% of health visitors have been repurposed to other aspects of the health service to deal with covid. That really is a false economy.
I pay tribute to Cheryll Adams, the chief executive of the Institute of Health Visiting, who is standing down from the outstanding role she has played for the cause of health visitors and their importance in the first 1,001 days. She will be greatly missed, but I am sure she will not quit the scene altogether, because of her dedication to the cause. Her report showed that 82% of health visitors reported an increase in domestic violence and abuse; 81% an increase in perinatal mental illness and poverty; 76% an increase in the use of food banks and speech and communication delay among children; 61% an increase in neglect; and 45% an increase in substance abuse. Finally, 65% of health visitors have a case load of more than 300 children under the age of five.
Is that sustainable? My worry is that even in the good times without a pandemic, health visiting was greatly stretched. One of the great achievements of the coalition Government was the delivery of a promise to institute 4,200 additional health visitors, based on the Kraamzorg system in Holland, which we visited and saw. It was a huge achievement—I think we were just a few dozen short of 4,200 by the time we got to 2015—and yet I fear that those numbers have dwindled back almost to the level that was inherited. That is such a false economy. Health visitors are a critical part of a universal offer to all families in the first 1,001 days. The report by the First 1001 Days Movement says:
“It is essential that governments invest in the delivery of the Healthy Child Programme and that this programme supports babies’ emotional wellbeing and development. We believe that all families should be able to access care from a named health visitor who offers them a high-quality service that is proportionate to their needs.”
I wholeheartedly concur.
What should be done? Many suggestions have been made. The LGA recently brought out a report saying that the Government should
“properly resource councils to enable investment in preventative universal and early help services to ensure that children, young people and their families receive the practical, emotional, education and mental health support they need”.
That is absolutely right. The Parent-Infant Foundation, in its “Babies in Lockdown” report, recommended funding for a
“Baby Boost to enable local services to support families who have had a baby during or close to lockdown.”
As my right hon. Friend said, more than half a million babies were born in that period. The report also said we should have a
“new Parent-Infant Premium providing new funding for local commissioners, targeted at improving outcomes for the most vulnerable children.”
I obviously agree with that.
Finally, I will go back to the “Building Great Britons” report, which was produced back in 2015 and made nine main recommendations: that a 1,001 critical days policy should be a mainstream undertaking by central Government; that all local authorities should be required to produce and implement a 1,001 days strategy within the next five years; that national Government must establish a 1,001 days strategy blueprint; that local health and wellbeing boards should demonstrate delivery of a sound primary prevention approach; that the early help recommendations from the Munro review, which I commissioned back in 2010, should be picked up and carried; that we should have a Minister for families, either close to or at Cabinet level, to carry the banner for the importance of the early years and family contexts, which are so important to the social policy of any Government; that we should have more inter-agency training on the importance of the early years; that children’s centres should be repurposed to be these family hubs, which this Government have committed to and which should be a Piccadilly Circus of these services available to all families; and that we should have the research evidence to go with all of that.
In short, we need a full “team around the family” approach; we need to invest in health visitors and other health professionals, including GPs and mental health specialists, particularly around attachment issues. We need them to work with all of those in the early years setting, alongside social workers and others with safeguarding responsibilities—supporting, not supplanting parents, but signposting them to the most appropriate services and ensuring that they are accessible when needed. We need a national roll-out, national guidance and national scrutiny to ensure that it is being delivered, but it should be implemented locally and governed by local circumstances. To not do that is a false economy, and children in future generations will pay the price.
Thank you, Sir Christopher. I thank the right hon. Lady for South Northamptonshire (Andrea Leadsom) for setting the scene so well, and to all those hon. Members who have made contributions.
As the grandfather of five grandchildren, this is an issue that is close to my heart. There is little that brings me as much joy as seeing my grandchildren—though that has not happened as often over the past few weeks because of the lockdown—and knowing that they are healthy and happy. Katie, Mia, Austin, Rhea, and Max, who is just eight weeks old, are bright and happy and in these dark days. That brings so much joy and I thank God daily for them.
I thank the Duchess of Cambridge, to whom the right the hon. Lady referred in her introduction, for the wonderful work she has done. She came to my constituency but unfortunately I was unable to be there. She visited the Ark Open Farm in Newtownards, and the results of what was done that day are clear.
Early years matter a great deal and the overarching response to the questionnaire undertaken is that more support must be given to young mums and families. Over the pandemic, many of us have realised how much we underestimated the support and help provided by the mums and toddlers groups in the local church or community centre. We had not understood that talking to another mum about their horrific day with their wee toddler—even if it was never really all that horrific—and exchanging viewpoints about how they felt made coping that little bit better. We have learned, more than ever, that it takes a village to raise a child, and so it does. It is little wonder that dedication and christening services highlight that a mum and dad cannot and should not do it alone.
When my parliamentary aide was pregnant with her daughter, one of the first signs I noticed was that her 10 cups of coffee per day were reduced to zero. She had read that caffeine would make her baby’s heart beat up to six times as fast; she loved her coffee, but she loved that unborn child even more. Mothers all through this nation make changes before a baby arrives, including eating more healthily, taking vitamins, stopping drinking. There are no laws that say they must do these things, but the mother knows to do it. Prenatal support for mum at this time is essential, and I believe that we need to give more advice, more listening ears and more communication for those who worry at this stage.
Together for Short Lives contacted me and asked me to briefly highlight a number of issues, as not all pregnancies end in the dream photo-op at the end of labour. Some have a much sadder story to tell—that is a fact of life. The majority of child death occurs in the first 28 days of life—the neonatal period. Every year, over 100,000 babies are admitted to neonatal intensive care in the UK. While many of these babies will only need to receive treatment for a few days or weeks before being discharged home, a minority will need more intensive care. The “Make Every Child Count” study, published this year, found that the prevalence of life-limiting conditions is highest in the under-one-year age group, at 226.5 per 10,000. That is the point that the right hon. Member for South Northamptonshire is making, and the very point of this debate. On average, there are 1,267 neonatal deaths each year from causes likely to require palliative care.
With this in mind, Together for Short Lives has highlighted the importance of the specific challenges faced by babies and children with life-limiting conditions and their families; they are not forgotten. The NHS England children’s hospice grant will increase to £25 million per year by 2023-24. It will be reallocated equitably to children’s hospices and there will be £7 million funding for children’s palliative care.
In conclusion, Sir Christopher, I briefly highlight the phenomenal work done by the WAVE Trust and Alex Williamson, and their 70/30 Campaign, which is about reducing the number of children who experience maltreatment by at least 70% by 2030. It is difficult to argue against their proposals or those of Together for Short Lives.
I look to the Minister, as I always do, to confirm that pregnancy and early years matter; if we want to see a generation of well-adjusted and happy youth it must be not simply because their parents have invested time and love. It has to be more than that. Our Government have to understand that funding for early years is not a grant of money, but an investment in our future—one certain to return a great yield. As the good book says, as you diligently sow, so you will reap. We must sow good for our children to get good from them as adults, and that must begin today.
It is always a pleasure to follow my friend, the hon. Member for Strangford (Jim Shannon). I commend my right hon. Friend the Member for South Northamptonshire (Andrea Leadsom) not only on securing this debate and on her excellent speech, but on the many years of work that she has undertaken in support of nought to three-year-olds. I very much support that.
The Early Intervention Foundation’s new report, “Planning early childhood services in 2020,” states:
“It is difficult to think of a more effective way in which the government might realise its vision to ‘level up’ Britain and ensure equality of opportunity than through ensuring access to high-quality local family services which start in maternity and run throughout childhood.”
It goes on to say:
“There is a logical case for more holistic and joined-up approaches to delivering area-based family services, which respond to concerns about a lack of service integration and artificial service boundaries.”
Recently, in making the levelling-up fund announcement, the Chancellor spoke about the opportunity to upgrade the centres of our communities:
“This is about funding the infrastructure of everyday life”—[Official Report, 25 November 2020; Vol. 684, c. 831.]
As vulnerable children and their families struggle with isolation, relationship conflict, poverty, addiction, death and many other problems during this pandemic, we need now more than ever to strengthen our community infrastructure so that every family needing support can access it locally and easily, when they need to. Many of us here are aware that the most pressured point in family life is often when the children are aged nought to three.
It will come as no surprise to colleagues that I want to use the rest of the two short minutes I have today to talk about family hubs. To put it bluntly, family hubs’ time has come. My hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) made an excellent speech in which he said that sometimes it is difficult to find something new to say about something one has been speaking about for years, but I should say that family hubs are local centres that ensure that families with children and young people can receive help to overcome a range of difficulties, and get the face-to-face support that, as we have heard this morning, is so necessary.
Recently, calls for progress in supporting family hubs have grown louder. The Children’s Commissioner wrote in July:
“Some parents may want help to find work, or deal with the new strains on their relationship, or on their mental health, that can come with having a baby—and those stressful issues may also be making it harder for them to give their young children the loving attention they need. The Hubs would also have these more targeted services—including perinatal and infant mental health teams, JobCentre advisors, Speech and Language Therapists and housing teams—co-located within the service.”
Recently, family law practitioners have got on the case as they see far too many—40%, in fact—separating couples using fractious court proceedings to determine child contact and residency. Last month, the Family Solutions Group concluded that
“Crucially, the Family Hub…could provide the signposting and gateway to the range of other direct support services for children which are so sadly lacking at present.”
Thankfully, the Government are now on the same page. Their manifesto commitment says that they will
“champion Family Hubs to serve vulnerable families with the intensive, integrated support they need to care for children – from the early years and throughout their lives.”
Recently, the Family Hubs Network was established to share best practice and drive the family hubs movement across the country. The movement is characterised by an understanding of the importance of early help and provision; by a relational approach, adopted by everyone who works in the hub; and by a whole-family approach, so that families have somewhere they know they can go to get information, advice or guidance. Parents can get help for difficulties in their own relationships, and there can be integrated health and public health priorities, including health visiting and maternity, with social services and, if necessary, troubled families programmes.
This month, the Department for Education is taking the first steps in establishing a national centre for family hubs, which will not only develop the evidence base but share good practice on how best to support families in the early years. There is no time to lose.
I thank my right hon. Friend the Member for South Northamptonshire (Andrea Leadsom) for securing this debate. I pay tribute to the work that she has done over the past 20 years and that of other right hon. and hon. Members. I am only just starting my journey in this House, and it is a pleasure to work with such experienced colleagues, but hopefully I can bring some real-life experience to the table, having only recently finished being at what my sister would call “the cliff face” of having a baby or a small child in the house.
I had two pregnancies. One ended with the joy of my eldest daughter, and one ended in tragedy with a loss. I am now the co-chair of the all-party parliamentary group on baby loss with my right hon. Friend the Member for South West Surrey (Jeremy Hunt). He is doing an inquiry with the Health Committee on maternity services. We have been able to listen and drill down on some of the risks to babies’ lives and some of the solutions. If we can improve the outcomes for stillbirth and neonatal death, we will automatically improve outcomes for at-risk children who survive. In theory, all families should benefit.
Many tools will need to be deployed in conjunction with how we reimagine supporting the first 1,001 days, and I look forward to reading the recommendations when they come forward. Today, I want to focus on just one tool: continuity of carer. As we have heard, nurturing relationships begin before birth. The foetal brain develops rapidly during pregnancy and is influenced by the physical environment of the mother’s womb and the environment beyond it. Babies can experience adversity in the womb. For example, where domestic abuse occurs, research shows that babies’ stress regulation systems adapt accordingly, leaving them more responsive to threat, and consequently more irritable and difficult to settle once they are born.
Research from NHS England shows that one in five mums and one in 10 dads experience mental health problems during pregnancy and after birth. As we have already heard, pregnancy can often be a trigger for domestic abuse, and between 15% and 30% of domestic violence cases start during that time. The impact of those adversities can have a profound effect on an infant, whose healthy social and emotional development depends on loving and consistent care.
Professor Jacqueline Dunkley-Bent, the chief midwifery officer for England, spoke to our APPG earlier this year, and I was struck by the work that midwives are already doing in this area and the results they are getting. Continuity of carer is relationship-based care that saves babies’ lives. Baby loss is reduced by 16%, and women are 19% less likely to lose their baby before 24 weeks. It also reduces pre-term birth. We are asking for women to have the same midwife or a small team of midwives. In March 2019, 10,500 women were on the continuity of carer pathway—17% of all women booked in. That will hopefully rise to 35% by March 2021, and black and Asian women, and those living in deprived neighbourhoods, are currently being targeted. I would like to see that rolled out.
I would like continuity of carer to be promoted to all families and replicated in the health visitor sector, because it is so important. Parents’ responses shape their experiences; if they have a trusted carer they can go to if they are in crisis or struggling, whether it is with domestic violence or coercion in a relationship—or post-natal depression, which many of us have felt—an awful lot of that stress will be expelled. They might even go to the trusted carer for things such as reduced movement. Yes, it is okay to go and talk to a healthcare professional, but many women think that they are bothering a midwife, especially if they do not know them. If they have continuity of carer, all those problems can potentially be solved by a quick phone call, because they will trust somebody at the end of the phone.
I conclude by saying that I look forward to the recommendations coming forward. It is my hope that this issue will be cross-party and long term and that we will have enough funding to put real change in place for all families to come.
It is, as always, a pleasure to serve under your chairmanship, Sir Christopher. As others have done, I want to start by congratulating the right hon. Member for South Northamptonshire (Andrea Leadsom) on securing today’s debate. The right hon. Lady—I would say she is a friend—has been an absolutely tenacious campaigner on this issue. I remember badgering her with questions on a Thursday morning when she was Leader of the House; she would always, even in Government, still find ways of getting this issue to the Dispatch Box. I think it is fair to say that the Government’s loss is this policy area’s gain. The issue is a massive passion of the right hon. Lady’s, so it is right that she leads the debate today.
In summing up for the Scottish National party today, I want to acknowledge the five contributions from Back-Bench Members. We have had very thoughtful speeches from my hon. Friend the Member for Glasgow Central (Alison Thewliss) and the hon. Members for East Worthing and Shoreham (Tim Loughton), for Strangford (Jim Shannon), for Congleton (Fiona Bruce) and for Truro and Falmouth (Cherilyn Mackrory). People who have a genuine interest in a policy will come to debate in Westminster Hall; I certainly felt this morning that Members were speaking about something they knew about, rather than something from a parliamentary research unit or parliamentary Labour party handout.
Before I outline what the Scottish Government’s policy landscape looks like in terms of the first 1,000 days, I want to reflect on the Royal Foundation’s study conducted last month in partnership with Ipsos MORI on early years in the UK. The results were fascinating: only 10% of parents mentioned taking the time to look after their own wellbeing when asked how they had prepared for the arrival of their baby. Ninety per cent. of people see parental mental health and wellbeing as critical to a child’s development. Parental loneliness has dramatically increased during the pandemic, from 38% feeling lonely before to 63%, and more than a third of all parents expect the covid-19 pandemic to have a negative impact on their long-term mental wellbeing. That focuses some of the immediate challenges, but what are the solutions?
For a start, Members will forgive me if I reference largely what happens in Scotland. This is very much a devolved area, but as a result of third-party obligations I want to offer some thoughts from that perspective. North of the border, the Scottish Government are investing £50 million, overseen and directed by the perinatal and infant mental health programme board, to improve perinatal and infant mental health services in Scotland across all levels of need—from specialist services, through to befriending and peer support. In addition, the Scottish Government have established the infant mental health implementation and advisory group. It provides clinical advice and support to inform the development of mental healthcare from conception to three years of age, and oversees the testing and implementation of evidence-based and innovative models for the delivery of those infant mental health services.
I want to look slightly wider at the policy initiatives currently in place and how those tie in with the topic we have been focusing on this morning. North of the border, the Scottish Government recognise that life chances and future attainment start at birth and we are certainly using our devolved powers to deliver a comprehensive package of support to ensure the best start for every child in Scotland. The Scottish Government provide a generous package of support for families to help them through this challenging time, including the three Best Start grant payments for people on low incomes, all providing a higher level of support or eligibility than the Department for Work and Pensions benefits that they replace. We have replaced the British Government’s Sure Start maternity grant with the Best Start grant and pregnancy and baby payment. That payment is higher than the UK Government payment and does not put a limit on the number of children supported: we believe that every child should be treated equally.
We have introduced baby boxes, which provide essentials to new parents in Scotland, of which more than 47,000 were delivered in 2019. Indeed, 93% of parents are taking up a baby box at the moment and there is nearly a 100% parent satisfaction rate. I declare an interest and speak from experience, as a result of receiving one in 2018 when my daughter Jessica was born. We are also delivering both nursery and school-age payments for our Best Start plan, together with the pregnancy and baby payment. We made £21 million of awards in 2019-20. Best Start Foods also provides a £17 payment for healthy food every four weeks during pregnancy and for any children between one and three years old, and £34 for babies up to the age of one.
My hon. Friend makes a good point about the Best Start Foods grant. The level of the equivalent payment in England is woeful and, although it will go up in April, there are families just now who cannot afford essentials like infant formula. Does he agree that the Government should put up the payment now to see families through the winter?
I am grateful to my hon. Friend for that intervention. I can remember—in a previous life, before I was elected to this place, when I worked for her—helping on the all-party parliamentary group on infant feeding and inequalities. I pay tribute to the work that she has done on that. The point she has made to the Government today is very much based on what the APPG has heard, so I would be more than happy to take that comment on to the Minister.
The Scottish child payment is also—and I quote—a “game changer” in the fight against child poverty that is available nowhere else in the UK. It could support up to 194,000 children this year. Together with the Best Start grant and Best Start Foods, this will provide over £5,200 in financial support for eligible families by the time their child turns six; for the second and subsequent children, it will provide over £4,900. To further support that early years provision, the Scottish Government will continue to review and transform maternity and neonatal services over five years through the Best Start programme. Through that, we will deliver person-centred care that reduces inequalities, keeps mother and baby together, provides choices and improves experience of care and clinical outcomes for the 50,000 pregnant women and their babies who use the services every year.
In the brief time I have spoken this morning, I have taken a quick canter through some of the support being provided in Scotland. I hope it has been helpful in adding to the wealth of information and policy initiatives that we have considered. I very much look forward to supporting the right hon. Member for South Northamptonshire as she seeks to raise the early years agenda in this place. She will have all of our support.
It is an honour to serve under your chairship, Sir Christopher. I congratulate the right hon. Member for South Northamptonshire (Andrea Leadsom) for securing this debate. She really is one of the leading parliamentarians on this issue, so we were very pleased to see her appointed as the early years healthy development adviser. She has shared with us a lot of insight from her 20 years as well as from the current review. I look forward to hearing those findings and recommendations from that first phase. I hope that we will have a parliamentary opportunity, whether here or the main Chamber, to discuss them further. Hopefully, they will really turbocharge this debate and lead to a renaissance of early intervention at the very forefront of public policy in Britain. I very much hope that will be the case, and I think this is a key moment.
The right hon. Lady’s point about brain development was so interesting; I cannot hear these points enough. Like many colleagues here, I have been involved in early intervention type activities throughout my time in Parliament, but we have been really reminded of the physical impact of emotion in the early stages and how profoundly responsible it is for whether young people—even babies—learn that the world is a good place. The hon. Member for East Worthing and Shoreham (Tim Loughton) said that these things have been well rehearsed, and they have, but I do not think they can be heard enough as they are very important.
The phrase that I underlined twice was “indisputable”; I completely agree there. The evidence for early intervention is indisputable. However, I am struck by the Royal Foundation research with Ipsos MORI that says that only one in four of our constituents understands that. We have a real job to do in taking something about which we are in such profound agreement in this place out to our constituents, so that they understand why it is such a good investment for the individual and for us all as a whole. That is something I am going to return to. The right hon. Member for South Northamptonshire’s points about the lockdown were extremely well made, and I look forward to the Minister’s response to them.
I turn to the contributions of other Members. I was glad that the hon. Member for Glasgow Central (Alison Thewliss) referenced her tireless work on breastfeeding and the importance of support services for that; I will reflect on the public health grant in England shortly. On what the hon. Member for East Worthing and Shoreham said, I make no comments about “old or very old”—I leave that only to the Member in charge. But I recall from his time as a Minister and our time serving together on the Home Affairs Committee his strong commitment to getting all children the best start in life. I thought his contribution was very much in line with that. I loved what he said about health visitors. That is such an important distinction in understanding. Health visitors are the best at getting uniformed services over the threshold for some of the hardest families to reach in our communities. That has to be an important part of our public health response.
The comment he made about all the big spending we do on getting it wrong is at the nub. I will expand on the point shortly, but we have to work it out. We know we are spending the money, but we also know that the old argument we make about what a difference it would make, if only we had a fraction of it invested, does not work with the Treasury. That has not worked with successive Treasuries of whatever political persuasion. We have to try to answer that question of how to do it in a way that is “cashable”, for want of a better word, and deliverable on a timeline that the Treasury will accept.
I will repeat what I said to the hon. Member for Strangford (Jim Shannon) when he and I were here in the late debate last night. In the early debate this morning, his contribution, as always, comes with a burden of empathy behind it. That is at the root of the issue: understanding the impact of empathy on the development of a young person. The reason that matters is because it is important for public finances, of course, but we are all here because we care about people. We do not want anybody to have their potential and outcomes curtailed before they have even had a chance. That is the importance of a source of empathy.
I will take great interest in family hubs and their development, having listened to the hon. Member for Congleton (Fiona Bruce). I recognised a lot of what she said from Sure Start. The loss of Sure Start is a real sadness, but I look forward to reading and hearing more as those other ideas develop.
I will finish by congratulating the hon. Member for Truro and Falmouth (Cherilyn Mackrory) on the anniversary of her first year here. I am sure it has gone in seconds. I know that colleagues and those watching will appreciate her work and her bravery in sharing her personal story of baby loss. That makes such a big difference to people listening and watching. Her points about continuity of care were really important and I hope the Minister will reflect on that.
I will make a few points of my own. Early intervention is the best gift we can give ourselves. It is brilliant for the individual, transforms lives and is great for the collective, not least financially. We saw that with Sure Start under the previous Labour Government, which made a tremendous difference, especially in the most disadvantaged communities such as mine. I see that work and its legacy close up in my community today, as I saw it when I was lead for health and social care on Nottingham City Council, prior to coming to this place.
Nottingham has a proud history in this area. My predecessor, Graham Allen, the previous Member for Nottingham North, was a real leader in the area of early intervention. It is 10 years next month since his first report, “Early Intervention: The Next Steps”, was published, and almost eight years since the founding of the Early Intervention Foundation, following his second report. He has played a formative role in my development on this issue, in politics and in life more generally, so I know he will not mind if I run out his ideas. He texted me on my way to this debate with a quote reminding me that the best early interventions we can make start 100 years prior to a baby’s birth, but I will start at conception, because that is what the right hon. Member for South Northamptonshire chose to do. I am sure he will forgive me for that.
We have good examples of the impact of failing to make these early interventions. I will draw on the Department for Education’s Wave Trust report of 2013 that provided the foundation for the 2014 cross-party manifesto, which was so important and provides a theme I hope we can return to in this decade. Disadvantaged mothers are more likely to have babies of low birth weight and low birth weight is associated with raised blood pressure, coronary heart disease, as well as reduced educational attainment, qualifications and employment. Optimal infant nutrition, especially breastfeeding, increases children’s chances of leading a future healthy life. By age five, according to analysis from the Millennium Cohort Study, breastfed children were already one to six months ahead of those who never were.
Those are little examples of the difference that one thing at birth or in the first two years makes for the rest of a life. We could also have drawn on stress and smoking during pregnancy, trauma, language inequalities and communications. I could go on and on. We know what is at the root of this. Those households in the lowest socio-economic groups have significantly worse health outcomes. If levelling up is the term of the day, this is the crucial piece of levelling up.
This is not a theoretical exercise. As colleagues have said, we are in significant agreement but not just in theory. We have seen excellent early-intervention models working over the past decade. I have talked about Sure Start but there is the Family Nurse Partnership, which has supported young parents and their babies for 13 years and is now in 60 areas across England, including my constituency. My friends at Roots of Empathy have reached over a million children around the world, and their Seeds of Empathy programme is incredible. I have joined in with that, and it helps young children learn by watching a baby’s development. It is a wonderful programme. Those sorts of things make such a big difference, and we can do more to champion them.
The Government have to do their bit. Over the last decade, early intervention grants were reduced by almost two-thirds: £2.8 billion to £1.1 billion. The public health grant has been exceptionally distressed over the last seven years. From my three years stewarding that grant in Nottingham, I know that after demand-led services such as drug, alcohol and sexual health services have been dealt with, there is not an awful lot left. Sometimes, some of those services with longer term impacts—such as early intervention services—are the ones that can get forgotten. It is a prime example of that. Similarly, local authority children’s services departments have been forced to cut back children’s centres—family support services that make such an impact—because of their finances. I do not know what Ministers think they have saved in the last decade by making those cuts, but the cost to the country’s finances in years to come will significantly exceed the savings. It is the falsest of false economies.
Well-implemented preventative services—along with early intervention in the foundation years and in the long run—deliver economic and social benefits, as well as being likely to do more to reduce abuse and neglect than would reactive services. Social return on investment studies have shown a return of between £2 and £9 on every £1 invested when there are well-designed early year interventions. The return could possibly be even greater. But that is easy to say. Similarly, the Royal Foundation says that its figure for late intervention was £17 billion each year. It is easy—certainly in Opposition—to say, “If only the Government were enlightened enough to hive off 10% of that and invest it. They would save all that money.” That is true but that is the argument of fixing an aeroplane in flight, so we must have a real conversation. I would be interested to hear the Minister’s reflections on that. The Treasury does not buy that argument and says that it is for idealists and daydreamers who do not understand the reality of public finances. But as the hon. Member for East Worthing and Shoreham says, we are spending an awful lot to get it wrong.
What do we have to change? How do we have to recalibrate that investment conversation to get the Treasury to move on the issue? Colleagues who are more enlightened on the issue than I am have been trying to do that year after year after year, and it does not happen. What is stopping us here? I have reflected—as have colleagues—on the Royal Foundation, now led by the Duchess of Cambridge, which has now spent nine years on early childhood experiences. That is wonderful political leadership, and has highlighted the fact that only one in four people in this country think that it is a priority. The royals would, hopefully, be good people for leading the conversation and helping to grow that figure, but we must also play our role and talk about the successes. We would be keen to do that in a cross-party manner because it needs helium in the public conversation so that we have greater public space to invest in it. We would all be better off if we did so.
I will not repeat points made by colleagues on the pandemic about the impact of isolation. The impact of covid will be the subject of longitudinal studies for the rest of my life. I want to raise the issue of the impact on local authorities, which is significant. That worries me because my local authority—and, I suspect, the vast majority of the 150 authorities in England—will be doing in-year budgets. They are a bad way to run public finances, because twice as much has to be cut to get the half-year effect. The public health grant, in particular, is likely to be distressed and squeezed by that. We will lose early intervention type activities from that. The Government need to look at that and to back-fill that public health grant loss from the previous seven years, not just from this year. That is the big prize. Dealing with covid and dealing with Brexit are vital. It is right that we spend these weeks and months doing that. As for getting our country where we want it to be—a country in which everybody can reach their potential and flourish—it is about those early interventions we make in the life course. I am glad to see the complete and cross-party agreement we have on the issue. We now need to translate that into more action.
It is a pleasure to serve under your chairmanship, Sir Christopher. I thank the right hon. Member for South Northamptonshire (Andrea Leadsom) for securing the debate. I know that her passion for this subject runs deep and has done for some considerable time, and she always speaks with great authority. That is why I was so pleased that the Prime Minister appointed her to lead the review. I am really looking forward to the results of that come the new year, because as so many right hon. and hon. Members have said, the time for change is here. Being able to deliver for families over those first 1,001 days is a responsibility that we should all share; we need to make sure that we not only speak about it, but actually deliver it.
I would also like to thank all hon. Members present, starting with my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton)—or, as I now like to refer to him, the hon. Member for health visiting, that very unsung part of our health ecosystem. I thank the hon. Member for Glasgow Central (Alison Thewliss), and commend her on the work that she does with her APPG on breastfeeding, which is such an important start to life. I also thank my hon. Friend the Member for family hubs, or for Congleton (Fiona Bruce), and the hon. Member for Strangford (Jim Shannon), who looks after the strength of the family in this place. Finally, I thank my hon. Friend the Member for Truro and Falmouth (Cherilyn Mackrory) for her plea for continuity of caring, but also for the fine work she does with the APPG on baby loss. I am following in some big shoes: those of my hon. Friend the Member for Colchester (Will Quince), of the former Member for Eddisbury, and of my hon. Friend the Member for Banbury (Victoria Prentis).
There is such power in this room for change, and it is both right and important that the Government have a care for the nation’s health. Just as we say about retirement, we should be investing in our health from the beginning: from early years through to older age. It must start from conception to be as effective as it can be. The period between conception and the age of two is absolutely critical in a child’s development, as we have heard. It is during this time that the important foundations are laid, creating that strong and healthy start that can see children through their life: to school, to work, to parenthood, and to better parenting themselves, as my right hon. Friend the Member for South Northamptonshire said, which very much struck me. This is a cycle that we really do need to get right.
Thankfully, most babies do have a fantastic start in life. They benefit from the support of loving parents and carers, as well as dedicated early years professionals. However, there are unacceptable variations across the country, both in different parts of the country and within regions, and both in terms of geography and population groups. We know that just over 66% of children in Bolton achieve a good level of development at age two to two and a half, but that rises to over 93% for a child born in Cambridgeshire. That differential should be unacceptable to us. Risk factors, often family based or socioeconomic, make our children—they are all our children—more vulnerable to poorer outcomes going forward.
The coronavirus has created enormous pressure, not only on services but on individuals. For many new parents, coronavirus has meant feeling isolated and losing that support mechanism, and my heart goes out to them. I think it was the hon. Member for Strangford who spoke about the importance of just meeting friends; just being able to have that little bit of “Does your baby do this? My baby does that.” They do not come with a manual, and I remember all four of mine, all under five at the same time, all being completely different: they all had completely different eating habits, and so on. Very often, I could not work out why. I thought, “I did a proper job before I had these children. Why on earth is this so difficult?” Some days, it was a real achievement to get the breakfast pots washed and go out with my pants on the right way around.
The Minister is making such an important point. Does she agree that we so often undervalue how important mothering, parenthood and ensuring children have that best start in life is? As a society, we should value that much more highly, because it is not an easy job.
I agree wholeheartedly with my hon. Friend. We are in a different time as regards parenting. Many couples choose that the father will stay at home. Often they do an excellent job at raising their children, as that part of the family unit. It is about communicating, sharing responsibility, and the services that wrap around families. My hon. Friend the Member for East Worthing and Shoreham used a lovely phrase when he talked about supporting, not supplanting, parents: holding hands to make sure that there is help there when someone struggles with breastfeeding or to understand the right thing to help a child sleep, or when there might be conflict in the house and they reach out. I take the point made by my hon. Friend the Member for Truro and Falmouth about a trusted carer giving people signposting. I asked my sister, who recently became a grandparent, what the most challenging thing was, and she said it was definitely the isolation and separation, which did not even allow her to hold her new granddaughter for six weeks after her birth.
The Minister is responding in just the way we knew she would, and I thank her for that. I mentioned in my contribution the importance of church and community groups, which by their nature are on hand to help and assist. Does the Minister recognise the good work that they do? Church groups are important to those of faith—and those of no faith—and the community groups are also important for what they can do, such as mother and tots provision.
Indeed. I think that often the role of family hubs can be support and education. However, a good health visitor can change a life, when it comes to moving on. An excellent midwife changed my journey, when I was struggling to feed my children for the first 10 days. Everyone says that those things are easy, but there is nothing easy about it, but after managing to get support people, hopefully, really feel they can fly. That is why it is vital.
Coronavirus has meant that many parents feel isolated, as I have said. They have not had access to the support of those closest to them, or other supporting work—whether that is faith-based or otherwise. That has added to the emotional pressures that many new parents face. For many babies the pandemic will represent time missed in, for example, getting to know grandparents. For some families it has meant a lack of professional wraparound support. There has been pressure throughout the system, but we have been in the middle of a global pandemic. It is just a statement of fact, not an excuse.
I assure my hon. Friend the Member for East Worthing and Shoreham and others that the advice from the chief nurse, the Local Government Association and others is that redeployment should not occur unless it is unavoidable, because it is seen as so important that families with young children get assistance. As my hon. Friend said, there are challenges with respect to health visitor numbers. Both of us have debated that issue in this place, and I have also met Professor Viv Bennett. I am looking forward to the review because some of the open sessions at which I have joined my hon. Friend have highlighted the importance of the service.
For the first set of lockdown restrictions the health professionals in question were redeployed, although I assure Members that vital safeguarding functions were still carried on. I have spoken to health visitors on the ground who said that that was a key priority, to keep children safe. We recognise that that level of support is not what people would want or expect. However, I really want us to go forward from this point to deliver into 2021 and beyond.
As the vaccination roll-out is happening and we start, hopefully, to return to a more normal, albeit covid-tinged, way of life, there is still a long way to go.
Coronavirus has shown us, if we needed more proof, how valuable data sharing can be across the services, as my right hon. Friend the Member for South Northamptonshire said. The join-up between services for the early years has accelerated out of necessity, but has brought a bit of a silver lining to what has been a very difficult time. Some of the services and support can be provided digitally. I would be the first to say that I do not want 100% of services to be on a digital platform, but there are mothers of tongue-tied babies who have been able to access immediate support, with a professional on the other end of the video conference call who is able to explain what is going on at the point when the mother is getting quite stressed about the situation. There is therefore a place not for only better data and information sharing to improve services, but for different ways of working to ensure that we get the most out of them.
The early years are not only important for health and care. Many Government Departments have an interest or play an active role, which brings me on to family hubs. They sit very much under the Department of Health and Social Care, while being integral to ensuring that we deliver properly for families. On Sure Start centres and the use of family hubs, findings from the local government programme, the Early Intervention Foundation and the review of family centres, family hubs and other delivery models will inform the next steps, including any future consultation of the role of children’s centres. I know that my hon. Friend the Member for Congleton will not cease to fight for family hubs to be at the centre of all our communities.
I thank the Minister for that comment. Will she also comment on the point made by my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) about the need for a dedicated Minister for families, ideally at Cabinet level? Within just a few minutes we have referred to many different Government Departments—the Department for Education, the Department of Health and Social Care, the Ministry of Housing, Communities and Local Government and others—all looking at family hubs. There needs to be one Minister who can really pull the thinking together and drive it forward.
I know that the Education Secretary has been given a leadership role for families, and £2.5 million to research and develop best practice on how we integrate family services. I know that my hon. Friend the Member for East Worthing and Shoreham has often called for a families Minister, and in the last Parliament my hon. Friend the Member for Congleton also made such a plea. Joined-up cross-Government working in many areas is always a challenge. I leave the plea of my hon. Friend the Member for East Worthing and Shoreham resting there. It is something else that will probably come out in the review.
The Department is taking important steps to improve the healthcare outcomes of babies and young children to give them the best start in life, including the most ambitious childhood obesity plan in the world. The Minister for Mental Health, Suicide Prevention and Patient Safety has done a lot of work on transforming children’s mental health and maternity services to identify those mothers and members of the broader family who are struggling. We also have a world-leading immunisation programme, which I will come back to.
All those policies are informed by the guiding principle of prevention, which I totally agree is better than cure. We want to identify and treat problems from the earliest stage and help parents to care for their children, change and improve behaviours, and protect against preventable diseases. We know that if parents and babies are well supported in the vital period from conception to age two, they are set up for a lifetime of better mental and physical health. Attachments, stimulation and foundations really are the backbone of their lives. While my right hon. Friend the Member for South Northamptonshire was talking, I thought of it as an emotional reservoir on which we can spend our lifetime drawing to ensure that we live healthier and more sustainable lives.
We are doing everything we can to help the NHS to improve outcomes for babies and children, and we are building that into the NHS long-term plan. The pandemic has made the public rely on new methods of accessing childcare. Information has been accessed from conduits such as 111 to an extent that we have never seen before. I am keen to explore how that can be used further to support parents and children going forward.
We are embracing opportunities presented by technology and pleased that the personal child health record, better known as the red book, is being digitised and made available. There are enormous opportunities here. We are also making sure that the modernisation of the healthy child programme is universal and personalised in response to every child’s needs. We remain committed to improving perinatal health. My hon. Friend the Minister for Patient Safety, Suicide Prevention and Mental Health is making sure this is at the top of her agenda.
I ask Members to encourage parents in their constituencies to ensure that their children are vaccinated. As my hon. Friend the Member for East Worthing and Shoreham said, vaccination rates are falling, and we lost the World Health Organisation status for measles. It is vital that parents use the free vaccination service to protect their children from measles. The actual disease is much worse than the second it takes to get vaccinated. I would really like us all to push to make sure that we regain the WHO status. The flu vaccination programme rolled out to school-aged children has been a phenomenal success this year, but if parents are worried about anything to do with vaccinations, they should go to their GP or a health professional and ask questions.
Before I finish, I will quickly comment on support bubbles. I hear my right hon. Friend the Member for South Northamptonshire. In all tiers, single adult households can form a bubble, and we have expanded this provision because we understand the pressure that they are under. Specifically, households containing a child with only one adult, and adult households with a child under one, or a disabled child under five who requires continuous care, can now also form a support bubble. In addition, households with one or more people who have a disability and require continuous care, as long as there is no more than one other individual over 18 who does not have a disability, can also form a support bubble. As my right hon. Friend knows, it is a challenge in the current pandemic to make sure that we balance the safety of everybody with access to support, in this case for young parents or perhaps people with needs arising from terminal illness.
The Duchess of Cambridge’s report was mentioned by several hon. Members. I am keen to understand whether the five recommendations are woven into the review, when it finally comes to us in January.
I recognise the impact of domestic violence on families. It has been incredibly difficult, and it is unseen. I pay tribute to the Under-Secretary of State for the Home Department, my hon. Friend the Member for Louth and Horncastle (Victoria Atkins), for her work in this space and on the Landmark Domestic Abuse Bill. We all need to be aware of the issue, and highlighting services and support for families is key.
On that note, I hand over to my right hon. Friend the Member for South Northamptonshire. I look forward to receiving the review in the new year and discussing the outcomes with her.
The extent of cross-party support is apparent in today’s debate, and it is going to be essential. I will pick up on a couple of points.
The hon. Member for Glasgow Central (Alison Thewliss) talked about the vital importance of infant feeding. She is exactly right: it will be a big feature of our recommendations. My hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) spoke particularly about the crucial importance of health visitors. I join him in paying tribute to Cheryll Adams, who has done a brilliant job. He also talked, as did my hon. Friend the Member for Congleton (Fiona Bruce), about the importance of leadership. That will be one of the recommendations that we will look at carefully in our report.
The hon. Member for Strangford (Jim Shannon), whom I have worked with many times, talked about his own grandchildren—how lovely to hear about them. He also talked about how it takes a village to raise a child, and I absolutely agree. My hon. Friend the Member for Congleton was right to talk about family hubs. They are the absolutely proper place for better support in the early years. I thank my hon. Friend the Member for Truro and Falmouth (Cherilyn Mackrory) for her bravery in talking about her own story. She has been a critical member of the parliamentary advisory group. I thank all colleagues for a very helpful and useful discussion to inform the review.
Motion lapsed (Standing Order No. 10(6)).
Commonwealth War Graves Commission Staff
I beg to move,
That this House has considered Commonwealth War Graves Commission staff.
It is a pleasure to serve under your chairship today, Sir Christopher, and a privilege to speak today on behalf of the Commonwealth War Graves Commission staff. They are unsung heroes, who care for the cemeteries and memorials of over 1.7 million Commonwealth casualties of war. Although the commission employs local staff across the globe, it has always retained a proud and important link to the UK by sending domestically based staff to work abroad, primarily in France and Belgium. Gardeners, stonemasons and other staff tend cemeteries across those countries, including in the Somme, Ypres, Passchendaele, Normandy and Dunkirk.
Before I continue, I wish to assure the Minister that I come to this debate with sincerity. This is an important matter and I have not come here today to debate leaving the EU—indeed, I hope that their researcher did their homework and understands my position.
This matter touches me personally in a number of ways. First, I am a member of both Unite and the Public and Commercial Services Union, which stems from a career in the wider civil service before coming to this place. Often, I worked for organisations that not many people knew about, but when they found out what those organisations did, they appreciated their importance. Secondly, I have lived abroad and been affected by a significant drop in income through no fault of my own. I was a student in France in 1992 on Black Wednesday, when the UK dropped out of the European exchange rate mechanism, and overnight we lost two francs to every pound—a 20% drop. Finally and most importantly, like so many members of the public, I have three family members buried in cemeteries in France and Belgium. I wish to put on the record my personal thanks for the brilliant work that all the staff in those cemeteries do, which I saw at first hand when I visited some of those cemeteries.
I congratulate my hon. Friend on securing this important debate. I rise as a Commonwealth war graves commissioner to express the commissioners’ concern about and our respect for the workers she is talking about—those gardeners in Belgium and France. We must ensure that we do exactly the right thing by them, especially in the context of the rather challenging employment situation they are in and against the background of Brexit. I very much look forward to hearing what the Minister says on behalf of the Secretary of State, who is the chair of the Commonwealth War Graves Commission.
I thank my hon. Friend for making those really important points. This debate focuses very much on those staff, and I, too, look forward to hearing the Minister’s response.
My great-grandmother lost her first brother, my great-uncle, Private Ernest Henry Butterfield of the Middlesex Regiment, Third Battalion, on 23 May 1915. He is buried in the Hop Store cemetery, which is to the west of Ypres in Belgium. My great-grandfather, Private Arthur John Langley of the Middlesex Regiment, Second Battalion, died on 23 October 1916. He is buried in Caterpillar Valley cemetery, just outside Longueval, in the Somme in France. That date was not a good one for my great-grandmother, as her second brother died on 23 October in 1918. My great-uncle, Lance Corporal Sidney John Butterfield of the Northampton Regiment, First Battalion, is buried in the Highland cemetery, Le Cateau, in France.
I have visited Caterpillar Valley cemetery in France. It was the end of summer, but it was still pretty bleak. I take with me that feeling of not only desolation but the beauty of the cemetery. I went past the Hop Store cemetery on the train between Ypres and Poperinge before I realised my great-uncle was buried there. It is small and beautiful, with just over 200 graves. It was there that I found out that he died of his wounds, because there is always a small book on a little shelf to say who is buried there.
I visited the visitor centre at the Somme and the Thiepval memorial designed by Sir Edwin Lutyens, who also designed and laid out the house and gardens up at Putteridge Bury, which is now part of the University of Bedfordshire, just on the edge of my constituency. Thiepval is absolutely stunning from afar, and as I got closer I realised that the gigantic memorial is inscribed with the names of more than 70,000 soldiers who lost their lives on the Somme.
I congratulate the hon. Lady on bringing this debate forward and her impassioned description of her visits to those cemeteries. I have been contacted over the years by many constituents, but one in particular comes to mind in relation to this debate. He wrote about a war grave for his uncle. The importance of the Commonwealth War Graves Commission cannot be overstated—it was incredibly helpful. It is important to ensure that staff in Belgium and France have job security and options. Does the hon. Lady agree that we need to hear definitive answers about exactly what is going to happen, and not generalised possibilities for all those staff?
I thank the hon. Gentleman for that really important point about genuine options and security for the staff. I will come to that in my speech, and hopefully we will have a response from the Minister.
The amazing work carried out by CWGC staff and the many volunteers in many countries who support the cemeteries must not be forgotten. Across the House and across the country, we proudly recognise the national value of the work they do. Some staff who have been posted to France and Belgium, although not permanently, have stayed for many years—some for decades—and have had families on the continent. As they are posted abroad from the UK for work, they are offered affordable housing and a living allowance to stay for the duration of their posting by the commission. That is commonplace when UK staff are sent to work abroad, and has been the situation for a number of years.
That supportive agreement between the commission and its staff has ended. Following remembrance events this year on 12 November, the commission’s management provided Unite, PCS and Prospect—the trade unions representing staff—with a decision that it would be presenting to its UK-employed staff abroad. At three weeks’ notice and without consultation, staff, many of whom have lengthy service with the commission, would be forced to decide between transferring to new pay and contractual terms, which means choosing to have their income drastically cut, or being repatriated back to the UK in January.
Staff had to respond to that ultimatum by 7 December, and if they did not, they would be repatriated. I first want to highlight to the Minister the inappropriateness of the timing of that announcement. Releasing life-changing information that would completely upend the lives of staff the day after Armistice Day is completely unacceptable.
My right hon. Friend the Member for Ludlow (Philip Dunne) is extremely sorry that he cannot be here to listen to this important debate. The point that the hon. Lady makes is extremely important. It is not necessarily a question of the employment terms of those people; it is the way in which the choice was put to them and the time they were given. I am sure she will agree that, by and large, the CWGC is a first-class employer, but on this occasion it seems to me to have slipped up, and it really ought to get it sorted out.
I thank the hon. Gentleman for making that completely pertinent point.
The decision is perceived by some as a communications strategy to limit the backlash against the mistreatment of staff, and by others as an attempt to silence staff and prevent them from speaking out, as they know that those loyal, dedicated staff would not want to be criticising the situation at an important time for remembering those who sacrificed their lives. I hasten to add that it may have been a logical decision taken to meet tax and payroll deadlines, made with the head but sadly not with the heart.
I hope the Minister will agree that the timing of the announcement is pretty shameful. The excuse that the EU transition period deadline is approaching is actually thoroughly inadequate. The vote to leave was more than four years ago. Implementing a plan to support staff should have been a priority for the commission. As an employer, the commission has a duty to protect the staff’s wellbeing.
I am deeply concerned that the new employment contracts for staff who choose to remain in Europe remove their entitlement to additional allowances, which will lead to staff having their income drastically cut. A PCS member in France at a supervisory grade, who shared their situation with me, is having their total employment package cut by 53%, equating to about €32,000. That is not an anomaly. Two other staff members working abroad have told me that their package will be cut by more than 50%. Staff are being told to sign new contracts by 22 December, although they have been told that they cannot negotiate their new pay levels, as pay is a decision for human resources to make. Many long-serving staff are being transferred to a level that is between 50% and 75% of the corresponding local pay scale, without any opportunity to negotiate. The staff involved also still do not know what will happen with their state or occupational pension.
I understand that the commission points to the Brexit mitigation payment that offers staff who want to stay in a European country £30,000 to account for the loss of income under the new contract. In most cases, it will cover only one to two years of allowances, and they will not be entitled to any assistance to repatriate when they retire or if they need to move back to the UK for compassionate reasons. Furthermore, I am aware that the commission has offered an additional payment of between £5,000 and £10,000 to assist with housing costs following the initial removal of rental and living allowances. That is a positive step, but it fails to confront the central issues: the long-term impact on staff’s pay and pensions arrangements.
Such decisions have a real impact on staff’s wellbeing. Accounts that I have received state that many of the staff are extremely distressed and feel completely let down and abandoned by the commission. The situation has had a tremendous toll on them, with four out of the 32 PCS members now unable to work because of illness. I have spoken virtually to some of the staff, and it is heart-breaking to hear how they have been treated after dedicating so many years to caring for the cemeteries. The support offered is essentially a stopgap, and an improved package is needed to ensure these important workers do not have to face significant upheaval in their lives and/or downgrade their living standards. What confuses the situation further is that such jobs are needed—they are essential. The cemeteries need caring for, and the incumbent staff have the skills and dedication to do it.
I am aware that the commission’s management state that, legally, the staff can no longer stay on UK contracts and will need to localise in order to pay into the local tax system, but the UK’s exit from the EU should not be used by the commission as an excuse to reduce its overall costs. Indeed, the legal advisers to the trade unions have not been able to identify a clear legal reason why the commission is seeking to change the contracts of staff working abroad. As I understand it, the British Commonwealth war graves overseas situation is based on the 1951 treaty. It therefore derives from international law, not EU law.
That raises the question of whether the UK leaving the EU changes the immigration employment situation of staff. Subject to international law, the 1951 treaty is between individual sovereign states, and not all are members of the EU. I say that because I am concerned at the commission’s response. It not only refused to disclose its legal advice, but claimed that its external legal advice was verbal only. I would have thought it would have been to the commission’s benefit to have legal advice in writing, which it could then have shared with the trade unions to ensure that there was mutual trust in the process.
I hope the Minister can shed some further light on the legal position, as I believe the lack of transparency and trust is at the heart of the dispute. Through greater transparency and negotiation with the trade unions, the commission could have averted the crisis. Trade unions have repeatedly asked for more time to consider the legal position and for better pay protection for the staff involved, but they have received little to no movement from management.
I understand that things may need to change, but the jobs that those workers do are of national importance. I am sure the Minister and the Secretary of State agree with me on that, so will the Minister discuss this issue with the Secretary of State, who is also the chair of the commission, to increase the level of support provided to these workers? That should include improving pay protection for staff who are transferring to localised contracts. Importantly, the trade unions should be involved in representing staff and working collectively towards a negotiated settlement that continues to value the staff and the work they do, and that reflects the respect that I and so many members of the public have for them, as part of our connection to those who gave so much for our country. Nous n’oublierons pas.
It is a pleasure to speak under your chairmanship, Sir Christopher. I begin by paying tribute to the hon. Member for Luton South (Rachel Hopkins) for securing the debate. We all agree on the admiration that we have for the extraordinary work of the Commonwealth War Graves Commission—I see it in my own constituency in Plymouth—and its desire to ensure that those who do such an important job with dedication and dignity are treated fairly, in keeping with the values of the organisation. I certainly share that commitment.
I welcome, too, the opportunity to shed light on an institution whose work is often unsung, and I am grateful for a chance to provide some clarity on an issue on which I suspect there has been a degree of misunderstanding. My friend the hon. Member for Luton South does not want to talk about Brexit and I desperately share that ambition, but the reality is that it has had an impact on this situation, and I will outline that. I want to work with her going forward. I believe that she has a meeting with the Secretary of State tomorrow, so this is not a closed door. I will lay out the position as it stands, but I think that we should continue to work together to see what we can do to ensure that these people are looked after.
As we know, the commission was set up more than a century ago to honour in perpetuity the memory of 1.7 million people who died in the two world wars. In total, it oversees cemeteries and memorials at some 23,000 locations in 154 countries. In the United Kingdom alone, the commission maintains graves and memorials in approximately 13,000 locations. Last year, I was fortunate enough to attend the Commonwealth War Graves Commission cemetery at Arnhem. It is the final resting place of some 1,700 Commonwealth soldiers who lost their lives during Operation Market Garden. The serenity of that peaceful place, with its row on row of perfectly maintained and meticulously ordered white headstones, is particularly suited to the contemplation of service and sacrifice, and it continues to provide solace and consolation to all those whose relatives lie there. It is no wonder, because for more than 100 years horticulturalists and architects have laboured together to develop these cemeteries into something more, into great gardens of remembrance. As a former soldier, I find it humbling to think that there, as in all war grave cemeteries, no distinction is made for rank, race or creed; everyone is treated the same. It is a powerful reminder of our nation’s moral responsibility to ensure the legacy of every person who has given their life to keep us safe.
Today, our particular focus has been on the 30 UK nationals with UK-based contracts who work in Belgium and France alongside 550 staff. We are proud of those skilled British gardeners and want them to continue doing their excellent work, but, as with all UK citizens who work overseas, the end of the transition period from exiting the European Union and the end of free movement of labour have meant the introduction of new arrangements to ensure that they can continue working there after 1 January next year. That meant that they were faced with two stark choices: to remain in the EU on local terms, identical to those of their French and Belgian colleagues, or to return to the UK.
An additional complication has been that these staff enjoy certain unique advantages thanks to a set of historical anomalies. Not only do they not pay income tax in the UK or in their host nation, but they receive an allowance in recognition of the fact that they may be required to move anywhere in the world as part of their duties. Inevitably, once they have become permanently located, these arrangements will be brought into line with those for their counterparts. They would then have to pay local tax and lose their allowances. Although that is not a pay cut in the traditional sense, it does represent a significant reduction in their overall remuneration package. Consequently, the commission has been at pains to ensure that its employees are not disadvantaged. It offered employees a tax repayment of £30,000 and agreed to fund removal expenses where required. That was assessed as equivalent to 18 to 24 months of current benefits and will be paid in one lump sum to ensure that tax-free status.
I am pleased that, following a meeting with unions last week, the commission has further decided to help those remaining in the EU by making an additional one-off payment of up to €10,000, which, for the majority, will cover housing costs for the next 12 months. Should they decide to move house, the commission will also pay up to €5,000 to cover costs. Those choosing to return to Britain have also been offered equivalent employment with the commission here in the UK.
The hon. Member for Luton South asked specifically about union negotiations. Initial conversations between the CWGC and three UK trade unions took place in October, with detailed proposals to individuals in November, alongside collective briefing and discussions with those affected. It is certainly a matter of regret that employees were not given more time to make their decision, and I have no desire to minimise how tough these relatively sudden decisions will have been for them to make. That said, it should also be acknowledged that matters have been complicated by the absence of a clearly defined host nation policy on residency status. In the end, a balance had to be struck between ensuring enough certainty for any arrangements to be legally compliant while also giving personnel sufficient time to consider their options. Staff were asked to make their decisions before 8 December so that their payments could be processed before the start of the French and Belgian tax years, which, unlike the UK’s, run from 1 January to 31 December.
The hon. Member also asked whether the Ministry of Defence will intervene, but it is important to remember that although the Secretary of State is an ex-officio chair of the commission by virtue of the fact that the UK is the largest financial contributor to the Commonwealth War Graves Commission, ultimately the commission is independent, with its own commissioners and director general having direct responsibility for their personnel. Those affected by the changes are not MOD employees, so it would be inappropriate for the Department to intervene in this instance, but I believe my right hon. Friend the Defence Secretary is meeting the hon. Member tomorrow to continue these discussions.
We certainly agree that it would have been preferable for CWGC staff to have been informed earlier; we do not dispute that. However, all 30 employees have now confirmed their options, with 21 remaining in Europe, seven returning to the UK and two retiring. I hope that the commission’s increased offer last week will be welcomed. Those individuals now have the clarity needed to move forward, while our country has the certainty of knowing that the vital work of the Commonwealth War Graves Commission in preserving the memory of the fallen will continue come what may.
Question put and agreed to.
Planning for the Future
[Sir Charles Walker in the Chair]
I beg to move,
That this House has considered the Planning for the Future White Paper.
It is a pleasure to serve under your chairmanship, Sir Charles. There is a great deal to consider in the White Paper, which takes as its starting point the idea that the lack of progress in building the homes we need in this country is largely due to our system of planning controls and approval. I should declare an interest at the outset. I have been happily married to a town planner —a member of the Royal Town Planning Institute—for 18 years, which just goes to show that not all politicians are at loggerheads with town planners. I can see by the number of people who have applied to speak in the debate that the issues raised in the White Paper have generated a great deal of interest. As an MP for an urban constituency that none the less has more than half its square mileage covered by a national nature reserve I believe I have as much insight as anyone into the balances that need to be struck in our planning system between preserving our environment and building more homes.
The White Paper proposes a number of reforms to how planning permissions are granted. Among them are a proposal that development land should be divided up into different zones—growth, renewal and protected—each with different approval rules. That proposal will remove the ability of locally elected councillors to scrutinise individual applications on their merits. Engagement with local communities will instead be only in the development of the local plan. In the White Paper it is envisaged somehow that that approach will engage groups who have previously been excluded from planning decisions, although it does not give details of how that will be achieved.
There are many other contentious proposals in the White Paper and I am confident that each of the points will be fully debated during the sitting, but I want to make two specific points. The world faces a climate emergency—a fact that the Conservative Government have belatedly woken up to. Having spent a decade trying to cut the “green crap”, in the words of their former leader, the Conservatives have recently made encouraging moves towards recognising that the climate crisis is real, our environment is degrading, and it is high time our Government got on and did something about it.
Among the most urgent challenges facing us, not just as a nation but in partnership with other nations across the world, is that of cutting our carbon emissions. I welcome the Government’s commitment to achieving net zero carbon emissions by 2050. That commitment was underlined by the Prime Minister’s announcement of his 10-point plan last month. There was also an announcement on renewables in yesterday’s energy White Paper. However, all those announcements are missing the details of the actual plan to get there. Where are the policies? Where are the interim targets? Where is the funding?
The areas that need to be tackled are well known. We need to decarbonise our transport, power generation, agriculture and industry; but above all we need to decarbonise our housing. We need a step change in how our homes are built, how we heat them and how we cook our food. There are two key approaches we need to take to combat carbon emissions. The first is to upgrade existing homes with better insulation and sources of heating and power. The second is to ensure that all new homes are built to net zero carbon standards. That standard was ready to go in 2015 when the Liberal Democrats left government but was rejected by the Conservatives in 2016. The Government are now returning to it, but promise only a 75% decrease in carbon emissions by 2025. A million homes have been built since 2015. In itself that is hardly suggestive of a planning system that impedes development. Those homes have been built without a zero carbon homes standard. All of them will need to be expensively upgraded in the future.
I am grateful to my near neighbour for giving way. She mentioned going back to existing buildings. Is she aware of the Architects’ Journal campaign to retrofit? That could be an idea. Does she share my concern that often design is sacrificed in all this? There was a report last year by the Building Better, Building Beautiful Commission, but it feels as if there is a possibility of ushering in the slums of the future. We need to emphasise more retrofitting stuff—and beauty, properly.
The hon. Lady makes some interesting points. The Liberal Democrats are absolutely committed to supporting policies for retrofitting—or upgrading, as I prefer to call it, as it is a slightly more future-focused look. I believe that the particular value of that policy is that it will benefit our lowest-income families the most. They are the ones who are living in the worst housing and who will benefit most from the reduction in heating bills that will result from, for example, better insulated homes. I am glad that she mentioned building design, because that is precisely the point I am making. If we can design our buildings from the start to achieve a net zero carbon output, those benefits would be there from day one and could be seen both in reduced carbon emissions and reduced heating bills.
The planning White Paper is a missed opportunity to do much more to embed this net zero carbon ambition into our planning policy and thus facilitate the step change that we need to see in our new housing developments. It is only through the constraints applied by the planning system that we can hope to see net zero carbon homes built by private sector housing companies that want to build cheaply and quickly.
The legislative framework already exists if the Government would only use it. The proposed planning reforms should bind together the Town and Country Planning Act 1990 and the Climate Change Act 2008 to confirm that local planning authorities have a clear and specific duty to address climate change in their planning decisions. Carbon reduction would then become a material consideration in the planning process, enabling local authorities to reject applications that would not seek to achieve net zero carbon in the resulting developments, and the law could enable local authorities to go further if they wished by allowing them to put carbon reduction targets in their local plan.
The failure of the White Paper to explore opportunities to achieve net zero carbon in our housing is indicative of the Government’s failure to provide a proper plan to achieve their overall target of net zero carbon by 2050. However, it is not just a climate emergency that we face; we are also confronted by an environmental emergency. The threat to our natural environment has never been greater and the Government must do much more to tackle it. There could not be a better opportunity than a planning White Paper to make proposals about how we balance our need for housing and economic development with our need to protect our green spaces and wildlife.
There is a very real environmental pressure in every part of the country and the Government urgently need to set policy on it and provide a clear lead. However, in proposing a zoned approach to development, they are heading in precisely the wrong direction. By allowing the automatic granting of planning permissions in growth and renewal zones, the planning process will no longer be able to mitigate against environmental damage in those locations or restrict development where environmental damage cannot be mitigated.
I would struggle to think of a single part of my constituency that could be designated as an unrestricted growth zone, where development would need to take no account at all of environmental impact. The proposal to introduce such zones rides roughshod over the many small decisions that can be made by those who know their local areas and can arrive at the best solution for the local population and the local environment.
Government-commissioned research from University College London has found that homes built through permitted development rather than by going through the planning process are also of worse quality. Does my hon. Friend agree that that is also a very regressive step rather than a progressive step?
I thank my hon. Friend for making that point, because it highlights the fact that the more we weaken the planning decisions made by local authorities at local level, the more we risk allowing unsuitable development, including architecturally displeasing development, environmentally damaging development and development that is not primarily designed to meet the needs of the local community. That is why bypassing local authorities is the wrong approach.
The planning White Paper proposes to bypass much local authority planning involvement in the mistaken belief that it is local nimbys who are blocking development. In my constituency, it is local people who have provided many of the ideas for local authority action that have improved our environment and guided planning policies. Local authorities, especially Liberal Democrat-controlled ones, are often willing to go much further than the national Government in reducing carbon and improving our environment. In Richmond and Kingston, for example, the councils have introduced new cycle lanes to encourage people to reduce the number of car journeys they make, and electric vehicle charging infrastructure to encourage the switch to cars with lower emissions. Liberal Democrat councils up and down the country are also planting trees, installing solar panels on the roofs of council buildings, switching council vehicles to electric, and insulating council-owned homes. In each case, they are responding to the needs of their own environment and that of their local population.
When the public inquiry into the handling of the coronavirus is completed, I believe that it will clearly demonstrate that some of the response could have been more effectively delivered by local authorities or neighbourhood groups. We have seen the weaknesses of a centralised test and trace system, for example, and even today the Government are setting central rules for school openings that might be better decided by local education authorities.
The same is true for planning. A group of concerned local residents, whether elected representatives or volunteers, are much better placed to decide how their street should be adapted to keep pace with the challenges of modern life than a few unknown Government workers in Whitehall. If all bodies making decisions about future developments can be tasked with the responsibility of achieving net-zero carbon and protecting our environment, then the ingenuity and enthusiasm of our local authorities, and the residents they serve, can take us a lot further towards the Government’s 2050 goal than any amount of top-down diktat. It is time for the Government to show they are serious about climate change and the environmental emergency, and that starts with some serious revision to this planning White Paper.
It is a pleasure to serve under your chairmanship, Sir Charles. I thank the hon. Member for Richmond Park (Sarah Olney) for securing this debate.
The proposed algorithm linked to the White Paper would more than double the annual housing target for the borough of Barnet to 5,744 units a year. That would place intolerable pressure on an area that is already building thousands of new homes—it is already playing its part in tackling the housing shortage. The numbers proposed in the algorithm for London and the south east would be impossible to deliver without significant urbanisation of the suburbs, encroachment on the green belt, or both. They would inevitably mean the construction of hundreds of high-rise blocks of flats, changing the landscape and the skyline forever and permanently blighting the local communities that we represent in this House; the open, low-rise, leafy suburban environment could become a thing of the past.
Even before these reforms come into operation, there are currently around 3,500 new homes proposed, and at various stages in the planning process, just in my Chipping Barnet constituency. Strong opposition is felt, for example, towards development proposals for Victoria Quarter, Colney Hatch Lane, Whalebones and—most controversially of all—for the station car parks at High Barnet and Cockfosters, just over the borough boundary. The reality is that more or less every brownfield site is already in the pipeline for development; there is simply no space for thousands more flats.
Page 54 of the White Paper suggests that these astonishingly high targets might be delivered by redeveloping streets of semi-detached homes. They call it “gentle densification”. To come anywhere near delivering these numbers using such a method would require the mass compulsory purchase and demolition of suburban streets. That is not remotely realistic, is not acceptable, and would be anything but gentle.
It is also unacceptable for the White Paper to deprive local communities of a say over building in designated growth zones. A faster process for creating a local plan is no substitute for input by residents and the local councillors they elect in a formal planning application process.
Finally, the White Paper indicates that as long as a building meets certain design standards, it should go ahead—even if it is far more dense than was previously acceptable under longstanding planning principles. This is an attempt to substitute nationally set design standards for rules on character, height, massing and bulk. However, as the Barnet Residents Association points out in its response to the consultation,
“a block of flats is still a block, no matter how tastefully it might be presented”.
This tendency is already evident in the Mayor of London’s draft plan, and I am deeply worried that if we pursue it in the White Paper as well, it would lead to the removal of the vital protections enshrined in planning rules. In conclusion, our suburbs, extolled by John Betjeman in his Metroland poems, are often underappreciated, but the people who live there form the bedrock of much our economic and civic life. Today, I call on the Minister to give us an early Christmas present. Tinkering with the algorithm will not be enough; let us junk that algorithm and scrap much of the White Paper, so that we can save the suburbs and defend our local environment.
It is a great pleasure to see you in the chair today, Sir Charles. I congratulate the hon. Member for Richmond Park (Sarah Olney) on securing this important debate.
The last time we debated this subject, in October in the main Chamber, I talked about three main themes. I will cover broadly the same three themes today, but I hope to do so in a fresh and original way in the time available.
The first is that, with any algorithm or formula, of course it is right to look at the inputs, how the formula works and the logic of it and to see whether we think those things are right. It is also right to look at the output of that formula and, if it seems to jar with the original intention, to go back and look at the inputs and logic.
This is not the time and the place to do that. Constructing an algorithm in a Westminster Hall debate is probably about as sensible as design by committee, but all those aspects warrant a fresh look. That starts with very basic things, such as how we define affordability. Sometimes the median is not the most appropriate thing to use. There is a danger in a constituency such as mine, where median incomes are based to some extent on the incomes of people working outside the area, that if house-building targets are driven based on those numbers, the result might be building more and more pricey larger executive homes that remain unaffordable to the people for whom the housing was intended to be more affordable.
In a constituency such as mine, and I suspect those of some others, yes, we need more houses. I think everybody these days accepts that we need to get supply and demand in better kilter. There is also an important question of mix and ensuring that as we increase those numbers that means an increase in houses that are genuinely affordable, in the sense meant by people who come to our surgeries. That is not only capital A Affordable as it is meant in the public sector, but affordable as in a home that I can afford to aspire to buy.
The hon. Member raises important points. There is a need for housing of all different types, sizes and tenures, and there are different ways of delivering them. In the time we have available, I am afraid we are not going to get to the bottom of evaluating them in an ordinal way.
The third and important point I want to make is about national parks. I do not know whether there are others here who represent national park areas. There is the particular issue where part of a constituency is in a national park and parts are outside, so there are very different constraints in how land can be used. There is a danger that if a housing target or requirement is set based on the entire area, containing both national park and non-national park, with different constraints on what can be done in each part, the result will be the insufficient creation of new homes inside the national park and potentially too much on the edge.
A piece of work came out from Nationwide a few weeks ago that suggested that house prices in national parks have something like a 20% house price premium compared with those outside. In a constituency such as mine that is a huge amount of money. The Office for National Statistics is doing some further work, so hopefully we will be able to develop those figures. It is also important for the areas just outside the national park. In my constituency, that means areas such as Alton and Four Marks, where there is potentially a disproportionate amount of development in the border zone that can put considerable strain on infrastructure and provision of service. It can then be difficult to ensure adequate provision.
There has been a lot of debate about the proposals. Ministers have been in listening mode and have been very good in listening to colleagues across the House. I hope, as the matter develops further, it will be possible to take these considerations into account.
I am grateful to be called in today’s debate, Sir Charles, yet again discussing “Planning for the Future”. I am surprised we are still here after the debate in the Chamber a few weeks ago, when there was deep concern across the House about the proposals, since the language painted a very different picture from the reality of what they would bring.
I want to focus on York, my constituency, and the real challenges we are facing with the whole planning system that will be exacerbated by “Planning for the Future”. The Government talk about giving back control and local people having a say, but when it comes to “Planning for the Future”, there is virtually no meaningful involvement. There may be consultation but certainly no involvement in the depth of planning decisions about their local environment.
Public engagement seems to be higher for individual planning applications than broader planning consultations. Does my hon. Friend agree that it would be more democratic to encourage and facilitate public engagement at every stage and at every level, and that these changes will lead to more decisions being made behind closed doors and make things worse, not better?
I absolutely do agree with my hon. Friend, not least when infill housing development proposals come forward and there is actually very little accountability. That is why it is so important that local people have a say about their community—they know it best.
The reality is that whoever holds the cheque book holds the power in planning, and it is set to get worse under the proposed changes. I want to set out the problem that we are facing in York Central, in what would be a renewable area, and why the current system and “Planning for the Future” will fail York for generations.
Some 80% of housing need is for family housing, and I do not know a family that does not want a house with a garden, yet the planning for York Central will mean that 80% of housing is unaffordable one or two-bedroom flats—nothing that our constituency needs, despite over £155 million of public money being poured into the scheme—built on 45 hectares of public land. Already, under the current system, the housing is for investors, not residents.
That is nothing short of immoral when people are living in damp, overcrowded, poor-quality private rented sector houses. I was just looking at the figures: in York we have lost 45 socially rented homes, and that situation is getting worse with right to buy. We have a real housing crisis here, and this paper does not match our needs. These people have nowhere to go in York: if they cannot move out, which is the only option, they are left in this housing crisis; if they do move out, our local economy suffers, because we do not have the skills mix that our city needs.
York Central is adjacent to the rail station, which is one of the best-connected locations in the country; it is the mid-point between Edinburgh and London, a destination for HS2, if that is still going ahead—although today that looks uncertain—and at the intersection with the trans-Pennine route. If I look across to places such as Crewe or Curzon Street in Birmingham, the opportunity for creating jobs on these sites has been realised, and economic investment has been prioritised. However, York Central will provide just 6,500 jobs because the majority of the site is being handed over to housing.
The way the partnership has been set out means that Network Rail, Homes England and the National Railway Museum own the site and control the decisions. These bodies are not based in York. The Lib Dem-Green council, bizarrely, extracted itself from any decision making on the site. We now have the largest brownfield site in Europe, in the northern powerhouse, having its future determined by three national organisations with no interest in the future of the city.
The National Railway Museum rightly wants to see an upgrade to the museum by 2025 to celebrate 200 years of the railway, but Homes England has the power and money, and is certainly not putting forward the proposals our city needs. Homes England has a responsibility not only for developing housing, but for the economic future of our city, yet it has no understanding of our current economic situation. It is talking about putting low-wage, low-skill jobs on the site, when we need high-value jobs. We have a great opportunity with the bioscience industry, the digital creative sector and rail jobs for the future, and we know that there is investment interest. However, those things will be locked out of the site because of this imbalance, with Homes England holding the cards.
What we want to do is truly build back better by ensuring that we have good-quality jobs and the homes that people need in our city for the wider economy. “Planning for the Future” fails to address the situation. We must first address local need and then local opportunities to drive development. “Planning for the Future” further takes away powers of local scrutiny and will mean that those with the power, money and opportunity end up recreating our cities in a way that meets their short-term financial interests and undermines the long-term economic health of our city.
When it comes to the incredible city of York, it will result in future generations not having the good-quality jobs that I want them to have. Families will not have the housing they need, our local economy will be completely skewed, we will not have the skills we need and we will be overrun by speculative investors. Surely that is not what the Minister wants, and yet that will be the outcome of “Planning for the Future”.
I thank the hon. Member for Richmond Park (Sarah Olney) for bringing forward such an important debate. Others in the Chamber will no doubt make arguments about algorithms and housing numbers, but I want to focus my remarks on the delivery of affordable housing, particularly in our Cornish communities. Obviously, that goes hand in hand with housing targets.
Cornwall has a proud track record of delivering 30% affordable housing over the past 10 years. I would not be in this place if, at 29 years old, as a postman, I could afford an open market house in my home town. That was the driving force for my getting involved in politics; I wanted to give people opportunity. At the time, the Labour Government seemed very interested in providing houses for people who were out of work, but not particularly interested in trying to help people who were. I support the Government’s plans for key worker housing, particularly the 30% key worker discount that the Secretary of State announced recently—I am very keen to support that.
Cornwall has a very low wage base and a very high house price market, and that creates all sorts of intrinsic problems with our housing stock. One of the ways that we saw to that in my time on the district council, before it was abolished, was to implement a community self-build scheme in a community very close to me, so that locals were able to purchase a plot of land and build their own houses. It was an exceptional scheme, and I hope the Government and Ministers will look at it.
We have done a lot of work on sites such as rural exemption sites. They are not completely a panacea, but I would like to see their use increase to allow local people in towns and villages where there is not a development boundary at present to get a house in the town or village in which they grew up.
One issue that I want to cover is public sector land. Cornwall is supposed to be integrating into the One Public Estate programme, but we have had some significant problems, particularly with the NHS property holdings company, which seems to want to keep hold of its land. If the Minister is able to apply some pressure to it, we would be very keen to get hold of some of its land to provide some key worker housing for our community hospitals, particularly in the Bude and Stratton area.
We have had significant challenges in the system with land values. I frequently talk to developers in Cornwall, and they say that they have long discussions with planners about affordable housing criteria, road allocations and access, which take forever. We really need to start delivering houses for people now, so I would ask that we look at speeding that up.
I would also ask that we consider more accurate town and village housing data. Some of our town and parish councils have been exceptionally good in collecting information about the people who are in need of housing in their areas and what the tenure mix needs to be, and I would ask that we look at that. I know that the Government are making progress on the challenges around sizeable deposits, and I welcome the Prime Minister’s commitment on longer term mortgages. I think that is a good step.
I have highlighted some of the problems, and there are also the challenges relating to covid. A lot of people wish to relocate their businesses and move to Cornwall, and that is a great thing. If they are taking second homes and living in them permanently, that is an exceptionally good thing, but it puts more pressure on Cornish housing stock. If the Minister is looking at pilots, we would be very keen to have a community self-build pilot in Cornwall to demonstrate our willingness to support people. I also ask the Minister to apply some pressure to Cornwall Council, which seems very resistant to the idea of Rentplus, which I think is an exceptionally good model for people who do not have a deposit but want to own a house, and want to use the rent that they pay as a deposit for their mortgage.
On NHS property holdings, can we get One Public Estate working so that we can get key worker housing for some of our nurses in Bude and the surrounding areas? Can we simplify the system so that developers do not have to go on a massively long journey to get the planning that they are seeking? Can we have a service plot provision in Cornwall as a pilot, more flexible tenures, and a simpler planning system for schemes that are exemption sites? Can the Minister look at agricultural ties? So many farmers approach me to say their family are looking to build a house on land. Can we look at that as well, please, Minister?
Thank you, Sir Charles. I add my congratulations to the hon. Member for Richmond Park (Sarah Olney) on securing this debate. I congratulate the Minister because, since he has been Housing Minister, we have achieved the magic target of 250,000 homes a year in this country.
On behalf of West Worcestershire, let me say that we are keen and positive on home building. We have been delivering at the pace of nearly 2,000 homes a year, and that has been generally very good for the area. However, while there is a lot to welcome in the “Planning for the Future White Paper”, there are also elements I would like to see the Government put more emphasis on in terms of local areas.
First, it has been mentioned before, but I want to put on record that the algorithm does not make any sense to me at all. It has ended up with something that is completely undeliverable for the Malvern Hills area, where we have floodplain and hills, and where we simply do not have the sites to deliver the numbers calculated by this algorithm.
However, the Minister starts from a very strong base. He has the 250,000 homes a year being delivered. Through his “Planning for the Future” consultation, he needs to make some incremental and more localist changes. I think a lot of colleagues this afternoon will mention similar things, along the lines of putting more emphasis on the small builder. I know that is in the White Paper, but it would be lovely to see it come out as part of the change in the direction of travel.
There should also be more emphasis on neighbourhood planning. If we ask communities to find sites for housing, we will be surprised how much more we find. In Malvern Hills, I have never been able to understand why some villages are categorised as not being able to have any development whatever because it is described as unsustainable. Many of my 78 parishes cannot build a single house. If we made things more granular, more incremental and more small scale and we worked with our neighbourhoods to develop them, we would end up producing those additional houses—that incremental development over and above the already significant numbers that are being delivered.
I want to feed in a point about the bottlenecks that builders tell me they find in local authorities in terms of highways engineers being able to do highways studies quickly enough. There are physically not necessarily going to be enough qualified people in this country to produce the studies required. Has the Minister thought about taking steps to ensure that that is addressed or simplified in some way?
I do not need to take up too much time, because I have made the point about smaller being better. Let us put more emphasis on the ability of smaller communities to add a little bit. Let us not hand a developer’s charter to these very large housing sites that only big developers can deliver. Let us unblock some of the issues that stop existing planning permissions being built out, through things such as ensuring that there is a good quality of highways engineers who can complete the studies. Let us move from the strong foundation that we currently have in house building by making some incremental changes that favour the little guy.
I stand to carry on the conversation that we have just had with my hon. Friend the Member for North Cornwall (Scott Mann). I thank the hon. Member for Richmond Park (Sarah Olney) for securing this important debate and the Minister for all he does and for his willingness to engage with all those who are keen to be involved in this area.
As we heard, the White Paper proposes a range of reforms, and I will not go over everything that has been said. In fact, I want to focus on the fact that the gist of the White Paper is to increase access to homes and ownership of a home. To own a home is an amazing thing; it gives a sense of security, builds community and provides opportunity, so we should absolutely continue to do all we can to ensure that people can own a home.
However, here lies the problem in Cornwall, in particular, where, as we have heard, prices are high and wages are low. That is what I want to try to address. The truth is that there are people elsewhere in the country who fancy a bit of Cornwall, particularly at the moment, with it being in tier 1—sorry for rubbing that in, Sir Charles; that was insensitive. We have seen an enormous rush of people buying a home in Cornwall because they have seen it as the place to be not just during the recent restrictions but for the whole year. That is nothing new. We could build all the homes that the country could cope with, but the people who need them would not necessarily get them. That is absolutely the case in Cornwall.
I have three suggestions. First, local authorities should be given power to support local home ownership. St Ives, a key part of my constituency—so key that the constituency is named after it—captured headlines around the world when it introduced a primary residence clause in its neighbourhood plan so that no new home could be built in the St Ives Town Council area unless it was for local ownership as a primary residence. That was not necessarily supported at the time, but it has really helped the community to stake the case that building homes for people who live elsewhere is not at all helpful. I ask the Minister to consider putting something in the White Paper that would enable local authorities, where there is a need, to provide access to homes to local people when they are built, somehow restricting them for other people for a period, even when on the market. I do not know how that can be done—I leave him with the problem, not the solution.
As my hon. Friend the Member for North Cornwall said, innovative home ownership models should be a must—[Interruption.]
Sitting suspended for a Division in the House.
I was asking the Minister to consider a way to enable local authorities to ensure that local people have access to the homes once they are built. I will now look at other models that enable working families to get on the property ladder, not forgetting what I said earlier about the promise, security and opportunity of owning one’s own home. My hon. Friend the Member for North Cornwall referred to rent to buy. Rent to buy offers access to working families: it gives them a discounted rent for a period; they then have the opportunity to buy the freehold of that property, and in return some models offer them help towards their deposit. The Treasury supports it, the Prime Minister supports it and No. 10 recently produced a paper to encourage councils to take it up, but Cornwall Council, for some reason—I have discussed this with it on a number of occasions—has consistently refused to allow the model to be available to working families in Cornwall. When I met the council the last time, it accepted that about 800 homes would have been built for local families.
The truth is that where places such as Cornwall have a long waiting list for social and affordable housing, the working families are very low on that list. As my hon. Friend hinted, lots of other people genuinely have a greater need, but the truth is that working families who rent their property and who could benefit from the rent-to-buy model find themselves paying very high rents. That is often what drives the kind of poverty and deprivation that we see in Cornwall. I am interested in hearing from the Minister whether, through the reforms, we can find a way to ensure that local authorities cannot deny this opportunity to local families.
Finally, if through the White Paper we can continue discussions about the opportunity to improve the build quality and efficiency and reduce the cost of running homes, that will be gratefully welcomed.
It is a pleasure to serve under your chairmanship, Sir Charles. I congratulate the hon. Member for Richmond Park (Sarah Olney) on securing this debate. As we all know, and as she rightly said, it was only a matter of a few weeks ago that we were discussing this issue. The almost united position across the House was that we were displeased with the White Paper and the housing algorithm.
I will start by thanking the Minister, however, because he has routinely engaged with those who have concerns. He is a credit to the Department. In fact, he has alleviated my concerns about various aspects, and while I am unable to completely support all elements of the housing White Paper, or indeed the algorithm, I am aware that there are some significant positive parts to it, and I hope we can build on that in the future.
We have heard a little bit too much about the nature of Cornwall and we might well be told that everyone fancies a bit of Cornwall, but we favour Devon more. As my right hon. Friend the Member for East Hampshire (Damian Hinds) raised, in constituencies such as mine in Totnes and south Devon, where there is a national park in the north and an area of outstanding natural beauty in the south, with a small gap in between that under the White Paper is now the focal point for development, that needs to be taken into consideration. Otherwise, all the housing requirements are likely to be put in that small, specific area, which would be totally unfit and totally inappropriate.
Of course, areas such as mine in Totnes and south Devon, where we have areas of outstanding natural beauty and national parks, are also tourist destinations and places where second homes are purchased at a huge rate of knots. When houses are built, even with the best of intentions—selling them to local people at affordable prices—all too often they end up as second homes, with no opportunity to become homes for people who will live and work in the area. There is an appropriate level, which is this tiered system, and I think there is some validity in it. I hope we can expand on it, and I look forward to hearing the Minister’s comments.
One objection I have to the White Paper in its entirety is the lack of mention of rural areas. In fact, I think “rural” is mentioned in a significant category only once. It is important that we understand that the rural build structure is very different to that of the urban one. In the same way we need to be able to understand what is best for the rural community and how we are to achieve it. I am sure that my colleagues from the south west would universally agree.
There are areas of extraordinary success. South Hams District Council in my constituency has successfully implemented a joint local plan with Plymouth where they have met their housing targets and continue to deliver for the people of south Devon. That plan should not be taken away just because we are looking at new reforms.
The third point I wish to make, which my hon. Friend the Member for West Worcestershire (Harriett Baldwin) made with great effect, was about neighbourhood plans. We know the value of communities engaging in this process, because they know what is best for their area. I think about Collaton St Mary and its fantastic neighbourhood plan or new neighbourhood plans that have been formulated in Dartmouth. Those are all places where we can engage with the community and make sure we are building what is right for them and right for the area, and make sure that it has a long-term benefit.
Since it is important that we also hear about Bath, is it not also true that local councils know best? In Bath, 1,500 homes are permitted to be built. The council has made the decision. The issue is the developers not building the homes, not the councils not making the decisions to build the homes.
The hon. Lady makes an important point. Like all these things it is about finding balance, but I always argue that including the local community in that decision and making sure that the right decisions are made at the right times ensures that it is maintained.
My final point is about jobs. We should not be building in areas where there are no jobs to sustain them. We need to make sure that there is an approach in which jobs are available so that people can live and work in the area and can also afford those homes. A related point is about infrastructure viability. All too often, I have seen housing development plans proposed without adequate infrastructure. Will the Minister add to the point about how we will be able to deliver on the infrastructure network, and how we can make sure that we are building in the right areas and not on flood plains or next to roads that cannot deal with the increase?
I would be pleased to be able to go back to my constituents and inform them that we are cultivating and creating policy that will make a difference in delivering for those new housing sites. I welcome elements of the White Paper, and I thank the Minister for what he has done and is doing. It is right that we recognise that delivering 250,000 homes is a massive achievement that was not achieved by previous Governments. I congratulate him on that and look forward to working with him and his team to shape this housing policy for the future.
It is a pleasure to serve under your chairmanship, Sir Charles. I also congratulate the hon. Member for Richmond Park (Sarah Olney) on securing this important and timely debate, as well as my colleagues from the south-west who have spoken. It has been a bit of a south-west fest so far and I feel like I need to pull the centre of gravity back and further north towards the north midlands, because, sadly, we have similar challenges to those of many of my colleagues who have already spoken.
I represent a constituency bedevilled for more than a decade by planning issues caused by the failure to put a local plan in place in a timely and effective manner, as is so often the case. That means a cascade of unwanted and unnecessary development, followed by a local plan that does not necessarily work for the local community in its first iteration and initial drafts. We are in the middle of trying to resolve that knotty conundrum after so many years of it failing to be resolved.
As a concept, I welcome many of the things that the Government are trying to do. There is no denying that the planning system, as it stands, is sub-optimal. It is broken, in places, and does not work either for those seeking to get on the housing ladder to be housed in the first place or for those interacting more closely with it, be they developers, planners or applicants. I accept that there is a fundamental problem with planning that needs to be resolved. The evidence bases that have to be put together by local councils are too detailed and take too long. The overall process is laborious, and the plans produced often bear—at best—a relationship to problems that existed five years ago rather than current problems.
We need to reinvent community engagement. I welcome the Government putting all those ideas on the table in principle but, as with everything in planning, the devil is in the detail. The Government have brought forward a set of consultations that are deliberately high-level and that deliberately encourage this kind of debate. I welcome their commitment to that, but the challenge is the detail and the devil within it. I can see that zoning could be welcome for my constituency in principle, or it could be significantly deleterious to my constituency if it was not not implemented in the right way. I can see that the streamlining of the planning processes should be welcomed because it gives an effective outcome to everybody involved more quickly, and I should be able to welcome that in principle, but the issue is the devil underneath that streamlining. I can see the replacement of soundness as positive in principle, as long as the actual reality on the ground enables us as communities to make better decisions.
The same goes for better engagement and planning, fast-track for beauty, and section 106 replacements: they could all be good in principle but we need that detail. We need it in the next stages of the consultation before we can have the comfort that our communities demand. That is particularly the case for those communities who have had historical challenges with planning to ensure they have confidence that the White Paper will try to resolve some of those challenges.
The questions that remain for communities such as mine are about how, for example, we reconcile the building of more houses, which is necessary in many parts of the country, with the desire to protect, which is apparently underneath the principle of zoning. There is a tension between those two principles and at the end of that process, one will have to take priority over the other. It is that decision that is the most important for my community.
How do you speed up the creation of a local plan process—a great idea in principle—while ensuring that a greater decision-making process is embedded at the start of that process and that people have the right level of oversight and ability to influence it? How will you reduce an evidence base—again, a great idea in principle—in a system that is so formal and specific to individual areas, and at times so litigious, which is the whole point of why the evidence base is often created and takes so long?
How will localism be maintained with such an increase in standardisation? How will we ensure that the neighbourhood plans that my hon. Friend the Member for Totnes (Anthony Mangnall) highlighted will have a continued central place within this system? How fundamentally will the very good ideas and principles within “Planning for the Future” interact with the housing methodology? In that regard, I also have concerns about the overall implementation and impact on areas such as mine.
In principle, there are some good ideas and opportunities to make a system that has not worked for many decades better. However, it is the detail that we need and that our communities require to be comfortable with these ideas.
It is a pleasure to serve under your chairmanship, Sir Charles. I congratulate the hon. Member for Richmond Park (Sarah Olney) on securing the debate. Like that of my hon. Friend the Member for North East Derbyshire (Lee Rowley), my local authority in Chester East has suffered enormously from speculative housing developments that took place because there was no local plan. They have turned a corner now and are delivering housing at a sustainable rate, but that is on the back of having had all sorts of developments go on that local people did not want, and that I do not think should have taken place.
I do want to begin by recognising the positive elements in the proposals. The emphasis on a national design code and locally produced designed guides is very welcome. For the reasons that I mentioned before, getting local plans in place all over the country is only going to be a benefit, if we can do that right.
The more certainty we have in the planning system, the fewer delays we get and the less money that is spent by taxpayers and local authorities in costly legal battles with developers about whether a development can take place. I also welcome the measures aimed at helping small and medium-sized enterprise builders and zero carbon homes. But we have to be realistic about the world into which these proposals are seeking to introduce reform. As constituency MPs, we all know that too many developers are incredibly well-resourced and have legal teams to match. While many planning and enforcement departments of local authorities are excellent, some may be found wanting because of a lack of resources, a lack of competence or a mixture of both. We need to be mindful that whatever changes will need to withstand the full force of developers’ legal teams, which all too often operate on the basis that they only have to be successful in one of the developments they are fighting for to pay the costs of the lawyers for all the others for which they are agitating to get permission.
Let us take the idea, for example, that permission might be automatically given to developments if decisions are not taken soon enough. I can see that becoming a real favourite of developers who bombard local authorities that are behind the curve, knowing that they will not get decisions done in time. Those authorities end up with lots of developments that they would not otherwise have wanted. I appreciate the Minister and the Government want to see decisions made more quickly, but some local authorities are going to suffer in that transition if we put in that kind of a big stick.
When it comes to zoning, again I can see big arguments over who has made the right or wrong decision over zones, and lawyers pushing to get more areas put into the development zones. Similarly, the decision potentially to take out councillors from more detailed decisions on planning matters means that they will be left just to officers and developer pressure. Councillors play a vital role, with their local knowledge and their representation of local people.
In other areas, I feel like the proposals are more about what they are missing—for example, on infrastructure. I do not see clearly what we will do to stop this cat-and-mouse game with developers and local authorities about when to start building infrastructure for developments that they have already built, and when they start about how quickly they finish.
There is a whole gap around NHS provision. Again and again, I see decisions on planning that never even mention provision for the NHS. We have gotten okay at getting provision for schools or highways, but the Government’s focus in this area is lacking. I would have liked to see something in the proposals to specifically address that balance. The algorithm will almost double the number of homes that my local authority is expected to build and the infrastructure for that is incredibly important.
Finally, and most importantly for me, the answer to our desire to build more homes, which is a laudable desire and on which we have already made good progress, is to get the homes built for which we already have permission. We would not need to go down the road of radically reshaping proposals. There are more than 1 million homes for which permission has been granted; every year, tens of thousands of homes get given permission. Let us make that the No. 1 focus of our proposals, then we would have everybody onside and everybody on board, wanting to deliver homes for people in a balanced way. I ask that the Minister goes away and thinks again in terms of putting forward proposals that will see homes with permission built first and foremost, before we tear up some of the institutions that help keep local decision making as a priority.
It is a pleasure to serve under your chairmanship, Sir Charles. I congratulate the hon. Member for Richmond Park (Sarah Olney) on securing this debate. We appear to have a bit of a zoning theme in the way that this debate has been scheduled. We have had the south-west and we are in the north now. Now we are up north, we will talk proper and get this debate sorted.
I am sure most of us in this place will agree that our planning system has been in need of urgent reform for some time; the disagreement is about how we actually do that. The speed at which we need to level up and the changes we need to see—the changes that voters backed a year ago—mean that we need to start to do things differently. Many of the issues that are relevant today—the technologies we use and the way we live our lives—have evolved, and that needs to be reflected in planning legislation. There is no doubt our planning system is far too complicated, driven in part by the litigious nature of developers, and that has been a barrier to building the homes people need to see and getting them in the right places.
That is exactly the case in Warrington, where the borough council has spent the past five years producing a plan, largely ignoring 4,000 responses to consultations, and still we have no plan available for inspectors to review. We are now told we will not have one until at least the summer of next year.
Many of the proposals put forward by the Secretary of State for Housing, Communities and Local Government back in August are a welcome step. They lay the foundations for a brighter future. It is about providing affordable homes for young people and creating a better quality of neighbourhood right across the country, but, as my hon. Friend the Member for North East Derbyshire (Lee Rowley) said, it is also about getting the detail right in the legislation. That is why I am so pleased we have the consultation at this stage, so we can bring those issues forward to the Minister to address.
I want to reflect on the proposed submission version of the Warrington local plan, which expected growth above anything previously achieved, with little evidence to support that expectation. To me, that highlights why we need some of these changes. The scale of new development being proposed in Warrington meant that large areas of the green belt, particularly across my constituency of Warrington South, were to be released for development. That is where the current Labour local council plan gets it so wrong. It concentrated on placing new development on the green belt and previously undeveloped sites, rather than providing for regeneration and redevelopment of a town centre massively impacted by years of neglect. While the council needed to reflect Government requirements for the assessment of the number of new homes to be built, the figure they used in the PSV exceeded all national requirements and proposes housebuilding at a level never, ever previously achieved in Warrington.
The plan does not address more obvious housing needs, but instead proposes large new suburbs and urban extensions, and there is no clear plan as to how developers would be required to deliver the type of housing in the right places of the town that would most benefit existing residents. In short, the number of homes does not make sense, but the location of the new houses is even less understandable.
Frustratingly, the largest brownfield site in Warrington—one of the largest brownfield sites in the north-west of England—the Fiddler’s Ferry power station, which closed earlier this year, has not been included in a plan that extends for the next 20 years. It even has its own rail line, which would satisfy some of the issues that we need to address in how we move around the country. It would allow us to retain some of the green belt, but it has not been considered.
On the back of the planning reforms, I am pleased to see that Warrington borough council will be pausing its work on the local plan, looking again at the homes we need and making a fresh assessment of the opportunity to redevelop our town centre and use brownfield sites. I have a request for the Minister: can we have some clarity soon on the housing numbers? The proposal in the White Paper will actually reduce the number of homes being built in Warrington, so I am perhaps one of the few people in this place who really like the algorithm—it is doing the right thing, and I thank the Minister.
Absolutely. It is about getting the right types of homes in the right places. Land designated for growth will allow new homes, schools, shops and hospitals to be built quickly, and we need that levelling up to happen urgently. Getting the right places is the most important thing.
The hon. Member for Bath (Wera Hobhouse), and I think also the hon. Member for Richmond Park, talked about how local councils are best placed to try to work these things through. I have to say that is not the case in Warrington. The local Labour council ignored all the Liberal Democrat councillors, who argued that it was building in the wrong places. I am afraid that the very simple system that we have at the moment is broken and needs to be fixed.
I welcome the new planning system. There are a lot of good elements in the proposals, but it will come down to the detail. I look forward to continuing the conversation with the Minister, who has been so good in responding to the issues that have been raised with him.
Thank you, Sir Charles. I congratulate the hon. Member for Richmond Park (Sarah Olney) on securing the debate. I think all Members present agree that we need more homes, and more affordable homes. Picking up the point made by my hon. Friend the Member for Warrington South (Andy Carter), however, we need the right types of homes in the right places.
I congratulate the Minister on building 250,000 homes, which is an excellent achievement, and I would like to contrast that with what is happening in my city, London, where we are failing to build enough homes. The Mayor of London was given just under £5 billion to build 116,000 new homes, but we have started only 52,000, which is disgraceful. My borough and many other London boroughs need more homes.
Is the problem about providing not affordable homes but social homes for rent? In Bath, the average house price is almost £500,000, and an affordable home would cost 20% less. It will never be affordable for anybody to rent, let alone to buy. What is actually “affordable” in her words?
I agree with the hon. Lady that we need more socially rented homes. As my right hon. Friend the Member for East Hampshire (Damian Hinds) said, we need a wide range of tenures across the spectrum. In my local authority, we are building 600 new homes this year. Of that, half—300—will be socially rented.
Let me indulge myself for a moment and talk about my borough, because it is slightly unique. We are the densest residential borough in the entire country. We were fully built out by 1900, and we already have a high skyline. We have just approved a 29-storey tower. Others have been approved, such as Newcombe House, which has 18 storeys. We have a huge physical constraint on our ability to build more houses in our borough. Some 73% of my borough is a conservation area, which we are delighted about. In fact, we think more of it should be a conservation area, but it brings constraints.
I want to limit my remarks to the White Paper, as opposed to the algorithm, because I have talked about the algorithm in the main Chamber. By the way, under the algorithm the housing target in my borough goes up sevenfold, relative to the December 2019 London plan, which has not gone through yet.
Let me focus on the White Paper. I think that local engagement in planning and local democracy are absolutely critical. I have spent one year in this place, and the more time I spend here, the more I believe in local democracy, since local authorities are closest to the people.
The current plan in the White Paper is that there will be local engagement in the plan for a growth zone, but it is up front, and once the plan is formulated there is no need for specific planning permission. I am very concerned about that. Although I have great residents associations and the Kensington Society, which work very hard and will submit input at that stage, the vast majority of people comment only when they know about a specific development on their doorstep. My constituents and residents will be up in arms if they find out that 18 months ago a plan was approved that they were not aware of and certainly did not give any feedback on, and now they simply have to suffer the consequences.
That is an exceptionally good point. The other point I want to make about local plans being decided up front, with no subsequent planning permission, is that they cover a period of three years, and we all know how volatile the housing market has been over the course of the past three years. What was planned a few years ago at one of the two brownfield sites in my constituency—the Earl’s Court exhibition site—is definitely not what is being considered today. It is very important that we do not have one plan that stays in place for three years.
The other point that I want to make is also about localism. We should not have a standard national plan that every local authority adopts. We need the ability to adapt each plan to the local authority. I will give hon. Members an example from my local authority. We have fought very hard on basements, and we now allow only one additional basement. On my street a few years ago, a house went down three additional basements underneath lower ground floor level. Goodness—the terrace could fall down, but never mind. It is very important that local authorities can tailor things to their individual communities. There are good things in the White Paper. The move to digital first must be recommended, as must the move to beauty in design—although one person’s beauty can be another person’s something else.
[Ms Nusrat Ghani in the Chair]
It is a pleasure to serve under your chairmanship, Ms Ghani. I thank the hon. Member for Richmond Park (Sarah Olney) for securing this important debate and for putting net zero—there is a big gap—at the heart of her argument. I agree wholeheartedly with that.
I also thank the 11 Members or so who contributed—initially, 15 were down to speak, but it has been a case of shifting sands. I thank the right hon. Members for Chipping Barnet (Theresa Villiers) and for East Hampshire (Damian Hinds), my hon. Friend the Member for York Central (Rachael Maskell), the hon. Members for North Cornwall (Scott Mann), for West Worcestershire (Harriett Baldwin), for St Ives (Derek Thomas), for Totnes (Anthony Mangnall), for North East Derbyshire (Lee Rowley), for Crewe and Nantwich (Dr Mullan), for Warrington South (Andy Carter), and for Kensington (Felicity Buchan), and I certainly cannot forget our colleagues from Cornwall. We have heard their powerful voices today, and they are clearly showing off about being in tier 1. It has been a powerful, informed discussion and debate.
The proposals in the White Paper come at a time when we hear much talk about building, not just to solve the housing crisis but as a way to boost the economy, create new sustainable jobs, help us to meet the net zero goals and, very importantly, respond to the covid crisis. Some of the proposals, at first glance, are reforms that we on the Labour Benches welcome and have called for in the past—timely local plans, moving from the analogue, paper-centric world to the digital world, while not excluding others, and improving the quality and design standards. Yet people do not have to scratch beneath the surface to discover that the very heart of the proposals—the hon. Member for North East Derbyshire referred to the details—is a huge shift of control and influence from communities and local democracy to well-resourced developers and Whitehall. People across the Chamber have certainly said that.
In reality the proposals do little to build back better, more beautiful, or greener. In many cases they do exactly the opposite—a point made powerfully by the right hon. Member for Chipping Barnet. They create permitted development monstrosities, high rises, over-development, two-storey extensions on every house in suburbia, in every street, and give a green light, in many areas, to ghettos of houses in multiple occupation. We do not need more of those.
Coming on the back of a decade of austerity and the current economic crisis, the reforms are a further attack on councils. They strip away power and finance from local authorities and, with that, take away communities’ ability to have their voice heard throughout the planning process. That case was put forward powerfully by the hon. Member for Totnes.
The zonal approach of growth, renewal and protection is of particular concern. It risks creating a free-for-all in which well-resourced developers and associated lobbyists carve up our villages, towns and cities, creating further segregation, and encroaching on our green belt. The hon. Member for Warrington South (Andy Carter) and I share a border, in Moore. My concern is that the approach will do nothing of the sort—it will just maintain the status quo. Undoubtedly we will have a debate about that locally, but we have a shared interest.
The vast majority of councillors throughout the land believe that the proposals are undemocratic, including 61% of Conservative councillors. More than 250,000 supporters of the countryside charity the Campaign to Protect Rural England argue the same. I think we have all been lobbied by them—rightly, along with the Royal Town Planning Institute, the Town and Country Planning Association, the Royal Institute of British Architects, Civic Voice, and many more in and beyond the housing sector. Only yesterday The Times reported that the Prime Minister stood up for his constituents and took advantage of the very right that he wants to abolish for others, opposing a development in his constituency using the current system. What role does the Minister believe residents and councillors should have throughout the planning process?
As has been argued in the Chamber today, good place-making must keep planning local, not developer-centric and certainly not based on a diktat from a Whitehall algorithm. That algorithm instructs local planning authorities to build 161% more homes in London and the south-east but 28% fewer homes overall in the north—pouring concrete over London and the south-east, while hollowing out the north. How does that fit with the Government’s levelling up agenda for communities in the midlands and the north?
Like organisations such as the Woodland Trust, I would also like to hear the Minister’s comments about environmental protections in this White Paper. It is not at all clear how the Government can reconcile the proposals in the Environment Bill, and the Prime Minister’s comments about “newt-counting” do not exactly instil confidence that the Government take ecological or environmental protection seriously.
There are still 1 million unbuilt housing permissions from the last 10 years; I think the hon. Member for Crewe and Nantwich made that point. Yet the White Paper does nothing to explain how we will ensure that developers either “use it or lose it”—that is, lose such permissions. Also, the lack of any mention of social housing in the White Paper means that we will remain over-reliant on private builders and market cycles to get homes built.
If we are serious about maximising housing delivery and meeting building targets, the Government need to stop ignoring the answer that is right in front of them and build a new generation of social housing—and, yes, make it net zero. Just 6,500 homes for social rent were built last year. The White Paper on social housing, which was published recently, has some good things in it, but the key thing that it was lacking was a plan to build more social homes.
The Local Government Association found that in the last five years 30,000 affordable homes would have gone unbuilt if the Government’s proposal to scrap section 106 for developments under 40 or 50 homes had been in place, which would have affected rural areas such as Cornwall; I have to mention Cornwall again. Can the Minister set out the evidence behind the proposal to scrap section 106?
I would also like to hear from the Minister about the new levy that is being proposed to replace section 106 and the community infrastructure levy. We have had very little detail about how this new levy would work. The current proposals seem to mean that councils would provide up-front cash, and yet they would really struggle to fund infrastructure. So, more detail on that would be very much appreciated. Why are the Government continuing with their absurd extensions to permitted development? They know very well that such extensions create bad homes and blight communities; we have all seen examples of those things in our own communities.
I am pleased that the Minister, responding to our prayer against the recent statutory instrument in this area and a potential Back-Bench rebellion, finally recognised that space and light are important for human habitation; there must be at least minimum amounts of both. I urge him to go further and adopt some of the principles in the Healthy Homes Bill, to give local communities a voice again on these matters.
Members from all parties do not want streets, villages, towns and cities to be littered with inappropriate two-storey extensions that pitch neighbour against neighbour, and nor do they want high streets to be hollowed out, with former shops being converted into HMOs and wheelie bins flowing into the streets of the towns and cities that we represent. There is nothing beautiful, and nothing greener or better, about that reality.
In conclusion, we cannot cheat our way out of the housing crisis; building healthy and sustainable homes should be the response to this pandemic. However, clear and measurable targets for net zero are currently missing from these proposals. We should put communities at the heart of good place-making, strengthening and resourcing our planning system, and extending local democracy, to build good-quality housing for all.
It is a great pleasure to serve under your chairmanship, Ms Ghani. I shall do my utmost to respond to this wide-ranging debate in nine minutes. I congratulate the hon. Member for Richmond Park (Sarah Olney) on securing this debate. For her, Christmas has come early, as it has for other right hon. and hon. Members around the Chamber who have been able to express themselves eloquently and passionately on a matter that should concern us all. I will try to address all the points raised by colleagues.
I shall begin by trying to clear up a misunderstanding that has been abroad in this debate and has also been around for some time, which is about what happens to the existing planning system. What we are trying to do through the proposals that we have tabled is to create a quicker, more transparent planning system. When applications that vary from the local plan are made, however, they will still need to be made through the present planning application process. In conservation and protected areas, all applications will require a bespoke approach through the present planning system, so it does not go away. We simply want a quicker and faster process that we can also apply. I hope that clears up that particular matter.
Two consultations were launched on 6 August. The first, on the local housing need calculation, closed on 1 October, and the second, on the broader, more forward-looking reforms in our White Paper, closed on 29 October. We received 2,500 responses to the local housing need calculation and some 44,000 to the White Paper. The local housing need calculation was all about making sure that we address the issue of affordability, which we know is a challenge in many communities around our country where housing is simply too expensive for many people to achieve. We all recognise that we need to do something about that.
We also need to make sure that we regenerate our communities and level up, and ensure the best use of brownfield. Those are considerations in our local housing need calculation. We also, to address the points raised by my right hon. Friend the Member for Chipping Barnet (Theresa Villiers) and others, need to be very clear about the challenge of building tall buildings in places that do not have them and do not want them because they are simply not appropriate.
It is not for me to try to play Santa Claus in this debate. My ministerial portfolio does not include responsibility for the festive season, but I hope that my right hon. Friend the Secretary of State will be able to say something soon about local housing need. This debate is focused particularly on the White Paper on planning reform. I am sure all of us will recognise that with so many responses to the consultation, it will take us a while to work through them. We want to do that because it is a genuine consultation, as I have said to colleagues across the Chamber on numerous occasions.
The consultation was not the end of the process of working through our reform proposals; it is the beginning. Through the first several months of next year, we will need to kick off workstreams on specific themes that develop out of the consultation, and to refine our proposals such that they are good and tight for the legislation that must and will come. That will enable us to table a Bill to deliver quickly the planning reforms we want, begin the systemic and cultural change necessary in our planning system, and ensure that the proposals are embedded, with public consent, as quickly as possible.
When I became the Minister with responsibility for housing and planning, I learned how long it took to implement the Town and Country Planning Act 1947, which we rely on for the majority of our planning decisions. I assumed that by 1948 everything was working effectively and quickly and everybody knew what to do. In fact, that particular Act was not fully enforced until the early 1960s. The Town and Country Planning Act 1990 took 14 or 15 years to fully roll out. The Planning and Compulsory Purchase Act 2004 and the Localism Act 2011 have still not been fully implemented. My point is that we need to approach this with care, think through our proposals with as much consensus as possible, and ready all the stakeholders in the planning process so that we can effect that cultural and systemic shift. That is our approach and it will remain as such over the coming weeks and months.
We all agree that we must reform our planning system. My hon. Friend the Member for Kensington (Felicity Buchan) was kind in her remarks: she said that the Government have done very well in building new homes for people over several years. Our target is to build 300,000 new homes a year by the middle of this decade. That is a manifesto commitment that we will deliver.
The fact is that our present local planning system accounts for only 178,000 new homes a year, so the system must improve. Organisations as disparate as Crisis and KPMG all say that we need to build more than 250,000 homes a year if we are going to meet our needs. Therefore, a system that takes seven years to adopt a local plan, and which can take a further five years to develop large-scale housing and the infrastructure that supports it, is simply not going to build the homes we need.
The hon. Lady makes a fair point. It is for local councils and local authorities to determine what sorts of housing they need in their local communities. The whole point of our proposal is to give local authorities and communities much more power to design their communities strategically and holistically, so that they can say where they want homes to be built; the types of homes they want them to be; what they are going to look like; what sort of infrastructure is going to support them; and what the building requirement controls will be.
We want to make sure that we build more affordable housing. Members will know that our affordable homes programme injects £12.2 billion of funds into affordable housing, which is the biggest cash injection in 50 years. More than 50% of the properties that will be built under that programme in the next five years will be for affordable or social rent. Some 32,000 of them will be for social rent—double the number built under the previous programme and substantially more than the number of council houses built in Wales last year. Only 12 council houses were built in Labour-run Wales in 2019. Thanks to its approach to council housing, the Labour party cannot even house a Welsh rugby team in Wales, so we will take no lectures from the Opposition about our approach to affordable housing.
In the short time I have left, let me say a word about the environment, because it is important. Through the Environment Bill, we want to make sure that we offer a net gain in biodiversity. That will form the basis of our approach to housing proposals, as adumbrated in our White Paper, including the future homes standard, which will drive a 75% improvement in carbon emissions from our new housing stock. The green homes grant will invest in and retrofit about 600,000 homes around our country, ensuring that they are more fuel efficient and effective in delivering for their residents.
We are determined to make our proposals work and to ensure that all our colleagues around the House of Commons, of whatever stripe, as well as other stakeholders, understand and support them, whether they be planning professionals, local councillors, local communities with neighbourhood plans—which I am keen to build into our process—or developers, big or small. We are determined to make sure that these plans have the wholehearted support of all those involved in them, because only through that mechanism can we make them work.
Thank you, Ms Ghani. It has been a real pleasure to serve under your chairmanship. I thank the Minister for his comments. He did not fulfil my every Christmas wish, but this has nevertheless been an entertaining and interesting debate, and I value everyone’s contributions. We have heard from representatives of the rural south-west, the urban north, and even the urban south-west, and the theme I am really getting is that planning decisions are incredibly difficult. There is a balance of competing interests; we all know that, and we are all plugged into what is going on in our constituencies.
I also heard that everybody agrees that those decisions are best made at a local level, to take a full account of all of those different factors, and I believe that is the biggest pushback against the planning White Paper in its current form. I repeat what I said at the beginning: it does not make enough progress towards the Government’s plans for net zero. The Minister just said it himself: he is only targeting a 75% reduction. Another point that has come across very strongly is that the White Paper does not give local councils enough powers to deliver the affordable homes that are so desperately needed in every region. However, I thank him very much for his response. Thank you, Ms Ghani, for your chairmanship, and I thank all Members for their contributions.
Question put and agreed to.
That this House has considered the Planning for the Future White Paper.
Welsh Food: Protected Status
I remind hon. Members that we have made some changes to normal practice in order to support the new call list, and to ensure that social distancing can be respected. I remind Members that they must arrive at the start of the debate, and also ask everyone to respect the one-way system and to please sanitise microphones and everything that they may be touching before they exit the room.
I beg to move,
That this House has considered Welsh food and protected status.
Môn Mam Cymru translates to “Anglesey, the mother of Wales”, and this name reflects the fact that our island once fed the entirety of Wales from its green pastures. We can still see some of the nearly 50 windmills on the island that once produced the wheat that fed Wales. My constituency has a long and proud history of producing the finest British food, and that tradition continues today.
The industry is visible all over our island, from the lush rolling fields filled with cattle, sheep and crops, to the beautiful oceans from which Halen Môn extracts all of its Anglesey sea salt and Holyhead Shellfish takes its catch. The hard work of our farmers is evident as my family and I tuck into roast lamb from Raymond the butcher in Holyhead on a Sunday: we can taste the extra effort that Anglesey farmers such as Gwilym Williams and Will Edwards put into their produce. It has been a pleasure to visit so many of the food producers on Ynys Môn, from The Marram Grass restaurant in Newborough, which uses produce directly from its own farm, to The Lobster Pot in Church Bay, which has been supplying top-quality, fresh, sustainably sourced seafood for 65 years, and is run by the third generation of the Wilson family.
Every year, the island’s talent is on display at the Anglesey county show at the Mona showground, an event that dates back more than 200 years. Many of my constituents have wonderful memories of the food on offer at the show, including one of my staff members, Bethan, who tried her very first pizza there at the age of 13. All types of food and drink are showcased, including Condessa Welsh Liqueurs, which are produced on the island but sold across the UK, and Hooton’s Homegrown, which grows its own fruit and vegetables and rears and butchers its own livestock. The show is also an educational opportunity, with NFU Cymru, the Farmers Union of Wales, the Country Land and Business Association and Ffermwyr Ifanc having stalls to discuss the work they do representing the farming community.
I have invited the Prime Minister to the Anglesey County Show next August and I am looking forward to showing him around. Anglesey’s agricultural food and drink industry is also part of a larger community of inspiring producers across Wales, which has a proud history of excellence in food. Last year, businesses in the Welsh food and drink supply chain had a turnover of more than £22 billion. We have nearly three times as many people working in hospitality and food on the island than the UK average.
I am thrilled that the quality of Welsh food is being recognised globally as well as nationally. In order to mark the enhanced quality of these goods, it is vital that we continue to give them the geographical indicators that inform customers nationally and internationally of their first-class standard. That is why I am pleased that the UK Government will establish the new UK geographical indication schemes at the end of the transition period. Existing UK GI products, including favourites such as Welsh lamb, Scotch whisky and Cornish pasties, will continue to receive protection under the UK GI schemes. The GI schemes offer a range of benefits to UK producers and both domestic and international customers.
The GI scheme includes Welsh beef and lamb, both of which are important to the farmers on my island constituency of Anglesey.
I congratulate my hon. Friend on securing this debate. Last year the Vale of Clwyd Denbigh plum was awarded protected designation of origin status. [Hon. Members: “Hear, hear!”] Indeed. Does my hon. Friend agree that protected status for food and drink can be a source of great community pride as well as an economic benefit?
I congratulate the hon. Member on securing the debate. I fully agree with her on the importance of protected indicators. A few applications for Welsh produce, such as Gower salt marsh lamb and Cambrian meat, have been going through the European certification process but have not been able to complete it. Does the hon. Lady agree that it is a good idea that these products and others that started the European journey are prioritised under the new UK scheme?
I absolutely agree that Wales does punch above its weight. Welsh lamb and beef have long been recognised for their quality. Our farmers practise high standards of animal husbandry and pastureland management, working primarily on family-run farms. That means that, when people see the prestigious GI mark on our meat, they will know that those lambs and cattle were born and reared in Wales, that they roamed freely and ate from our lush, naturally watered pastures. All of that means that customers are assured that the meat they are buying is of the very best quality.
Welsh products make up 10 of the 12 most recent GI applications for the UK, showing the position of Welsh farmers and producers at the forefront of this important scheme. The Welsh holders of GIs make best use of the opportunity made available to them, working collaboratively to support each other’s businesses. Producers often support and champion each other to grow together. That feeling was echoed by Fay Francis, the GI consultant, who recently spoke to members of the all-party parliamentary group on geographically protected foods, who said,
“Wales has an impressive ‘family’ of Welsh GI products which promote the heritage and culture of Wales. Hopefully, with the UK GI scheme, Wales will have more new GI applications from Welsh producers who recognise the potential value attaining GI status can have for their business.”
As we prepare for our departure from the European Union, we are investigating methods to ensure that the high standards of British goods enhance our trade opportunities overseas. To that end, the UK Government are working with their global trading partners to transition the EU free trade and other sectoral agreements. We are exploring the potential for new agreements with international trading partners, including commitments relevant to the recognition and protection of UK GIs, and GIs from the rest of the world. As GIs represent around 25% of UK food and drink exports by value, approaching £6 billion in export value, it is clear that they will play a central role in future trade.
The recently announced UK-Japan comprehensive economic partnership agreement is an example of how we will offer new protection for more iconic UK goods in future. That will clearly improve the awareness and recognition of key UK brands within the Japanese market, which includes protection for Anglesey sea salt from my constituency.
I know, having spoken with my hon. Friend the Member for Rutland and Melton (Alicia Kearns), who chairs the APPG on geographically protected foods, about the clearly huge significance that the status can have for businesses. My hon. Friend has many protected foods in her constituency: Rutland bitter, Stilton cheese and the delicious Melton Mowbray pork pie, whose GI was vital to stop external manufacturers counterfeiting the economically valuable Melton Mowbray moniker. My hon. Friend the Member for Copeland (Trudy Harrison) has the celebrated Lakeland Herdwick sheep in her constituency. The meat from those sheep is famous for its flavour, which is, of course, second only to Welsh lamb.
I also welcome the new research funded by the UK Government recently which will advise on how to better promote UK GI brands and underpin a new promotional strategy. Over the coming weeks and months, we will see an increased awareness of our GI brands, within the UK and overseas. GIs not only give a quality mark when a product is retailed, but they have a natural affinity to food tourism. The Welsh products with GI status epitomise our culture, heritage and tradition. Tourists and locals alike flock to events such as the Beaumaris food festival to sample local delicacies ranging from cheese to ice cream and sausages to cider, all made using high quality, locally sourced produce.
One of the first geographical indicators awarded in Wales was for Halen Môn, Anglesey sea salt, which has opened an award-winning saltcote and visitor centre, encouraging tourists to learn about the production process and purchase their products. On my recent visit, I appreciated the opportunity to learn more about its products and meet the wonderful staff, including Eifion Jones, the dispatch team leader. As the UK county most dependent on tourism, it is vital that Anglesey’s businesses take every opportunity to boost revenue and re-invest in our community.
I would like to end by asking the Minister to confirm that the UK Government will continue to invest in the new scheme to secure its future. Do the Government recognise the importance of supporting food producers, especially post-Brexit? Is her Department working closely with the Department for International Trade to bring meaningful benefits to food producers? I look forward to a future where Anglesey sea salt is found in the finest foreign cuisines all over the globe and Welsh lamb and beef are even more recognised delicacies internationally. I especially look forward to tasting more food that is awarded the special recognition of a geographical indicator.
We are soon approaching our departure from the European Union and across the country a year of unrest has led to concerns about the opportunities for businesses in the upcoming years. As the party of business, we must open doors for UK producers. One of these is the geographical indicator that elevates our products above their world-wide competitors and drives success for their owners.
It is a great pleasure to serve under your chairmanship, for the first time, Ms Ghani, and an enormous pleasure to speak in this very important debate. I congratulate my hon. Friend the Member for Ynys Môn (Virginia Crosbie) on securing this debate on a fascinating topic. Everybody in the Room feels passionately about it and has spoken with such enthusiasm, both in the Room and outside while we were waiting.
I was not surprised to hear all Members talk about great Welsh food. Wales is home to the UK’s highest concentration of protected food and drink products, with a total of 16 protected products. I was brought up partially by my grandmother, who is 97 and avidly waiting for her covid vaccine in a care home on the Gower. She is somebody who believes that food is only good if it comes from Wales. She routinely used to turn up at our house when I was a small child,—and still would if she were able to travel at the moment—with a ham and a leg of lamb under her arm.
This became slightly more difficult when my aunt moved from South Wales to Sierra Leone. Granny set off to visit, as she was wont to do, with the leg of lamb in her suitcase. The leg of lamb sadly got lost in Sierra Leone airport and travelled around five African countries that we know of—it had stamps from them all—before reaching my aunt’s house, where, sadly, it was only fit for burial in the garden. My cousins, however, were equally excited—they were little girls as well, this is all over 40 years ago, I am sorry, but I think it is relevant to the debate today—
They were waiting for the chocolate biscuits, which were packed with the leg of lamb and had also travelled around Africa. Needless to say, they got eaten. I was brought up clearly knowing that Welsh lamb was far and away the best in the world and that other Welsh products, including laver bread, to which I know the hon. Member for Ceredigion (Ben Lake) is partial, are pretty good too. The Denbigh plum is of enormous interest to my own family, as plum growers for many years. I am pleased to confirm to the House that the Government will launch the UK GI schemes on 1 January. The new schemes will ensure that all existing UK and EU GI products will continue to receive protection under the schemes.
The fabulous APPG for geographically protected foods, which is so well led by its joint chairs, are working hard on this, and I understand that they are very keen—when covid restrictions permit—to have a launch event in the House for a new GI scheme. I would be very excited to attend and to try all the great produce that I hope will be available. I am happy to reassure hon. Members that, in addition to receiving protection under the UK schemes, all current UK GIs, including all Welsh products, will continue to receive protection in the EU and through future international trade agreements.
When the new UK GI schemes are launched in the new year, the Department for Environment, Food and Rural Affairs will seek to work with producers across the four nations, including, of course, in Wales, to use GIs as a tool to showcase our great British products, both in the UK and overseas. I really hope that logo will have sales value abroad; we are working closely with the Department for International Trade on that.
Welsh exports will be essential to our efforts to grow our collective reputation for quality food and drink around the world. Overall, the UK’s GI products represent about 25% of UK food and drink export value, which was about £6 billion last year, and we hope that will grow exponentially. I would also like to take this opportunity to thank Welsh producers, including the Anglesey Sea Salt Company in the hon. Lady’s constituency, for their contribution in helping us to develop those smart new logos. I am sure hon. Members from across the House will be as delighted as I am to see the new logos on our products in the future.
I would like to thank everybody who has taken part in this debate. As we launch our new GI schemes in the new year, I encourage hon. Members from across the House to engage with DEFRA to help us to identify new opportunities for food and drink producers in Wales, and beyond.
Question put and agreed to
Covid-19: Effect on People with Learning Disabilities
I remind the hon. Members that we have some changes due to covid and that we must observe social distancing rules. Before they exit, Members should wipe down any surfaces that they have spoken into or touched. I will call Members according to the list in front of me.
I beg to move,
That this House has considered the effect of the covid-19 outbreak on people with learning disabilities.
It is a great pleasure to serve under your chairmanship, Ms Ghani. I thank all colleagues and hon. Members for attending this debate.
Health inequality for people with learning disabilities has been evident for decades; even during non-covid times, there were three preventable deaths every day. In 2004, it was reported that 37% of deaths of people with learning disabilities were preventable, and, in 2017, the Equality and Human Rights Commission found that 42% of people with learning disabilities died prematurely.
Despite clear data showing those disproportionate health inequalities, very little has been achieved in tackling the issue in the intervening years. The pandemic has highlighted the issues that many people with learning disabilities face and the lack of understanding in our society of their needs. Things need to change, and quickly; these are deaths that can be prevented and lives that should be lived.
The pandemic has provided a wave of challenges for the NHS and care systems; we do recognise the workers there for their hard work and their sacrifices. However, underlying the struggles faced by the NHS this year are 10 years of austerity and cuts to our public services. It is the most vulnerable who suffer most from these cuts.
In addition to the historic health inequalities, the pandemic has only made things worse and had an even greater, disproportionate impact on people with learning disabilities. They face reduced access to vital care and support, as well as to valued activities and day centres. Increased isolation and loneliness, during the lockdowns, have also had a profound effect on their mental health and will leave lasting effects on their health and wellbeing.
This isolation and loneliness is exacerbated because people with learning disabilities are less likely to have access to technology, which so many people relied on to stay in touch during the pandemic. Professor Jane Seale from the Open University found that, before the pandemic, there was evidence to show that people with learning disabilities already experienced significant digital exclusion, and that this had a devastating impact on their mental health and wellbeing.
A number of my own constituents have been in touch to raise these issues and to tell me how important it is for people with learning disabilities to have some kind of normality—or, at least, access to specialist activities and day centres. One of my constituents was worried that they were not able to take their son to a disabled swimming club—which the son had been attending for years and finds extremely beneficial—because it was across the border, in Wales. Can the Minister clarify that exemptions for cross-border travel exist? Will she make the guidelines easily accessible to ensure that people with learning disabilities are able to access valued activities and care, during the pandemic, without any extra anxiety?
People with learning disabilities have always been more likely to die in hospital, but during the pandemic that percentage has been particularly high. Perhaps one of the main issues that has led to their disproportionate deaths is the lack of awareness and understanding about people with learning disabilities and their needs. The learning disabilities mortality review found that during covid, in 21% of cases that indicated a need for reasonable adjustments—such as the provision of specialist learning disabilities services in hospital, tailored care provisions, or ensuring that the person was supported in an unfamiliar setting by those who knew them—the adjustments were not made.
During the height of the pandemic, specialist learning disabilities support was one of the most requested reasonable adjustments. However, many healthcare staff have been redeployed—working in unfamiliar environments, stressed and exhausted—making it harder to provide the adjustments and specialist care needed for people with learning disabilities. One nurse commented that she was
“redeployed for four weeks to another ward. During this period there was no specialist learning disability service provided across the Trust.”
Additionally, during the pandemic, a parent or carer simply not being able to accompany a patient with learning disabilities to the hospital can have profound results. Official guidelines stated that non-essential persons were unable to accompany covid-19 patients in ambulances or in hospital, but no definition of “essential” was provided; it was often left as a decision for the healthcare staff. Many people with learning disabilities struggle to communicate—especially in unfamiliar settings—and rely on their carers. Such a lack of communication placed patients at an even higher risk. Will the Minister work with the public health bodies across all the nations to review their guidance to ambulance and hospital services on that important issue? The lack of ability to communicate, and often the lack of specialist training, means that many non-verbal cues such as posture, gestures and general body language are often missed. That has become even more serious during the pandemic as the number of remote consultations and the reliance on the NHS 111 service has increased. NHS 111 is heavily reliant on algorithms, but the specialist care needed for people with learning disabilities cannot simply be picked up by an algorithm. We need an urgent review of the service and whether it is the right way to treat people with learning disabilities.
One of the biggest factors in preventable deaths is diagnostic overshadowing, which is when changes in behaviour are simply attributed to the individual’s learning disability and not investigated further as separate symptoms. My main inspiration for seeking the debate was my constituent Angela, who has led a vocal and active campaign to improve healthcare for people with learning disabilities following her experiences with her son. Parents and carers are crucial to helping to determine if something is wrong with their child. People with learning disabilities do not always demonstrate pain in the same way as other patients, so they cannot always express that something is wrong. Angela’s son was in pain and she knew it, yet healthcare staff refused to listen to her and just attributed her son’s pain to his learning disabilities. It was later revealed that he had a severe case of appendicitis. Their story was later used as a storyline on “Casualty”.
Training specialised nurses for people with learning disabilities is a good step forward, but that must be supported by a widespread understanding of learning disabilities across healthcare staff. The ability of all healthcare staff to provide reasonable adjustments or to be aware of the need just to listen and take parents or carers seriously could be a matter of life and death. Will the Minister therefore commit to providing adequate support to improve the understanding of learning disabilities across all healthcare staff and ensure that all people with learning disabilities are prioritised for face-to-face consultation and care?
People with learning disabilities have faced other huge healthcare challenges. Throughout the pandemic, hundreds of people with learning disabilities have been wrongly—in some cases unlawfully—denied potential life-saving treatment. At the beginning of the first wave of the pandemic, the National Institute for Health and Care Excellence published new guidance on the treatment of patients in critical care, grading them on a clinical frailty scale. The guidelines suggested that those who cannot do everyday tasks such as cooking, handling or making money or performing personal care independently would be considered frail and, as a result, not receive intensive care. All of those tasks are often difficult for people with learning disabilities, but that does not make them frail. I believe the policy was hastily reversed in April, but it has had ongoing damaging consequences, and many individuals with learning difficulties still have do not attempt cardiopulmonary resuscitation orders and do not resuscitate notices on their records without their knowledge. I welcome the Secretary of State’s requesting that the Care Quality Commission looks into inappropriate use of DNACPRs, but will the Minister commit to ensuring that all people with such unjust DNR notices are identified and that those notices are removed from their records to ensure that they can receive intensive care treatment that may save their lives?
Furthermore, in March 2020, the policy of rapid discharge was introduced, leading to thousands of patients being discharged prematurely, discharged without support, discharged to care homes without being tested and discharged into unfamiliar settings with unfamiliar staff who were unable to meet their needs, all of which have a huge impact on people with learning disabilities and are wholly avoidable. I hope we are moving away from that.
Finally, I wish to draw attention to how the pandemic has affected young people with learning disabilities. Statistics show that when it comes to preventable deaths, young people with learning disabilities are worse affected than older people. However, healthcare was not the only factor that greatly affected young people with learning disabilities. Children with learning disabilities or special educational needs faced challenges in education even before the pandemic. Lockdown, the closure of schools and cutbacks to additional support services during lockdown therefore raised new challenges and had specific implications for children with special educational needs, in terms of their learning support, structure, routine and behaviour. Although organisations such as Scope and the National Society for the Prevention of Cruelty to Children have produced resources for parents, achieving a constructive learning environment is likely to have proved extremely challenging in many cases.
Matters were made even more challenging as the supplementary support and activities provided outside school, which promote children’s wellbeing, provide social engagement and routine, and act as an additional resource for parents, were also affected by lockdown. The Petitions Committee highlighted an e-petition that asks for an urgent extension of the statutory age limit for special educational needs provision due to the effects of covid-19. I thank everybody who signed it, and I hope this debate covers their concerns. Young people with learning disabilities often rely on going out in order to learn life skills. They must not be left behind as a result of this pandemic.
Professor Sam Parsons of University College London and Lucinda Platt of the London School of Economics found that the disruption to routine caused by lockdown can be particularly negative for children with special educational needs and can exacerbate behavioural problems. A lack of structure has negative impacts on the social and emotional development of children with learning disabilities and exacerbates mental health problems. Their research also suggests that, given the need for additional educational support, difficulties in catching up are likely to be exacerbated for children with learning difficulties, so ensuring that local authorities have adequate resources to provide services for those children will be even more important in the coming year, following the current disruption to their education and support. What steps will the Minister take to ensure that adequate funding is provided to support children with learning disabilities and special educational needs properly in their education following the school closures during lockdown?
Many of the figures and stories I have mentioned today are shocking, but sadly for many that is the reality and the norm. Some 37% of deaths of people with learning disabilities were preventable. That is simply not acceptable. We must work together to ensure that people with learning disabilities are not an afterthought when it comes to healthcare, education and day-to-day life. More needs to be done to understand their needs properly and give them the support they deserve. The pandemic has shown that the social care system is at breaking point. The Government must provide adequate funding for the care sector and learn from each death of a person with learning disabilities to ensure that those disproportionate and horrific inequalities do not continue.
Thank you, Ms Ghani. In the time-honoured words, it is a pleasure to serve under your chairmanship. From the bottom of my heart, I thank the hon. Member for City of Chester (Christian Matheson) for bringing forward this debate. I know from my three and a half years’ experience in this place that he treats any subject that he chooses with sincerity and dedication. That is recognised across the House, and we are thankful for that.
I will make the slightly boring point, which many Members have heard me make before, that I represent the most remote and distance-challenged constituency in the UK—or one of the two most remote. Therefore, when it comes to connectivity and empowering people who have learning disabilities, there is a big challenge because we do not have 3G in many places and people just cannot go online. I think I am duty-bound to put that on the record. Hopefully, between the Scottish Government and Her Majesty’s Government in Westminster, we will eventually address the issue. In the meantime, I have that fundamental stumbling block that gets in the way of it all.
It is very easy in one’s family life to think that learning disabilities are for others. People do not think that it is going to come close to home, but in my case it did. My daughter—can you believe this, in this day and age?—went undiagnosed as dyslexic until she went to college. On her first or second day, she came back with that astounding news and said, “They say I’m dyslexic, and I am getting a free laptop.” That empowered her in a way that she had never been at school. She struggled with written answers, getting the letters in the right order and so on. That is not a very severe case, compared with what the hon. Gentleman has been talking about, but it brought it home to me that the idea that technology can tackle this issue is for real.
I give credit where it is due. It would be very churlish of me not to say that I welcomed the Chancellor of the Exchequer’s announcement in the spring that he would be scrapping VAT on electronic publications, which was a seriously good move. With that in place, the challenge remains how we get the electronic publications to work on a Kindle or whatever people use. I will not repeat myself on that, as I think enough has been said for the record.
I move on to a second personal anecdote. I have been within my family bubble during this wretched pandemic and have found myself in situations with relatives young and old—I make no apology for digressing into the issue of older people, because they are connected—who say, “I have my desktop computer,” or iPad, or iPhone, “and it’s been great, but I’ve been sending emails and they’re not going anywhere. I don’t understand.” I have had to say, “I’m afraid they have gone to the outbox.” I have to sit down and say, “This is what you do.” Just a few days ago, someone said, “I have a Zoom meeting with a loved one, but I don’t know how to work Zoom.” I would then sit down and say, “This is how you do Zoom. This is what happens.”
My point is that there are people with learning disabilities in remote parts of my constituency. If they have a connection, that is great, but to start it all off they need the tuition. They need somebody who can come in and say, “This is what is not working for you,” because the collapse in morale when the iPad or whatever does not work is almost counterproductive. It leads to people putting the device on a shelf and saying, “I’m not going to bother with that. I’ll just be lonely and miserable.”
There are two points that I want to make to our friend the Minister. The first is that, in a general sense, it would be good if we were sure that professional carers, either state or private, who go out to help people young or old had an element of IT training, so that as and when a person has been helped to dress, or whatever the need was, the carer can then say, “Ah, you’ve got a problem. Let’s see what I can do for you. This won’t take two minutes.” That would be good.
My second plea is about the provision of services for people with learning disabilities, regardless of whether they live in Strangford, the City of Chester or the highlands of Scotland. We have a great expression in Scotland, which the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) will know: we are all Jock Tamson’s bairns—we are all John Thompson’s children. It means we are all the same; we are all egalitarian. That is something we hold dear to our hearts in Scotland. We are all Jock Tamson’s bairns, regardless of whether we live north or south of the border, or whether we live in Wales or Northern Ireland.
My plea is for a co-ordinated approach between Her Majesty’s Government and the devolved Administrations to tackling this issue, because learning disability is no respecter of borders. People with learning disabilities have a fundamental human right to a quality of life, which the technology can offer. As the vaccine is rolled out, and as we have discovered what we can do with virtual technology, the challenge for the Government is to ensure that the technology now sticks and remains in place to benefit people with learning disabilities. This debate is about offering such help to the youngest, but we should also extend it to older people—although I am chancing my arm on that one.
It is a pleasure to serve under your chairmanship, Ms Ghani, and I congratulate my hon. Friend the Member for City of Chester (Christian Matheson) on securing this important debate. I want to start by extending my gratitude to all those working with people with disabilities, particularly in the education system and wider social care system, during these incredibly difficult times.
We know from our family members about the challenges that children are facing with their learning. Of course, those challenges are even greater for children with special educational needs and disabilities. Like colleagues, I have seen that in my constituency. The transition from face-to-face learning during the first lockdown to using technology has presented some challenges, particularly for young people who have learning disabilities. Of course, adults who need social care and support face huge challenges, as we have already seen. Along with other agencies, local authorities have been on the frontline in trying to protect them, but they have been doing so in the context of a decade of austerity.
In my borough, we have seen a £200 million funding reduction over a decade. That kind of austerity in public service provision does not come without consequences: it has a knock-on effect. When we faced the pandemic, we saw local services that were on the edge in any case having to support those who really need support. The reality is that we have seen the virus have a bigger impact on those who are particularly vulnerable. As we have already heard, this group faces huge vulnerabilities.
According to Government figures released in October, almost a fifth of pupils with special educational needs are currently absent from school. To compound that, only 6.5% of parents of children with SEND said that their online home learning platforms were accessible, according to the National Education Union. The evidence is clear that the education system is not able to cope effectively in responding to the needs of young people with disabilities. It is well documented in recent reports on differential impacts that there is a higher prevalence of deaths among black and Asian minority ethnic groups. Also, according to Public Health England, people with learning disabilities were up to six times more likely to die from covid-19 during the first wave of the pandemic. That is shocking, and it requires action by the Government to make sure that we learn the lessons, just as we need to learn the lessons on the differential impact in terms of death rates among black and Asian minority ethnic groups. Of course, it is important to understand these intersectional issues and the interactions relating to those in minority groups who also have a disability.
We face more restrictions in the coming weeks in London and the south-east and are now in tier 3, so when the Minister responds, will she explain what actions the Government are taking to protect this vulnerable group—particularly those with disabilities—to ensure they are getting the support they need? Since 2010 we have seen reductions, as I said, in local government funding and, despite the Government’s commitment to give the resources that local authorities need, the reality during the pandemic is that the extra burden and costs of covid in boroughs such as mine have not been fully met. That is having a knock-on effect on services, including services to those who need adult social care and young people with disabilities in need of additional support.
As for schools, a number have already said to me that the additional cost of making sure they are covid-secure has been between £50,000 and £100,000, depending on the school and its population size. It is important that the Department of Health and Social Care works closely with education to make sure that the institutions on the frontline protecting those who are vulnerable and those with learning disabilities get the support they need, and take action to prevent further loss of life.
On the funding shortfall, my local authority still has a £30 million shortage just because of the cost of covid. When the Minister responds, will she update us on what she is doing with other Departments to make sure that local authorities and other providers, including frontline care providers and education providers, are getting the support they need, particularly during the coming months, until we get a proper implementation plan for the vaccine, especially for the most vulnerable, as are many in that group?
I want to highlight some of the challenges facing my constituency. Some 60% of children live in poverty, and unfortunately we have one of the highest rates of children with autism in the country, not to mention severe overcrowding. That is why my constituency faced the fourth highest age-standardised death rate in the country, despite having a relatively young population.
These systemic challenges and the plight of those with disabilities mean that the situation is serious, which is why it is really important that the Government look carefully at the evidence and data, and respond with resources and support based on need, rather than other considerations. That is how we will be able to protect the vulnerable in our communities. My plea to the Minister is to provide the support that local authorities and other providers urgently need. If she can, I will be grateful if she can update us on what steps her Department in particular is taking to address the differential death rates for those with learning disabilities, as the Public Health England report highlights.
It is a pleasure to serve under your chairmanship, Ms Ghani; I appreciate the generosity of spirit you have shown in calling me to speak. I congratulate the hon. Member for City of Chester (Christian Matheson) on securing the debate.
There is no doubt that the pandemic has had a huge impact on people with learning disabilities. As was mentioned, the recent Public Health England report identified a much higher death rate among people with learning disabilities. Particularly worryingly, it found that the gap is even greater for young people. The death rate for people aged 18 to 34 with learning disabilities was 30 times higher than those in the same age group without disabilities. I expect some of that relates to the overlap with other physical health conditions that are present at a higher rate in this population, as the report alludes to, but I do not imagine it will be the entire answer to why people with learning disabilities have suffered as they have in the pandemic.
My speech will focus on an issue that has been brought to my attention as a local MP: the risk of economic consequences that the pandemic poses.
Sitting suspended for a Division in the House.
To continue, I will focus today on the risks that the economic consequences of covid pose to the job opportunities of people with learning disabilities. Locally in Crewe and Nantwich, there are a range of organisations that try to find job opportunities for people. Organisations such as Safe Opportunities and Seetec Pluss, employers such as AO.com and charities such as Community Recycle Cycles have all worked tremendously hard, and secured successful and ongoing employment for people with diagnoses associated with learning disabilities, such as Down’s syndrome and autism.
Those organisations are understandably concerned about the impact the covid-19 pandemic we will have on their ability to carry on delivering this work. We know that even before the pandemic there was a significant gap in the employment of those with learning disabilities. I have heard from residents who have struggled to find work because of their disabilities, and from their families. Recently, I took part in a meeting with Scope that explored this issue and heard from people with lived experience of it.
What might happen now? Employers might rightly be concerned about the health risks their employees could face, given what we discussed earlier regarding the additional risks that we have seen for people with learning disabilities. If we are being realistic, employers who are laying people off and struggling to make ends meet might not go as far as they ordinarily would to try and stretch people’s employability and support people into employment who have disabilities of any kind, including learning disabilities. That is the reality we will face.
Nevertheless, we cannot afford to have a lost generation of young people with learning disabilities who have missed out on employment that they would otherwise have been able to secure. The Disability Confident campaign was launched by the then Prime Minister in 2013, and it aims to encourage businesses to employ disabled people. By December 2019, more than 15,000 employers had signed up to the scheme, as they wanted to offer disabled people roles in their organisations.
There are also local initiatives. As I mentioned, we have an organisation in Crewe and Nantwich called Safe Opportunities. It has launched a campaign called Big10forSEN, which is building towards having 10 big employers locally that are putting in the effort to secure employment for people with learning disabilities.
There are other measures available. There is the 2017 personal support package, which gives people access to a disability employment adviser, and the Access to Work scheme, which provides financial support for the extra costs of being in work that go beyond the reasonable adjustments that are required in law. As part of the Access to Work scheme, specialist support is provided to people with learning disabilities and other less visible disabilities through a hidden impairment specialist team.
In response to the pandemic, the Department for Work and Pensions has worked tremendously hard to develop policy to prevent ill health-related job losses, but we must not forget the Government’s ambition to get 1 million more disabled people into work by 2027. We cannot allow the coronavirus to prevent that from happening.
It is a pleasure to serve under your chairmanship, Ms Ghani. I thank my hon. Friend the Member for City of Chester (Christian Matheson) for securing this important debate, which is well overdue.
I have had many messages from people who have been worried about changes to services during this crisis and about the impact that the crisis has had on their day-to-day living, with many describing it as devastating. I serve on the Public Accounts Committee, and last week we heard from care home witnesses that those with learning disabilities were
“very much ignored at the start of the pandemic.”
We were discussing the provision of personal protective equipment in care settings, but it is fair to say that many people feel that way about the whole pandemic.
Too often, people with learning disabilities have been an afterthought throughout this public health crisis. That is entirely the wrong approach because we know that the health outcomes for those with learning disabilities are poor. While more research into the impact of covid-19 is needed, what we know so far is damning. As has been pointed out, those with learning disabilities have a death rate that is 4.1 times higher than that of the general population, and 30 times higher than for those aged 18 to 34. Access to easy-read information was also raised with me, as were concerns about good public health messaging.
As if those figures were not worrying enough, many disability rights campaigners, including myself, were alarmed at the NICE guidelines for intensive care unit referrals, which seemed to actively discriminate against admitting people with learning disabilities into intensive care or life-saving treatment. I am glad that NICE has updated the guidance, but the episode shines a light on the way people with learning disabilities have been treated throughout, and perhaps before, this crisis.
As the chair of the all-party parliamentary group on special educational needs and disabilities, I have heard first-hand testimony about the huge amount of added pressure on young people and their families throughout the crisis, including the difficulties accessing education online, which my hon. Friend the Member for City of Chester described; access to hydrotherapy disappearing; other therapeutic interventions being withdrawn from schools; and a host of other issues. We will be publishing our report and recommendations early next year, which obviously go broader than learning disabilities. It is clear that, after years of being a Cinderella service, provision for children and young people with learning disabilities is already very stretched. We are badly positioned to support some of the most vulnerable people through this crisis, and that needs to improve.
I am also concerned about the delay in the publication of the SEND review. That is worrying as there is urgent work to be done in that area. The people most affected by covid—those with learning disabilities—should be at the forefront of the Government’s planning and at the forefront of their minds. Time and time again, the people with such needs, who are most affected by the covid outbreak, are given the least thought. That needs to change. While there has been progress with the roll-out of vaccines, people with learning disabilities should rightly be given priority. I see they are on the priority list, but not that high.
Let us end the Cinderella services in education, health and social care, and learn the hard lessons. We have seen some abject failures in that area in recent history. Let us learn from this pandemic, so that people with learning disabilities no longer have to wait to be treated with the dignity and respect that they deserve. Let us also ensure that all our healthcare professionals are adequately trained in this area, so that no one need fear entering health services at the moment.
Ms Ghani, it is obviously a pleasure to serve under your chairmanship—sorry, I think “chairship” is the right word in this PC age we live in. It is always a pleasure to follow many other hon. Members. Some of the speeches so far have been incredible, and we thank the Members for them. It is a pleasure to follow the hon. Member for Sheffield, Hallam (Olivia Blake). We seem to spar with each other here. In our first debate, we were of the same mind. In the second debate, we had different opinions. And now we are back together again to support the same thing on this issue. The hon. Member for City of Chester (Christian Matheson) always brings to the Chamber, with compassion and understanding, points that certainly I and, I think, many Members can subscribe to and are very pleased to be part of.
During lockdown, I experienced teachers and parents alike expressing grave concern for the children who need this specialised additional help, who thrive in specially designed schemes and education, and whose parents could see the adverse effect of their not being able to follow their routines and get the external help and support that they needed. Particularly for disabled children and children with educational challenges, it is so important to have a routine in place. From my constituency, I can easily call to mind two cases of children with special needs who required emergency day placement at their school during the initial lockdown period in order to give them some of their routine back. I want to express my thanks to Longstone and Tor Bank, which filled the breach; those are two of the special schools back home in Northern Ireland.
Children with special needs saw an impact on their entire routines, starting from the change in their at-home morning routine of getting up and getting ready for school. Then they were not collected as usual by their school bus. They did not have the presence of their teacher, assistant and peers in their daily lives. And they were restricted in their daily movements by not being able to go out and about. One child was unable to be taken as usual to the local playground to get the sensory stimulation that he needed, as it was locked for an extended period.
This was not the fault of any Department or person, but the fact is that the ramifications of the lockdown and subsequent extension of holidays and so on are still being felt even now by some of the most vulnerable in our society. As schools have closed and additional support has been halted, respite and rehabilitation services have been withdrawn. These are all the complications that we see.
In particular, parents of children with autism were on their own each day in their homes with no specialist assistance, and they reported that dealing with their child’s needs impacted on the family. Some reported that they felt at breaking point because of having little or no support while their children’s special needs schools were closed. I deal with parents of autistic children nearly every week in my office—my staff do as well—and I know the particular issues for those with autism. Support workers were unable to enter the family home, and tutors who provided one-to-one tuition to statemented children were unable to visit them, so their education was interrupted. If an autistic child’s routine is changed, that makes life extremely difficult for the child and for the family as well.
The pandemic has seen an attainment gap result from the isolation of the children from their teachers and peers. Continued schooling for children with a statement of special needs, which typically represents those with severe needs, was provided in some cases, but that was not universal by any means and did not cover all the additional support. I understand that the Minister does not have responsibility for Northern Ireland, but I want to tell the story, because I think it is replicated across the whole of the United Kingdom of Great Britain and Northern Ireland. The hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron), whose speech will follow mine, will probably confirm that. The gap in schooling can also be expected to make the full return to school and subsequent social interaction more challenging, especially for children with anxiety problems.
The economic impacts of the pandemic have been felt directly by those who had special educational needs in childhood. We see that in the use of food banks. Between March and September of this year, we had 180 families who were experiencing financial, social and emotional pressures, but the food bank in Thriving Life Church in Newtownards was able to help.
Since the onset of the pandemic, more than 70% of the youth who study or combine study with work have been adversely affected by the closing of schools, universities and training centres. Programmes such as STRIDE—support and training to realise individual development and employment—aimed at training and integrating vulnerable youth into the workplace, were halted because they are based in specific cafés and factories and those were closed during the pandemic. Right away, those people, who needed the daily routine of work, were not getting it, so things were quite difficult. Those programmes impart important social and educational skills and, where the young people make progress through routine and socialisation with members of the public and peers, their progress was impacted by the closure of the services.
I will conclude with this point. The most vulnerable have felt this pandemic more than anyone else. Now is the time to rebuild and restore their wee lives and the support for the families who have been left so alone. We in this place can make a difference with innovative programming and considered funding, and now is the time to take steps to make that difference.
It is a pleasure to serve under your chairmanship, Ms Ghani. I start by thanking the hon. Member for City of Chester (Christian Matheson), who has provided such a detailed overview of the issues that need to be addressed. I thank him for that, not just as a Member who is speaking today, but as the chair of the all-party parliamentary group on disability. It is wonderful that he has secured this debate, and that he has spoken so eloquently and in such an important manner to raise the issues that the Government should be addressing.
I also thank all hon. Members who have taken part in the debate. We have heard excellent speeches, touching on education, employment and issues related to autism spectrum disorder. We also heard from the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone), who spoke about the impact of the internet and technology and the importance of access, as well as about family issues. As he highlighted, it is very important that we should not think of helping or assisting people with disabilities as something that is removed from our own lives, because these issues will touch our families at some point.
Great thanks have to go to the staff—to the teachers and care staff—who have worked with people with disabilities throughout the pandemic in our NHS and care settings, who have pulled out all the stops and shown absolute determination and dedication in their role, as well as to the charities, including Mencap, Sense and Scope, to name just a few.
In terms of the immediate consequences of the pandemic that need urgent attention, there are a number of pressing concerns, the first of which is access to healthcare under the Equality Act 2010. People with learning disabilities are, of course, entitled to reasonable adjustments when admitted to hospital. Although those adjustments have not been officially revoked under the Coronavirus Act 2020, one in four people surveyed by Mencap who work as nurses in the learning disability sector said that they had seen instances in which people with a learning disability were not allowed to be accompanied by a family member, carer or supporter in hospital due to covid restrictions.
The Scottish Government have been addressing that issue: people with learning disabilities are excluded from the no visitors policy, and a guide for clinicians working in hospitals has been provided, which I think has been very helpful in terms of shared practice. A top priority for future guidance must be to ensure that those with learning disabilities are allowed to be accompanied in ambulances, to hospital, for check-ups and so on, and to bring someone with them to help with communication and their healthcare needs.
Although the move towards remote consultation to treat many conditions during the pandemic has been welcomed—indeed, it has been a necessity—there is concern, as we have heard, that people with learning disabilities often do not have access to technology or find it more difficult to use, and many do not have the adaptations in technology that enable them to access those consultations in the most effective manner. Those are some of the issues that the Minister will also need to address when it comes to clinical need.
There has also been a disturbing increase in the use of physical restraint on people with learning disabilities reported by health and care settings since the start of the pandemic, with usage increasing by over 150% at the peak of the pandemic compared with pre-covid levels. I would be obliged if the Minister would look at that extremely important matter.
I will finish by mentioning mental health. Often, we think about physical health—particularly in the midst of a pandemic—but forget to mention mental health, and I think mental health is going to be one of the key priorities right across the United Kingdom going forward. The mental health consequences of extended periods of isolation, increased care burden and financial stress have been well documented in recent months, but those mental health outcomes are exacerbated for those with learning disabilities and those who care for them. A survey by Mencap found that over 70% of parents of children with a disability admitted that their mental and psychological health had worsened as a result of the pandemic; four out of five family carers had been forced to provide unpaid care for their family members, leading to increased poverty; and one in five people with a disabled family member feared they would go into debt as a result of the pandemic.
These are extremely serious issues, and I invite the Minister to the all-party parliamentary group on disability to further discuss them. I thank everybody who has taken part in today’s debate.
It is good to see you in the Chair, Ms Ghani.
I congratulate my hon. Friend the Member for City of Chester (Christian Matheson) on securing this important debate. Among the most important duties of a Member of Parliament is to speak up for the voiceless, and he has done a proud service today. I join him in paying tribute to the campaigning efforts of his constituent Angela, an exceptional woman whom I have been lucky enough to meet.
One of the overriding messages that we have heard in 2020 is that we are all in this together. Whether people have found it comforting or frightening, it has characterised our national response, but it is not really accurate. My hon. Friend the Member for Sheffield, Hallam (Olivia Blake) is right to raise the abject failures that have taken place in some aspects of provision for those with learning disabilities. The twin crises that we have faced and continue to address—the health and economic emergencies caused by the covid pandemic—impact people differently. We have learned so much about the groups who are more susceptible to serious illness and death from covid—older people, those who are overweight, those with comorbidities and, because of housing conditions and frontline jobs, ethnic minorities. We are still learning about who is suffering most from the economic impact—young people and those in precarious employment and the hospitality sector. Those differential impacts were raised powerfully by my hon. Friend the Member for Bethnal Green and Bow (Rushanara Ali).
Above all, vulnerable people suffer the most, including those with learning disabilities. Even before the pandemic, they faced serious health challenges. In 2017 the Equality and Human Rights Commission found that 42% die prematurely. Last year, the learning disability mortality review found a median life expectancy of 61 for men and 59 for women, which is more than 20 years less than the national average. People with learning disabilities are four times more likely to die of a treatable health condition. That was the situation before covid.
What we have heard today has been shocking but not surprising. We understand why guidance for ambulances and hospitals was written in haste in March, but clearly it did not fully consider the needs of people with learning disabilities—with all the consequences that we have heard today. The ambulance services’ guidance must be amended. As we have heard, it has been interpreted to mean that people over the age of 16 cannot be accompanied to hospital or bring documents with them. That leaves people with learning disabilities terrifyingly exposed, given the challenges that they face in communicating their medical needs. I hope that the Minister can now confirm that that is being changed.
What I have described has certainly contributed to the lack of reasonable adjustments being made, as has the number of learning disability nurses who have been redeployed—I have seen the figure of 34%. That has left people with learning disabilities even more exposed, as their needs are not met. Will the Minister set out what she is doing to restore and expand that crucial expertise?
The number of people with learning disabilities who were given “Do not attempt to resuscitate” notices was appalling, partly because initial guidance led to many being wrongly defined as frail. Although that guidance was reversed, many individuals may still have such notices on their records, without their knowledge, and that could have tragic consequences for their future healthcare. What is the Minister doing about that?
The Minister will recognise the wider challenge of remote consultations, which are particularly difficult for people with learning disabilities in situations where non-verbal cues and body language cannot be seen. They also increase the chance of diagnostic overshadowing, where behaviour is attributed to a learning disability rather than being considered a symptom. That has apparently been an issue with NHS 111. The NHS long-term plan is to remove one third of face-to-face appointments for out-patients, which includes the use of more remote consultations. Will the Minister assure us that people with learning disabilities will be prioritised for in-person consultations, and can she explain what guidance is being put in place for autistic people in in-patient care settings to go home for Christmas? Autism charities have warned that autistic people in residential care will have to self-isolate for 14 days when they come back from visiting their families this Christmas. That is not fair on those who need routine and support. The Government must make their guidance autism-friendly.
That all shows the need to consider the most vulnerable when making important decisions. Equality impact assessments must be made by central Government. That is something that local authorities are routinely obliged to do. Was such an impact assessment made on the guidance for ambulances and hospitals and, if so, what steps were taken to mitigate impacts? If not, what discussions were had with Mencap before the policies were introduced?
People with learning disabilities have suffered and died disproportionately in this pandemic, so can the Minister explain why only those with severe and profound learning disabilities have been prioritised for vaccination, rather than everyone in that highly vulnerable group? When will unpaid carers receive the vaccine?
Following the Government’s easements, which reduced statutory adult social care support, 69% of people with a learning disability reported in a Mencap survey that their social care support had been cut or reduced during the pandemic. What will the Minister do to ensure the support that those families and individuals badly need? The Government have an obligation to support the most vulnerable citizens first. I look forward to hearing the Minister’s reply.
It is a pleasure to serve under your chairmanship, Ms Ghani. I thank the hon. Member for City of Chester (Christian Matheson) for securing a debate on this very important topic.
The pandemic has impacted everybody, but many of those with learning disabilities have been particularly hard hit. I know how difficult it has been for them, their carers and loved ones to continue to be supported to live fulfilling lives during the pandemic. Wherever possible, we have made exemptions and reasonable adjustments to the restrictions for disabled people, while balancing that with the need to keep people safe. Sadly, we know that some of those with a learning disability have suffered the worst effects of covid-19 and passed away. I send my deepest condolences to their families and friends.
The hon. Member for Bethnal Green and Bow (Rushanara Ali) asked me to talk about what we are doing about the high mortality from covid of those with learning disabilities. We commissioned Public Health England to analyse the information about deaths for people with learning disabilities in order to understand the impact of covid-19 and ensure that we could take every possible step to protect people. As hon. Members have said, its report estimated that, in the first wave, people with learning disabilities had a mortality rate from covid-19 that was between 4.1 and 6.3 times higher than the general population. We know that some of the difference is associated with having other health conditions such as Down’s syndrome and with place of residence.
The University of Bristol recently published a LeDeR—Learning Disabilities Mortality Review—report setting out findings from reviews of deaths from covid-19 of people with learning disabilities, which adds to our understanding. The findings of those reports are very concerning. I want to reassure hon. Members that we did not wait for the publication of those reports to take action. Rather, we have worked continuously to protect people throughout the pandemic, and I will briefly set out some of the actions we have taken.
From the adult social care action plan back in April to the adult social care winter plan published in November, we have worked to ensure that people who need care, including those with learning disabilities, are protected as much as possible from the worst outcomes of covid-19. That has included introducing the infection control fund, now totalling £1.1 billion, to ensure that care settings, including day services, are covid-secure. We are providing free PPE for adult social care providers until March 2021. That includes domiciliary care and personal assistance, as well as residential care homes. As testing capacity has increased, we have extended asymptomatic testing not only across care homes but to domiciliary care staff. Following the roll-out of the single round of national testing to the most high-risk extra care and supported living settings, we have launched regular retesting for those settings.
The hon. Member for City of Chester spoke about DNACPRs and the concern about their inappropriate recording in patient records. When I heard about that, I too was very concerned and shocked. The blanket application of DNACPRs to any group of people is completely unacceptable, and I want that message to be said as many times as it needs to be to ensure that that practice does not continue. When we heard that it was happening, a series of communications went out from the Department, the Secretary of State and NHS England to say that there needed to be an immediate stop to that practice. As has been said, the Care Quality Commission is looking into that. The 2021 general medical services quality and outcome framework was updated in September, and it requires GPs to review all DNACPR decisions for people with learning disabilities to make sure they are appropriate.
The hon. Gentleman also spoke about the need for training to ensure healthcare staff have the skill and understanding they need to care for people with learning disabilities. I completely agree with that, which is why I am working with Health Education England and Skills for Care to develop the Oliver McGowan mandatory training to ensure that all staff have the skills and understanding they need.
Several Members asked about remote consultations. The NHS medical director of primary care wrote to GPs in September, asking them to continue to ensure that patients who need to can access face-to-face care.
I am sure that, like me, hon. Members welcomed the incredible news that a vaccine against covid has been approved. They will know that the Joint Committee on Vaccination and Immunisation, the independent body responsible for identifying priority groups for vaccinations, has published its advice on prioritisation. In advance of that process, we shared with the JCVI the latest evidence on people with learning disabilities and covid—including the Public Health England work that I referred to—to inform their approach and ensure that those with learning disabilities would be considered alongside older people, for instance, for whom the risks are very well known. The JCVI’s advice, published in December, stated that people on the clinically extremely vulnerable list, including those with Down’s syndrome, should be in priority group four for vaccination, and that people with a severe or profound learning disability should be in priority group six.
Could the Minister tell us now or in writing about how the actions she is taking to reduce the disproportionate impact of death rates for those with learning disabilities is being addressed with facts, so that we can see the progress that the actions of her Department have led to, given the number of deaths in the second wave? It is not clear whether those interventions are working, and it would be reassuring to see how those actions are helping.
We will continue to scrutinise all possible evidence and data we can get to understand the impact of the steps we are taking. For instance, as I have set out, we have supported residential care settings and other carers to ensure that they have the PPE and infection control support they need. Sadly, we still see that care homes are experiencing outbreaks of covid. It is incredibly hard to stop the disease getting into these places when it is prevalent in the community. We know that the most important thing we can all do to keep those who are most vulnerable to covid safe is to take steps to reduce the spread of covid in the wider community. I assure the hon. Member that we are continually looking at the evidence and at what more is possible to do to keep people safe.
In fact—I was coming to this exact point—I have asked the Scientific Advisory Group for Emergencies care working group to consider the findings in the Public Health England and LeDeR reports to help us develop further targeted actions. The Department has commissioned research to better understand the impact of the pandemic on the wellbeing and lives of people with a learning disability. That is being led by the University of Warwick and Manchester Metropolitan University. The insights from this research will help us to further mitigate and reduce harm from covid-19, including tackling isolation and loneliness. We will keep the evidence under review.
I come now more broadly to restrictions, which I know have been particularly hard for people with learning disabilities. In particular, visiting loved ones for those who are in residential care settings has been incredibly difficult for families, friends and the individual themselves. On 1 December, we published updated guidance on visiting care homes. We advised care homes to use the rapid tests that we are providing, together with PPE and other infection control measures, to enable safer visiting. There is also guidance on visiting in-patient healthcare settings. That was updated in October, and NHS England and NHS Improvement wrote to mental health learning disability and autism in-patient providers to remind them that they must take all possible steps to enable safe regular visits.
The hon. Member for Warrington North (Charlotte Nichols) asked about the visiting out guidance for those of working age. An enormous amount of care was taken over that to try and establish the right balance to enable people to go and see their family if that is what they normally do while they live in a residential care setting, while recognising that they may well be in a setting where others in that care home, for instance, may be extremely clinically vulnerable to covid. As I have said, we know that once covid gets into a residential setting, it is really hard to stop it spreading. That is why the clinical advice is very strong on saying that those returning to a care setting after a visit out should quarantine for 14 days. I am really aware that that is a very difficult thing to ask people to do, but the reason it is in there is because that setting may well have people who are clinically extremely vulnerable, and there is such a risk. It is not just about the one individual visiting out; we must bear in mind the risk to the whole group of residents. That is why the guidance is as it is.
Before I conclude my remarks, I will talk about the restrictions on the day-to-day activities, which all of us have been complying with. We have made exceptions and reasonable adjustments wherever possible, for example by excluding support groups such as day services from the rule of six, setting out clear exemptions to mandatory face coverings, including where a person cannot wear one due to a disability, and working to ensure that that is communicated. There has been some debate about this and whether the ban should be much more strongly enforced, but I have personally worked really hard to communicate the importance of there being exemptions.
We have also, wherever possible, produced guidance in accessible formats, such as easy-read. We continue to work with stakeholder groups and organisations such as Mencap, which has rightly been mentioned during the debate, to ensure that we get input on the potential implications of restrictions on people with a learning disability, and how we can best mitigate those implications.
To conclude, I thank all hon. Members for their contributions on this important topic. We are all deeply committed to helping protect people with a learning disability from the worst effects of covid-19, and I hope that what I have set out today does assure Members that the Government are working tirelessly to make that happen.
I am grateful to you, Ms Ghani, and to all hon. Members for contributing to this debate. I think it was the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) who talked about the range of different examples that we have heard today, from employment opportunities, local government cuts and the importance of technology, and she is absolutely right.
I also thank the Minister for directly answering quite a few of the questions that were posed to her. In preparing for this debate, it has been made clear to me that there is a sense of frustration among people with learning disabilities, their carers and their families, who are looking for continued progress. I simply ask the Minister and her colleagues that this debate is considered not as a destination, but as a staging post on the way to genuine equality.
Question put and agreed to.
That this House has considered the effect of the covid-19 outbreak on people with learning disabilities.